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Spokane, Washington  Est. May 19, 1883

It’s easy to believe that hearing is last sense to go

Q: I have heard that hearing is the last sense that dying people have. How do we know this is true?

A: We really don’t. When you plug into an Internet search engine the phrase “hearing is the last sense to go,” you’ll find dozens of articles focusing on this “fact.”

Some of the articles make reference to research based on electroencephalograms (EEGs) of people’s brain waves that somehow indicate that hearing is the last sense to go. Tracking that research to its origins results in a dead end, pun intended.

But when you talk with hospice professionals and volunteers, or with health workers who care for dying or critically injured patients, they are pretty certain that many dying or unconscious people retain some awareness of what is going on around them, via their hearing.

Some professionals base it on later conversations with patients who were revived in emergency rooms and recognize the voices of nurses and doctors who saved their lives.

Maggie Callanan of Cape Cod, Mass., is a critical care nurse turned hospice professional and author of two books, including “Final Gifts: Understanding the Special Awareness, Needs and Communications of the Dying” (Bantam, 1997). She has been part of the “dying journey” with 2,000 people.

In a recent phone interview, she said she tells families of dying people that it appears from experience that hearing is the last sense to go.

But she adds: “Can I guarantee this is going to happen with everyone? No. Can I prove it? No. But I’m telling you we have seen this over and over again.

“So do not say anything you do not want this dying person to hear. Just don’t. Not in the room, but not even down the hall, because it appears hearing becomes acute.”

Callanan suggests that those at the bedside of an unconscious patient, or those holding vigil with dying loved ones, act “as if” they can hear their words and voices.

“Please tell the unconscious person why you are there,” she says. “Name the people there.”

What if you are doubtful that the dying or critically ill people can hear a thing? Talk anyway.

“Give the words you want to give,” Callanan says. “You have wasted words on far less (important) things than this.”

Q: My cousin was recently diagnosed with lung cancer. His oncologist has referred him to a “patient navigator.” What is a patient navigator?

A: Patient navigation in health care is a recently established service offered to patients with complex or difficult diagnoses such as breast cancer, lung cancer or congestive heart failure.

Patient navigators help patients and their families understand the illness and care plan from the day of diagnosis until treatment ends. If a patient dies, the navigator offers bereavement resources for the family.

Successfully “navigating” the health care maze requires knowledge and skill to access the best care, create and follow a strategy for each step, communicate with doctors and interact with insurance providers – not an easy task for even the most health care-savvy person.

In 2004, Elizabeth Schuler Russell founded her company Patient Navigator ( after a traumatic health challenge. Her 2-year-old daughter suddenly couldn’t walk normally.

When doctors discovered a brain tumor, the blur of information led Russell to use her problem-solving skills. She began calling pediatric specialists until she had enough information to make a good decision. That was 1998; today Russell’s daughter is a healthy teenager.

While independent patient navigators like Russell charge a fee for service, some hospitals and clinics employ patient navigators at no cost to their patients.

Pat Himlie, a longtime nurse, works at Providence Regional Cancer System in Olympia as a patient navigator for lung cancer patients. Himlie guides patients through their care as she helps them understand their diagnosis and treatment options, assesses medical and emotional needs, and helps them access educational and support sources, such as counseling, support groups, websites and books.

And she listens to patients’ fears as well as requests for complementary therapies such as yoga, massage and nutrition.

If patients miss appointments, Himlie calls them. Perhaps they felt too ill to drive or had no money for gas. Patient navigators address these practical challenges, too.

“I was a runner, and I use that example to describe my work. I go onto the track and take the hurdles off. Then we begin the race together,” Himlie says.

Lung cancer is a scary diagnosis, but a patient navigator can make the journey through the health care system easier by offering medical wisdom, emotional support and guidance for your cousin and his family.

Catherine Johnston, a health care professional from Olympia, and Rebecca Nappi, a Spokesman-Review features writer, welcome your questions about what to do in times of illness, dying, death and grief. Contact them through their EndNotes blog at blogs/endnotes.