Before my Dad died, he often talked about 'dying a good death'. I didn't favor this topic so I never asked my Dad what he meant by that. I didn't want to face the fact that someday I would walk this earth without my parents. Orphaned, if you will. Dad had Asbestosis and a slow-growing tumor that was gradually taking up more space than his organs would allow. According to Mom's journals, it was untreatable and had become a part of his physiology nearly thirty years earlier; unbeknownst to me.
Dad's health gradually deteriorated. Eventually he required oxygen twenty-four hours a day and could barely walk ten steps without taking a rest. This was not my Superhero Dad, invincible protector of those he loved. I ignored all the outward signs and was in denial that my Dad was dying. It wasn't until we had what would be our last family dinner that the light donned. Dad always bought the best cuts of roast beef and Mom cooked it to perfection. It was a banquet of roast beef, Yorkshire pudding, mashed potatoes, Waldorf salad, a tossed green salad, corn, turnips and "Granny's Special Sauce". That's what my kids called Mom's gravy. It was heaven. Dad sat at his usual place at the head of the table, leaning on the arm of his chair. He wasn't able to reach or pass so I helped get his plate ready. When he sat looking at his plate, unable to take a single bite I knew his time was approaching. That was Easter 2003. A few days later he was hospitalized.
I called him in the hospital on his eighty-fifth birthday in May and he seemed adamant that he was going home. Five days later the family was called. He was unresponsive that morning and died early the next day with my Mom at his side. His heart just stopped and he became so very still. I suppose as the process goes this could be described as a good death. It was painless and he had been relatively coherent until near the end. Then he just slipped away. He went home.
I called him in the hospital on his eighty-fifth birthday in May and he seemed adamant that he was going home. Five days later the family was called. He was unresponsive that morning and died early the next day with my Mom at his side. His heart just stopped and he became so very still. I suppose as the process goes this could be described as a good death. It was painless and he had been relatively coherent until near the end. Then he just slipped away. He went home.
My Mom's journey home was not as easy. I would describe her death as an ordeal. She started to go about the business of dying Christmas morning of 2010. Her cast iron stomach was unusually upset and she was out of sorts. During the weeks following the holidays, angina attacks became more frequent and her blood pressure dropped to near cadaver levels. She was weakening, spending more time in bed, refusing meals, acting strangely. At the facility where she was living I told as many who would listen that I thought my Mother was dying. My words fell on deaf ears.
Then on a Saturday in March, nine days before her death she woke up with a terrible sore throat and a cough. Mom's voice was typically a whisper but this sore throat endowed her with the voice of a demon. I advised the nursing staff and they administered Robitussin. The next day she was worse so I asked that a physician see her. I asked repeatedly for five days that she be seen by a doctor. Finally on Friday they faxed the staff doctor who prescribed treatment for either pneumonia or heart failure, sight unseen.
They began administering the medication on Saturday, one week after the onset of her symptoms. Mom was already struggling to breathe due to the buildup of fluid in her lungs and was often in a state of panic when the next breath seemed out of reach. The registered nurse on duty was beckoned but she declined to give her any medication to ease her discomfort, "It might slow her respiration and heart rate." she said. I asked at that time if she thought my Mother was dying. She replied, "Hard to say, some rally from this." When I returned on Sunday morning the situation was much more dire.
The nurse was unable to administer Mom's morning meds because she could no longer swallow. She was unable to speak now and held my hand like it was a lifeline. I left her side for only two hours that day. Her breathing became more labored as the day progressed but not once did anyone advise me to notify my family. At the supper hour, one of the aides came in to turn her and noticed my Mom's breathing. She said, "The way your Mom is breathing is called 'chainstoking'. Death is imminent. Say your goodbyes."
I was in shock - paralyzed with grief. My eyes were almost swollen shut from crying. I hoped help would come. But none arrived. Various aides came to reposition her and greeted her like she was vibrant and healthy and able to respond. I was tired and sore from sitting on a straight-backed chair since seven o'clock that morning with only a two hour break midday. No comfort measures were offered to either one of us. From the supper hour until I finally left Mom's side at one o'clock in the morning not one registered nurse crossed the threshold of her room. I was all she had and I left her. I waited until she closed her eyes in sleep. Then I gently pried my hand from hers, kissed her and told her I was going home for a couple of hours to get some rest. When I got home the first words out of my mouth to my husband were, "I'm a coward. I've left her in her hour of need. But I just couldn't stay any longer."
We were nearly ready to return to Mom's side when the phone rang at six thirty-two the morning of March twenty-first. I was advised by a voice on the phone that my Mom's breathing had worsened. We arrived shortly after to find her alone, her head turned to one side, her eyes closed, and her body so very still. The oxygen mask was still over her face so I removed it and silenced the whir of the machine with a flip of a switch. My husband and I sat there with my Mom in the quiet of death for forty-five minutes before any of the morning staff came into her room. There was some scurrying, the nurse was called and Mom was pronounced dead. Everyone but me seemed so surprised.
Then on a Saturday in March, nine days before her death she woke up with a terrible sore throat and a cough. Mom's voice was typically a whisper but this sore throat endowed her with the voice of a demon. I advised the nursing staff and they administered Robitussin. The next day she was worse so I asked that a physician see her. I asked repeatedly for five days that she be seen by a doctor. Finally on Friday they faxed the staff doctor who prescribed treatment for either pneumonia or heart failure, sight unseen.
They began administering the medication on Saturday, one week after the onset of her symptoms. Mom was already struggling to breathe due to the buildup of fluid in her lungs and was often in a state of panic when the next breath seemed out of reach. The registered nurse on duty was beckoned but she declined to give her any medication to ease her discomfort, "It might slow her respiration and heart rate." she said. I asked at that time if she thought my Mother was dying. She replied, "Hard to say, some rally from this." When I returned on Sunday morning the situation was much more dire.
I was in shock - paralyzed with grief. My eyes were almost swollen shut from crying. I hoped help would come. But none arrived. Various aides came to reposition her and greeted her like she was vibrant and healthy and able to respond. I was tired and sore from sitting on a straight-backed chair since seven o'clock that morning with only a two hour break midday. No comfort measures were offered to either one of us. From the supper hour until I finally left Mom's side at one o'clock in the morning not one registered nurse crossed the threshold of her room. I was all she had and I left her. I waited until she closed her eyes in sleep. Then I gently pried my hand from hers, kissed her and told her I was going home for a couple of hours to get some rest. When I got home the first words out of my mouth to my husband were, "I'm a coward. I've left her in her hour of need. But I just couldn't stay any longer."
We were nearly ready to return to Mom's side when the phone rang at six thirty-two the morning of March twenty-first. I was advised by a voice on the phone that my Mom's breathing had worsened. We arrived shortly after to find her alone, her head turned to one side, her eyes closed, and her body so very still. The oxygen mask was still over her face so I removed it and silenced the whir of the machine with a flip of a switch. My husband and I sat there with my Mom in the quiet of death for forty-five minutes before any of the morning staff came into her room. There was some scurrying, the nurse was called and Mom was pronounced dead. Everyone but me seemed so surprised.
After the memorial service I wrote a letter to the Executive Director of the Facility and cc'd the Minister of Health and Protection for Persons in Care. I outlined succinctly the series of events that lead to my Mom's passing and how I felt they had failed my Mom and me. I received a letter of acknowledgement from the Executive Director weeks later with a cavalier invitation to call her anytime, like we were old friends. I heard nothing from Protection for Persons in Care. Eventually I heard from the Deputy Minister of Health who expressed condolences and advised me to call Patient Relations. Thanks to them, on Friday of this week, five months after my Mom's death I will have a face to face meeting with the Executive Director. I'm not sure what I hope to achieve from this close encounter.
Part of me wants to hold someone's feet to the fire. The other part of me just wants to lay my guilt at abandoning my Mom to rest. I know I can't change the outcome and give my Mom a do-over so she can die a good death. I can't press the call bell or go screaming down the halls now. I'd like to think I can change things for people who have yet to experience losing a loved one in an extended care facility. By speaking out maybe they will be given the comfort and support they need. At least that would give me some peace - some closure. Fingers crossed.
The rest is pixie dust...
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