Showing posts with label end of life care. Show all posts
Showing posts with label end of life care. Show all posts

31 January 2008

Today has been rough

It has been five months since my dad died. I was not certain. I had to count on my fingers to figure it out.

Sometimes it feels like such a long time. Sometimes it feels like it just happened.

Cancer can be so hard on everyone. Both my parents had a brush with it. My father had colon cancer 14 years ago, and survived, miraculously considering the growth in his colon was the size of a large grapefruit. No one expected him to make it. My mother at that time had just lost her sister to pancreatic cancer and a good friend to ovarian cancer, and when she heard the doctor say that my dad had cancer she just sort of shut down. I had just moved back into their household with my five kids (ages 5 - 15), and was working full-time and going to school full-time too. I ended up at times being the primary caretaker for my dad since my mother had such a problem with it all. She had to disconnect a bit in order to get through it all. She knew it but could not help it. It was okay, after all. It was a way to get past it and go on.

About 7 years ago my mother was diagnosed with breast cancer (which did not show up adequately enough for a diagnosis on a mammogram until she'd had it for around two years). This time she was as solid as a rock about it all. I do not know if it was because it was her and not someone she loved that was facing it or what the reason was for the stoic and peaceful approach to the diagnosis and treatments. Perhaps it was because my father had survived his cancer... Maybe inside she was just as upset and simply did not feel she should burden us with that. I was not there much. I do not know.

Anyway she is healthy right now and has been for years now.

However, my father, during a routine checkup at the veteran’s hospital this past June, was told he had some "suspicious" spots in his right lung and something strange on one of his ribs. Next step, bone scans and more tests. In late July the diagnosis came back: Small Cell Lung Cancer - Stage IV, metastasized to left thigh, ribs, spine, left hip and skull, inoperable, 9 months maximum life expectancy. This time my mother took care of everything. Things that no one wants to do. I could not be there this time. I could not help very much at all.

I currently live 600 miles from my parents. It takes between 10 & 11 hours to get there by automobile. My father died on August 31st at 8:45pm. I was somewhere in the middle of central Illinois, trying like mad to get there. I pulled into their driveway just before midnight. They had already taken my father’s body away. My mother fought with them trying to get them to wait for me. But the law required the hospice workers to remove his body from the home immediately.

For me, one of the hardest things about his death was that I waited until noon, because of some stupid meeting at work, to leave Minnesota and drive down to Indiana.

My daily battle is against the tendency to let that fact swamp me and take precedence over the fact that my family went to visit him as many weekends as we could during June, July and August and had wonderful visits, full of stories, tears and laughter each and every time. I did have some time to be with him with full knowledge that his days were limited and I would not be able to be with him any more.

The days that I can remember that go well.

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30 August 2007

My mother called again last night...

My father is dying right before her eyes, a little bit each day.

Yesterday he only had about a tablespoon of water - no food, no other liquids. He seemed to not know my sister.

I called my oldest daughter in Las Vegas and told her she needed to get to Indiana if she wanted to see him while there was any possibility that he would know her or her daughter.

We spent all day today trying to get airline tickets we could afford for her, my granddaughter, and my second daughter. We thought at first the hospice foundation that is associated with the hospice company that is taking care of my dad might be able to help. The people that come to the house to care for him and counsel my family said that there should be funding available.

However, with the increase in airline prices (partially due to the holiday weekend) and the less-than-stellar donation levels this year, we were told that they could only help us with one ticket. One ticket would not do, not at all.

So we kept hunting. Finally my daughter found tickets with US Airways, a red-eye flight that shortens their visit by a day, but is going to cost us considerably less than the $2000.00 we first thought we were going to have to spend. We bought the tickets directly from the airline, which usually costs more, but this time it did not.

So they will be flying out next Tuesday. I hope he is still alive by then. I hope he at least recognizes them at some point while they are there. I hope he does not die while they are there. I do not pray much, but I am praying hard for just those things, nothing more right now, nothing more.

We thought we would have more time with him. All the doctors said months, not weeks, not days, when he was diagnosed earlier this month with metastatic lung cancer. I think he is surprising everyone with his rapid decline.

Perhaps it is not a decline, or at least not a decline in his world. Since when is it a decline to be at rest, at peace, unafraid and calm. I think that is closer to an uplifting than a decline.

I would surely like to think about it in that way...

28 August 2007

The days are speeding by, too fast, too fast...

I should have been calling more often. I keep telling myself "I will call tonight..." then I get home and get started on a project or a book, and the next thing I know, it is too late to call them. They live in a different time zone from us.

Last night I heard from my mother. My father is weakening more rapidly than we expected. He has not eaten - not more than a bite of cereal and a slice of canned peaches - in two or three days. He sleeps all but just a few hours. I do not think he will be with us much longer...

Early last week he went out to breakfast with a friend. The friend, a good friend, came and picked him up. He must have taken the wheelchair, loaded my father into and out of the vehicle and rolled him into McDonalds, and then reversed the process for the trip home.

Breakfast is the only meal that is even slightly worth eating at McDonalds.

When I was a kid, we never went to McDonalds when we went out to eat when my father was going along. He did not think it was real food. But sometime, sometime in the last 10 or 15 years, my father joined the McDonalds' breakfast clique. I find it interesting that no matter where you go, no matter what part of the country you are in, if you stop in a McDonalds early in the morning, it is full of retirees nibbling on egg mcmuffins and hot cakes, sausage biscuit sandwiches and egg burritos, drinking their coffee and juice and talking up a storm.

I think I like that. I wish I would have gone once or twice with my father.

17 August 2007

My Father's Life

People keep asking how my father is doing.

I have no idea how to answer that. I sometimes just say "He is dying." That is the blunt truth, baring a miracle, he will die sometime soon.

Soon is relative though. Soon could be sometime in the next two months, or soon could be sometime in the next year. The uncertainty could get to be overwhelming.

But I do not want to hurt the kind people that ask. So, instead, I usually tell them about his strength... About his peace with all of this... He has said on more than one occasion, "I've had a good life..." and "I don't want people coming over and sitting there crying. I want to have good times with them now. They can cry later, when I'm gone..." I also tell people about wanting to be with him more often than I can be.

He wants all of us to have good memories - good memories from before he became so ill, and good memories of this time too. The first is easy - he has been a great father. The second, well, I am trying... but it is so hard.

I so resent the fact that circumstances have me 10 hours away from him. I would love to be able to check in with him more often. I would love to be able to stop by in the evening, bringing him a chocolate malt (his current food craving), or watch old BBC comedies with him.

I would like to be able to help my mother more too. I know she needs more breaks than she is getting. For so many years he was on the road most of the time - when they first married he worked as an over-the-road truck driver and was gone a great deal; then he worked at Imported Motors, in Indianapolis, driving up there on Monday morning and home on Friday evening; after that he worked for Fiat Roosevelt, with the same sort of schedule; then after a brief interlude working for one of the Fiat dealers, he returned to trucking; and finally, after retiring 10 years ago, he started working as a "drug-runner" for a pharmaceutical company, making deliveries to nursing homes and hospitals over a large area of the state.

During the time when he was away she was used to running things her way. When he was home, he could have it his way. This worked so well for both these strong individuals. Now things are so different for them. The changes have come so suddenly - until the cancer diagnosis last month, he was still working full-time.

Next time Abelisto and I drive down I want to send my mother off with one or two of my daughters, to spend the day in Bloomington or Terre Haute, shopping, eating out, relaxing and having fun together. Abelisto and I will stay with my father so that she can do this without worry or feeling guilty.

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10 August 2007

Strangely intimate...

Today I performed a strangely intimate task for my father - I brushed and cleaned his dentures. At first it made me a bit queasy. I do not know why - it was not gross (although he thought it might seem so to me so that when he asked me he said it was a nasty job and that I did not have to if I did not want to...) but it felt way too personal. I did not even know that his upper teeth were dentures. Whoever made that plate for him made them look just like his original teeth, right down to the gold capped bicuspid he has always had (when I was young and would loose a tooth he would tell me if I could keep from putting my tongue in empty socket my new tooth would grow in gold like his) and the uneven bite that makes his smile so memorable.
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I do not mind using my physical strength to help my father. It is not a big deal to help him move from a prone to a sitting position (although since they gave him a trapeze above his hospice bed he can do it for himself). I do not mind lifting him into his pickup truck. It makes me feel both helpful and powerful to do those things - like a good daughter. Those are things that do not intrude on my comfort level. They cost me nothing, in fact, if I am honest with myself, I think I feed off of them. They make me feel good when I do them.

Cleaning his dentures was different. He hated to ask, but he cannot stand without keeping both hands on his walker. So cleaning his dentures at the bathroom sink is not possible for him to do. Cleaning them in his bed would be a messy, daunting task. He does not want to use the wheel chair inside the house, not yet anyway. I suppose someday he might have to...

Anyway, while cleaning his dentures I felt uneasy, kind of fluttery and odd. It seemed so deeply personal. For years I brushed my kid's teeth every morning and evening. But this was so different, cleaning the disembodied teeth of my father.

I was not sure how to go about cleaning the dentures, so I just slathered them with toothpaste and scrubbed them with his toothbrush. I know I keep going on about how strange it was, but I cannot think of another word to describe it. Anyway, as I scrubbed the teeth and gums it became sort of a meditative exercise (maybe zen, although I do not know exactly what constitutes "zen") and it became supremely important to do this task perfectly for my father.


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