Wednesday, November 9, 2011

Not Much Longer

I sat and held my dad's hand for a while tonight. It was cold as ice, though for the last few days this normally heat-loving guy has fought his blankets away. I pulled them up again while holding his hand, and he didn't fight, me or the blankets. He was pretty unresponsive in all respects. I expect they'll be pushed to arm's limit away again by the time I finish this.

It's hard to get any water into him now. He doesn't get fully alert, and swallowing anything under those conditions is risking choking. There's barely enough lung left to enable him to cough something out. Yesterday was the last day he got any food in. We had him drinking juice for a while to get him some nutrition, more than the two bites of food a day he'd been taking. We had been able to get him awake enough to say he was hungry or thirsty, but if the food or drink wasn't there immediately, he'd be asleep again before it arrived. If it was ready, he'd fall asleep after a couple swallows. With his current low alertness level, anything we offer is just water. Aspirating juice would be worse.

Breathing is the one thing he's still doing well. It's rapid and shallow, but strong and regular. He was good at moving his face away from the nebulizer this morning - even when we hold it for him he still hates it - but I just move it so he's still inhaling the mist regardless. Yesterday he pulled my hand away from his mouth with both of his, and I just plucked the nebulizer away with my free hand and held it in place while he was holding my other hand in his lap. This morning he closed his lips so I held it under his nose.

I'd been noticing how the flesh on his face has sagged, so that there's now a fold of skin over the front of his ears. This morning I was struck by how sunken his eyes have become. I'd heard the phrase, but this is the first time I saw what it meant. The eye is actually in the same place but everything around it but bone has wasted away, leaving a dark sunken ring around the eye. It's slightly cracked open, just enough that you can't say it's fully closed. He doesn't track light or sound with his eyes any more, however, so I suspect it's just lack of muscle tone that it isn't completely closed.

Sunday was his last active day. He kept asking for water every ten minutes or so, or if vocabulary failed him, just call out, "help". His voice was hoarse and raspy, as though he'd been using it for hours, when he'd been mostly quiet for days. By yesterday he was just making sounds, and we'd have to ask and guess what he wanted. Today I haven't heard anything from him at all, even when talking to him. They say hearing is the last thing to go, so I did talk to him for a while. I told him we all loved him, that he'd had a good long life, and when he decided it was time to go and join Mom, it was OK. I remember saying the same thing to Mom minutes before she died, telling her we'd take care of Daddy for her, and it was OK to go. I don't know if either of them heard me, but I felt better for having said it.

Yesterday was unsettling. I had another medication run to a nursing home at the end of my work day. I was feeling pretty nostalgic already, having driven through woody countryside in the dark - hyper-alert for deer, 'tis the season - and smelled somebody's wood and leaf smoke, a particular combination remembered from my childhood. It struck me how seldom we'd had our own bonfires this year with Daddy unable to go out with us and enjoy them, and by extension of that line of thought, how little of anything I'd actually done this year. I hadn't let myself notice or miss them, though I've fought with cabin fever on occasion, but now I was feeling it fully.

Walking into the nursing home, I had a few minutes to wait for the authorized nurse to sign for the meds, and noticed the residents. They were walking with an assistant, or watching TV, or holding a card game. It struck me how different it all looked this time. Most times I'd walk in to one and think to myself how much better Daddy was than any of the people I saw. Last night I realized how much better every single one of them looked than Daddy. For a moment I even had the ridiculous thought that he was to sick to be in a facility like this! It was a complete shock to realize how starkly my perceptions had swapped positions.

It's one thing to tell yourself he's in the process of dying. After all, he's been in "hospice" status for 11 months now. It's different when your gut slaps you with the realization that it's imminent.

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