Thursday, October 18, 2012

His last days

Little did I know that the "walk" I had with him on October 7, 2012, would be the last on this earth. On Wednesday, October 10, 2012, at 11:36pm, my beloved father passed from this earth to his eternal home.

On the evening of October 8, the nursing home called to tell me that after he had eaten his meal, he vomited and had loose bowels and then became unresponsive. His breathing rate also increased some, and his oxygen saturation went down. They had cleaned him up then put him in bed and put him on oxygen. My husband and I went with our daughter to go see him. I went in first, and when I spoke to him and told him who I was and rubbed his arms, he began to move around and I could tell by his body language and facial expression that he knew I was there, even though his eyes remained closed.

We stayed with him about an hour or so, and I held his hand and tried to make sure he was comfortable. My daughter held his hand briefly a couple of times as well. At that point I didn't know if this was a temporary or permanent downturn in his condition. His breathing wasn't that bad yet, just a little bit faster than normal. He wasn't taking food or drink, though, despite their best efforts, but again, I didn't know if it was only temporary. He would also move his hands to his stomach area from time to time and wince a little as if in some pain. A couple of times, he did try to open his eyes, as if to look at me, but was only able to do so for a few seconds before closing them again.

The physician's assistant came by and examined him and talked with us briefly, then said he would be back the next morning to check on him again. They said they would put him on some Tylenol for the pain. I had already called my brother, so he came as well. As soon as he came in the room and spoke to my dad, my dad began moving around and even tried to sit up, and his eyes opened slightly for a brief moment before they closed again. My brother told me later that after my husband, daughter and I had left, our dad had opened his eyes again briefly to try and look at him.

That night I had trouble sleeping, despite my best efforts to relax. Then next morning I went to see him again after dropping my daughter off at school. He seemed about the same, except he appeared to be in more pain, though his eyes remained closed. I spent a couple of hours with him, and spoke with the resident RN who was there at that time, as well as the physician's assistant when he came by again. We discussed what might be going on and what the next steps were. Their best guess what that he had an infection in his lungs, which the antibiotics he had been on had not helped. The physician's assistant talked about doing another chest x-ray. My dad had just finished a second round of antibiotics, which was a different type from the first one he had been on. We talked about trying another round. After giving it some thought and praying for wisdom, I felt it would be best not to, and the physician's assistant and RN agreed, as well as my step mom when they called her. Their thinking was the same as mine, that if two rounds of antibiotics had not helped, then why do a third round at this point and risk giving him nausea as a side effect. We also all agreed to go ahead and order a low dose of pain medication to be given every few hours.

After picking up my daughter from school that day, we went to visit my step mom in the Rehab Center. On the way back home, something was urging me to go back by and see my dad again, despite having my daughter with me and needing to get her home since it was a school night. I'm so glad now that I listened. When we got there, his breathing was markedly worse. Not only was he breathing much faster, he also had the sound of thick congestion in his lungs, which you could hear with every breath. The one positive thing is that the pain medication was helping, he was no longer wincing in pain. I stayed as long as I could, holding his hand and making sure he was comfortable.

Thinking it might help some, they suctioned him while I went out of the room with my daughter, then began trying to give him a breathing treatment. Giving him the breathing treatment was no easy task. Since he couldn't hold anything in his mouth, they had to put a mask on him so that he could breathe it in, but he clearly didn't want the mask, and began fighting to take it off. We tried, in vain, to stop him and convince him to leave it on. I was amazed at how strong he still was. Finally they had me hold the mask right in front of his face so that he would simply breathe it in naturally, which he allowed me to do. It didn't seem to help with his breathing or congestion, however, at least not that I could tell.

At one point I hugged him and told him that it was from (my step mom's name). I told him she would be there with him if she could, but that she was still in a Rehab Center, and that she was slowly getting better. As clear as day, his facial expression changed and he nodded in acknowledgement. Later I told my step mom about that moment, and my hope is that it helped ease the pain in some way of her not being able to be there in person.

I didn't want to leave that night, but I had to get my daughter home. I knew he had all the signs that it wouldn't be much longer, and was expecting them to call sometime during the night. I still held out hope, of course, that something would change and that he would suddenly get better again, but I also knew that it may simply be his time to go. My dad was upgraded to critical care status with Hospice, and a nurse was called in to sit with him overnight. That made me feel better to know that someone would be with him.

At about 11:40pm, the phone rang. I knew who it was. The hospice nurse said it was that it was peaceful, that he simply slowed down his breathing gradually, then stopped.

The Memorial Service in celebration of my father's life was held this past Monday. It was very nice. Five of my father's former employees spoke about him, and I was awed by their words. My father helped so many people and had a much greater effect on peoples' lives than I ever realized. I take comfort in the fact that my father's influence will continue to live on through many in this community and all over the country.

I also take comfort in knowing that he very likely at some point along the way returned to the faith he knew in his younger years as the son of a Baptist preacher--according to the book of John in the Holy Bible--and therefore is now in no more pain or suffering, but is in Heaven praising God, full of joy and peace, reunited with family and friends who preceded him and held the same belief, including someone very close to my heart - my precious mother.




Sunday, October 7, 2012

"Walking" hand in hand

Today my dad was having one of his better days. When I arrived, he was slumped over in his wheelchair sound asleep and it concerned me at first when he didn't respond to my touch, but then I hugged him from the side and spoke louder to him, rubbing his arm, and he woke up then.

It was only moments before he was ready to rock and roll, so off we went. Because of my foot being hurt and still swollen a bit, I wanted to sit with him at a table the whole time, so my daughter and I could sit down while visiting with him, so I directed him to a table that had a missing chair, rolled him up under it, and locked his wheelchair. About ten minutes went by with him growing more and more restless, though we did get to enjoy being with him during that time, but then I decided to let him roam, since it makes him happy. So I unlocked him and off we went again, and my daughter went to the counter at the nurses' station to play with a puzzle.

This time I decided to walk beside him and hold his hand as he rolled himself along with his feet, versus guiding him from behind. I could tell he really liked that. We walked to one end of his residence area, then he turned himself around and we walked to the other end, and back and forth again a couple of times. I could sense how relaxed and content he was.

At one point, a nurse was coming on shift who really likes my dad and she came over to say Hi to him while we were walking, but he didn't like that too much. It was comical watching him let her know with facial expression and body language alone that he was with his daughter and enjoying walking with her and wanted nothing to do with anything else.

Someone reading this might ask, "Are you sure your dad knows who you are? That you're even his daughter?" And my answer is, "Yes, I think he does." While we were still sitting at the table, there was a moment when his facial expression came alive, he looked right at me, then smiled and said, "Well Hello there." It wasn't a Hello you would give a stranger you had just met, or even just someone familiar. It was a Hello a father would give to a daughter. The same Hello he used to give me all the time before Alzheimer's even entered the picture.

I enjoyed walking with him, too. My foot hurt after that, but it was worth it. It was something I could do with him, since we can't have any kind of real conversation anymore. Funny how just being together can mean so much sometimes, no words required.

Saturday, October 6, 2012

Hospice

It's been a long time since my last post. I didn't really feel much like writing in my Blog for a period of time, but now I'm ready.

I'm not sure where to start, so I'll just start with the most recent happenings. My dad's ability to swallow has declined considerably, and he is now on a thick-liquid-only diet. He aspirates fluid on a regular basis now, and it goes into his lungs. Sometimes I find him not doing well, and can hear a gurgle when he tries to talk. Other times, I find him doing better, like the last visit on Friday morning when he was talking clearly, breathing fine, and VERY feisty. He was "running" all over the place in his wheelchair, going into other residents' rooms, on a mission of some sort.

A feeding tube was recommended for my dad, but in his Will, way back before he was even diagnosed with Alzheimer's, he specified that if his health ever declined to the point where a permanent feeding tube would be required, that he did not want one.

His doctor recommended that Hospice be brought in. They do that when they believe their patient is declining to the point that they feel they have less than a year to go. I was the one who had to meet with Hospice to discuss it, and thankfully my husband was there with me. It was harder than I thought it would be, but I got through it. The reason I was the one who had to do it versus my step mom is because something has happened to her as well, and she is now in a Rehab Center.

Let me explain. A few weeks ago, my healthy, very active step mom was meeting with some of the staff at my dad's nursing home to talk about my dad, and had a brain hemorrhage. Thankfully, there were nurses present. She said she was dizzy, then became weak and closed her eyes, and began vomiting. I was also in the nursing home that day, with my daughter, in visiting with my dad, with no clue whatsoever that my step mom was meeting with the staff in another part of the nursing home. They had tried to call me when it happened, but when my phone rang, I didn't recognize the number (that nursing home had never called me prior to that), so I let it go to voice mail. Something was telling me to answer it, but I didn't want to interrupt the time with my dad. I figured I would check the voice mail later. Then as I was leaving the nursing home with my daughter, we walked out the front door and saw the emergency vehicles parked at the entrance to the nursing home, idling, lights flashing, but no one inside the vehicles, so I figured they must already be inside. Something "checked" in my spirit and it made me pause, and I wondered who they were there for, and prayed that God would be with them and help them. Little did I know at the time that I was praying for my step mom.

When I got home, I still had not checked the voice mail. It wasn't until about an hour later that I remembered to check it. I could not believe what I was hearing. I called them back immediately and spoke with one of the nurses to get more details, then asked what time it had happened. It was then that I realized I was THERE when it was happening and was kicking myself swiftly in the rear. I found out what hospital they had taken her to and since my husband was about to get home, I waited for him and we all went to the emergency room. They didn't know yet what was wrong with her and were running tests. After finding out it was a brain hemorrhage and that it could go either way--get much worse, or stop bleeding--we prayed hard that it would stop, and were so thankful and relieved when the second CAT scan showed that the hemorrhage had stayed the same size and had not grown. She was transferred to another hospital, where she stayed for several days, and was then moved to a Rehab Center. Her recovery has been painstakingly slow... she is still having double vision and feels dizzy if she tries to sit up for too long... but we are continuing to pray and hoping for the best.