The nursing home phoned me late Monday morning to say that my mother had likely had a stroke on the weekend: her speech was slurred, her tendency to lean to one side was more pronounced, and her oxygen levels had been low. The initial call was framed as an update: they knew we were already planning to come up the following week for Mom’s birthday, and thought that would be fine; but needed to discuss some treatment options in the interim. Mom’s oxygen levels were back up, but she was experiencing difficulty eating and drinking. Was I in favor of increasing her fluid levels?
The second call was more urgent; she had lost the ability to swallow. By 4:30 I was on a plane to Edmonton to be with her.
She was unconscious when I arrived, but seemed to derive some comfort from my being there and holding her hand. I sat with her through the evening and tried to get a sense from the staff what her condition was, but no one was able to be definitive. One staff member I know and trust told me she was growing weaker by the hour; another, more medically qualified, member said that Mom seemed to have stabilized and was resting comfortably, and that it would certainly be safe for me to go home to sleep for a few hours. A third said she could offer no such guarantees.
In the end, I judged mom to be stable and comfortable, and with the nurse’s promise that I would be called if mom suddenly started to get worse, I risked going to Mom’s condo to sleep. I might as well have stayed as I was unable to sleep: restless, I paced and read and distracted myself as best I could, but eventually gave up and returned to the nursing home in the early morning.
I sat with her through the rest of the day, holding and stroking her hand. She would occasionally withdraw her hand briefly: as mentioned in a previous post, if I held her hand too long the blood would stop flowing, so I interpreted this as her hand having fallen asleep, especially as my own hand would sometimes start to have pins and needles after holding in the same position for too long, so I would leave it be for a bit and just talk quietly to her. My impression is that she knew and appreciated my presence, but was too busy breathing to have much energy to respond. The staff kept reassuring me that hearing was the last sense to go and that Mom knew I was there. (I had just read some recent research where the researchers were able to communicate with a man in a vegetative state by asking him to imagine two different types of scenes -- one for 'yes', the other for 'no'-- while in a MRI machine, so I am inclined to believe that they were right about my mom.) So I alternated between stroking her hand when I ran out of things to say (it's amazingly difficult to keep talking to someone who is not responding), and talking when I judged her hand was getting tired. But I made sure she knew I was there with her.
At about 2AM, I lay down for an hour's break. Mom was calm and her breathing had been steady if labored for several hours so I judged it a good time to break; the nurse had assured me Mom was not in pain because she was laying quietly, whereas those in pain tend to wave their arms around and appear agitated. Mom's movements were few and slow. 45 minutes later, I heard Mom say something, halfway between a moan and a call, and woke up. Then I realized I must have dreamt that because the 'quiet room' was well down the hall from her room and it would not have been possible for me to have heard her. So I turned over to go back to sleep when the nurse knocked on the door and told me my mom had gone. I said, "Oh so that was her I heard?" and she gave me this really odd expression and said, "No, it was just my time to check on her. [Name] had just checked on her a minute before, and your mom was fine then; but I didn't know that she had gone in already, so I went again just now, and she was gone. But we didn't hear anything. She just went quietly in her sleep."
I had been sorry I hadn't been with her, but the nurse told me, "Its often that way. The family will sit all day, but when they leave to go to the washroom, the patient will go in that moment. We think that they know and wait to spare the family that last moment. Its either that, of they wait until everyone is there. We had a woman last month, the whole family was there and they were waiting for hours, but when the last grandson arrived, and they all started singing a hymn, she left. It happens like that a lot too. Either way."
So my Mom passed away about 2:45 March 31, 2010. She would have been 101 April 5.
Part of me had kind of hoped she would make her birthday, but I know that's silly: there is no prize for crossing a particular finish line. Indeed the Chaplin had told me earlier in the day that vast majority went just before their birthdays. "You tell them that they are going to turn a hundred and they say, 'No, no I don't think I want to be a hundred', and they'll go a day or two before. So we don't ever mention their precise age unless they specifically ask..."
I was surprised to learn there were four residents older than my mom, two of whom had lived at home up until and only arrived in the nursing home after their 101 birthday. So we are definitely living longer. He related the story of one lady who on her hundredth birthday had announced to her family that she was the oldest person in the building, and when he had looked away not to disagree with her, she had noticed and demanded to be taken to someone older. so he had wheeled her to a resident who was 102 and they had had a long if shouted conversation (both being quite deaf).
A lot of staff told me stories like that over the two days I was sitting there. Each one made a point, on their own and spontaneously to see Mom and to tell me a story about her. Two of them were fighting back their own tears. It was very clear to me that they sincerely cared for my mom. Their support was very important to me, and I know that they had always taken very good care of my mom. I want to say here that I have always appreciated the humor, warmth, patience and above all, the commitment to the care of my mom and the other elderly in that home (The Dr. Gerald Zetter Care Center). Doug had spent months researching nursing homes before permitting himself to place her in one, and I had come up and toured the three 'finalists' with him, and in the end there had been no question in my mind that this was the best one. There was something about the culture of the place that was obvious even on my short visits that made it the place we wanted her to be. Then Doug had gone there to feed mom supper every day for two years, so he had really gotten to know and trust the staff before he passed away. I could only visit for a weekend once a month or so in the two years since, but I got the same impression of the staff, partly because they treated me as they had Doug, and partly because I was able to observe them with other residents when they didn't even know I was watching, and they were all unfailingly great. I know I could not do the job they do.
I miss my Mom, and Doug, a lot.
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