Final wishes

Yesterday evening, Mom was alert, chipper, and feeling very well. Peg and Bill were able to enjoy a nice evening visit (I was still in Pullman), and her doctor was talking about a release date.

Overnight, her condition changed dramatically.

This morning, when the pulmonary therapist came in to administer a treatment, she heard a lot of "crackling" in Mom's lungs, which is a sign of fluid build up. So the "Rapid Response" team was called in to get Mom stabilized. The members of this team are exceptionally skilled in their areas of expertise. Their efforts were successful.

Peg was called, of course, and she called me. She and Bill, who has been staying here in Spokane ever since last weekend, came to the hospital, and I drove up from Pullman. All four of us conferred as a group. Mom has been saying to many of us over these past two weeks that she is ready to die. She has said this so often, and to so many of us at various points, that we, her children, pursued with her a serious, end-of-life wishes conversation. Although she has been very weak all day, she has been alert and clear-headed, so we felt confident about having this discussion today.

We very carefully and thoroughly discussed what exactly Mom wanted to do at this point. We identified the options for her. These options roughly fall into categories of
• "do not resuscitate if pulse and/or breathing stop";
• do everything medically possible
• do some things but not others (do antibiotics but no artificial feeding, for example)
• do only what will keep her comfortable

After about two hours of talking among ourselves (Bill, Peg, Mom and me), going through the hospital's forms, and getting clarifications from the various medical specialists, Mom has decided to accept only comfort-level treatment and there is a "do not resuscitate" order if her pulse/breathing stops.

Over the course of the afternoon, several specialists who have been involved with her care have come in to talk with her and us. She has confirmed this decision with all of them.

She will continue to accept IV infusions that keep the fluid levels in balance, and she is accepting the pulmonary therapy, a broncho-dialator. She will accept IV antibiotics to address an infection. But that's it. No new medicines, no new treatments, no aggressive measures.

There is a wonderful hospice program in Spokane with a just-recently-built 12-bed facility, Hospice House. She has been accepted to be taken there when a bed becomes available. That will probably be Monday or so.

Peg was particularly comforted to know that a former colleague--a nurse whom Peg admires, respects enormously--is the director of nursing for this hospice organization. Mom could not be going into better hands.

It is very sad news, I know, for all of us who love her so much that we will soon be saying goodbye to this wonderful, wonderful woman. Peg, Bill and I are so grateful to have been graced by such a mother. She has truly taught us what love is. As one expression of our gratitude for her love and motherly care, we want to support her desire, which she has made clear to us many, many times over the years, for a dignified death, not a protracted feeble helplessness. Sad as I, my brother and my sister are right now, we know this is what she wants for herself.

Thank you to everyone for your thoughts and prayers.