Death is not for sissies. This past week was an experience I would not want to repeat. There were moments of beauty and love that will be in my heart forever. But watching someone die is not something I want to do again. Now I know that I will not partake in Hospice work as a volunteer, even though I am trained to do so.
My mother in law (MIL) spent over a week in the hospital. The family dynamics made it a difficult situation. The oldest son wanted control of his parent’s estate and health proxy, but it was given to my sister in law (SIL). My hubby is the middle child and always on the outside looking in. There were arguments that were nothing but my BIL and SIL battling for control.
My MIL was admitted for aspirated pneumonia. She had dementia. She has spent the last couple of years in and out of the hospital and was placed into a nursing home. The place she was in was depressing and ugly. It was close and convenient for my SIL to go to. Mom was kept pretty much in a wheelchair when not in a tiny half room. My SIL moved her out of her private room and told no one. After my father in law passed last September, the family splintered as the SIL was totally in charge of the estate and money and what happened to Mom.
From the moment Mom was in ED, my SIL thought there was hope she would recover completely. She took measures to keep her alive that she should not have. The Wednesday after she was admitted, the charge nurse on the floor pleaded with her to allow her to go into comfort care and be released from her illness. They were suctioning her, giving her nebulizer treatments and she was sustained on high power oxygen. She could not eat. They were giving her mega doses of potassium IV and antibiotics. Her infection stopped spreading, but it did not get better.
Finally, on day six, my SIL agreed to comfort care. BUT….she did not want them giving my MIL any morphine. She felt that was what killed my father in law. Long story but the bottom line is my SIL is very selfish and undereducated and once she gets an idea in her head, there is no changing it. She named the one insistent nurse: Nurse Kevorkian. And she was very upset with the fact that Mom got a variety of nurses, care technicians and PA’s. She hated the PA’s and was quite rude to them. The MD assigned to Mom said she would not make it from day one, but agreed to let my SIL decide when to go to comfort care. Then she liked him.
Finally on day six, she signed Mom over to comfort care, they wanted to immediately removed the IV. My SIL almost changed her mind accept that it was explained to her that it was painful and not doing anything. It took another day for her to agree to have the line removed. She did not want the O2 turned down or changed to normal. The staff, fortunately, have to followed protocol and when we left at night they took her off the high pressure and put her on a very low dose of 02. Mom hated the cannula and pulled it off her face. SIL kept fighting with her to put it back on. When I felt it, I told her there was barely anything coming through and I said to her, “Let’s leave it off for a while.”
But the hardest thing for SIL to understand was the course of medications they give the dying. She kept saying no to anything but they did medicate her. They told her the morphine (they used the name of the drug and not the word morphine in front of her) they were giving her was helping her breath, so she let them administer it. Mom became very agitated and they wanted to give her Ativan to calm her. They tried to give her a pill which of course she could not swallow. But when they came back to give her the Ativan sublingually, SIL had a fit. That made no sense because she was OK with the pill of the same drug. For three hours Mom thrashed about.
But she did drink a sip of water when they tried to give her the pill. My SIL went off the deep end and said she could finally eat and ordered food. They brought trays up of pureed foods which of course she did not eat. But she offered to her son when he was visiting.
Mom spent the next couple of days in and out of it. She would call for Clara. She would smile at me when I leaned over. She knew us. And then the last day, she was totally out of it. She was talking to whoever she saw in her “sleep”. She made hand gestures that indicated that there were people in the room for her. We could not understand her because she often switched to French, which is her native tongue. She would hold out her arm, her fingers grasping for someone. At one point she made the gesture of “you and me” and then smiled. But there were many moments of anguish and pain as her face contorted in a painful grimace. Her body would become rigid and she tried to sit up. She had longer pauses between breaths (apnea) and then would shutter and take the next breath. Her toes were a curled mess. She suffered the indignity of being rolled in the bed to get cleaned up and left for hours in uncomfortable positions when she slipped in the bed. Before they put her on comfort care, she would moan. I never understood how my SIL was not bothered by that.
I was angry at my SIL for allowing my MIL to suffer. The nursing staff was very nice and they would talk to me instead of my SIL because she was so rude to them. They knew not to say anything about drugs in front of her. They would tell me her stats and were very upfront with me. After being there from 9 am on Wednesday, I asked the nurse if she would make it through the night and she felt she would. Although her O2 level was fluctuating, it was rebounding back to 90. We left, my BIL left and then at 9, my SIL left to go home for the night. Mom was sleeping quietly and we all thought she would be there the next day. At 10:15pm, all alone, she crossed over. Eight days and nights of being by her bed and she still died alone. I think she knew my SIL would have freaked.
The next phased of drama is the service and funeral. We talked about the planning of it front of my MIL every day prior to her death. My SIL was going through menus and calling places. One night, she and my hubby wrote the obit and talked about it very loudly in front of my MIL. Then, the next day, she said no more talking like that in front of Mom. She had Googled it and said she found out Mom could hear. I told her that from day one, but what did I know? No matter what anyone said, my SIL wanted what she wanted and that is what would happen. I do not care as I do not believe in big elaborate funerals. Spend the time and money when the person is alive. But at the end of the month, there will be a memorial service and funeral.
Now, the real battle starts as the accounting of the estate will take place and my SIL is going to have a lot of explaining to do. Can’t wait.