I said before it is a hard thing to watch a parent in decline.
I’ve written twice before about the shrinking world of my mother as she aged. As I recall the first one we had been out on a walk along a trail that she enjoyed after she had moved in with my wife and myself. There were nearly daily walks for a couple of years and then they tapered off. it seems that as they did so, she also lost her ability to go the distance. One day she was unable to make it all the way back to the truck, and I had to leave her on the sidewalk sitting in the grass while the dog and I ran the mile back to the truck to come and retrieve her.
The second time I noticed this, she had gone for a “walk around the block“. After she’s been gone an hour, I went looking for her and found her about a mile away and still moving away from the house. I didn’t want to embarrass her, so I drove past, around the block and came back, and when I had done so she had reversed her direction and was headed toward the house. After another hour, I went looking and found her about a block away, and looking at street times. She was obviously lost, but I asked her if she knew where she was, and she said “I’m just making sure.“
Then she became hospitalized with a serious UTI. After a week’s stay in the hospital on IV antibiotics she was discharged into the care of a hospice service.
Over the next 14 months or so, she continued to slowly decline. Decline with dementia is horrible. There are gradual decreases followed by sudden drops in the ability to function. There were several of these over the last year. Then six weeks ago one day there was a sudden decline far greater than any of the others. She was no longer able to speak clearly and her voice was very weak. Her ability to stand or to walk even a couple of steps had gone.
Also during the last few months prior to this, she was increasingly living in the past. At night she would ask about the cattle having enough hay and if they were being taken care of. These cattle were sold off in the early 1960s. She would ask if there was anyone “staying at that cold farm house” (where she grew up). She would ask when her father would come to pick her up (he died in 1975). She looked at my wife, then at me, and asked “What you doing running around with that tart?” My father and I share a first name and look more alike as I get older. He died in 2005.
We continued to take care of her for another three weeks, but it was becoming impossible. Her needs had increased to the point that we could no longer meet them safely. I finally made the decision to move mom to a nursing home in the town where my sisters live. I also made the decision not to tell her ahead of time. There really would not have been any point as her ability to remember was almost nil.
When it was time to go, we called 911 and asked for a nonemergency lift assist. In these cases, paramedics will come out and assist with getting someone out of the house and into a car, or vice versa. The drive to the nursing home took about 90 minutes and it was conducted in near silence. Mom spent most of her time looking out the window or leaning over as she seemed to have lost ability to hold herself up.
My brother-in-law is a paramedic and met us at the nursing home. While I went inside to deal with paperwork, he spent some time visiting with mom. When I talked to him later, he said he thought she had suffered a stroke sometime in the previous three weeks or possibly a series of small strokes.
For a week, mom stayed at the nursing home and was visited by my sisters at least twice a day. Her grandchildren also were able to come by a number of times. They knew that they were saying goodbye. This continued for a few days and then mom asked when she was getting out of there. I don’t know what my sister said to her. No doubt she deflected the question. The following week mom took another downturn. She was refusing to eat very much or even drink her shakes. She spent most of her time sleeping. Finally, the second Friday of her stay, she experienced what appeared to be a seizure, but it was really just a period of shaking really hard enough to make the bed move. The nurses were called and they administered the prescribed medication which calmed her down for a few hours. The second time it happened she slipped into unconsciousness and never woke.
We made it to the nursing home about 10 a.m. the next day. Mom was unconscious. Her breathing was labored. We settled in for the vigil.
The entire family was there. We spent most of the time talking quietly or in silence, sharing in the comfort of each other‘s company. I spend most of the time praying that my mother would stop breathing. Even with the comfort medication she seemed to have great difficulty.
The hospice nurse said that people near death and unconscious are still able to sense the people around them. She said that this often prolong the amount of time that the dying person will hang onto life. I spent some of the time watching a timer on my Garmin and counting her breaths. She varied between six and 15 per minute over period of several hours.
At one point, a few of us slipped out to get a bite to eat and then come back. While at dinner, I got a text message stating that the nurse thought that the time was near. We grabbed our food to go cleared the check and made it back to the nursing home. As we entered the room, she began breathing more rapidly again. Finally about 10 o’clock that night my wife and I had to go home to take care of animals. About 4 AM my phone rang and the nurse told me that she had passed.
I had written before about the shrinking of the world of the elderly. Mom‘s world shrank from driving to see her daughter’s grandchildren to just going into town to the store to barely doing that. When she moved in with us, we took the keys to the car, so it shrank even more. At that point though, she said she did not want to drive anymore. That was a good decision on her part. At that point her world shrink to as far as she could walk and at first, that was a mile in one direction and then back or down the trail and back. And then one day she couldn’t make it back. At that point, she limited herself to going down the patio, but then she didn’t like the stairs. Then she was only on the deck and eventually not even that. I suppose that is the way it is for all who age into senescence , and I suppose someday I will find out. I know that we did what we could for her and feel very privileged that we were able to do so. But still, it is a hard thing to watch a parent die.
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