Medical update — 041211

Mom’s been slowly declining since Saturday.  While her vital signs hold steady, she keeps asserting her strongest desire to be done; to leave her body behind; to be with Jesus.  Naturally, others want her to stay.  No matter…when it’s time, it’s time; Mom can’t hasten it, no human can stop it.

She drinks water like a fish, yet stopped taking liquids (other than that administered via IV drip) over two days ago.  She has a healthy appetite, and puts a dent in each of her three meals a day.  This, too, she stopped a couple of days ago.

Even in her delirium, Mom made it emphatically clear that she wanted “to go home,” and wanted nothing to do with anything that would keep her here.

Seeing the end in sight, I called Elizabeth in Maryland who drove late at night to be with her mother at the hospital.  I called Michael in Germany, who made flight plans.  I called key people in Mom’s life to keep them up to date on these going-on.

I recalled the wonderful experience we’d had with my father’s passing while in Palliative care last August.  I inquired whether Mom fit the criteria for that level of care.  Yes, the doctor said; she did.

After a long and difficult day, Mom was moved one floor down to the hospital Palliative Care Unit late this afternoon.  This was her third room transfer since arriving at the hospital on Saturday.  In an increasingly rare moment of clarity, Mom asked me if this would be her last move.  I assured her that it was.

This was a room with subdued lighting, soft music to her liking, a large couch and several stuffed chairs for guests; the assumption being that visitors would stay longer than usual.

Then the first of many people came to visit.  It’s not like she hasn’t had visitors before, but, suddenly, Mom became energized, and she engaged in coherent and meaningful dialog with each guest…even with her nurses.

I was stunned.  I realized immediately that I had absolutely no control over what was happening.  Mom would become exhausted, I feared, and this would harm her in some way.  But my mother and her guests had other ideas, and I had to resign myself to allowing what would happen to happen.  Mom has many, many relationships that go well beyond friendship, and these relationships blossomed yet again today.

I was also confused.  I talked with Mom’s PCU nurse who, beside being a professional, is also a Believer, and had participated in the first of several dialogs held by Mom and her guests today.  I told Mary of the sweetness of Palliative Care when my father needed it; that he passed away in as much peace and comfort as could possibly have been given him.  I asked, in light of her faith and her profession, what was happening here.  Was Mom or wasn’t Mom qualified to be on this floor?

Mary explained that people sometimes bounce back…at any level of care including Palliative.  She differentiated Palliative from Hospice where the clinical assumption is that the patient was soon to die.  Her type of care respected the patient’s final wishes, did not respond to “codes” (i.e. resuscitation upon heart failure), and generally gave the patient every aesthetic and real comfort possible.  Yet, she said again, patients do sometimes bounce back.

Mom didn’t just bounce back today, she asked for and ate an entire meal without help.  Mary said that Mom could be gone from this world tomorrow.  But more likely – given evidence so presently visible – she could soon be released to the appropriate level of care outside of her institution; even possibly returning to her much-cherished room at Piedmont Place.

I quickly understood the incompleteness of my knowledge base — just as I have many times before.  I feared that I had ‘pulled the trigger’ too soon on the final notifications to friends.  I realized that more than two days without sleep was making me cranky, and had removed from me the ability to make good decisions.

Elizabeth wanted to stay tonight at the hospital.  After a phony attempt to convince her otherwise, I went home.

I have no idea what tomorrow brings.  But then, I’m not supposed to, am I?

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About FredMarx

Old enough to have wisdom; young enough to learn.
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