The Final Journey Part 2 (The Last Hospice)

Thursday October 6, 2016

As I sat in the evening and contemplated the decision I made earlier to put Gram on hospice, I thought about all of the wonderful memories. For the past couple of weeks, my life with Gram had been passing before me. Perhaps it was a premonition for what was now happening. At random times, images of wonderful memories and moments would pop into my head. They were special things we did together and things she did for me. There were memories of West View Park, Kennywood Park, Christmases, Thanksgivings, visits to Emlenton, saving me from thunderstorms and fireworks, comforting me during nightmares, high school graduation, college graduations, family day at Gateway Rehab, and many others.

Gram was my rock, my guide, my inspiration, and my friend. She was the first person I wanted to tell when good or bad things happened in my life. Whether it was a new job, new car, buying my house, a new relationship, ending a relationship, or getting sober, I couldn’t wait to tell her.
           These memories made me feel so grateful now, but at the same time, terrified. Even though I hadn’t been able to share things with her over the last several years the way I had before, I still went to her. I still got comfort and strength from her. I had never been able to imagine my life without her. Now I knew I had to.

Where would I be without her? How would I see myself had it not been for her? Would I know how to really care for and love another person? What type of person would I be? These questions churned in my head as I thought about losing her. Then suddenly I flashed back to the day I moved her out of Elmcroft Senior Care.

Leaving Elmcroft was another one of those turning points in Gram’s journey where there was no turning back - another plateau in the disease reached. Gram had been taken to the emergency room because of a urinary tract infection coupled with a C-diff infection. She was very sick and almost died in the ICU, but was subsequently moved to ManorCare. We were convinced she was placed there to die. Even if she survived, Elmcroft wouldn’t take her back with a C-diff infection unless she could test negative three consecutive times. That was unlikely. And the hospital social worker was helping find skilled nursing care if we needed it. I had to move her out.

She didn’t have much there, but it took me hours that day to move her out of that room. My sobbing continually interrupted the packing and emptying process and I’d find myself alone, sitting on the bed or in the chair, paralyzed in my own emotions. It was a slow, difficult process.

But now, when Dr. Woodburn’s physician’s assistant called me, after seeing Gram, and suggested hospice, she said, “She’ll get the extra help that she needs at mealtime. Maybe she’ll eat better.”
            “Ok,” I agreed. 

Although a momentary surge of hope went through me, I didn’t have a good feeling this time. Even though Gram had been on hospice twice before and discharged, this time felt different. She was only 105 pounds. She lost two pounds in just the last week and 12 since late July. My milkshake routine didn't seem to be working. Yes, I hoped hospice would get her additional attention at mealtime and just maybe she’d start eating again, but I didn’t think she was going to recover for the long term. I most certainly, though, didn’t think she’d be gone inside a week either.

Eating had become such an issue lately with Gram. She had actually become angry about it. That’s also why this time was different. “I don’t want it,” She’d yell when I tried to feed her. She even began throwing food at me, like the french fries she flung at me when I tried to put them in her mouth. Perhaps she made her decision then. Perhaps that was her way of saying, “I’m done.” We always said Gram would decide when it was her time. In hindsight, I think she had.

The physician’s assistant contacted Heartland Hospice. It wasn’t long before the hospice liaison contacted me and we planned to meet the next day at 1 p.m. in Gram’s room at ManorCare to sign the papers. I was sad. At that point, I thought the worst part of going on hospice was taking her off blood thinners and knowing that a clot could form, travel to her lungs or brain, and kill her. Later, I would find out it really wasn’t a big deal and eliminating the blood thinners was necessary.

When I visited Gram the night before, she wouldn’t even drink the milkshake. She was somewhat talkative, but her voice was soft and strained. She was weak, I could tell. She made mostly random sounds, but at one point said, “That Sandy is a good boy.” (Sandy was Jude’s old dog). Where did that come from? I thought, as she continued on with the random sounds, Later, right before I left, she managed to clearly speak the words, “I have to get the hell outta here.”

But on this night, she lay in her bed, asleep and peaceful. She was breathing so lightly, it was if she was already dead, except her heart was beating.