Sunday, December 21, 2008

Light Perpetual

Mom died peacefully at Capital Hospice in Arlington, VA yesterday afternoon. We sat at her bedside Friday night, told her we loved her, said our good-byes. We think she knew we were there. We are deeply grateful to the staff and volunteers at Capital Hospice for the loving care they gave her in her final hours.

Rest eternal grant to her, O Lord:
And let light perpetual shine upon her.

Friday, December 19, 2008

And Then She Was Gone

Yesterday the ambulance came at noon and took Mom to the hospice's inpatient center. For nearly a week, she'd been in severe pain from a fall. She'd also become increasingly agitated, constantly trying to get out of bed despite extreme weakness. Her voice became like a little girl's. She spoke barely above a whisper; her wishes made no sense. When in bed, she wanted to be in her chair. Once in her chair, she wanted to go back to bed. She fell the other night while trying to get out of bed. Phil and I found her crumpled and shivering on the floor at 4 AM.

Yesterday, during the hospice nurse's visit, Mom was determined to get out of bed. Carol said, "Stay in bed, Sweetie." "I will," Mom would say, but within seconds she'd start struggling again.

Carol thought Mom might be experiencing "terminal agitation." When a couple of doses of morphine and Haloperidol failed to calm Mom, Carol suggested a short stay at the inpatient center. If Mom's agitation is indeed a sign that the end is near, then the Haloperidol might help her let go and pass away. If her agitation is due to pain or infection, the hospice center will treat the underlying condition and send her back to us.

It happened so suddenly. Binta, the home health care aide, was also here yesterday morning. She stripped the bed, cleaned Mom up, put her in a fresh nightie, and got her into her hooded winter coat for the ambulance ride. She also combed Mom's long hair and plaited it into a single braid. Mom looked so sweet. Still, it was sad to see her on that bright yellow gurney all ready to go, her hair in a braid. How furious she would have been about that hairdo just a month ago.

Tuesday, December 16, 2008

The Ball Is in My Court

The hospice nurse just called. She had spoken with the doctor who suggested that I "might want" to take Mom to the Emergency Room to have her wrist x-rayed for a possible hairline fracture. I don't want. Not after the awful experience we had when I took her to the Emergency Room on November 16th.

We arrived at 2 PM. Mom was in her bathrobe and so lethargic that she could hardly sit upright on her chair. "Triage" seemed to think that everyone else's problems were more serious, so we waited and waited. Finally, I dared to ask why all these other people were being seen ahead of my 99-year-old mother. I got a starchy, professional response: "Patients are seen in order of the urgency of their complaints." Didn't look to me as if anyone was bleeding to death from a gunshot wound. Everyone else seemed cheerful and ambulatory, even the guy who had been poked in the eye.

Finally, around 4, we were admitted to the Inner Sanctum. They drew Mom's blood and did an EKG. They put her on an IV, but as she got rehydrated, she got antsy. Tearing at the wires and tubes, she asked, "Why am I here?" "What are we waiting for?" Finally I approached the attending physician. She was wearing purple scrubs and rhinestone-studded high heels. The shoes irritated me.

"What are we waiting for?"

She turned poisonous eyes away from the computer screen for a moment and replied icily, "I am waiting for the results of the urinalysis."

"But you haven't done one yet."

"We most certainly did!" she snapped. She grabbed a printout and hurriedly scanned it. "Um, we seem to have missed that. Well, someone will be right in."

A nurse placed Mom on the bedpan and left. Forty minutes later, I went looking for her. She apologized for forgetting all about Mom, but Mom had been unable to urinate in any case. A technician came in to catheterize her. After several unsuccessful attempts, she called in a nurse to help. The ghouls finally got their specimen, which they sent to the lab.

Around 10:15, the doctor breezed back in. Ignoring me, she delivered a speech to Mom, who blinked at her uncomprehendingly. "Well, my dear," she proclaimed grandly, " I am sending you home. I am giving you a prescription for an antibiotic, which you can have your pharmacist fill tomorrow. I want you to see your regular doctor first thing in the morning."

We were home by 11 PM. Mom fell into bed, exhausted. I don't want to return to the Emergency Room. The hospice nurse says it's my call. The ball is in my court.

Monday, December 15, 2008

Another Bad Fall

Mom fell again on Saturday. As usual, she was trying to get around without the hated walker, and the inevitable happened. Her wrist is hideously swollen and her tiny arm is black and blue to the elbow. The pain must be excrutiating. When the hospice nurse asked her to rate the pain on a scale of 1 to 10, with 10 being the worst pain imaginable, she said "9" without hesitation. She's now on morphine.

Thursday, December 11, 2008

Two Thousand and One

Last night I heard Mom muttering, "Two thousand and one. Two thousand and one."

"What about two thousand and one, Mom?" I asked.

"That's how old I will be in April, " she replied.

"Independent" and feisty one day, lost in a fog the next.

Last weekend the Grand Dame of Independent Living was back in residence. She informed Phil that it was past time to feed Ramsey and Violet, because "those dogs are starving." She instructed me to wash her favorite slacks in cold water. I was to stop "babying" her because she has always "done for herself." This she said while shakily pouring boiling water into a cup for instant coffee. Finally, I was to take "that thing (walker) out of here." She did not need it. How many other 99-year-old women did I know who could get around as well as she? About that fall a week ago when she banged her head on a protruding corner and made half her face black-and-blue? It was nothing. I should stop making a mountain out of a, out of a . . .

Wednesday, December 10, 2008

He Makes Me Laugh

Andrew, our 6-year-old grandson, recently informed me that "nobody can count to 100."

"I can, " I said, "but it's boring."

Pause. Then Andrew asked, "Is there a shortcut?"

Sunday, December 7, 2008

Our Friend, David

Two and a half years ago, on the weekend of July 4th, our friend David woke and found himself unable to speak. Within days, he was diagnosed with a malignant brain tumor. A month later, he and his girlfriend of many years attended our daughter's wedding. David wore a straw brimmed hat to cover the scar from his surgery. His wife-to-be said that he looked like the "perfect Southern gentleman."

Another surgery followed that October. He never really recovered his ability to speak, but, despite his difficulties with communicating, we knew that David was still there behind his impish grin. The next spring he and M were married. They both quit working. He took an "extended leave of absence" because the work he loved had become impossible, and she retired, in order to care for him. On December 4th, M called to tell us that David had died at home early that morning.

We'll never forget David. He was a bit eccentric and very opinionated. Even as a young man, he affected the persona of an irascible curmudgeon. He professed to live by three rules:

1) Never buy a house.
2) Never get married.
3) Never have children.

His friends were surprised and delighted when he broke rules one and two.

He was fun to be with. For years, before he and M began celebrating holidays with her grown-up children, he would usually spend Thanksgiving with our family. He'd have us all roaring with laughter at the stories he'd tell, such as the merry chase that ensued on Christmas morning at his cousin's house when a gift piglet escaped from its box under the tree.

Until his widowed mother moved in with him in her 90's, he would fly home during holidays and at other times to be with her. One October, after he'd just returned from a visit, I asked how she was doing.

"Oh, she's fine, now that she knows that her furnace wasn't stolen."

"Why'd she think it was stolen?"

"She went down in the basement and it wasn't where she thought it should be."

"So what made her realize that it wasn't stolen?"

"Well, it came ON."

He pronounced "on" like "own," being from Alabama. During our last visit with him in July, we saw a photo of his grandfather in his Confederate Army uniform, sitting tall astride a horse. We saw a portrait of his father, a pilot in the first World War. David's grandfather--but perhaps it was his father-- spent a brief time in jail for refusing to pay some kind of tax or fine. This sounds like something David would have done.

He worked in the same office as my husband. They disagreed on most things political. When my husband bemoaned the loss of habitat for the spotted owl, David would have none of it. "So what if it becomes extinct?" he said. "Science can always breed something better than the spotted owl." Their disagreements rarely got in the way of their discussions.

David loved classical music. He had a huge collection of CDs, which he kept scattered all over the floor of his living room. Another friend, who meticulously catalogued and organized his own enormous collection, was aghast at David's indifference to order. "But what happens when you want to compare one guy's performance with another?" (This was the kind of music lovers they were.) "Oh," said David, "I just paw through the stuff on the floor, and if I don't find what I'm looking for, I always find something else I'm just as happy to listen to."

This was our David. We loved him, and now he is gone.