3 pm Saturday the 17th. The vigil continues.

View from the Serenity Room at the Hospice House

Three weeks ago today, Mom was admitted to Sacred Heart Medical Center with a fever and very low white blood cell count. One week ago today, she seemed to be rebounding, and the doctor was talking about a possible release date. Today, she continues to be in the near-death coma that began last Monday.

At several points this week, death has seemed imminent. Yesterday evening, the suspense seemed to reach a climax. Her breathing began to change again. The hospice workers said that signs suggested it might be in the next few hours or perhaps even minutes, although they always remind us that each individual is different.

Peg, Bill and I, sharing our grief, all spent the night in her hospice room. None of us wanted to be at Peg's home in bed when our dear mother drew her last breath.

Today, she inhales and exhales, and her rapid pulse continues to flutter under the fragile skin of her neck. The body can be tenacious of life, even after the essence, the individuality has all but evaporated.

Only very gradually, and in waves, I realize that she and I won't be making new memories, teaching me the meaning of the word "heartsick." My mother's amazing friendship will continue to sustain me, I know, but only as I treasure the memories we've made. Maybe consolation will come in telling stories of her, as Peg, Bill and I have been doing, especially last night at her bedside.

Right now, even though we know she isn't suffering, we all are wishing she could let go. "Go to those Pearly Gates, Rita. Jim is already in the van with the motor running and is waiting for you to go fishing. Go on now. We'll miss you tremendously, but we will be OK. Go on now."

She is getting the death she wanted--a dignified one. She hasn't endured a long internment in a nursing home. She was active and engaged with life up to the previous few weeks.

But these three weeks have been an eternity. That slow ole' specter death, he is a long, long time a-comin'.

My mom's HEART

Friday, May 16, 2008

She's all Heart
Yesterday I met the Medical Director of the Hospice House, Dr. Soffe. He seemed to be a very kind, compassionate man and I felt very comfortable with him. He wanted to know about our mom- not just about the "patient". I told him what an amazing woman, nurse and mother she has been. He was particularly interested in the part of her nursing career when she taught nursing at Lewis-Clark State College. He asked if he could have the medical student, who was with him, listen to her heart because it was "classic" atrial fibrillation. They both listened to her heart with their stethescopes. Dr. Soffe looked at me and said "See, your mother is still teaching students even now." What a kind thing to say! I asked if I could listen to my mom's heart. He took off his stethescope, handed it to me and placed the end on my mom's heart. I could hear and feel my mom's heart pounding in my head. Her appearance is changing as her body fades, but I was able to feel so close to our mom through this kindness. Everyone who met our mother knew what an amazing heart she has- I have been fortunate enough to not only feel it all of my life, but hear it as well.
Posted by Peg

Mom's heart

The posting about "my Mom's heart" was written by Peg, not Bill.

Holding vigil

My sister, brother and I are taking turns holding vigil. Sometimes we're all here, and sometimes just one or two. We have been taking turns spending the night.

The night before last, which was Peg's night, my mother began having tremors. Peg called Bill and me, who were asleep at her house, thinking that Mom was about to pass away, so we drove over to the Hospice House to join her, so she wouldn't have to be alone. By the time we got there--this was at 3 am--the medications administered by the Hospice House staff had calmed Mom's tremors. Her breathing was still very labored, and there were long spells of 30-50 seconds when she didn't inhale (apnea), but she continued to hang on.

After a few hours, Peg went back to her house to try to sleep, while Bill and I did the best we could to rest while staying with Mom.

Last night, Bill stayed. Mom's breathing has become more regular and a lot more shallow. The breaths are not as loud as they have been for the past two days. This is a mixed blessing, because holding vigil while Mom's inhalations were so noisy was so, so sad that it made us almost crazy. Now that her inhalations are quieter, it is easier to believe that she is passing on peacefully. To be blunt, it is now easier to conceive of the process of dying as a spiritual transition, while yesterday, death seemed to be a cruel, tortuous mechanical failure.

From one perspective, the perspective of these past three weeks, my mother is not passing away quickly, but from the overview, as my Aunt Rose Van Dyk reminded me on the phone yesterday, Mom has been able to participate actively in life nearly up to the end. In just February, Mom, Peg, I, she and Mom's brother Uncle Adrian were all in Kaui'i, Hawaii, and Mom was pretty much keeping up with her daughters, doing everything that we did.

I think that's pretty much the ending Mom has hoped for herself: live actively, and then stop rather suddenly. She has made for herself a good, good life, I believe.

Such a strong body . . .

. . . that one breath very belatedly follows another.

I know that she is in no discomfort, but

As she lays dying . . .

Yesterday morning Mom was transported to Hospice House of Spokane to receive comfort care during her final hours or days.

Last night, Peg stayed with her and found it to be a very sad experience, for Mom, while still alive, has been unconscious since yesterday morning and is clearly in her final stages of life.

Bill and I joined Peg in the vigil at about 3 this morning because signs suggested that the end was near. But that ole' body that she took such good care of doesn't seem to want to finally wind down, in spite of herself.

Bill, Peg and I are each handling our mom's death in our own ways, but we're continuing to be supportive of one another. Living through this sad, sad time with them as my companions has given me a new level of admiration and love for each of them. Bill's sense of humor has continued to help relieve us of some stress, even as he struggles mightily with his own grief. Peg's wonderful sensitivity and understanding, coupled with her admirable professional expertise from years as a social worker make her the best resource a sister could possibly hope for in such a situation.

Mom has received many kindnesses from her other relatives and friends over these difficult two-and-a-half weeks--visits from Jim's sons and their families, gifts like a beautiful quilt made by a long-time friend and neighbor, and kind assistance with things like collecting the mail. There have been too many to mention.

The vigil continues, sadly, but will soon, we expect, come to an end.

Love to all on Rita's behalf.

On her way

It's Tuesday morning. I spent the night at the hospital, as Bill did the night before and Peg the night before that.

In the mornings, she seems a bit more responsive, and we've been able to exchange "I love yous."

Just now, as I was typing, one of the nurses, Debbie, came in to check on mom as her shift waa beginning. She asked me how Mom was doing. I told her about our exchanges. Debbie agreed, "Yeah, she's still here. She's all here." I responded, "Yeah, and mom is probably thinking, 'Damn!" That made Mom smile.

The Hospice Staff is here completing paperwork for the transfer, which should happen any minute.

Winding down slowly

Mom has been less and less responsive as the day has worn on, and her breathing has been more and more erratic. One characteristic of the process of dying is apnea, pauses in breathing that can last 30 seconds or more. These pauses don't necessarily mean that her breathing is about to stop. Nevertheless, it's distressing to hear it.

She is being very sensitively cared for and is medicated for pain. Of course, that may have something to do with the non-responsiveness. It's a difficult balance to strike between pain management and over-medication.

Peg talks with her about how she's just about to be joining Jim and that they're going fishing together again. Peg says she detects a slight smile when she says that. I said to her that I was going to miss her very, very much, and her forehead wrinkled. So at some level, she's still with us, even though her body is failing.

Tomorrow morning, she will be transported to Hospice House in Spokane.

Sorry not to be more informative, but it has been long day. What a long, strange trip it's been!

Winding down slowly

Mom has been less and less responsive as the day has worn on, and her breathing has been more and more erratic. One characteristic of the

Why won't God let me go?

Mom has been asking this question of everyone, nurses, ministers, her kids; all say, "Well, I guess God must not be ready."

"He's stubborn," she says.

"Well, you are, too, Mom," we say back.

From the way she seems today, that stubborn ole' God is relenting.

Bill, who spent the night here in her room at the hospital, said that she slept peacefully, but when she woke up, she seemed to have a fever, her breathing was erratic, and she seemed to be delirious. He texted Peg and me, who were at her house having morning coffee and getting ready to come to the hospital anyway. We got here quickly and saw that

She is definitely weaker today. Hospice organization is sizing up her status to be tranported to the Hospice House.

A musical thanatologist came with her harp and played very soothingly for about a half hour. We warned her not to get confused when the harp music began. It's not angels at the pearly gates.