I've just returned from a ten day visit with my mother-in-law. It will surely be my last. Two days after my husband & I left she took a turn for the worse and is now in a coma. Update: My mother-in-law passed away peacefully in the middle-of-the-night on 3/19/09. I woke up at 3:33 am that night, looked at the clock & wondered if something had happened. When I put on my watch that morning it had stopped at 3:33.
Back in June, days before my mother-in-law turned 85, she got the news that she had cancer--and not the kind that one can just ignore and get on with life. Her type of cancer was fast-growing and brought with it intolerable symptoms that she just didn't want to live with.
As an active, sharp, young-for-her-years, healthy, and independent woman she decided to attack it head on. To give it her best shot. If she couldn't beat the cancer & live a "normal" life, then she wanted the end to come quickly.
Her difficult four month chemotherapy regimen shrunk the tumor enough to make it possible for her surgeon to operate, performing a complete hysterectomy. And her surgery and recuperation went without a hitch. We all held our collective breaths and congratulated each other on our good fortune. I guess we were pretty naive.
By mid-January her health took a drastic turn for the worse, resulting in a too-long hospitalization and a disappointing-hard-to-believe-depressing prognosis. She wasn't going to get better and we needed to contact hospice.
She Did It Her Way - And It's A Week We Will Always Remember
She was in charge--surrounded by everything familiar to her. She had the around-the-clock company of an amazing caregiver who became her dear friend--and a guide through this journey.
For the last 2 weeks hospice has sent in around-the-clock nurses to attend to her every need with kindness, gentleness and dignity. They have been, for the most part, the same nurses, and she got to know them all.
She slept much of the day, and I was afraid that by the time her grandchildren and her sister arrived she would be asleep throughout the day, and they wouldn't have a chance to visit.
It was almost as if Hollywood had scripted our visit. If I had seen it in a movie I would have rolled my eyes in disbelief.
As if by magic she drew deeply on energy reserves to really BE WITH everyone. She got to feel the 7 month pregnant belly of her granddaughter-in-law and her face just beamed with joy.
She got to gossip & chat about "old times" with her sister, just like they always do when they get together. They munched together on my mother-in-law's new favorite cancer food--Breyer's or Edy's All Fruit Popsicles. Her sister left for home feeling so good about the visit--comforted and satisfied in spite of her sadness.
My nephew, the Florida grandson brought over fresh-caught fish, and together with my sons they cooked up a feast for their grandma. Grilled fish and portabello mushrooms, rice pilaf and salad. They served her up a mini-sized sampler platter and wonder-of-wonders she was able to eat & enjoy it all.
The Comfort of Hands-On Care
Somewhere in one of those books they talk about the healing and comfort that the family gets from attending to some of the daily care needs of their loved ones. It's not always so easy to do this when there are nurses and aides who are so skilled & seem to know better--but we were graced with nurses who had become our friends and they encouraged us to help them with my mother-in-law's care.
It felt like a gift.
My mother-in-law couldn't move much at all. She was confined to the bed and she needed to be turned every two hours---bathed, washed, medicated, changed and constantly repositioned for comfort. This was 24/7 care.
I know how difficult this around-the-clock care is, and the toll it can take on families that must take this on by themselves. You can't leave the house or even take a shower without someone to relieve you. Then add jobs & other family responsibilities into the mix... To have hospice care and a full-time caregiver was an amazing blessing.
She needed frequent sips of ice cold water--and was somehow blessed to still have her joy & pleasure for food. She only had an appetite for 2 bites--but she still relished what I call "Terminal Tapas". Lox & bagel, rugelach, hummus on Indian naan, Sweet Potato Pineapple Peanut Butter Soup, Starbuck's Expresso Chip Ice Cream, steaming hot coffee sweetened just-so, and my husband's Famous Scrambled Eggs. All only two bites or two sips!
We gave her a Mary Kay facial and applied makeup before her sister arrived. Then she was through with that sort of fussing. She wore her own nightgowns, all slit up the back for ease of dressing.
Soft instrumental music played on my computer (CD players weren't part of her world) and the room was filled with the scent of cinnamon & vanilla.
Mostly we sat by her side, held her hand, lightly rubbed her forehead and talked when she felt like talking.
I chanced to peek in while my oldest son said his final goodbye. His hand was on her forehead. When we talked later the next day I asked him if he was giving her a blessing & if he noticed the embroidered blessing that hung on her wall. Yes, to both questions.
Thanks to morphine for pain; "magic mouth wash" for esophageal discomfort; decadron for dizziness, headaches & nausea; ducolax for constipation; and ativan for anxiety she was mostly comfortable, peaceful and still alert, aware and able to be herself---not in a fog.
My father-in-law died in a hospital room a few days after a massive stroke.
My mother died in a nursing home after strokes & seizures left her in a partial comatose state for 6 months.
To be able to die in your own home, alert, awake and comfortable to "almost" the very end is a blessing for all of us. A Final Gift.
I was very touched by Dr. Larry Zaroff's 2005 NYT essay about his mother's death, "One Last Recipe From Mother, For the Good Death." Take a read.
For the early parts of this story:
A Parent's Illness: Act Four
Unhappiness - When Those Closest To You Face Difficult Times & You Can't Make It OK
Cancer & New Life - It's All About Hope - And Finding the Balance