Communion Of Dreams


“Thank you, son.”
November 9, 2007, 2:18 pm
Filed under: Alzheimer's, Health, Hospice, Sleep

It has been a difficult week in caring for my MIL. As noted previously, we went to a three-day trandsdermal patch to help with the pain associated with her aspiration and breathing difficulties. And that has worked pretty well. But as I suspected would happen, after her trial period with the oxygen she didn’t want to use it any longer – even when she was laboring to breathe and I offered it to her, she declined. Only once, when she was having a coughing spasm, did she consent to put up with it again. This means that she has continued her slide, probably at a faster pace than were she using the oxygen. It is a tough thing to watch.

* * * * * * * * * * * * *

After a particularly rough patch of it yesterday morning, I was helping her from the toilet to her usual seat in the front room, where she likes to sit and look at magazines. As we transitioned from the wheelchair to her comfy chair, and I got her settled safely there, she looked up at me, her frail thin arms still around my neck, her light brown eyes clear for a moment, and said “thank you, son.”

In the over twenty years I’ve known her, in the twenty years I have been married to her daughter, she has never once before called me “son.” In fact, since my own parents died almost 40 years ago, no one has called me that for a very long time. It was a strange word to hear directed my way. And it touched me like no other thanks she has ever offered.

* * * * * * * * * * * * *

She had a restless night last night. I was ‘on call’, and consequently didn’t get a lot of solid sleep. After I had been downstairs early this morning, trying to get her to settle down through one of her (fairly rare) combative fits, it hit me: we’d screwed up and not replaced her duragesic patch late afternoon, like we should have. Meaning that the opioid in her system had been tapering off for about 12 hours, with nothing else to mitigate the effects of pain. And with all the other difficulties her brain faces, that extra pain causes unpredictable effects.

I mentioned this to my wife, who woke somewhat as I came back to bed. Shortly thereafter, we were back downstairs, getting a new patch on my MIL, and getting her something else to relieve her pain more quickly than the patch would kick in. As we were getting her tucked back in, she whispered to my wife, asking: “who is that strange man?”

* * * * * * * * * * * * *

Lisa, our hospice nurse, did her routine check of vitals, asked the usual questions about changes we’d noticed. After spending an extra long time with the stethoscope, she looked over to me and my wife, an honest but pained look in her eyes.

Later, after all the rest was done, she chatted with us on the front porch, my MIL again sitting in her comfy chair in the living room. “Yeah, there’s a lot more crackling all over her lungs.”

This came as no surprise. I’d been able to hear it myself, just in my MIL’s routine breathing. But it was a substantial change from the aspiration congestion being confined to just one part of one or another lung.

Then she added: “And her heartbeat is much more irregular.”

Ah. I asked, already knowing the answer: “Is that . . . significant?”

“Yes.”

* * * * * * * * * * * * *

My wife’s older sister is coming to visit from California beginning Thanksgiving weekend. Last week I was worried that my MIL might not last that long, given how things had been going. The beginning of this week I had changed my mind, since the duragesic patch seemed to help so much.

Now I’m not sure again, even though we are a week closer to Thanksgiving.

That may be the toughest thing about this, the not knowing. I mean, there are few of us who know in advance the how and when of our deaths – I’ve long accepted that, having lost both parents suddenly (and separately) just as I was on the verge of adolescence. But when you are dealing with a terminal illness, such as hospice usually aids with, you usually have some kind of time-frame that everyone understands. This is different – this isn’t cancer, or a fever, or some other relatively simple cause & effect. This is a general debility, prolonged by our caring and care giving in a way that both breaks your heart and makes you proud.

Jim Downey

(Cross posted to dKos.)

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4 Comments so far
Leave a comment

I’m so glad that you and Martha are there for Gramma and so grateful to know that people that really love Gramma are taking care of her.

Thank you

Comment by Bones

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