Tuesday, June 10, 2014

Chapter 4: The Toughest Decision

After a second episode of congestive heart failure symptoms that caused her lungs to fill with fluid and caused an emergency trip to the local hospital, Mom made the decision to no longer prolong her life.  She didn’t want the fluid drained – again.  She didn’t want any more painful procedures.  She is ready to go on to the afterlife where she is absolutely certain that Dad waits for her.

Our sister called the local hospice to arrange for her end-of-life-care.  We were familiar with the hospice mission and philosophy, which follows word for word.  Per the National Hospice and Palliative Care Organization (nhpco.org):
Hospice provides support and care for persons in the last phases of an incurable disease so that they may live as fully and as comfortably as possible. Hospice recognizes that the dying process is a part of the normal process of living and focuses on enhancing the quality of remaining life. Hospice affirms life and neither hastens nor postpones death. Hospice exists in the hope and belief that through appropriate care, and the promotion of a caring community sensitive to their needs that individuals and their families may be free to attain a degree of satisfaction in preparation for death. Hospice recognizes that human growth and development can be a lifelong process. Hospice seeks to preserve and promote the inherent potential for growth within individuals and families during the last phase of life.
The assisted living center where she had stayed the past two months was not equipped to handle the skilled care that Mom would need, so our sister moved her to a larger facility.  The ratio of nurses to patients in Mom’s wing is 1 to 6, and the nurses are capable of assisting her with bathing and toileting as well as administering medication and painkillers.  Of course, the cost is almost double.  In the assisted living business, more care costs more.  It makes sense.
We visited her in the new care center.  She was having a bad day, and told us she was really, truly, ready to go.  She was in pain.  She wanted to lie down.  We asked the nurse if she could have more morphine.  About a half hour later a nurse brought a syringe without a needle, which was used to administer the drug orally.  She lay in her hospice-supplied hospital bed and closed her eyes.
I held her hand.  She was a bit cold.  I watched the veins in her fingers expand and contract under the involuntary tremors of her Parkinson’s disease.  I watched her slow, steady breathing, enabled by the cannula that wrapped around her face.  I listened to the oxygen machine pumping slowly, almost laboriously.  I memorized her face, now peaceful as she drifted off to sleep.  I see a faint smile, and I hope she is dreaming of Dad, and dreaming of joining him in a better place. 
She waited only a few days longer.  Mom left this world and joined Dad today.

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