Her end – part one

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Some of you have been on this journey with me since my mother’s first Thanksgiving after moving into a nursing home. Some much longer, some shorter. It seems only fitting to share the end of her story.

At the end of January, we learned that my mother’s health was declining and that she had, maybe, up to a year to live. The following Monday, only four days later, she had a seizure-like episode.  When I wrote last month, we were waiting to see whether she was going to recover from it. We did not wait long.

The day after the episode, I was in NY for a funeral. I was with my brother and we called to check on her multiple times.  Each time, we received good reports. It seemed the worst may have passed.

While together, we talked about what we would want to do to celebrate our mother after her death. My family is less than traditional but we have come together, across the country, to honor the four members we have lost in the last seven years. My brother and I agreed that there was no urgency in honoring her life, no reason to fly out at once. We could plan a family gathering at a time that was convenient to those traveling.

Over the course of the next few days, I checked in with the nurses. On Wednesday, she seemed to be doing well.  She was tired but was eating some of what was offered to her.  She was given morphine to manage discomfort. On Thursday, she was sleeping a lot and not really awake. But if the nurse touched her shoulder and said her name, she would open her eyes.

Then, on Friday, her nurse called me to tell me that my mother was not eating. I knew she had not eaten much the day before and I was worried that her end was coming. My brother was initially less alarmed, recognizing that hydration was far more important than eating. But when I called back to ask about her liquids, I was told she was not taking anything.

While I was having a great deal of contact with the nursing home, I felt like I had more questions than answers. I planned to be there Saturday, and when my brother learned that our mother was not drinking, he opted to come up and join me.

While it was out of the way, my brother planned to come to me so that we could go to visit our mother together. About 20 minutes before he arrived, the nurse called me to tell me our mother was non-responsive. I explained we would be there within the hour. We needed to figure out what was going on.

When we got there, we asked to speak with the administrator. He met with us at length.  He explained that the morphine she received was not substantial enough to make her non-responsive. Every 2.5 hours, workers would come and shift her body, to keep her circulation up and avoid bedsores.  My mother would grimace during that process, so she was given a small dose of the drug to make her more comfortable.

I was trying to get a sense of how much time she might have left. My brother was laughing at me, explaining that the administrator would be rich if he could predict the future. But the administrator said, while people do cheat death on occasion, generally, when a patient goes more than 48 hours without eating or drinking, she does not recover. It was clear that unless something drastically changed quickly, our mother was not long for this world.

This brought about a lot more questioning from me. I wanted to get a sense of what the timing could be if she did not recover. There was no part of me that, by that time, thought that she could.

Ultimately, the administrator stated that, without a significant change in her health, he would expect her to pass within the week. He explained that there are physical signs that precede death. For example, they would expect to see blueish purple spots on her legs and hands, a sign that her body was shutting down. Her face would become gaunt, which had not yet happened. When these signs occur, death is generally not immediate, although it is forthcoming.

My brother and I spent the afternoon with our mother. While there, we spoke with cousins and my mother’s best friend. We talked to our mother. We joked a bit about our non-traditional childhood. We also had more serious time, thanking her for being our mom, recognizing that it was not always easy. We also talked a bit about her illness, about all of us doing the best we could with a horrible situation.

Ultimately, we said goodbye. My brother expected to return to CT that week. He hoped to see her again before she passed but recognized that it might be to help with whatever needed to be done, after.

Maybe four or so hours later, while I was in bed reading, the nurse called. There was a change in my mother’s breathing. While she did not come out and say it, it was clear that it was serious.

I talked with my husband. It was late. We had some wine. He suggested that I steal a few hours of rest and then head over as early as I wanted, that he would take care of our family.

Within the hour, they called to say she had passed.

To be continued….

3 comments on “Her end – part one”

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