Sunday, May 28, 2017
A little over a month ago, Steve and I were driving up to Amherst to visit with family, and about five hours into the trip, we got a phone call from a very polite police officer who told us that my mother had pushed her Medical Alert button, and that they were at our house, but there was no answer at the door. We gave him the code to the garage door, and he and the EMTs went in and found her on the floor in her apartment. She had fallen and could not get up (just like in the commercials). So they took her to the Emergency Room. In the mean time, I was able to contact our wonderful Geriatric Care Manager, Deb Soltis, who met her at the ER, and stayed with her until we could get there. She also texted me and let me know that the X-rays showed left hip and left elbow fractures.
When we got there, the Emergency Room doctor had already asked her about surgery and she had refused, and I confirmed that she did not want surgery. The truth is that for the previous six months she had been on a steady downward trajectory due to increasing sciatic pain. She had tried medication and physical therapy, but had gotten no relief. She was more and more dependent on a walker, and in the month prior to her fall, she was really only comfortable in bed or in her recliner. For an active, social person, this was not the life she wanted. She also had stated on many occasions that she did not want surgery, specifically for a broken hip, because of her experience with her own mother.
So our goal was very clear: to get as much pain relief as possible so she could be comfortable. Because of the two fractures, our original plan, which is that she would return home with home health care, was no longer practical...it took two and sometimes three people to move her. Luckily, Deb found out that two of our local Continuing Care Retirement Communities had available beds in their nursing home units, and since I knew that both provided excellent care, we chose one of them. She spent four days in the hospital, and during the first two it seemed that she might rally. She talked about having her card-playing friends in for games, and she knew people at the Community she was going to. However, as the reality sank in that she would never walk again and that she would be totally dependent on others for personal care, she began to withdraw into herself. We also suspect that she may have had a stroke around this time. She had a history of small strokes, and this time her speech was slurred and she was very disoriented. At this point she stopped wanting to talk to anyone who called, and she was very clear that she did not want visitors. She directed me to tell them that she did not want them to see her the way she was now, and that she wanted everyone to remember her the way she was the last time they saw her.
She was transferred to the nursing home, where we tried therapies, but in the end they were discontinued because she really did not want to do anything except lie in bed. Over the next ten days she gradually slipped away, finally succumbing to pneumonia.
While this has been a very difficult time, I feel good about the planning we had done, as well as about my ability to grant her wishes. In her last months, as her pain and disability increased, she talked more and more about being ready to die. When the fall happened (which may well have been the result of a small stroke), she knew and I knew that this might well precipitate the end for her. I won't pretend that made it easier to watch, but it made it much easier for me to be certain that I was carrying out her wishes. In the end, she had about six months of declining mobility, and two weeks of letting go of life. She was 91 years old, and she had a long, full life. Now I'm glad she's at peace.