If the last 1% is happy, then that person's life is happy: What an occupational therapist who has attended to 100 people in special nursing homes wants to convey

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*I have started a YouTube channel. If you would like to listen to the audio, please click here; if you prefer to read the text version, please scroll down. *Regarding the term 'mitori' (end-of-life care) used this time, there are parts that could not be corrected due to AI limitations, so it may be unpleasant to hear, but I believe the content itself is solid.

A special nursing home is a 'final residence'.

Many of the people who come here can no longer return home. They live with dementia, their bodies gradually stop moving, and they spend their final moments there.

I have worked as a functional training instructor at a special nursing home for over seven years. While holding an occupational therapist qualification, I have been by the sides of residents in their final moments in a way that is slightly different from 'rehabilitation'.

I have attended to nearly 100 people.

Today, I would like to talk about that.

My job at a special nursing home is to 'protect their daily life'

If I were to describe my work at a special nursing home in one phrase, it would be 'protecting a life that is true to the individual until the very end'.

Eating, excreting, bathing, and changing clothes. I provide exercises tailored to each individual to maintain the movements necessary for daily life. I also provide psychological approaches through dementia prevention programs and hobby activities such as handicrafts and gardening. I select wheelchairs and canes, create self-help tools, and propose environmental adjustments. For bedridden residents, I provide positioning to prevent bedsores.

And above all, listening to the residents.

What are they worried about? How do they want to live? I read between the lines of what they cannot express well due to dementia, while listening, accepting, and empathizing. This is the most important part of my job.

When someone says 'I want to die'

When working at a special nursing home, I sometimes hear words like these.

'I am the only one being left out.'

'I want to die.'

Some residents say these things when their interactions with care staff do not go well, or when their requests are not met.

What I do at these times is not to deny them. I do not offer encouragement. I do not try to change the subject.

First, I accept their feelings just as they are.

'I see, you are in so much pain that you want to die.'

From there, I gradually explore with them why they feel that way. When the root of the pain becomes visible, we can sometimes find parts that can be improved.

It is a busy workplace. Time is limited. But creating a moment to face only that person without worrying about the time—I believe that is the work only I can do.

Searching for the "proof of a life lived"

There is something I do first when providing mental care for residents.

It is to find out how that person has lived their life.

What were they good at? What were they interested in? What kind of work did they do? What did they enjoy?

For someone who has always knitted, I knit with them. For someone who was good at gardening, I have them touch plants. For someone who liked making things, we make something. For someone whose hobby was shogi, I sit across from them with the board.

Even if they have forgotten many things due to dementia, their body remembers what they have done for many years. The moment they touch that activity, their expression changes. Their eyes sparkle.

I believe I do this job to see that moment.

The day I attended to a classmate's grandmother

After working for over 10 years, you end up attending to nearly 100 residents.

Among them, there is someone I still cannot forget.

It was the grandmother of a classmate I went to junior high and high school with. By chance, she was admitted to the same special nursing home. She was the grandmother of a friend I was close enough with to go to the movies together.

Perhaps because of that connection, that resident trusted me very much. She also recognized me as a friend of her grandchild.

For three years, we did functional training together.

But she gradually grew older, and her appetite decreased. Eventually, she could no longer eat. Like a plant withering, little by little, her life grew thinner.

Even so, she would smile when I spoke to her.

That smile still remains in my heart.

I am glad I was able to be involved with this person. I will never forget her. It made me feel like I could keep doing my best from here on out.

Death is not a sad thing

Having attended to nearly 100 people, there is something I think.

Death is not a bad thing. It is something that will come to everyone.

I believe what matters is whether they were able to be 'themselves' until that very moment.

If the last 1% is happy, then that person's life is happy.

These words are at the core of my work at the special nursing home.

Being able to see a smile until the very last moment. Being able to get a response when you speak to them. Seeing their expression soften when they touch something they loved.

I believe that accumulating such moments is what end-of-life care is all about.

It's not the residents, but the human relationships that wear you down mentally

I will be honest.

I rarely feel mentally drained by parting with residents.

It is sad, but if I was able to support their final moments, I have no regrets. Rather, those partings give me the strength to keep trying.

However, I have been worn down many times by relationships in the workplace.

I was treated with aggression by a long-tenured care leader. I was worn thin by the awkward atmosphere between nurses and care staff.

People who do work that supports others are being exhausted by their relationships with colleagues. I think this is true not only for special nursing homes but for the entire medical and nursing care field.

What I want to tell you today

To those working in nursing care and medical fields.

And to those who are currently caring for a loved one.

Being by someone's side until the end is not something that drains you.

Being able to be there during the final time of someone's life is an irreplaceable experience.

If they smile when you speak to them, I think that is enough.

Because if the last 1% is happy, then that person's life is happy.

Occupational therapist, 15th year. Working at a special nursing home. As a functional training instructor, I am by someone's side at their end again today.

📚 Recommended reading and listening

The difference between "people who have regrets at the end" and "those who do not," as seen in special nursing homes

Common traits of people who stay healthy until the very end, as seen by an occupational therapist who has attended to nearly 100 people in special nursing homes

I kept going, while running away. The story of an HSP occupational therapist of 16 years

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