Pondering difficult end-of-life situations made me think, naturally, of Chevy Chase

In the Oscar-not-winning movie “Fletch,” his character feigns sadness that a man’s death was so sudden. “He was dying for years, and had been in intensive care for eight weeks,” responds a puzzled physician.

“Yeah, but I mean the very end, when he actually died,” Fletch responds. “That was extremely sudden.”

He’s right, but in the context of long-term care, that inane movie moment is anything but amusing. Whenever it comes, the end of a life is still all too jarring and sudden for those who grieve, no matter how much time and emotional preparation have come before. 

Nobel Prize-winning psychologist Daniel Kahneman set out to determine how people remember the pain of an event, and concluded that a person’s perception actually isn’t shaped by the total of all the pain experienced. 

“The pain at the end — whether it is getting better or worse — plays a disproportionately large role in determining how we remember an experience,” summarized New York Times health policy blogger Ezekiel Emanuel.

Knowing that fact should shape how we respond when the journey ends for someone in our care. 

Even if the struggle has played out over weeks or months, and even though you and your staff have provided the best care possible, it’s the memory of the ending that will linger in the minds of family members. Forever. 

When the bed is empty, and the work is technically done, that’s when the little things are so important. The fruit basket or flowers. The card signed by all the staff. The follow-up phone calls just to express compassion and support. 

Not because it’s good business or textbook marketing strategy, though it is. 

But because when the end comes, always too suddenly, you just want to be there when it matters most.