Please forgive me if this post is a little disjointed and for any punctuation and/or spelling errors. My head is spinning from the events of the past few days. I also just discovered I’ve been misspelling pneumonia all weekend.
With both my parents, the process of saying goodbye began so gradually I didn’t even notice.
Dad had Alzheimer’s, and the person he’d been was gone by the time he died, having already disappeared in tiny incremenents. When he died, I was relieved because I knew, wherever he was, he was finally whole for the first time in many years.
Mom lived to 93, so her goodbye lasted longer. As with Dad, it began before I knew it was happening, probably when she got pneumonia in her late fifties or early sixties. When I saw her in the hospital, my normally vibrant mother was scarily wan. Her medical team had also drained an astounding amount of water from her lungs and diagnosed Congestive Heart Failure.
A few years later, she broke her arm for the first time, the result of a simple fall.
I began to understand she wasn’t going to live forever. No one does, obviously, but understanding the ramifications of Mom dying connotes a different level of knowledge that was somehow different from when my father was ill.
She had one knee replaced, re-learned how to walk, then repeated the process with her other one.
Mom continued living her best life, remarried and moved to Florida with her second husband.
When he died, she moved back to Ohio, and for a few years, there were no further mishaps other being diagnosed with Atrial Fibrillation.
Then, in her early eighties, she was diagnosed with cancer. I worried about the resulting surgery, afraid with her age and heart issues she might not make it through, .
I began to prepare for the end, that inevitable part of life most of us prefer to forget. Once again, my concerns proved unwarranted. Mom sailed through surgery and rehab, and went on doing pretty much as she pleased.
She eventually transitioned from a cane to a rollator walker, which enabled her to remain independent, but in the years that followed, there were other medical crises — at least one more bout of pneumonia and several falls — one of which resulted in what the orthopedic surgeon called a “crushed” elbow.
We thought she’d never use her arm again, not an ideal scenario since she had arthritis in the opposite shoulder.
She ended up being fine. But between the falls and the illnesses, there were many mornings I’d have to make an unplanned visit to her apartment because she didn’t pick up my morning check-in call.
Each time, the drive there was spent rehearsing what I needed to do if I found her laying on the floor, injured or dead.
It this sounds morbid to you, you’ve probably never had an eighty-something parent who lived on their own.
Mom would laugh when she saw me at the door.
“What are you doing here?”
I’d say I’d been trying to reach her.
“My phone never rang!” she always exclaimed. “It must have turned off somehow.”
I’d remind her that I called every morning, and if she didn’t hear from me, could she maybe just please ring to say she was ok?
Her reply was the same every time. She was fine, and I didn’t need to drive over just to check on her.
“Yes, Mom,” I’d answer, seething with frustration, “I do. What would happen if you fell again? You could be lying on the floor, and no one would know.”
There were more falls, not as bad as the crushed elbow one, but enough for us to know what was coming. We discussed the future possibility of Mom moving into some kind of long-term care.
Then came a day when Mom just wasn’t herself. My brother and I took her to the doctor who did all the usual doctorly things.
Blood oxygen, blood pressure, pulse, ears and throat … all were fine. And although we still believed something wasn’t quite right, there wasn’t much more her doctor could do.
Two mornings later, it happened again. Mom didn’t answer her phone, and as I drove to her apartment, I prayed my worries would once more be proven wrong.
But she didn’t answer the door, and when I opened it with my key, I heard her weak “Help” coming from the bathroom.
She had gotten up to use the toilet and fallen. Unable to right herself, my 88-year-old mother had lain on the cold floor for hours.
You may be wondering why she wasn’t wearing a life-alert bracelet or necklace.
I don’t know the answer to that. Mom had both, the necklace for daytime, and the bracelet for night. In fact, we’d argued about her habit of taking off the bracelet, then walking to the bathroom before putting on the necklace.
“Mom,” I’d say, “When are you most likely to fall? When you get out of bed or in the middle of the night when you get up to use the bathroom. You have to keep them both by the bed, and swap them before you get up in the morning.”
Yet, there she was, sprawled on the tile in her nightgown, while that damned necklace lay in a dish on the sink, just out of her reach.
Against her protest, I called 911. When the paramedics arrived, they got her off the floor and into a chair where they checked her vital signs. Discovering how low her blood oxygen was, they and I agreed she should go to the hospital for evaluation. There, she was diagnosed with pneumonia again, resulting in a weeklong stay.
Mom never lived independently again. Instead, we moved her into assisted living at a care center in Burbank, and later into their long-term care. The center wasn’t part of a huge chain and was surrounded by fields and trees, with all single rooms. Also, the employees seemed friendly, as if they genuinely cared about their residents.
More importantly, it was only ten-minutes from my brother and the same thirty-minutes from me as her old place — an easy drive for both of us.
It felt like a physical burden had been lifted from my shoulders, knowing the next time Mom fell — and we knew there would be a next time — a nurse would be there to assess and treat any injuries.
Six months later, COVID struck.
News stories about the horrible conditions in nursing homes made us begin to question our decision about Mom’s living arrangements. Death spread rapidly through populations of elderly people with multiple pre-existing health issues, and I avidly tracked the number of employees and residents who fell ill or died in our county.
Mom’s nursing home was one of the few with no fatalities.
It also, we soon realized, had another heretofore unrecognized asset — outside windows on every room of its single story building. We were able to visit face to face with only a screen or window pane between us. Though we couldn’t hug or touch, we could at least see Mom was okay. We even managed to celebrate her 90th birthday with her in lockdown.
She got COVID at least twice, and made a full recovery.
Then came October 2022.
The first phone call: “Kym, your mom fell. We think she broke her hip.”
Second phone call (Mom): “Kym, I fell. They think I broke my hip. It really hurts.”
I think this was the first time I’d ever hear her volunteer that she was in pain.
More bad news followed. Surgery was required to repair the hip, never a great scenario for a 92-year-old with heart problems.
The operation was a long one, mostly because anesthesiologist took his time putting Mom under, but the orthopedic surgeon was happy with the result. The anesthesia, however, threw her for a loop.
The ensuing confusion eventually abated, but never completely subsided, growing worse after each hospitalization.
February 2023: A late-night phone call — Mom was being transported to the hospital, having succumbed to aspiration pneumonia in the less than twelve hours since I’d seen her. To try to prevent further aspiration of food, when she returned to Burbank, her diet was restricted to soft foods.
May 2023: Another late-night call. Mom had fallen again. She’d broken her hip again — the other one this time — which meant more surgery and learning to walk again for the fourth time.
October 2023: Another phone call, another bout of aspiration pneumonia, another week-long hospital stay.
She never could remember breaking either hip. If I mentioned her needing the aide for anything, she’s insist she could <insert task here> on her own. When I’d try to explain that wasn’t true, she’d ask why. And when told her it was because she’d broken both hips, her reply was always “They keep telling me that.”
There were more falls, many more phone calls. The dark cloud of dread began to descend whenever Burbank’s number came up on my phone.
But although Mom’s dementia grew worse, but her sense of humor faded. She made jokes, teased the staff, made everyone smile.
I can’t tell you how many Burbank employees — sometimes ones I’d never even met — would come up to me saying, “I just love your mother. She’s so feisty! I want to be like her when I get old.”
Last Friday, I got another call. Mom was a bit under the weather. The doctor had ordered labs and a chest x-ray, but the nurse didn’t sound too concerned, reassuring me she’d call back with the results. I planned to visit Sunday so I didn’t worry much when I didn’t hear back.
After all, there had been a few times when Mom had gotten a cold and recovered just fine.
This time, however, was different, and when the phone rang at 4 a.m., I jolted awake. Mom’s oxygen levels had plummeted, and she was being transported to the hospital.
When I met her there, the ER doctor reviewed her code status: DNR-CC (Do Not Resuscitate — Comfort Care only). Following these guidelines meant she would receive only the medication necessary to keep her comfortable. It was time to call hospice for their special brand of care.
The doctor explained she would probably be transported to the hospital and eventually to a hospice center. In the end, Mom’s doctor recommended sending her back to Burbank for hospice care in familiar surroundings, a much better option.
I stayed with her for several hours as she settled back into her room. Though her breathing was labored, Mom dozed and seemed fairly comfortable. I knew my Big Brother would be there later, and that we were in for a long hall, so I left for a planned overnight trip to attend a sporting event with Darling Daughter and The Engineer. I’d be back the next day, ready to face the difficult week or weeks ahead.
But that night, in the unfamiliar darkness our hotel room, the phone rang at 3 a.m. I stumbled to the bathroom, closing the door behind me. The nurse at Burbank said Mom needed morphine. She was getting uncomfortable, and this would make her feel better. Did I give my permission?
Of course.
Not five minutes later, another phone call. The nurse thought she was beginning the process of dying.
I rang Big Brother in the hope he could get there in time, but the phone rang again immediately after we spoke.
Mom was gone.
It had been less than 48 hours since she first felt sick. No one expected her to go so fast, yet we are thankful she didn’t suffer long. And I know each of us who loved her wish it had been us — rather than than the nursing aide to whom we will always be grateful — who were next to her.
Despite this, these two thoughts bring me comfort: I know Mom knew she was loved, and ultimately we all experience death alone, no matter who is beside us.
How do you say goodbye? Well, for both my father and my mother, it was slowly — oh, so slowly — and then all at once.
Helen Mildred
28 August 1930 — 7 April 2024.
Rest in peace, Mom. You live on in our hearts.
The Byrd and the Bees 