The Gracious Gift of Acceptance at the End of Life

By Karin 

 “To refrain from giving advice, to refrain from the affairs of others, to refrain, even though the motives be the highest, from tampering with another’s way of life – so simple, yet so difficult for an active spirit.”  – Henry Miller

I consider myself an “active spirit.” As a hospice chaplain, I am trained to be involved in people’s lives. I am also a mother, daughter, sister and friend. A “hands off” approach just doesn’t fit my understanding of what it means to love.

It was difficult to sit by and watch both my parents die from a cigarette addiction.  Periodically, I encouraged and even pleaded with them to quit smoking. When my Mom was diagnosed with end-stage, COPD—a lung disease, my family’s intervention allowed her (and us) to receive the benefit of hospice care.

My Mom wanted to die at home, and we wanted to make that happen. However, due to her decline and our inability to provide enough home care, we had to intervene in her life once more. The hospice staff assisted us in finding an appropriate placement.

While Mom watched from her wheelchair, my brother and I prepared for her final move to a nursing home. We went through drawers, closets and cupboards packing up her things. We stopped to tell stories, look at pictures, and marvel over our findings. Given my Mom’s cigarette addiction, it wasn’t surprising that we also found cartons of cigarettes tucked away in the oddest places.

Everything smelled like smoke. We took the pictures off the walls of her one-room apartment. A yellowish smoke stain created a frame around the empty spaces where the pictures once hung. The smoke of her addiction colored not only her walls and her lungs but also so much of her life.

That night, my Mom grabbed my hand and said, “Karin, I am done.” I asked, “Done with what, Mom?” She said, “I am done smoking.”

How many times over the years had she said those words? “This time,” she said, “I am done for sure.”

Later that night, she had me turn off her oxygen and roll her out to the balcony as she held two cigarettes and a lighter in her shaking hands.

I was mesmerized by the peace that settled over her as she gazed out over the city of San Diego from fifteen stories up—breathing in the night air, the remarkable view of the city lights and the last few puffs of pain and pleasure. It was almost as if her heart turned toward thoughts of home … past, present and future.

It was probably the only time I watched her smoke that I didn’t want to tamper with her way of life—the only time I didn’t think of her as indulging in a deadly habit. In fact, that night it reminded me of the Ojibwa belief that the rise and the fall of the smoke is a reminder of where we come from and where we are going; the act itself a sacred prayer. (Kent Nerburn, Small Graces)

I didn’t want to interrupt her as I watched from a distance … one still shot of the beauty and the brokenness of life.

It took my breath away.

The grace of acceptance filled those moments.

Mom was right. Those were her last two cigarettes. She was done smoking. As she said, “this time for sure.”

She died two days later.

I have witnessed variations of “my story” many times over as a hospice chaplain; the spiritual work attributed to the end of life is as simple and complex as we are. We aren’t always sure when to intervene and when acceptance will enter some moment to offer a gracious gift.

Our role as hospice chaplains is not to impose a particular religious or spiritual agenda. Rather, we can give witness and support to the amazing, and unique, spiritual journeys of our patients and families.

About Hospice of the Red River Valley
In 1981, Hospice of the Red River Valley was founded on the belief that everyone deserves access to high-quality end-of-life care. We fulfill our nonprofit mission by providing medical, emotional, personal and spiritual care, as well as grief support to our patients, their families and caregivers during a tender time in life. Our staff helps those we serve experience more meaningful moments through exceptional hospice care, 24 hours a day, 365 days a year, wherever a patient calls home. The organization serves more than 40,000 square miles in North Dakota and Minnesota, including in and around Bismarck, Detroit Lakes, Devils Lake, Fargo, Fergus Falls, Grand Forks, Lisbon, Thief River Falls, Valley City and many more communities. Hospice of the Red River Valley offers round-the-clock availability via phone, prompt response times and same-day admissions, including evenings, weekends and holidays. Contact us anytime at 800-237-4629 or


Return to the blog homepage →