In Her Final Days

Sorry, dear readers. I've been busy.

Mom is in her final stage of lung cancer. I feel like a part of me is dying with her. Thank goodness our town has unbelievable hospice services since both my husband and I have been down for the count with a virus.

If you are in a similar situation:

Use palliative and hospice services. They accept Medicare and make the whole process for both the patient and family easier. This is not recuperative care--it is comfort care.

I don't recommend the cots they can put in hospital rooms. I think they are meant to put you there but when a dear one feels better about having you beside her, be aware that you can probably get one in a pinch.

I am preparing myself for the inevitable. Mom has already told me what she wants for her funeral. But I wish I could capture her essence. Maybe if I had a video of her beautiful smile while telling the stories I've heard dozens of times, it would comfort me.

But mom is resting more, talking less and eating practically non-existent.

Imagine almost a century of life. The Depression, WWII, the Cold War, Korea, Vietnam and it goes on and on. Will the wars ever stop?

Now the last great-grandchild that she will meet coos at her, smiles at her and naps with her. I witness the beauty of generations, the power of legacy. I know I am one lucky lady to experience this but I can't stop dying inside.

Mom's Miracle: Why It's Important to Plan Ahead

It's been a while since I last posted. That's because my mom, age 92 years, landed in the hospital three times since March.

This last visit looked like the final one. The rabbi lead the family in prayer for a miracle or for gentle passing (honestly, I don't remember because I was so distraught). Because mom was obviously struggling and in discomfort, I, as the health care advocate who knew her Do Not Resuscitate wishes, agonizingly ordered the removal of the breathing tube.

To our surprise (and the doctors consternation!) Mom started breathing on her own.

She is now home. She'll have nurse aide visits and physical therapy for as long as Medicare will cover the costs.

She uses a walker but is anxious to get rid of it. She continues to do her exercises as she brushes her teeth twice a day. She is feisty and sharp as ever.

And I am lucky to have her around for however much precious time she has left.

Please, please, please plan ahead. Have your loved one select a health care advocate. Provide your physician and hospital with a copy of your health care directive. Keep a copy of current medications in the medicine cabinet and/or above the refrigerator. Check out how hospice or palliative care can help. And do a lot of praying. I did.

Stent vs. Endarectomy

According to studies by the National Hospital for Neurology and Neurosurgery and Institute of Neurology at the University College London and the Duke Stroke Center in Durham, North Carolina (CREST):

If you're 70 or older and have a blocked neck artery, opt to surgically widen the artery rather than having a stent put in because research has found that your chances of dying or having a stroke are 50% as likely than inserting a stent.

Until now (September 10, 2010) many experts thought that the lesser-invasive stenting procedure would be safer.

Source: MedlinePlus, health information from the National Library of Medicine

For more on heart disease and stroke, visit 50somethinginfo.com

No Rest For Car-Man

We finished a movie. I lingered in my office going over my email. Then I ambled into the bedroom to join Car-man.

I moved over to snuggle into his arms and we fall asleep.

I awakened to his laughter. I had pushed him over to the end of the bed. He had been dreaming about dogs (maybe this is a good sign--I want one). In his dream, one dog in particular, a German Shepherd, leaned against him with his full weight. Car-man moved to steady himself...and he almost fell out of bed.

I gave him half the bed and we both settled into restful slumber.

I don't know what I was dreaming about (I have an overblown imagination) when I yelled, "Help."

Poor Car-man. No wonder he dragged himself out of bed this morning.

This whole scenario could be a problem if it happened regularly. Studies have shown that "men who slept for short periods of time were much more likely to die over a 14-year period."

Why? It may be that sleep problems may contribute to clogged arteries or disrupt the immune system.

End of Life Decision Making

Lynn Hudson's mother didn't want to go to a hospice.  Nor did her family want her to remain in her own home.  The best option, they agreed, was that Yiayia at 98 years of age and succumbing to cancer would live her final days with one of her daughters, son-in-law and her triplet teen grandchildren.  

This is what Lynn graciously shared with me about overseeing her mother's end of life care:

1. Be clear about your parent's death wishes.

2. Provided they have the mental capacity to do so, the patient/parent should have enough information so that he/she can decide how they want to proceed (for instance, ice chips can prolong life.  Moistening lips can keep the patient comfortable).  

3. Get all affairs including finances in order.

4. Discuss any unfinished business and unresolved feelings.

5. Make them comfortable (take advantage of various comfort aids).

6. Provide privacy (in crowded quarters, curtains can be hung).

7. Call in the clergy for final rituals and check out books on spirituality at the end of life.

8. Understand that the senses such as hearing may become more pronounced near death.

9. Grant loved ones private time with the patient.

Read what therapists Rosemary Lichtman and Phyllis Goldberg have to say.

Also, www.50somethinginfo.com has an enormous amount of information about death and dying.  Check it out.  

Tips For Caregivers Who Need Love Too

Care giving is physically and emotionally exhausting.  Lynn Hudson, my hairstylist, oversaw the last months of her mother's life.  This is what she shared with me about end of life care: 

1. Be conscious of burnout:  Enlist the help of family members and hired help.

2. Take advantage of all the aids to make the patient more comfortable.

3. Keep visitors on the premises for no longer than 10 minutes (it's easier on both the caregiver and the patient)

4. Know what to expect ahead of time.

5. Be aware that rituals may feel calming.  

Should you want to know more about this stage, consider asking therapists Rosemary Lichtman and Phyllis Goldberg.   

Or if you want to know everything you need to know about caregiving, visit www.50somethinginfo.com.

Dealing With Death

I used to get depressed this time of year.

I'd fixate on all the people who lost someone (family member, friend, pet) who they loved and how the holidays for them would be especially painful.

Frankly, I don't know what brought me out of the funk (but probably it had something to do with Car-man).

Now I'm faced with questions from my granddaughter about life and death. She measures impending doom by gray hair and wrinkles. But we all know that those aren't necessarily prerequisites for sudden death.

How do you soften the blow of first loss?

As I librarian, I'd recommend a couple of books which were popular at the time, The Fall of Freddie the Leaf and The Tenth Good Thing About Barney.

Maybe you have some other suggestions for our readers?

Passion For Life

Nancy featured an animated inspirational speaker Randy Pausch on her blog. 

This 47 year old Carnegie Mellon computer scientist recognized that he wouldn't participate in some of  life's most precious moments with his children so he condensed who he was, where he came from, and what he believed in in a 10 minute lecture.

We are fortunate to have his wisdom memorialized.  Do yourself a favor.  Watch it. Witness one man's passion for life. 

Planning for the Future

Home Instead Senior Care and author Jo Myers have provided the ultimate planning guide for baby boomers and their parents.  

No, I'm not referring to a travel itinerary (even though I could use one just about now).

This is a simple list to prepare for the inevitable. 

No one over 50 should postpone most of these chores.   

Better yet, do your own will and/or trust or get it done by a competent attorney now.  

Estate Planning As A Gift To Your Children

Thanks, Mom, for painstakingly sorting through your stuff before I have to.  Thanks for having the foresight to give away things while you are present in our lives and can witness how your children and grandchildren use precious family heirlooms.  

I know this process doesn't happen without consequences.  How you want your things distributed might be radically different from the way your offspring thinks (feelings might get hurt; jealousy or envy might surface).  It takes stamina and guts to divide your belongings the way you want and I applaud the manner with which you handled it all with dignity and grace.  

Too often children are left with the enormous job of  cleaning up the home after parents die. Coupled with shock and grief, sons and daughters are saddled with the additional burden of putting financial affairs in order and disposing of real and personal estate. 

Aging parents who clean up their affairs and  who clarify how and where they want their personal items distributed--eliminating some of the emotional toll on their children--epitomize one way to prove their love.  

  

Obituaries

Remember the scene in Mel Brooks' History of the World where a lovely lady "sizes" up a lineup of men? She was grouping them into the "yeses," "nos," and "yes! yes! yeses!!!!"?

Sometimes I, too, like to measure things in terms of "long" and "short."

I didn't always fixate on the obituary pages. Now it's part of my daily routine--checking out how long or short a time someone lived, what they did with their lives, who was left among family and friends. I'd figure that donation suggestions tied into either the cause of death or a favorite charity.

It appalls me at how many young people have died prematurely. It makes me face my mortality head-on especially when the deceased is younger than I. Accidents and disease can strike without warning. May you live your life the way you'd want to be remembered.