At the End of Life, Documenting What Came Before...

Lessons from conversations with hospice patients

Aug 14, 2025

I was at a memorial service for a friend in Knoxville on Monday, and her husband thanked a local nonprofit hospice for the wonderful care they had given his wife during her last months. As he spoke, I remembered how the same hospice had helped my mom and an aunt during their final days.

Since I’m an old radio guy and handy with a recorder and editing software, and when I served on the hospice board, I did what are called “life reviews” for patients who wanted to record stories for their kids and grandkids.

During the service, I was reminded of a column I wrote for the Des Moines Register in July of 2021 about what I had learned during these life reviews, which was a lot. The life reviews stopped during COVID-19, but my story lives. You can read it at the Register, or here, below:

I talk to people who are dying. Most I’ve never met before, but we all have one thing in common. We are dying. I work in small-town radio and do a daily public affairs program. But for the last dozen years or so, I’ve had a volunteer side gig. Two local nonprofit hospices offer what they call “life reviews” to their patients, and that’s where I come in. Life reviews are easy. I sit beside the patient, next to their bed, or across a table from them, turn on my recorder, and ask them a few questions.

I almost always start out with the same question. “Where are you from?” It’s a comfortable question, and everyone knows the answer. Most often, I follow up with a similar question, “What was it like when you were growing up?” These questions make them comfortable. My purpose is simple. I want to curate a few of their stories and the sound of their voices, for their families when they are gone. I see it as a kind of memoir that actually gets finished. Few people have the time or interest to write a memoir, but everyone can take an hour or so and talk one. I always hope that each person I talk with shares not only some stories from their life, but also leaves a precious gift or two in words for those they will leave behind. Perhaps how much they love them, or some words of wisdom or advice for their kids or grandkids.

When the recording is done, I email a copy to their social worker, and when they tell me the family has it, I delete my copy.

All of my questions are open-ended, with the hope that the patient will take the conversation where they want it to go. Surprisingly, even a simple question like “Do you have brothers or sisters?” has the potential for upsetting them. I asked that question to a man once, and I think if he had the strength, he would have hit me with his oxygen tank. His reply: “GODDAM, yes, I have a brother, but I’m not going to talk about that bastard!”

The youngest people I have interviewed have been in their thirties. At least three have been over 100. I’ve learned that almost always men want to talk about their accomplishments; women about relationships--the people they love. Their spouse. Their children. Their grandchildren. Brothers, sisters. Friends.

Sometimes getting the men to talk about their family, the people they love, is like landing a whale with a bamboo rod rigged with thread and a rubber hook. I don’t have a chance. Other times, I nail it.

One farmer, so big he made his plump Lazy Boy recliner seem like a child’s chair, talked about how he built his farm, acre by acre. Buying out his neighbors one by one over the past 50 years because, as he told me, he was smarter and a harder worker than they were. His wife sat in a wooden chair behind him to his left, out of his sight. Her weathered face was hard and grooved like a walnut, her spine as rigid as the back of her wooden chair.

I took a chance and asked him, “Do you remember the moment when you first knew you loved your wife? Startled at the question, his watermelon-sized head rolled back, and he shut his eyes, and said, “Like yesterday…” He told me where they met, how beautiful she was, how her laughter thrilled him, how much he loved her still, and that she had been a gift from God. As he answered, I watched as her eyes widened, then she put her head in her hands as she listened, and wept tears of joy into a lace hanky.

A man in his 30s lounged on his patio one pretty August day, his beautiful flower garden behind him. His sister, a friend of mine, sat nearby. We drank ice tea. I knew he had kids in elementary school, and I tried to get him to say something about them. Just something nice. Maybe how much he loved them. Anything. But all he wanted to talk about were his college days and nights out with his drinking buddies. He grew tired, and I thanked him and started packing up my gear. His sister smiled at me, shrugged her shoulders, and opened her hands in the universal “what can I say?” gesture. I walked down a cobbled path, admiring his flowers, and drove away.

A man over 100 was quite an adventurer when he was a youth. As we looked through an old photo album together, he grew sad and asked me if I knew why his family didn’t come visit him. “Do they think if they come to visit, they’ll have to take care of me? If so, they won’t...I just want to sit with them awhile...” I had no answer.

Another man over 100 told me about the Armistice Day blizzard of 1940, when the morning started out with temperatures in the 50s. He and some friends went out hunting, and it started to rain, then sleet, then snow, as temperatures dropped 30 degrees in a couple hours, soon to reach single digits. He told me that the freeze happened so quickly they saw hundreds of ducks frozen in ponds, trapped, before they could take flight. He remembered that a tornado was seen somewhere in eastern Iowa, and dozens died, and thousands of livestock perished as winds 70-80 mph pushed snow drifts a dozen feet high. There were shipwrecks on the Great Lakes. He was grateful he and his buddies arrived home safe.

Across the kitchen table from me, his eyes were like bright blue lanterns, his mind sharp, his translucent body looking like it could slough off him any moment.

He told me of how, when he was a boy, his family would drive a horse-drawn wagon 30 miles every August to the Iowa State Fairgrounds in Des Moines, with the animals they were going to exhibit tied behind. It was the highlight of every year for the family. He says once during the 1930s, fair officials staged a head-on train wreck, where locomotives collided going 40-50 mph, the engineers leaping out at the very last minute. He said the crowd was in the thousands, and he thought he was going to be crushed to death. He told me every day since then was a miracle.

A woman over 100 sank into a couch holding hands with a friend--a kid in her 80s. Recognizing that she would have been a teenager when movies were first coming out, I asked her if she remembered the first movie she ever saw. “No movies,” she said. “No movies.”

I asked her what they used to do on Saturday nights, something like “did you used to go out dancing?” “No dancing,” she said. “No dancing.”

“Why no movies, why no dancing?” I asked.

“Papa and Pastor said movies and dancing was sinful.” The woman sitting next to her squeezed her hand and nodded vigorously, saying to me, “It is, it is.”

“Have you traveled?” I asked.

“Oh yes,” she said.

“Where?”

“I’ve been to Des Moines and Oskaloosa.”

Both towns are about 25 miles away.

“Nowhere else?” I asked.

“No need to,” she replied.

One man was a farmer who also built houses. I had grown up building houses too, and so we spent lots of time talking about craftsmanship, hard work, and about how few people know how to build a good house anymore. We shared some laughs, and I think he had a good time. I did. I was asked to come back a second time because he had more to tell me. Both times, his daughter and her husband listened, out of sight, leaning against a counter in the kitchen, just in case we needed anything.

Months later, at an event, I saw a woman crossing a crowded room, heading toward me like a shark. She looked familiar, but I couldn’t place her. She gave me a great big hug, and recognizing that I had no idea who she was, she reminded me of the time I had spent with her father, the farmer and carpenter.

“You know,” she said, “we took that recording you made with Dad, and put it in the side room of the funeral home with all his photos and memorabilia, and put it on loop, and it was just like he was there with us, like he wasn’t gone, hearing him laugh and talk with you, it was wonderful. Wasn’t like a funeral at all, and everyone had a good time just hearing his voice, his stories, and it was more like a party than a funeral, and he would have just loved it, so thank you.”

I interviewed a woman in her thirties in her basement, photos of her family and books around her. Let’s call her Claire Sanders. The house was oddly dark and quiet that afternoon--her kids still at school, and her husband at work. The sky was dark too; I think a storm just missed us, passing to the south. I’d seen her around at school events, at the grocery store, and at restaurants. She and I were, well, I guess I will say, nodding acquaintances. We had never really spoken to each other before, but nodded or waved, or maybe said hi when we passed.

I’d heard a rumor that she had breast cancer.

I turned on my recorder, placing it between us on the table. As our conversation unfolded, I quickly learned that she was really nice. Interesting and charming. Kind, thoughtful, and full to the brim with love, even in her pain. The more we talked, the more my heart ached for her, her family, her husband and kids, her friends, and I realized that I had missed much too, not taking the opportunity in our busy lives to get to know her. I felt stupid with loss.

She died a few weeks later.

Maybe six months passed, and after work on a hot Friday afternoon, I stood up from my friends to go get another beer at our local brewery, and a big man in a sports jacket stood up from his table, made his way toward me through the packed tap room, and blocked my path.

He stuck out his hand, and I took it.

“You don’t know me, Bob, but I’m Claire Sanders' husband.”

I paused, as I never know what to say during moments like this. “I’m sorry,” I said finally, and then immediately asked, “Have you listened?”

“No,” he said. “I can’t yet. Not just yet.”

I grabbed his meaty shoulders and gently shook him. Tears welled in my eyes, and I looked into his, and saw his tears rising too.

Just this side of losing it, I said, “Man, oh man, she loved you. She loved you, so, so much...” and he pulled me into his arms, and we gently rocked together for a while standing on the concrete floor, between tables, alone together, but with Claire, in the crowded room.

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