Wednesday, November 22, 2006

Never mind

Eh, I'm not making pie this week. I'd have had to make the dough for the crust today, and have to find time to bake tomorrow, and know for sure if we were going up north for the holiday. My last remaining grandparent, my late dad's mother, is easing toward death.

A couple weeks ago, she'd ended up in the hospital yet again, and the medical specialists all agreed that there was really nothing more they could do to remedy matters, and they recommended that my grandma consider hospice care. So she returned to the nursing home that's been her home this year (and she likes it there—the staff adores her. The lunch lady pops in to visit every day, and a young maintenance guy checked on Gram this evening) a week and a half ago, agreeing to stay there and receive palliative care rather than returning to the hospital. We figured she had months to go, but she had a precipitous decline yesterday morning.

The hospice nurses and volunteers who visit Gram have indicated that she's been showing a number of textbook signs that she's near the end of her life now. The best guess seems to be that she has a few more days left. So I spent all day yesterday, this morning, and this evening visiting her, along with assorted cousins, cousins' kids, and uncles.

I think hospice care is a wonderful thing. It's not just for cancer patients—Gram's got end-stage congestive heart failure and she's 94. She seems pretty ready to die, and her body's slowing down—she's hardly eating or drinking, she sleeps most of the time, and she's not upset. She even seems slightly peeved that every time she peeps open an eyelid, somebody starts in on her with "Are you comfortable? Do you need anything? Do you want a sip of juice? Do you have any pain? Are you cold? Are you hot?" Invariably, she says she's fine. (She gets a little morphine to ease breathing difficulties.) The hospice approach seems orders of magnitude more humane than the average hospital death. No heart monitor beeping, no IV needle prickling in her vein, no being intubated, no hospital schedules, no pointless prolongation of life + suffering. The hospice volunteers and nurses are so incredibly helpful to family members, too, as the hospice approach is to ease the process of death for everyone involved. I truly believe my grandmother will have a good death, and she deserves no less after the long life she's led and the physical and psychic pain she's experienced.

It's exhausting, what with all the 30-mile drives and tapping into emotional reserves. Ideally, perhaps, Grandma would have died peacefully in her sleep after a really good day. Second best is dying when she's had time to prepare herself for it, when she's had all her family gathered around and saying their goodbyes, when the hospice protocol is focused on keeping her comfortable at all times. Hospice doesn't mean giving up hope—it means you stop expecting successful treatment of medical conditions and instead focus on giving someone the best and least stressful end of life possible. It really has been a moving experience so far, and I'm honored to be able to share some of that time with my grandmother.


The Scarlet Pervygirl said...

I'm sad and happy for you at the same time; I'm sorry this is happening, but I'm glad that, since it is, it's happening in a way that's good for your grandmother and a little easier on you. I wish you all well, and I hope things continue in a way that's okay for her and for you.

Cricket said...

Hospice is a graceful way to die. After living such a long, full life, your grandmother deserves a big dose of grace. It sounds like you have peace about it, too.

Klynn said...

I lost my dad to lung cancer in 1999, and for the last 2 1/2 months of his life, Mom and I took care of him, with a daily visit from hospice to manage his meds, and to help us bathe him. (He was 54). Hospice was a blessing for us. When Dad passed, we called the hospice nurse, and she actually delayed calling the authorities, so that Dad's sister could come from an hour away, and say her final goodbyes before they took his body away to be cremated.

It sounds like your grandmother is prepared and accepting of what is to come. So glad that your family is able to be close and visit her.

I hope that she stays comfortable, and able to enjoy the love that is pouring out from her visitors, and is able to go peacefully and with dignity.

E. said...

Oh, please let me have hospice care instead of a hospital if I am lucky enough to make it to old old age.

I lost my two remaining grandparents within 9 months of each other a couple years back, and I was very grateful to be able to spend lots of time with them at the end. (Though making the 100 mile drive was tiring.) It was hard to see those good and very dear people go, but nice that they both died at home and with family nearby.

Orange said...

Okay, the pies are in the oven. The crust is ugly, but maybe it will taste good 'n' buttery. One pie with a veritable crapload of pecans (hey, people with colitis or diverticulitis do react badly to nuts), one with a pecan crapload plus chocolate chips. Mr. Tangerine is perplexed: If we're taking two pies up north tomorrow (after visiting Gram on the way), how are we going to be able to eat some tonight? Ah, the eternal struggle between man and virgin pie.

Anonymous said...

My sister-in-law was not pleased when she discovered that we the apple pie I made this afternoon was not on tonight's dinner menu. Ah, well, anticipation is good for the appetite.

You and your family are in my thoughts.

Jenni, occasional hospice doc, who heartily agrees with your assessment of the care

Feral Mom said...

Sorry to hear about your grandma, but happy to hear that she's in hospice--hospice rules--and that you're able to spend time with her. I imagine it means a lot to her as well.

DoctorMama said...

I will miss your updates on your granny.

Hospice is fantastic. This makes me think I should add a hospice requirement to my living will. If I had one. And if anyone paid attention to them.

I have to say, though, I hate pecan pie. Turns my stomach just to hear about it.

Larki said...

I was a hospice nurse for a while, and I cannot tell you how good it is to hear that you and your grandmother and your whole family are together, peaceful, and comfortable (physically) so that you can move through this death in the best possible way.

I'll be thinking of y'all, especially you and your grandmother.

Julie said...

Hospice care is truly a good thing and something for which hospitals usually take great care in developing a good program. I'm glad it was an option for your family and that your grandmother passes peacefully and respectfully. Love to your family...

Anonymous said...

All the best to you and your family.

Both my grams were guided in their final days by hospice angels. Wonderful strength and love that those folks have.
My mom now works for a hospice/homecare doing intakes, and it's nice to know that the people are honestly all there because they do care. All sorts, all reasons, all conditions. They are often independant companies, not affiliated with any hospital.
Enjoy your family.

Krupskaya said...

Mr. K's grandma had in-home hospice care for the last two weeks or so of her life. I don't often use this word, but it was a blessing, and she went the way she wanted. Y'all are in my thoughts and I wish you all the comfort and strength you need.