Nobody wants to spend time in a hospice center. We
might imagine hushed hallways, weeping family members, and quiet conversations. We may have vague notions of uniquely kind nurses who minister to the dying, but we think of them as sad, dreary places. At least that was my impression of a
hospice center, before spending time in one, at the end of my mother’s life.
Hospice was all of those things. And more.
My 87-year-old mother entered hospice care after a
serious heart attack that damaged her heart. Another pressing problem was the
damage inflicted by CPR.
On television shows, CPR looks like a miraculous,
magical technique. Indeed, it is miraculous, and it saves lives. However, it
also shatters ribs, damages muscles, and yanks tissue away from bones. After
CPR, every breath she took was excruciating for Mom. She groaned when she had
to take pills and shrieked in pain when the nurses moved her arm or performed the
most minor of procedures. Even when in a heavily drugged sleep, the grimace of facial
muscles gave away the degree of her pain.
My mother was never one to fuss much about pain.
She’d had eleven spinal surgeries, and many, many medical procedures. She
didn’t complain. But this was different.
It is terrible to watch a loved one suffer. When I
learned that pain relief is the goal of hospice, a sense of relief filled me, because I knew they could make her comfortable. Once it was clear there was no
hope for recovery, Mom made the decision to go to hospice, and I’m grateful she
was able to do that.
The first time I walked into the hospice center,
peace settled over my fretful soul like a warm blanket on a winter’s night. At
first glance, it looked like a hospital. The walls were beige and tan;
paintings of Colorado landscapes adorned the walls. Waiting rooms were large,
with cushiony couches and overstuffed chairs the color of coffee. Boxes of
tissues perched on every table. A beautiful chapel, with a vividly colored
stained glass window, was visible at the end of the hallway.
There was one difference though. It was quiet. Blissfully, peacefully quiet. Beeps
and alarms did not punctuate the air every few minutes. Busy nurses did not rush
through the halls. The smell of antiseptics did not drift in the air. Even
televisions in the rooms seemed hushed, and most were off.
Mom was asleep when my sisters and I arrived, and I
was glad to see her relaxed. I had so feared the transport to hospice. How
could they possibly get her there, when every movement made her writhe in pain? But they did. And I was thankful.
At first, Mom talked with us, in the same animated
way she always had. The chaplain came in and asked questions. She talked about
Oscar and her family. Occasionally, the pain medications would take over, and
she would drift off. We filled in the answers for the chaplain. He told us he
liked LDS patients, because the community was so supportive. However, I knew
one’s religious preference made no difference in this place. The result would
be the same for all, as would the treatment.
We filled out forms and dealt with decisions. The
first time I saw “Choice of funeral home” on the form, it jolted me. Of course,
it shouldn’t have. People come to hospice to die. Everyone knows that. But that phrase on an intake form made it real. Practical decisions would have
to be made.
But not right away.
In truth, we didn’t know how much time she would
have. Would she – could she – linger for months? Would she go in the next 24
hours? We had no idea.
So we sat. Sometimes we watched her sleep. Sometimes
we talked, with her and with each other. I was so relieved to share this
experience with siblings Blaine, Bonnie, and Leanna.
Stan could not come,
because he was hospitalized in Utah. He checked in often, and we all knew he
would be there if he could.
Son Ethan and his wife, Andrea, also came every
night. I was so moved by their sweetness, goodness, and kindness. They stroked
Grandma’s arm. They brought balloons. They brought me an Amazon gift card, to
buy something to read during the long hours. They are young, but they didn’t
act young. They acted like people who have seen illness and death and the
harshness of life. They rose to the occasion.
Friends also came to visit. Some came several times.
Our good friends, Richard, Melody, and Liz, sat by her bedside just like family
members. They brought me diet Cokes and goodies. They took her hand and spoke
lovingly to her. Just like her own children. I knew why they are more like
family than friends.
Other friends came as well, mostly people from
church. It occurred to me that I’d never visited anyone in hospice and helped
me see how important it is.
Making a mental note to be more aware in the future,
I settled in. The first day was long. Mom was in
pain, a great deal of pain. But she was still anchored
firmly in our world, aware of her surroundings, aware of us, aware of suffering. As we sat by her bedside, we learned to recognize subtle
signs – a tightened jaw, clenched fists. We tried to become her
advocate, asking for medication when she couldn’t. We were reluctant to leave
in the evening, but knew she was in good hands.
The next couple of days began with an icy wind outside, sleet
on windshields, and gray skies. This seemed more appropriate than sunshine-yellow days. When we got to the hospice center on day two, things had changed,
much like the weather outside. Mom started seeing
things – babies in the corner, a little cat on her bed, a young girl by the doorway. We could not see
them, but she could. They brought her comfort. It was as if she had one foot in
our world . . . and one foot in another world. She hadn’t gone there yet, but
the journey out of our world was beginning.
This day also brought laughter. Mom kept talking
about the naked men she was seeing. I asked, “Are they good-looking?” She
didn’t answer, but I think they must have been because she kept mentioning
them. We chuckled about the naked men, and wondered what this meant. Angels?
Guardians? Guides?
She also wanted ice cream. Since the heart attack,
she’d only eaten a small cup of Jello, but on this night she wanted vanilla ice
cream. Leanna fed her, and she raved, as if this was ice cream made by angels.
“That’s the best I’ve ever had,” she said. “Leanna, that’s the best thing
you’ve ever done for me.” Then she asked for a second bowl.
Though we all sensed a change, we didn’t know
what it meant. Just that she was closer. She would call out, “Oscar, come and
get me.” She would look in the corners of the room, seeing . . . something. She
would tell us it was a fine day to die.
We told her she could go. We told her we loved her
and that we would be okay without her. She told us over and over that she loved
us. Whenever someone would call, she’d say, “I love you” and delight to hear
their voices. We called her sister, Clarmond, and they said good-bye to each
other, then talked about the bad weather coming to Boise, as if it was any
other day. We reassured her the pain would soon end.
And we sang. When Melody and Richard were there, we
all sang together. Hymns mostly. We would take turns choking up while our voices faltered, but the music kept going. We were the worst choir in
history, but still we sang. We were pretty sure Mom could hear. Some of the
hospice workers came in to listen. One told us she wanted to be in our family.
With each day, it seemed like Mom was more in the
other world than in ours. She would come back occasionally, make a comment or
notice that we were there. But mostly, she slept, lulled by morphine, while her
breathing worsened and her body filled with fluid. We patted her hand and sang
some more. We ate cookies and chips and listened to Ethan serenade her on his bassoon
(including the theme song from Lawrence Welk). We watched, wiping tears and not
knowing what to do, knowing we could do nothing.
It's an odd thing to watch someone leave the world,
but it was obvious that’s exactly what she was doing . . . or had done. She was just waiting for her body to catch up with her soul. We did what
we could to ease the journey, clasping her hand, holding the phone to her ear
when people called, keeping a vigil.
Those of us keeping vigil talked. We laughed at
times. We worked on computers and checked messages on phones. We always
had one eye on her, alert to facial expressions, conscious of her rattling breathing,
aware of imperceptible motions. We were ready to do . . . what, we didn’t know.
We just knew we didn’t want to leave. Sometimes we sat in meditative silence. We wanted to be there. We knew we couldn’t do a thing. We
knew she’d be fine in the gentle hands of the hospice nurses. But we wanted to
be there with her. Needed to be with her, for ourselves, if not for her.
The day she died – four days after entering hospice -
was a bright, sunny day. Of course, as we walked into the center, we didn’t
know it would be her last day. We didn’t know what we would find.
When we came to her room, she was barely conscious, with a few exceptions. She roused briefly for a phone call or two. One was her
granddaughter, Jenna, who called and sang to her. A tiny tear puddled in the
corner of her eye. She also roused when she saw my son, Bryce, who’d flown in from Salt Lake. When he walked into the room, her eyes flitted open,
and she smiled – just for a second - her big, ebullient smile. “Bryce!” she
said, clearly surprised, then added, “Well, I’ll be darned.”
The day proceeded like any other, as we watched,
waited, and listened. Her breathing was slow, but people leave this world on
their own unpredictable timetables, so we didn’t dare to predict or plan. We
discussed whether we wanted to be there when she went. Was that important? We
felt like she was already somewhere else – exactly where she wanted to be.
Almost.
Midday came, and we all went to lunch. It seemed an
ordinary thing to do, but I still remember where we ate, and what we had. After
lunch, we rushed back to hospice. We sat at her bedside and watched her
breathe. Each breath was an effort, and the pauses between breaths shortened.
Still, I thought we had more time. But we didn’t. She
took a breath and Robert, my husband, said, “I think that was her last breath.”
My sisters and I said, no, surely not. But he was right.
We called in the hospice nurse, and she listened to
Mom’s heart. “She’s gone.” The nurse’s voice was small and calm, barely above a
whisper.
I think back to her words often. Yes, she’s gone. But
is a mother ever really gone? Or does she live on in the actions of her
children and grandchildren? She taught us all how to live. She taught us
practical things, like how to sew on buttons and frost a cake. More important,
she gave us gifts of faith, confidence, and the exquisite joy of knowing we
were loved.
As this new stage crystallizes, I wonder about
so many things and ask myself questions. Was I kind enough, during these past
years when the challenges of age became oppressive and ever-present? Could I
have done things better, complained less, spent more time with her?
Of course, the answers are all over the map. I would
be lying if I didn’t admit to feeling occasional frustration the last years at
an endless line-up of doctors’ appointments for an ever-growing list of maladies, irritation at comments I deemed judgmental, or the challenge of scheduling caretaking duties into a busy life. But
I mostly remember the good times.
There are mostly good times. I remember sitting for hours in our living room, talking about the news from church or the latest presidential election, chatting about ordinary problems and happy events, and catching up on family gossip. I remember
adventurous wheelchair hikes in Rocky Mountain National Park and glorious drives through golden mountain aspen every autumn. I remember picnics at a
local pond, Sunday-night dinners, and more celebrations than I can name here. I remember her singing along with Lawrence Welk on Saturday nights and listening to Dr. Oz on weekday afternoons. I remember
her caring – always – about every single member of our family.
These memories are a balm to me now. It is never easy
to say good-bye, but the end of a life brings reflection on how life is lived. My
mom is gone, and it is my turn to live on. I try to do so, with joy and grace, remembering the lessons she taught me. Everyday I’m grateful for I had a mother who showed me the path.
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