Hospice care

Mom has been a patient at Burien Nursing and Rehabilitation since March 6th. She had a fall in February that resulted in a hospitalization and another fall at home on March 2nd, the day after her 92nd birthday.

Mom is on hospice care now. She will get some extra support from a hospice nurse, an extra bath a week, pain meds. and a more comfortable mattress as she has back pain. The hospice nurse told me today when I met with her that this is most likely due to pressure from the fluid in her lungs or it could be that the cancer has spread to her spine.

She has a mass in her chest, probably a malignancy that has spread from her breast cancer. Both lungs now have pleural effusions...basically her lungs are filling with fluid from the congestive heart failure.

She will also have a visiting chaplain and hospice volunteers who will check on her.

She sleeps more now and hopefully will just drift off ...for her sake, I hope sooner rather than later.

Monday, March 10, 2008

We managed to get Mom through her 88th birthday on Saturday, March 1, 2008. We took over a bucket of Kentucky Fried Chicken, potatoes, gravy and coleslaw. She was thrilled to be eating fried chicken...something she has not had for several months. Pamela and I decided that this worked so well that we would try and bring her a dinner like this more often. I also gave her a card that she loved and a box of sugar free chocolates.

I flew to San Francisco with a friend the next morning. My brother Mark had agreed to come over early in the week to have lunch with her. I checked in on Mom a couple of times each day while I was gone. I could tell that my physical absence and her long hours alone were taking a toll on Mom. I arrived back in Seattle on Wednesday night, March 5th and was out at Mom's apartment the next afternoon.

She has been talking lately about her wishes after she passes away. She specifically told me yesterday that she does not want a memorial service. She also told me that she didn't think she could possibly last much longer. This morning she told me that Dad was waiting for her. I don't really know if this is a form of grieving or if she has a premonition about her own death. I will just continue to do what I can to make things a little easier for her.

Getting away for a few days was really great...seeing new sights, eating out at good restaurants, seeing the Annie Leibovitz show in San Francisco....all of it helped restore my energy and perspective.

Simple things

Mom was kind of difficult to manage this morning…and I got to work a half hour late as a result of going to three stores and the bank. She needed to get new checks..and she thought she had to take Dad’s name off the checks, but it turned out that she did not have to do that. This little thing turned the rest of the morning into a trying experience. She was kind of difficult at Safeway…very impatient having to wait to get by people in the aisles…kind of yelling at me….then she burst into tears at home and was sobbing about missing Dad.

I checked on her twice in the afternoon and we got everything figured out. She felt like she wasn't yelling at me. Seems that she can barely hear me half the time and doesn't know how loud her own voice is projecting. Mom feels that she is a burden. She appreciates all that I do for her. It was alright in the end...she was just having a bad day. Everyone deserves understanding when it comes to having a bad day.

The good news is that I had the initial conversation with her about Arrowhead Gardens and she seemed interested.

http://www.housingseniors.com/arrowhead_gardens.php

I am going to an open house in Lake City at one of their other facilities on Saturday to see the floor plans etc. I found out that Arrowhead opens in August..they are taking deposits now…so I am going to try and move this process forward.

May Day - The final descent

I have a new routine these days.  On Tuesday and Thursday evenings, I go to the Skilled Nursing Center where I admitted Mom on March 6th.  I also see her sometime on Sundays.

Tonight when I arrived I found Mom in bed refusing to eat dinner.  I went and got my meal in the kitchen and then hooked her up with the earphones I had purchased for her.  I sat and ate while she watched the news.  When her nursing assistant arrived with her dinner she again refused it.  I asked the assistant to leave it and said I would try to get her to eat something.

She did take a few sips of coffee, ate two bites of a grilled cheese sandwich that I hand dunked in her tomato soup, and a beet.  Her breathing was labored and she was coughing a lot.  I put the head of the bed up for her and helped her with sips of coffee and small bites of food.  She seemed really frail and subdued.

I asked about her latest chest x-ray and found out that she has more fluid in her lungs.  Some days she takes her lasix and some days she refuses.  Today was a refusing day.

lasix (from Websters.com)

noun

commonly used diuretic (trade name Lasix) used to treat hypertension and edema

She also told me that she had called my brother.  Apparently, he used some foul language and she just said "goodbye" and hung up.  She talks him every time I see her.  All she wants is a chance to see him again.  That is not likely to happen.

Mom is making her final descent.  I am there as her daughter, her advocate and her supporter.  It makes me sad to see her dwindle away like this, after all she has lived through in her 92 years.  She is worried about her money and upset that there won't be any left for her children.  I told her we never expected that there would be an inheritance.  I tried to calm her down about the cost of the facility, all the while making out a check for over $4000 for one month.  Soon, she will be out of money.  I have submitted all the Medicaid paperwork and continue to have the facility fax off medical bills as I pay them.

I have built up some resilience over the last four plus years with Mom.  I am glad that she is somewhere safe.  I no longer worry constantly about finding her on the floor or worse.  I am starting my internal process of saying my farewells.

Whenever I leave I comb her hair, stroke her face, give her a kiss and tell her that I love her.   She always says that she loves me so much...that I am so good.  I look in her face and see what I will most likely look like if I live to be 92.  Her skin is soft to the touch.  Her arms are slender and her body is smaller that I have ever known it to be.  This is what my Mom's last days look like...and I am happy to be along side her for this final leg of her journey.