Friday, May 28, 2010

Another year older

Next week is my birthday. It's not a milestone birthday; that was last year. On the day commemorating my 50th year on the planet, I went to visit my mom, who as it turns out, was on her death bed. "Oh thank goodness you're here!," she said in a surprisingly loud voice considering her frail state. "Happy Birthday!" I smiled. It was an odd situation. Yes it was my birthday, but watching my mother slipping away from me every day was anything but happy, however,  it was amazing and even courageous that she should say that. But that's what most moms do isn't it? Wish happiness for their children.

Her death last June has haunted me every day since then. Neither the hospice people  or the nursing home staff had called to let me know that she had taken another turn for the worse. I dropped my son Sam off at church to practice the organ and went in for my daily visit and was startled by what I saw. Her legs were turning a deep bluish color, the wound they had been carefully tending for months had gone from a hopeful pinkish color of healing color to the black of necrosis, and her eyes were wide open and looked "glassy." I don't think "glassy is a very good way to describe them, although that is what every site about death I ever read has said about them. They were more of a whitish opaque, as if heavy cataracts had formed over her brown eyes. Her mouth was open wide, she was breathing heavy and turned on her right side. I tried this out at home after wards and I think this was because her body was trying to force as much air inside of her lungs a possible. When you open your mouth, arch your neck and lay on your right side you can force a tremendous amount of air into the lungs. Mom's body was on auto pilot/survival mode.

I called the nurse for assistance. "Look, I know oxygen won't prolong her life, but it seems to me that she is really struggling for air. Why can't we give her some oxygen?" And the nurse was agreeable. We had an oxygen tank in the room, so after checking mom's blood oxygen (which was only 80%), she put the nasal cannula on and left.

My mind reeled at what I was seeing. The weeks of research into what to expect at the time of death told me that this was it. She was in active death. But there was another part of me that said, "This isn't good. It's going to take a long time to recover from this." Denial. I know. And I also had it in my mind, despite what I was seeing before me that this was going to take hours and hours and perhaps days, so if I wanted to be with her, I needed to pick up Sam, take care of things at home, and then come back. I don't know why I thought this except that I didn't accept what was happening. I always thought there would be more time.

This is where I think the hospice folks let me down. What I clearly needed was someone to tell me the end was very near, not platitudes such as "In God's time" which they gave my sister earlier in the day. Surely people who are around death professionally must have some kind of idea about death time tables. Not an exact science but at least some idea. (A few years earlier my brother-in-law who is a physician, was able to predict my mother-in-law's time of death with great accuracy!  So I know it can be done.)  I needed someone to guide me through this to perhaps suggest, that someone else could pick up Sam, and that I might want to just stay nearby. Just a reality check like that would have done it for me. But there was not a single person from hospice around her room then and the nursing home folks walked around like they were avoiding - death. Which of course they were.

I reached over and tried to close mom's eyes so she could rest, but she wouldn't close them. I left, and she died before I could get back. Stupid, stupid, stupid, stupid.

When I did get back I was met at the door by my sister who told me that mom had passed. She too had missed it. When we got to the closed door of my mother's room, we could smell the strong stench. Ovarian cancer had been messing with her lower GI system for weeks. She never ever did get control of her bowels back, and despite not being unable to eat for days, her body emptied all that was in it when she died.

The nursing home's response to this was to send down a big tray of cookies and punch that we could share with each other over my mother's corpse?  I think was this was a well intentioned gesture but at the time it was the epitome of inappropriate. And who could eat with that smell anyway.

When Rebecca of Sunnybrook Farm. the hospice nurse arrived it all seemed like too little too late. I even had to help her find the number for the funeral home - I could have done it myself.

I've had a lot of anger towards the hospice people since then. I have come to the conclusion that having an outside hospice come into the nursing home is bad idea, because the hospice people think the nursing home people are doing the care, and the nursing home people think the hospice has it covered - so the ball gets dropped. About the only thing hospice was good for was making sure mom got enough pain meds, but as I recall on the last day of her life some lady from the office was coming down every hour or so to put drops of that in her mouth, which still seems odd to me.

For a time I thought I saw the hand of God in this. Perhaps, I reasoned, mom's death was so hard to watch that my sister and I were kept from seeing it. I don't know if I believe that any more, at least for me, because I have regretted not being there ever since. I also have wondered why my mother had to suffer so much at the end. Was this a final test for her? Was this last bit of suffering what she needed to avoid purgatory? I don't know, but as I approach my birthday and her first anniversary this month, I wonder if part of her suffering and death was meant to test and challenge me. 




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