Monday, October 20, 2014

The Last Day, Part II

This Is My Very Favorite Photo of My Father 
Finally, about 2:30 he fell asleep, with Maggie and Raymond heading home.  He slept, tossing and turning, most of the night.  He woke up about 4PM, going to the bathroom, no problem walking, then went back to sleep.

Around 7AM he was up, again, going to the bathroom, no problem. He went back to sleep, a little, then said he needed to go again.  My mother helped him to the bathroom.  It was now about 7:45. 
He began passing blood, hemorrhaging.  It was dark rusty blood, indicative of a long-term internal bleed.  Nearly 12 years earlier, he had nearly died with bleeding ulcers.  We had monitored his health since then.  It was that kind of bleed. 

While she called Maggie, I did my usual, I don't know what to do, hand wringing.  We called Cathy.  On weekends, due to her extremely busy restaurant, I try not to contact her, unless it is an emergency.  When she didn't answer, I called the main phone, and had one of her servers tell her it was an emergency.  She agreed we needed EMS.  We all knew, once he was transported it was the beginning of the end.  I felt so sorry for my mother...

First I quickly dressed, then called 911.  An ambulance needed to come from town, which was unusual.  By this time, he was up, sitting on the edge of the bed, down, up again, and his color was growing paler and paler.  We had noticed the past month or so, that his complexion was taking on a jaundiced tone.  We were also very well aware he was in the final stages of prostate cancer.  This happens in any late-stage cancer. 

By the time EMS arrived, I was outside, waiting.  The first thing I noticed was how young the guys were. They reminded me of my nephew, Dustin, who is now EMS.  So far, it has been the only part of the process where I've really shed a tear. 

They recognized it was a bleed out, and wanted to take him to Roswell for additional treatment.  We said no, take him to Ruidoso.  He had a medical directive.  My sister and I have medical POA for both parents.  Our mother made the call.  Just take him there and make him comfortable.

I followed the ambulance, working the phone the whole time.  By the time I was able to be admitted to the ER (where thankfully we knew the nursing team), he was extremely weak, his coloring even worse.  His condition had deteriorated, that much, in just 45 minutes or so.  The nursing team realized who he was, matching him up to my mother.  For the past 5 Saturdays, this was my 4th ER visit - the other three with my mother - so they knew me.  When she arrived, a half hour later, they were working on establishing a couple lines.  Since they were familiar with her condition, chairs, oxygen, and eyeballing of her status began. 

An hour later the attending physician called my mother and I over to talk. He helped her into a chair, telling her he was bleeding out.  If they were to stabilize him, it would take a good 3-4 pints of whole blood, then they would transport to either Roswell or Las Cruces for more tests.  That was not an option.  He agreed with us.  If it were his father, he would make him comfortable. 

I called Cathy, then made more calls, going outside to tell Maggie to just go home, and not wait for us.  She had driven my mother into town.  A half hour later, after making more calls, and I went back inside the ER, the attending told me the end was going to be much quicker than we thought it would be. 

More calls. 

By 2:30, the put him in a private room.  Fr. John Penn did last rites and a final communion for him.  Josie stayed with us until after 9PM.  She force-fed my mother a fried chicken sandwich from Sonic, then took me for a quick supper.    When friends began arriving, I skipped out, to change, do laundry, and brush my teeth.  Once I was back at the hospital, it was nearly 8PM.  They lock the front doors at 8.  Josie made a Sonic stop for me, getting me my usual iced tea, and some electrical tap to repair my MacBook Air cord.  When she left, my mother and I settled in for the long wait.  By this time Cathy and Rachel were nearly in Fort Smith, driving as quickly as possible.

His breathing became more difficult and labored around 10:45 or so.  I called Cathy to tell her it was reaching that point.  I went back into the room, to prop up my feet.  Neither my mother or I had slept - more than a few hours -  since the previous Thursday, with one night's exception.  I was so tired the bottom of my feet hurt! 

We were talking about what sort of service my mother wanted.  I watched his complexion become paler and paler. Finally, she checked his breathing.  Coward that I am, I fled the room. I called Danny and Terri Flores, asking them to help us get through it.  While he was being pronounced dead, I called Cathy.  I still can't imagine how hard this was for her, still 500 miles away, knowing he was dying.  I think she had the roughest time of any of us.

It was after 1AM before we could leave the hospital.  Danny and Terry stayed with us the whole time.  My mother cannot get over how well we were treated.  The attending checked on her, constantly.  Techs from various departments, who knew her, dropped in, constantly.  The nursing staff was incredible.  I can't get over the care and compassion. As we were leaving, the ER doc stopped me, telling me how sorry they were.  He said they had been praying for us - the entire evening.

The service will be late Wednesday afternoon.

His final hours were quiet and peaceful.  His final moments were at peace.  It was a time of peace. 
He had gone home.

All rights reserved, SJ Reidhead

Sunday, October 19, 2014

The Last Day - Part I

The Last Photo - He Never Stopped Praying
This may be the final post I do.  I may go back and add a few others, back listing them, for the book I plan, but for all intents and purposes, this is the final post.

As a genealogies, there is something quite useful about someone whose life falls in nice, easily calculated decades.  As I started writing this, I realized this holds true with my father.  After 90 years of life, and 63  years of marriage he did what he told my mother he wanted to do, go home.  His final journey was short, peaceful, and he went out doing his very favorite thing in life, his favorite hobby, and favorite pass-time - sleeping.  I don't think a person could ask for more.  When he was in the second grade, his only theatrical role, ever, was playing the dwarf, Gumpy.  Of course we always told him it was typecasting.  If not Grumpy, he could have also played Sleepy.  There was nothing he enjoyed more than a good nap.   There was nothing we, as his family enjoyed more in life, than interrupting his naps, often in the most creative ways possible.  I suspect my favorite will always be the time my mother, thinking she was just tossing a couple ladyfingers in the fireplace in the house in the mountains, grabbed M-80s instead.  The object was to wake him up, out of a nice, long afternoon nape.  We were upstairs playing a board game, sitting in front of the open bedroom door.  He woke with a start, jumping so high he fell off the bed.  It was a glorious moment punctuated by the falling of a couple bricks out of the fireplace.  True to form, he never said a word.

His final day began much the same way.  A little after midnight, on Saturday morning, he sat up, in bed.  The past 10 days had been Alzheimer's hell for my mother in I.  Cathy was here, visiting with Catie, earlier in the previous week.  She had been here two weeks earlier,  and felt she needed to come back, primarily to check on our mother.  Catie, the most important person in the world, always cheers them up, giving them a taste of cute little kid happiness.  That week's visit was no different. While she was here, I met them at the Great Wall, our favorite restaurant, owned by very dear friends.  We did not realize that it would be our last visit as a family. 

When dealing with the elderly, it is a given that they have moments where they go downhill, fast, then plateau.  He had begun going downhill about the time of Cathy's first visit.  It was quite obvious this last visit, but again, we were more worried about our mother, who was in serious medical condition.  That Wednesday night, APR did not sleep.  Our mother stayed awake with him. 

If you are familiar with AD, it's called Sundowners.  People with AD usually reach a point where they have a total break from reality, usually pushing late Stage 5.  It is a major trait with Stage 6, where he was.  He had begun wandering around at night, all night, to the point where I was staying down at the house 3-4 nights a week.  We were told, that Wednesday, that our mother had become so weak (from refusing to eat) that we were told we could no longer leave her alone.    He started roaming, up and down like a little kid, sleeping about 45 minutes, then getting up, almost lost.  He could no longer find his bedroom or the bathroom.  He knew who we were, and knew the dogs, the animals.  In that way, his AD was interesting.  He never lost a sense of who he was, or his identity.  He lost directions, locations, and time.

Beginning in early July, when my mother's back started hurting her, so badly, I started buying junk food for him.  It is a survival technique you quickly learn, when dealing with the very elderly - they literally live on junk food, especially Cheetos.  During an 8 week period, he consumed 7 double packages of fig newtons.  He was eating a large bag of crunchy Cheetos every week.  He was also drinking milk and OJ so voraciously, I began making Countrytime lemonade for him.  To keep him out of my mother's OJ, I finally started making orange Kool-Aid for him.  He loved his desserts and sweets to the point where we learned the best way to tank up his brain was to sugar it up, like one would a little kid. 

He grazed, constantly.

His grazing  stopped last Saturday.  He never again touched his Cheetos.  He quit feeding Sadie.  He basically started picking at his food to the point where we began fussing at him.  He would eat meat and gravy, bananas, cream, sugar, and a sweet ice-box pickle I invented. He would eat that, and not much else of anything.  Familiar with his eating habits, and with AD, we assumed this was yet another stage of AD.  It was and it wasn't.

We were in AD hell, up every night.  Finally, on Tuesday, Maggie spent the night, letting me go home - for once, and my mother sleep.  She could do more with him than anyone else.  His eating and sleeping habits became more adversarial, for want of another way to describe it.  Thursday was nothing more than Alzheimer's Hell.  On Friday, he was constipated.  (That's another topic - his constipation - a comic topic).  My mother gave him a stool softener.  He didn't eat much, but hit her OJ.  For dinner, I made Greek stuffed peppers, one of his favorite meals.  He ate the refrig pickles and picked at the peppers.  I was trying to get the kitchen clean, so I could go watch the SF's opera's incredible production of Porgy and Bess.  I even wondered if he would want to listen to a little.  He loved Gershwin.

As I was rushing to clean the kitchen, he wanted to pray.  I did dishes while he and my mother prayed.  All he prayed was "I have decided to follow Jesus, no turning back."  That was it.  He went to bed.  My mother and I watched the opera.  To me, opera is food for the soul.  We both needed it, badly.  Not long after that, the end began.

My mother had taken to sleeping in a swivel chair, with a footstool, near the bedroom.  She could see him, and sleep where he back wouldn't hurt.  He had begun tossing and turning, badly, which he had done his whole life.  Only now, it was worse, to the point where he was losing his way, not knowing how to actually complete the process of getting into bed, reclining.  It had become a week long battle.  I admit, I had completely lost patience with the process.

I am not a care-giver.

A little after midnight, Saturday morning, he fell.  My mother was trying to get him to get up and go to the bathroom before he went back to bed.  He said he did not know how to stand - he didn't know how to use his feet.  (It's an AD thing).  As he was on the brink of falling, I grabbed the pet gate which was leaning against the wall, suggesting he hold on to that, like a walker.  He did not know how to use his feet.  His stomach was bothering him.  He needed to go to the bathroom.

He fell.

We couldn't get him up.  I called Maggie.  She couldn't get him up, and drove back home to get Raymond.  By this time, after he had cut his hand (he was on blood thinners), I was ready to barf.  I don't care-give.  Once Raymond managed to get him up, and back into bed, he had to go to the bathroom.  It was a mess.  He began passing blood, had diarrhea.  Maggie cleaned up everything.  I nearly passed out, during the process, having to go outside before I passed out, it was that bad.
Finally, about 2:30 he fell asleep, with Maggie and Raymond heading home.  He slept, tossing and turning, most of the night.  He woke up about 4PM, going to the bathroom, no problem walking, then went back to sleep.

Part II will continue, tomorrow.

All rights reserved, SJ Reidhead