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February 2009
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
I arrived first, followed by my husband, followed by our two sons and our daughter-in-law, followed by my mother-in-law's younger sister, followed by my niece.
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.
What Your Doctor Never Tells You. What He Really Thinks. Maybe.
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
February 2009
In earlier times, death, like birth, was seen as a normal part of life. Babies were born at home; the sick and elderly were cared for at home; and death occurred in the bosom of one's family at home. Now, however, we live in an age of modern medicine. Medical technology has saved many lives and prolonged the lives of many others.
-From The Journey, a booklet about Hospice-
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
My mother-in-law is a women who knows what she wants--and she wanted to stay in her own home, no matter what. And that's exactly what she did. She hoped that she would have no pain. And for the most part, her wish has been granted. She wanted to see her friends and her family. And she did. Almost everyone.
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 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.
Last Week's Visit
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
One of our wonderful hospice nurses made sure I had a chance to read her favorite books: Final Gifts: Understanding the Special Awareness, Needs, and Communications of the Dying by Maggie Callanan
and Midwife for the Souls: Spiritual Care for the Dying, by Kathy Kalina
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.
The Alternatives
My dad died under a ventilator tent in the hospital ICU after a long illness of 16 years.
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
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
My condolences to your family. My father died at home in the care of hospice and it was so good for us all. I also work for a hospice agency and know how hard our nurses work and the interest they take in patients and thier families.
Posted by: Debbi | March 19, 2009 at 07:03 AM
While my mother was dying from ovarian cancer, I was given the following book as a gift, which was extraordinarily helpful and I highly recommend:
Grieving Mindfully: A Compassionate And Spiritual Guide To Coping With Loss
May all your fond memories give you peace and comfort during this difficult time.
Posted by: Evelyn Tribole, MS, RD | March 19, 2009 at 09:17 AM
What a gift for everyone to get together for a final good-bye. I have no doubt she was holding out to see your son and her great-grandson to be. God's blessings to you and your family.
Posted by: Chris G. | March 19, 2009 at 06:59 PM
I write about young adults with cancer, and am a patient myself. We young ones tend to shun end of life care up until the very last moment because we cling on to the hope that our youth will save us. I have talked to many bereaved young spouses who in retrospect wish they had engaged hospice care much earlier on in the process.
I am glad you were able to be together as a family. I have had similar experiences around the death of family members. They were quite profound experiences.
Posted by: Kairol Rosenthal | March 20, 2009 at 12:32 AM
My father died a sad death after a long bout with a chronic, debilitating disease. He did not enjoy his last years and it was tough on everyone close to him. We usually don't get to choose how our days are spent (recently I had two friends close to my age commit suicide so I suppose they did decide how to end their life) but we'd all like to do it "our way". It would be a blessing.
Posted by: Bob Lubran | March 20, 2009 at 02:38 PM
Dear B and D, Noel and I offer our sincere condolences. D, your chronicalling of this woman's wonderful life is a great tribute to her. Our thoughts and prayers and with her and your family.
Posted by: Ralph and Noel Burr | March 22, 2009 at 08:26 AM
Your mother-in-law's hospice story is one of the most beautiful I've heard. Thank you for sharing it with us. I hope many more will read it & learn how wonderful hospice can be at the end of life.
I wish you & your family peace as you grieve for your inspirational mother-in-law.
Posted by: medicine girl | March 22, 2009 at 10:18 AM
So generous of you to share your husband's thoughts with us. Interesting that he has stopped taking statins and is the better for it. My doctor wants to double my dose; I'm thinking about cutting it out altogether. Also read your account of your mother-in-law's passing and found it beautiful, in the writing and in the heartfelt story you shared. Thank you.
Posted by: George Pollock | May 26, 2009 at 06:20 PM