Goodbye Momma

November 15, 1928 - October 14, 2006

Saturday

The nurse just came in and said that she had taken off the rails of the bed and lowered it so we could sit next to mom and say goodbye, that she didn't think mom would make it through the day. Her apnea is about 45 seconds between breathes and her heart beat is escalating.

Friday Update

Sorry, but I just didn't have a lot of time to post this morning.

We went out and got the ball rolling on the funeral, then took a break over at Borders. Then home for a nap.

Mom's temperature was 102.4 this morning and her apnea is worse. She breathes normally a couple of times and then exhales - I could count to 21 before she took the next breath. Her doctor came to see her yesterday - the first time we'd seen a doctor since this began. She said that since mom could be roused, that it could be another 2 weeks. After Bebo and I picked our jaws off the floor she said "but she could die of a heart attack tonight". It's not that we were disappointed that it wouldn't be sooner, just that Bebo can't take that much off of work and I had planned three weeks at max, but that was supposed to include a week between the funeral and going back to work. So we decided to wait and talk to the hospice nurse - they're the ones that are "in the trenches" so to speak. And besides, we remembered that you could rouse dad on the day that he died. When the nurse arrived this morning, we pounced. We told her what the doctor said and she just rolled her eyes - she said she would not be surprised if mom went this weekend and that keeping to the original time-line of a week to 10 days was more realistic (today is the 6th day). She said that mom's body wouldn't hold out another 2 weeks.

Good news though - at least through the weekend mom has continual hospice care - that means that we have nurses 24 hours a day (hence my time for a nap). I won't have to get up at 2:00 a.m. to give her medicine, or turn her, etc. - at least until Monday. They will re-evaluate the situation then. They provide this care in times of crisis (the nurse deemed us exhausted) and for the last five days of the patients life. So if it continues after the weekend it will be because the hospice people believe that this is the end.So just continue to pray for a quick resolution - when people say they hope they don't sound cruel for saying that, we tell them "it's not like she's getting better - it's going to happen regardless so let it be swift."

Thursday Update

Mom took a turn yesterday. Her heartbeat is now irregular and she has a fever. The fever is not from fighting an infection, but rather a part of the dying process. She had to have a little oxygen and they have now brought in a suction machine. She can no longer cough up any mucus that builds up in her throat. From what I understand this can indicate hours or days until the end.

I understand the need to wait on some things, but there are others that I either want to get done or need to do. I'd like to write the obituary while I'm still thinking clearly, not when I'm grieving. There's bills to pay, bank accounts to balance, ebill options to change, etc. The things that can't wait while this is going on. We need to go to the funeral parlor and set things up (once again while we're thinking clearly). This necessitates finding her life insurance policy. We also want to cash in her IRA while the stock market is still high. Other things, like what will I do about money next month and a job, are being put on the back burner while this is going on.

Tuesday Update

Well, since the SIL said in her comment yesterday (on my other blog) most of what I wanted to post today, I'm just going to copy/paste the comment here:

First & foremost THANK YOU to all for hugs, prayers & your wonderful support. It is much appreciated.Now for Mom: The "cocktail" seems to only be working minimally right now. We keep trying various combinations, but nothing seems to give her relief from the pain in her legs/hips and from the hallucinations for more than 4hrs at a time. She's gurgling periodically & it's awful to hear & know that this is really the signal that the end is so near. Today she responded to us when we were working with her; Friday [Bailey's note - actually, it was Saturday] she recognized her sister. But the brief periods of lucidity only make the reality of this more devastating.I've been helping Eve w/ Mary for the past 6yrs. I love her like another mother & I can tell you that our hearts are simply broken. Yes, I will be staying with them at night now. Family members are coming & going, but not staying. Their presence only disturbs Mary at this point. Hospice is providing meds, equipment & support as well.KEEP PRAYING that Mary is released from this particular hell quickly. She deserves the blessed peace of passing.Personally I would urge all to support your local Alzheimer's Assoc, Hospice or VNA. They are angels in disguise.


Okay, my turn. They put mother on a Fentanyl patch Monday. It is for pain and takes approximately 48 hours to kick in, so in the meantime we are giving her a pain medication every 6 hours (Lortab Elixir). This doesn't always work as she has frequent "breakthrough" pains. I wondered exactly what it was we said to the evaluating nurse on Saturday to cause her to immediately pick up the admission papers and fill them out until the Social Worker handed me a 2 page information sheet last night entitled "The Final Stages of Life - Signs and Symptoms of Approaching Death". The first thing listed was:

Eating and drinking: There is a gradually decreasing need for food and fluids. The body naturally begins to conserve energy and requires less nourishment. At this stage, there is increased risk of choking secondary to confusion and/or the inability to swallow properly. Difficulty swallowing occurs first with solid foods. This progresses to difficulty swallowing fluids. Your loved one will say that he or she doesn't have an appetite and isn't hungry. This is the body's natural response to the dying process. It is telling you that eating and drinking are no longer helpful and that the body can no longer use food and fluid properly.

So I guess when we told her that mom was choking on liquids and refusing food, she knew immediately that the end is near. Mother had difficulty swallowing her pain medication last night - choking and gagging on the liquid. I don't know what they will do when she can no longer swallow it - injections maybe?There is so much I have to do during this time - make funeral arrangements, find insurance policies, change billing options on our utilities, get ready to close bank accounts, etc. My head is full and makes it difficult to concentrate on any one thing.

The Sounds of Silence

It’s finally quiet around here. We had to use a combination of three drugs (Lorazepam, Seroquel and Haloperidol for those interested) to get mom to quit screaming and ranting (Hallucinations), rest, and to get her combativeness under control. Saturday night she hit me while I tried to change her diaper. I am sure you would agree that she would much rather be drugged than to be abusing me. Its so quiet now that it's spooky.

A couple of weeks ago mom began choking on her food – she was losing that part of her brain that told her how to swallow. Last week she began to refuse food and water and we had to force her through coercion, bribery and down-right threats to get her to eat even a little bit. We could have had feeding tubes put in, but that would mean that she would either have to be tied down 24 hours a day or put in a comatose stage in order to keep her from pulling the tubes out. That is no kind of life. If there were a chance that she would get better, that would be different. But this is Alzheimer’s and there is no better. It was decided that there would be no feeding tubes and we would let nature (and God) take its course.

The worse part of this has been the hallucinations – the week-long screaming and ranting rage that lasted almost 24 hours a day (this was before hospice) – my mother lying in bed screaming like an animal and yelling obscenities at people who weren’t there. Also no way to live. The prognosis is a week to 10 days – it really depends upon her physical health (good) and her body fat – so it could be 2 weeks. I will try to keep you updated as things progress.

Mom is going into hospice. She is refusing food and water. At this rate, they believe it will be only a week or two and she will be gone. She is continuing to scream and rant at nothing - she is being tortured by demons only her Alzheimer's brain can see. She needs to be at peace - that is what I pray for.

Screaming

Screaming and screaming, ranting at no one, hour after hour. That's all I hear. The 25 mg of Serezone obviously isn't working, so the doctor upped it to 50 mg tonight. She's still going strong. When I go check on her to ask her why she's screaming, she says she isn't - that woman is. Well, "that woman" can just shut up as far as I'm concerned.

She's starting to have trouble swallowing and she has tremors in her right hand - palsy. She's also developed a bed sore - she resists laying on her side, but we're working on it.

Turning her is causing the arthritis to flare up in my hands. My fingers are often stiff and sore, making typing painful. I've practically stopped blogging, sorry about that. I miss the interaction, but everything is just overwhelming right now. I'm in that black hole that Deb mentioned on her blog the other day. I tried blogging that day, started at the bottom of my list, but only made it to the "S's" before I had to stop.

On Friday, a doctor is coming to the house to evaluate mom for a local Eldercare HouseCall service that one of the hospital runs. If she qualifies (and the physical therapist and the RN thinks she will) then she will no longer have to go to the doctor, they'll come here. Of course, this means switching doctors, but as I've said before, that's no problem for me.

That's all for now, I'll try to update as things go on.