Wednesday, November 21, 2012

seeking for understanding

So, here we are -- 10 days into the "last days" of mother's life and I am really struggling with WHY things are playing out as they are.  For all intent purposes my mother should have passed away last Thursday. But Thursday night came and she rallied for a whole 24 hours.  Gotta love my mom. 

She is on morphine every two hours, alternating other hour with Lorazepam.  The morphine is to ease any pain she is having as her body shuts down.  The Lorazepam is there to keep her relaxed as she was having lots of jerking (like she was being startled) and she was agitated.   So she is very relaxed and does not appear to be in any pain.  But she is completely comatose so who is to know, right?  Other than the one day on Friday where she spent her day "visiting" with beloved family who are on the other side - we have not even seen her eyes.  She is in a semi-coma.

Just to clear up any misunderstandings.  She was comatose BEFORE we started the morphine.  The morphine did not put her in this state.  okay?  I've actually been accused of launching this whole thing with morphine - not so.   We had to give her the Lorazepan because she was twitching and jerking so much she was hitting the wall and scaring herself. 

So here is the deal with my mother.  She is ONE STRONG WOMAN.  She is so healthy (other than Alzheimer's) - no other health issues. So here is her poor little body with a healthy heart and lungs just working so hard to keep her alive.  Apparently they have not got the newsflash about the Alzheimer's just yet :)

So I keep her bedside vigil, with music playing for her in the background and adjusting her covers, pillow, padding, etc.  I'll admit that this is getting old- not so much for me, but her!  Dang it mother, why are you hanging on so hard?

My family is all here and have all said good-bye.  We called my brothers family so they could tell her good-bye, everyone has told her to release and go.  I've told her I love her, I've made amends, told her that she is done here and needs to move on - I've been telling her for 5 days now that I need her spirit on the other side to help my children through their upcoming stages of life- that she's way more helpful to us as a family on the other side.  Lauren even made efforts (which always fail) to contact an estranged grand-daughter who has been avoiding her loving grandparents for nearly 10 years now.  It's been rather painful for my parents to be so rejected.  This was their first born grandchild and they adore her.   Well, she answered the phone call and Lauren told her that Nanny was dying and could not let go -- that maybe Lindseys voice could be the final puzzle piece to helping her cross to the other side.  Lots of tears in that moment for sure.  But--- that doesn't seem to be the KEY to her release.

We tell her when we are leaving the room and for how long and give her space to let go alone if that is her wish.  We have done everything we can think of but this girl is not budging.

So, thus is my dear mother.  She liked to be in charge, that is for sure.  She like to be in control and those traits are still with her.  She also LOVED drama, theater and productions - maybe this is it.  She wants to control the outcome a bit.  This is HER PLAY - SHE'S the director and she is doing it HER WAY.  She didn't want a tragedy - she wanted a comedy.  Mom was a big Danny Kaye fan - she loved his humor.  She has always told me she didn't want a bunch of us sitting around being all sad at her departure.  She wanted us to celebrate and have a party.  I'll admit that I'm losing my patience a bit and now we  (the staff and myself) are having a little bit of humor in all this about her control she is exercising.   I've gone from tears a few days ago to "C'mon Mom, we can't start the party if you are still here, lets get this rolling, okay?" 

While I know that she would be terribly disappointed to see her lot in these last days - a state no one wants - her wishes of no medical measures to preserve her are being honored.  So glad that my mother had a health care directive in place so we can handle this the way she wanted.  It's not been pretty, that is for sure.  But she also did not want to be "in a home" for 12 years like her mother.

More silent learning today for me - maybe I'm the one who is holding all this up.  I have come to love the other clients here in the memory care unit. I feel great compassion for them.  And the staff here?  Wow, what amazing people.  It takes a special person to care for the elderly/aging population.  They all have been here to offer such loving and tender care to my mother with such dignity and respect.  They have extended their loving arms to me - they  offer me meals, treats, emotional support and I feel so blessed by their efforts.  Strangely enough - I'm going to miss this place.  I might have to come visit after this ordeal is over.  hee hee.  Some of the clients think I work here  - pretty cute. 

Tuesday, November 20, 2012

Slipping slowly

Rough night last night.  This slow death process is just nasty.  I am not liking this one bit.

Mom has been comatose since last Monday --- NINE days ago.  Of course except for Friday when she spent the day "visiting with angels".  During the past 7 days when they rotated her or swabbed her mouth or changed her she would have some facial expressions and utter a moan or two, maybe reach out with her arms.  Now she is just completely motionless -- still.

The past couple days her breathing has been very labored and last night was the worst.  Her lungs are beginning to fill with fluid and she is on a schedule of medication every hour now - morphine and lorazepam. Morphine has been being used the past 4 days for pain.  Now that she cannot express anything to us - and her breathing is so difficult, she gets an oral dose every 2 hours.  This is part of her hospice care and the staff here (assisted living - not a skilled nursing facility) cannot administer it - I have to do it.  Yesterday they added in the Lorazepam which helps her to relax  - as she has been having muscle spasms and jerking a lot, which frightens her.

So, every hour she gets medication orally and I am the one to administer it.  Hence, other than going home for one hour to shower each day - I have been here since Friday morning.  Today is Tuesday - I honestly didn't think I'd still be here.

Last night was the worst - Mom started with the tragic "gurgle" when breathing - she was fighting for every breath; heavy chest compression, just terrible.  I truly believe that we lost her twice last night - no breathing but her little heart just won't give out.  I have never been with someone who is dying and this is not what I was anticipating.  I am so very glad she is on morphine and non responsive as that would be even worse for me.  I feel so helpless watching her gasp and gurgle.  This is just sad.  We got her through her two episodes each time - after a long long pause and uttering that last slow and gentle exhale, she would be so still and peaceful- and I would think, YES!  she did it.  She is done.  And then, she'd take a deep breath.  My mom..... the energizer bunny.  I can't believe this lady!

At one point last night I had to take a break from the hourly medication administration as to be honest, I really have not slept since Thursday night.  I have been keeping a bedside vigil, holding her hand, swabbing her mouth, adjusting her blankets.  But last night I thought I was going to lose it.  I was so tired and so emotionally spent that I told the nurses to hold off for a bit on medication.  So I got 2 hours of sleep and now I feel energized.

Her kidneys are starting to shut down and usually that means the end is near.  Her hospice nurse will be in today (she comes daily) and give us a better assessment of where she is at. Yesterday her oxygen level was at 76 (90's) is ideal. Right now her breathing is intermittent but she is peaceful - no struggling like we had last night, no more muscle twitching and spasms.... she is so calm and quiet today.  Maybe today is our lucky day.

Mom, make today your day please - go join your family who lovingly await you.  You are done here as our mother, grandmother, great grandmother, aunt and friend.  Your mortal body is just to pooped to participate any further :)   Let go and embrace the loved ones who await you and watch over our little family and be a guardian angel to your grandchildren and great grandchildren - THAT, you can do. 


Monday, November 19, 2012

Silent Learning

While I sit here at my mother's side tonight,  I am in a different world.  I can look out the window and see cars driving by hear others talking and living life outside.  And here I am - awaiting the ending of a life. It's so surreal.

This morning my parent's Bishop came with his dear wife and he and my father laid their hands upon her head and the Bishop gave her a "blessing of release" from this world.  It was so beautiful and the Lord's presence was surely here. 

I've been writing my mother's Life Sketch for her memorial -reading a personal history she wrote which only goes through my parents engagement. From that point on I am going on my memories of her.  I have so many and could roll on for pages and pages -- so hard to pick and choose.  As I read and re-read my written words I am learning a lot of my mother.

While I was the only daughter - only one of two children - we had some strained times in our life together as mother and daughter.   And - of course as a teen I was not as loving and forgiving as I should have been.  My mother had so many trials in her life - she did the best she could and I know I have been too harsh in judging her.  I have had to make some peace this weekend within my heart with her and with God. As I have had to expose some of my emotions that I have buried all these years.    I've had to soften my heart and truly forgive her for things that have bothered me for quite some time.  I am not speaking of "sins of commission" but more of "omission". 

I think that many of us see our parents as these "super hero's" in our lives when we are young.They can do no wrong and they know all.  Our parents are there to interpret the world for us, to protect us, to teach us and to love us.  And we - these tiny little spirits from heaven are uniquely different.  Our needs are just as unique as our spirits.  It's our parents lifelong journey to learn about who we are and what we need.  And along with this duty, they are living life and growing up also - they've never raised another human being like us -it's all new.

I know my mother loved me more than life itself.  I was her "bright and shiny penny".  We were pals when I was little and I accompanied her to her first teaching job at a Montessori school.  I attended preschool while she taught.  When we showed up at school and I realized I would not be with her -- I was not a happy little girl.    I was a very frightful child - didn't like change, anything new....yeah, I was pretty hard to raise I am sure.  And of course, kids don't always express how they are feeling because they don't know how - so, I was just super shy and whiny all the time. I'm sure this was so hard on my mother as she was also dealing with my brother who was a challenge himself.   I think as much as my mother loved me - she didn't know how to parent me, this difficult child.   And for years I felt overlooked and I distanced myself   It's crazy but it's my reality. 

So, I have had frustrations all these years with my relationship with my mother.  While it was good I am pretty sure that there was a lot left to be desired by my mother -- as I became a very emotionally independent little kid and adult.  I think this made my mother sad all these years. 

So why all this gibberish about me on my mothers blog?  Well - I figured out tonight while I am watching her struggle to hold on to life, with every breath,  that possibly the Good Lord Above needed me to unleash the emotions I have; to show my mother the love that maybe I haven't in the past.  She is still here struggling tonight because I needed to hold her, to caress her face, tell her I love her and tend to her every earthly need.  I had some very tender and silent teaching tonight with my mother. 

My mother - the eternal teacher.  She's been teaching in some form or another since her very first teaching job in the mid 1960's.  Teaching was a passion of hers and here she is, still trying to teach me some important lessons before she can leave me.  Love. Tolerance. Forgiveness. Compassion.

Gotta love this mother of mine.

Saturday, November 17, 2012

Nearing the end of life

Life has sure taken over for me and I so regret not keeping mom's blog up to date.

Here we are, November 17th -- it's been a very busy and emotional time in my own life -maybe that is why I avoided writing......  Mom has neared the end of her life rather quickly.   This is kind of coming as a shock because her mother lived for 12 years in nursing care with Alzheimer's -- so four and a half months seems rather "sudden" and yet its a relief.  I know that watching my mother care for her mother all those years - the visits to the nursing home and feeling like she could not ever leave and go anywhere was so hard.

In August there came an opening at the Homestead center in Rexburg- much closer to dad who was spending  an hour or so each day driving back and forth to St. Anthony.  She is in the Memory Care unit- much smaller and set up for this specific need.  But once Mom got here she really started to spiral downward - which I know is normal when their surroundings change. 

I have been coming every couple of weeks from Seattle to check in on my parents - spend time with my dad and keep a pulse on it all.  Dad had knee replacement surgery on October 10th and I came for that - he was in the hospital for 4 days and then in rehabilitative care for 2.5 weeks.  He is doing AWESOME but he went for 2 weeks without seeing my mother.  Leah my daughter lives close by so she was wonderful at visiting both of them and giving me reports. 

I actually stayed in Seattle the whole time he was in rehab care to live my life a little -- it was nice knowing they BOTH were being taken care of.  I came back when it was time for him to come home and stayed a week or so and he was doing so fabulous that he didn't really need me for physical assistance.  His neighbors and ward members were wonderful at bringing some meals and visiting with him- also driving him over to see mom the week I went back home.

I was just here in town with my father last week and went back home last Saturday - mom was doing as well as could be expected.  Not really talking anymore, unable to walk or feed herself.  Pretty much full time care at this point.  They still got her up everyday, dressed her, fed her, propped her up in a lounge chair and so forth.  Until Sunday.  Sunday was the beginning of what looks like we are nearing the end.

In just 3 months mom is now completely bedridden and the end stages are here as of this week. We have hospice care in place for her and it's been wonderful. We decided that to take measure to prolong her life was not fair. She did NOT want to go like this -- she told me very clearly while caring for her own mother that she did not, in anyway want any measures taken to stretch it out -at all. So - we are letting nature and her body do what it needs and wants to do. 

On Sunday my mother decided she didn't want to live anymore -I think.  Completely non-responsive to any stimulus.  She would not wake up - no food, no water, nothing.  Hospice called me Monday night an we decided that this was probably the end.  I started to make plans to quickly return back to Rexburg but could not fly out until Thursday.  From Sunday until Thursday she did not awaken and did not eat or drink.

Thursday afternoon she woke up a bit but was pretty incoherent, uttering gibberish, glassy-eyed and just out of it.  I arrived Thursday night and spent several hours by her bedside and then we went home. Came back on Friday (yesterday) and she was awake from 9:30 - 9:30 -- TWELVE hours.  This is no where near normal for her these days - especially the past several.  She was with us but "not with us".

Oh the veil is so very thin between earth and heaven and I have been a witness to that these past 2 days.  Yesterday her day, I truly believe, was filled with heavenly visitors to comfort her.  She talked a lot with them - reacted to them, smiled, laughed, etc.  It was one of the most interesting things I have witnessed in my life.  She would call out, "Mother and Dad, Grandfather...... say things like, "I want to go" and then "I'm not finished yet".  She would grimace with fright and then smile lovingly-- quite a broad expanse of emotions.  It was an exhausting day sitting with her as she visited with everyone.  Most of her speech was not understandable and then she'd blurt out a 3 or 4 word sentence - something I've not heard for months.  Who can actually deny that there is life beyond and that loved ones await our arrival back home?  I sure cannot.

I spent my day holding her hands, swabbing her mouth for moisture and giving her tiny bits of ice cream - her favorite treat.  I also whispered gently that she needed to "go" and to not be afraid.  This was my repetition all day long to her.  Near the evening she snapped for a millisecond and looked directly at me (she has not been able to make eye contact) and said, "I keep trying!'. She finally settled in late in the evening to sleep. 

The hospice nurse has her on morphine to ease the pain that comes as their bodies shut down.  And yesterday I apparently was not giving her enough and they think that is why she was so active.  Also, they say that many times a person will rally up shortly before dying and have some time in this "up" state. 

So this morning brought a much different picture.  She has been sleeping all day.  The staff rotate her every 2 hours to keep the bed sores from forming - and she does not like to be moved - it hurts her poor little body.  I think she is down to maybe 100 pounds at this point.  So, while she has not been very awake today we've increased the morphine to every 2 hours to keep her relaxed and pain free when she is moved.  I am pretty sure the dosage will be increased as right now it's pretty small.

Her breathing is rather irregular and she is non responsive once again.  Her body is shutting down ever so slowly. I am not sure how many more days she'll hang on but I'm here to say this mother of mine is a fighter. 

I spent 12 hours with her yesterday by her side - trying to calm her and understand her conversations with those beyond the veil.  Today, another 12 hours but spent much differently than yesterday.   I wrote her life sketch for her memorial.  It's been a calm and peaceful day here as I looked out the window, felt the sunshine come through on my face and listened to quiet music.  Kind of in our own little world over here and it's just fine. 

Because this is assisted living and mom is on round the clock medication at this point, I'll be staying the night with her to give her the morphine as the night staff are not allowed. I know it sounds a bit odd but this is not a nursing home - it's a lovely assisted living place that will keep them through death- as long as they don't have to be on life support. So we need to be more involved in her end stages especially for hospice type care.  They do all they can with bathing, changing, rotating and even some feeding but at this point, someone really needs to be with her almost full time and that is family.  

Praying for her release anytime now. 

A Fourth Follow up

This was sitting in my drafts!  I cannot believe I never posted this --

My last post was on the afternoon of July 4th -- it had not been really good day for mom.  Dad and I went to a friends for a BBQ and went back over about 8pm to see mom (I was leaving in the morning).  She was still up (called to confirm it)....the only one still awake.  She was sitting in the Big TV area watching a MOTAB special Patriotic show.  We came in and sat with her and she was just entranced by the music.

When the Battle Hymn of the Republic came on something came over her.  She said, "Oh, we have to march to this"....and she stood up- I stood with her.  We faced each other and grabbed hands and marched to the beat.  She was SO HAPPY!  Then she started singing and got louder and louder, she knew all the words.  Then, she took one hand away from mine and started "leading the band", singing, marching -- it was so incredibly sweet. But she wasn't making eye contact with me  - it was if she was in her own little world.   I haven't seen her exert that much energy in months.

When it was over, she slumped down on the couch and said she was tired.  And rightfully so.  We took her down to her room and put her to bed--- her head barely hit the pillow and she was out. 

I was so glad we went back - I needed a better ending to the day and my trip and that was exactly what I got.  Thank you Lord, for giving this to me.

Dad is doing fine - a little lonely and lost without mom to care for.  She cries everyday when he goes to see her --but then after a while of sitting together, she'll just get up and wander off.  That is when dad can leave because she doesn't remember he's there.

He's trying to reinvent himself a bit I think.  Starting to walk the running track down at BYU-Idaho, making plans to finish some things in his wood shop, do some fishing.  He's coming this week for a visit and I think it will be good for both of them.  Mom needs some settling in time and he needs to see the family.

Wednesday, July 4, 2012

Settling in

On Monday July 2, 2012 my father and I moved my mother into an assited living center in St. Anthony Idaho.  The Homestead is a wonderful place where mom will finish out the remainder of her earthly life.

Getting her ready for the day, that Monday morning was almost surreal.  I felt like I had a big secret that I was keeping from her.( Not too long ago I had a similar experience of being involved with an intervension/removal to rehab situation and I almost had the same feelings.)   We had talked about her going there to live - rather we told her that was what was going to happen and she was just fine with our story.  How much did she understand - I'm not sure. 

I had packed a few things of hers - just some clothes, 3 pairs of shoes, basic personal items and some pictures from home.  I had bought her new sheets for her twin bed (hasn't slept in one of those for over 50 years now), a nice new sea shell coverlet (because she loves shells/ocean) and we were off to the new place.  We walked in and the whole time it was as if she had no clue what was going on.  It was so awkward!  She and dad had lunch with everyone while I put her room together. 

Her first 2 nights have been hard -- she gets up and wanders most of the night and so they are going to get her somehting to relax her so she'll sleep.  She's just missing my dad's warm, cushy body next to her but she cannot explain that and she doesn't have to -- I know it.  They've been snugglin' for 53 years now :).   

She has been very pleasant and is so sweet to everyone.  They just love her.  She is helping folding towels which is what I did with her at home to occupy a few moments of the day.  We spent more time with her yesterday - dad and I can eat meals with her whenever we come to visit which is so nice.  The cooks are wonderful and EVERYTHING, down to the bread is homemade, fresh each day.
There is a nice large living room area/lobby area with a big screen TV and mom and dad have sat there cozied up together watching TV, just like home.

Today, July 4th dad and I went to the huge parade here in Rexburg -- kind of different not having mom along with us.  Afterwards we went to see mom and she was just finishing lunch. Meal time is hard for her -- very confused about the use of silverware - from which to use when and HOW to use it.  The staff is great about learning the likes and dislikes of each patient and helps them get their food down. 

Seeing as mom does not have a TV in her room (she can't operate it) I decided to bring her a CD player and dad burned some Tony Bennett and Glenn Miller CD"S for her.  We just put them on and mom perked up!  Dad and mom LOVE to ballroom dance so there they were, in this litttle bedroom with the music on and he took her into his arms and they swayed to the music.  I had to leave because for some reason - REALITY hit me HARD.  As my eyes welled with tears, so did my fathers.  My mom?  totally unware of what was going on, just loving the music.  I went out in the hall, had a good cry (my first one) and then returned to find them just sitting in awkward silence. 

 Mom can't really converse anymore -- just lots of "random phrases and words.  Today was so hard because it was if she had something really important to tell me... I could feel it and see it in her eyes.  The words? Locked up in her mind and heart as if they being held back by a dam.  I wanted the damn to break so she could verbalize what she so depserpately wanted to say but -- nope, not going to happen.  She just kept saying "now, about that.................." and "I was going to....................."  or remember now........."  those dots I just typed---- that's where she stops and looks around in frustration.  She is constantly looking for things  - but doesn't know what.  She grabs for things that aren't there........is that just a reflex thing or is she seeing something?  Oh, I am not liking this one bit.

After lunch and the dance - I laid her down to take a nap and left the music playing....  I hope the nurses just hit the play button when it stops.  maybe I need to find one that will just continue to play?

We just tell her that we're leaving and she says, "ok"......... this is just terrible.  I'm feeling ways I didn't think I would.  This is hard.  Super hard. Getting on that plan tomorrow night is going to be quite an emotional challenge.   While I have been talking myself into the idea and the reality of "this is what is best for my mom" it still hurts.  I should be living here to care for her - that was the plan.  I'm hurt.  I'm mad.  I'm frustrated --  Feeling many things I just have probably been supressing in order to keep my dad afloat. 

He's had a few moments each day when he gets choked up and lets a few tears flow - I'm sure he's trying to be strong for me - and I, for him.  I guess tomorrow night when I'm back home - we'll both let it out and just cry a good cry.

I feel so blessed to have such a great place for my mother -- I think that God knew her path and that she was going to need to be in this town with so many people who love her (her church and neighbors) and that The Homestead was going to be "her place".

My prayer is that she is not going to have to suffer much longer with this horrific disease. However, other than Alzhiemer's she is pretty darn healthy.  Curse or blessing - I just dont' know.   You know, the Lord has very clever ways of teaching us the things we need to know and I'm praying that I"ve been humbled about "old age" and I've learned what I needed to learn about these tender and sometimes very sad/lonely years in an elderly person's life.  I pray that my shortcomings and lessons to be learned are not directly related to my mother's time on earth.  I pray that I can be a quick learner and that she can "go home" and be freed from the hours, days and weeks of her frustrations. 

Sunday, July 1, 2012

To "the home" we go.....

It's been while since I posted -- what else is new?  I just have a few things going on in my life these days!  Tomorrow my mother will be a new resident at "The Homestead".  It's an assisted living center that is very very nice.  They will keep her there and care for her well beyond typical "assited living center" abilities - until she passes or gets far too ill and needs heavy medical care. 

We visited there on friday and introduced her to the staff.  She seemed to grasp the idea that she was going to be living there -- I think.  I told her that because she was not feeling well (her constant complaint) .. that she was going to go stay there where there were nurses who could help her with her medication and see if we can't get her feeling better.  "Oh, that's great", was her reply.   She met the staff and was pretty entertaining and chipper.  Lots of non-sensical comments and quirky sayings -- pretty funny.  I'm amazed that through it all, she still attempts to be jovial - at times.

My dad is starting to feel some relief I think.  I know this will be hard -- they are sweethearts of 50+ years.  But the burden  - and I dont' really mean burden because my dad was willing to do ANYTHING - of her care has been hard on dad.  I think, no.... I know he is looking forward to having a little bit of life for himself again.  I just hope we aren't too late.  He wants to go fishing, walking and join weight watchers :).   He's gained a lot of weight from sitting on the couch with mom all day and keeping his calorie consumption up with all the goodies he loves.  You know my dad -- he's a foodie, 150%.  He loves his ice cream, cookies, soda and salami and cheese!

I have to say they are pretty darn cute -- it's morning and I just peeked in on them because dad is usually up fairly early (so he says).  He's not up and usually is by now.  They are all snuggled up together, both snoring away in slumber bliss.  Most likely savoring the last few mornings of snuggle time before they are sleeping separately.  Kind of sad.  I'm pretty sure they never invisioned life as it is.  I don't know how many couples do.

Mom is pretty wobbly on her feet these day.  I had dad get a handicapped parking permit which should have been done a long time ago.  She really should have a wheeled-walker thing to use when manuevering around.  Going to look into that one.

She continues to become more and more confused - which is expected.  She sees a chair and knows it's to sit on, but starts to sit while facing it - just can't make the connection that her bum needs to be above the seat.  Eating is quite a task for her - finger food is best and even then, if there are too many things (choices) it's confusing.  We had shrimp and fries yesterday, little cup of cocktail sauce and little cup of slaw; she tried to drink the cocktail sauce - dipping her fries in her water .... so sad.

She just wants to sleep - and I don't blame her.  She is so confused, it must be tiring and emotionally draining.  I can't even imagine spending my day, everyday, wondering who I am, where I am, why things are they way they are and an inablilty to express myself.  I just want to climb into her head and see the world as she does.  It's such a mystery. 

I told dad last night that it was time we talk about HIS PLAN - "you are almost 80 dad, I hate to be the bearer of bad news but that is old, ya know?"  He agreed.  So, first things first; get mom settled and then we start to plan for a few different scenarios for this part of his life. He's been pretty house bound the past 2 years.  I am hoping that he'll take this freedom and do some of the things he's wanted to do but been unable to.