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Twenty years ago this summer my mom had triple bypass surgery and ten years before that she had a cardiac arrest which was treated with an angioplasty, the treatment of choice at the time.  Her recovery from the bypass was difficult, her heart just didn’t want to resume its regular rhythm and she returned to the hospital three times during the next year for congestive heart failure.  During that time I started house hunting for a place that would be comfortable for both of us, the doctors didn’t think she should live alone. Whenever she wa up to it she would tag along.  I think the thought of living with me was scary enough to affect a speedy recovery, by years end she was back to her busy schedule playing bridge and mall walking every morning with friends.

Flash forward fourteen years, add a diagnosis of macular degeneration and progressing dementia and it was time for the move.  She had the option of a live-in helper, assisted living senior community or living with me.  Being a private person and not comfortable with strangers, she chose to move in with me.  After some major adjustments we settled in to a comfortable routine. We went shopping weekly, mom always pushed the cart, it gave her a sense of security but more that one person said “you make your mom push the cart?!”   Every time anyone asked how she was doing I’d say “she’s like the Energizer bunny, she keeps going and going”. Over the years she gravitated from being fully mobile to using a cane for balance and finally a walker but it was like living near a runway, she was up and down the hallway from her room to the kitchen, past my room several times a day.

The dementia worsened considerably in the last eighteen months.  I had alway believed I’d rather lose my mind than my physical abilities but after watching mom’s struggle with feeling confused and realizing she couldn’t sort things out in her mind or understand TV programs or books on tape because she couldn’t follow the plot, I realized that was the greater trap and invoked much greater suffering.  She was literally trapped in her body but didn’t feel comfortable going places or even taking a walk, going out of the house became less and less of a pleasant diversion and so she sat in her room most days, lost in her circular thoughts and confusion.  She had a caregiver for a few hours each day while I was gone to work and they played cards, talked and she enjoyed being read to, mostly dog stories, she loved animals and enjoyed the company.

She enjoyed occasional trips with my brother and even went as far as new Zealand, camping and hiking the countryside about three years ago.  It was a wonderful respite for me, it had been difficult going anywhere for more than a day, arrangements had to be made for her care, and it was good for her since she felt left out of the routine here because she was unable to do household chores and participate in the activities of keeping a home that she had done for over forty years.

It came swiftly and unexpectedly, on Saturday evening she didn’t have much of an appetite and only ate a couple of bites of the delicious homemade soup we were having but I chalked it up to eating more lunch than usual or something, but on Sunday morning she still didn’t want to get up for breakfast before I left for church. I had talked to my brother the night before and he decided to make a trip to visit and said he’d send me the itinerary, she had been finding it harder and harder to get up out of her chair and seemed to be declining quickly. I thought I’d just wait until I got home after church and have a nice brunch with her on Sunday.  When I returned my son had already gotten her out to the kitchen and given her breakfast.  She had struggled with a bite of the coffee cake and barely tasted the cereal.  I asked her if she was feeling alright and she said she felt sick but could explain any more than that.  She denied having any discomfort, just a general sense of not feeling “well”.  So I asked if she wanted to go in and lie down for a nap and she agreed.  It had been harder for her to get up out of the chair for the past few days so I walked with her back into her room and helped her onto the bed and covered her with a blanket, she had complained of being cold for the past couple of years and always covered with an electric lap blanket when she was sitting in her chair.

That evening she still didn’t feel up to eating and I was beginning to have misgivings but didn’t think a trip to the ER or hospital would be a good idea, it would be really unpleasant for her to have to struggle to go out and then be poked and prodded with tests.  I guess I knew in my gut that the end was near and I also knew she didn’t want any heroic efforts being made, she had an “advance directive” on file, I also knew my brother would be here the next afternoon and she’d really like that, he was the apple of her eye.  He called her that evening and she was happy to hear from him.  I could hear them talking for some time and finally fell asleep myself around ten.  I left the door to my room ajar, at a little after midnight I heard her calling and hurried down the hallway to find her on the edge of the bed asking for help to go to the toilet.  It was a struggle for her to stand up and when we returned to the bedroom I changed and bathed her.  I pulled the bench from the foot of the bed to the side and sat with her as she tried to make sense of everything.  “Just relax, breathe, focus on your breath and think of one of your favorite places, visualize the scene” I said as I stroked her hair and held her hand.  After about a half hour she quieted and I went back to bed.  I woke up about 5:30 and went to check in with her, she seemed to be sleeping soundly for a change and was breathing deeply and evenly.  She looked more peaceful than i had seen her in a long time.  The dogs were anxious to be fed and the coffee waited to be started, I headed for the kitchen and decided not to set out Mom’s breakfast until she woke up then went back to see her about 6:30.  As I enter the room it was quiet, too still, and I knew she was gone, it had come so swiftly, only 72 hours since she first felt “unwell”.  I brushed her hair back from her forehead and caressed her cheek.  It was soft and warm.  I checked her pulse…nothing.  I sat down, said a prayer of thanks, and thought about the day ahead…it would be challenging but a blessing especially for Mom.  Goodbye dear one, go be with all those who have gone before…