The Day My Mother Died

When my mother returned from the doctor's office, she was smiling and laughing with the nurses as she signed the paperwork. Then she was called into another room. She looked at me as if confused and urged me to come with her. I grabbed Aimee's little hand and we went into a small room.

I thought the doctor was cold. He wrote in the notes, for the nurse to read to us, that they were putting my mother on 'hospice' and for her to sign some more papers. I knew nothing of hospice at the time, never even heard the word before, but I was to learn much more than I ever wanted to know about it in the near future.

While walking out, while Aimee ran down the stairs, Mom and I rode the elevator down. With her face as white as a sheet, literally, and visibly shaken, she told me that hospice is for people who have 6 months or less to live.

Talk about having the hammer fall!

What do you say to that? What CAN one say? The shock was incredible. I would compare it to a hard slap to the cheek. I wish that was all it was.

It didn't take long for the symptoms to appear. She was okay through August and I contacted everyone I could think of who could possibly stop by for a visit before there would be no more visits. I even video recorded a few of the more important visits but I doubt I will ever watch them - it's too hard.

By the start of September my mother's appetite had begun to get smaller and smaller until, by the end of the month, it was just nibbles of this and that throughout the day. She didn't get much exercise, except to go to the bathroom which was not very often at all, and just watched TV in the living room all day until bed time.

In October things were spiraling out of control and I was getting frustrated, angry, confused, and probably every other emotion you could think of, but it was certainly denial on my part. I kept calling the hospice nurses because my mother was not eating at all! Were they as alarmed as I was? Nope. They were calm as could be while I tore my hair out.

I wanted my mother to live but hospice, it seemed, did not - or just did not care.

I was talking to my wife on the phone when I heard a loud thud followed by my mother's cries for help. It seems she had fallen while getting out of bed to go to the bathroom. She was on the floor beside her bed, face down, when I arrived. I asked her if she was all right and gently lifted her up. I was taken back by two large golf-ball-sized lumps, one over her left eye and one higher up on her head. I quickly phoned hospice as was procedure (though my wife insisted I call 911.)

Hospice reassured me, through my explanations of my mother's condition and state of mind, that she would be fine until the nurse could check on her the next day. I was still itching to call 911 but I didn't want to start anything that might cause problems for my mother's health care. I think that was when everything really began to escalate in the wrong direction.

Luckily, my step-brother, Kent, arrived to help me in the final days though we didn't know it was the final days. Kent was already working in hospice in Washington state so his expertise was most welcome indeed. I was frazzled and disoriented by all that was going on. It was not a fun time.

My mother was weak, disoriented, in pain, and confused. I felt like I was useless, inadequate to supply her needs, unable to help her fight the cancer. We ordered a hospital bed, a respirator, and all the other gadgets that go along with all of that stuff. I was determined to fight for as long as possible although I could see my mother slipping away day by day.

From the day I arrived on July 30th, my mother went from a positive, vibrant woman to a bald, skinny, shell of her former self. In her final days, my mother spent her time in the hospital bed in her bedroom, sleeping and sleeping and sleeping. Kent would sit in the corner, in the rocking chair, reading a book and keeping an eye on Mama.

On October 20th, Kent called me into the room. "I think this is it," he said.

I ran into the room and knelt by her bedside while Kent went to the other side. We held her hands and stroked her arms. Mama was partially sitting up in bed at the time. Kent was telling her that it was okay to let go while I was frantically thinking of grabbing the respirator. Her breathing was very labored and erratic, with periods of silence followed by huge gasps. "I should be doing something!" I told myself.

I asked Kent if there was anything I could do at that moment but he said no, it was time. Since he had gone through this before, more than a few times, I figured it was best to listen to him though it was tearing my heart out to see my mother like that.

Finally, I told Mama that it was time, it was okay to go and be with Dad. I guess that was what she was waiting for because at that point she gulped in little bits of air before gasping it all out and falling silent. Kent and I waited for probably ten seconds before we fell into a silent prayer. Then I lost it.

If you grew up in the 1960's, as I did, you would know how a typical working mother was: up early to cook breakfast and get the kids off to school before heading off to work. My mother grew from her pain, experiences, and from her learning for she was always reading and learning how to do things. She loved nothing more than to grab a good pair of yard clippers and head towards those poor unsuspecting bushes. She would whack them into submission and call on me to clean up the mess.

In the 50's, my mother was a biker with her own Harley. In the 60's, after a stint with a foreign car called a Simka, she drove strictly Fords and was considered a conservative. In the 70's, she became a happy housewife after marrying my step-dad, Dave. In the 80's, they moved and she started learning how to grow vegetables and fruits.

They just don't make them like that anymore

My mother was a very positive, free-flowing spirit who loved to laugh and play games. She used to love playing 'Aggravation' but had to quit when all her opponents refused to play with her anymore (she ALWAYS won!) She was the ultimate host, providing everything one would ever need for a perfectly comfortable stay.

Mama taught me to always be good, always have a smile on my face, and be a positive, optimistic person. She taught me manners and grace. But, most of all, she taught me to love.

Watching her die was the most traumatic experience of my life but watching her live made up for it.

See you soon, Mama!

Of course no one can predict the exact time of death, and I don't think anyone would really want to know when they were to go, but certain symptoms are usually associated with the way the body shuts down.

These signs of approaching death are specific to the natural dying process itself, apart from the effects of particular illnesses the person may have.

Not everyone will have all these symptoms but most people experience some combination of the following in the final days or hours:

As energy needs decline, the person may begin to resist or refuse meals and liquids, or accept only small amounts of bland foods.

Meat, which is hard to digest, may be refused first. Even favorite foods hold little appeal.

Near the very end of life, the dying person may be physically unable to swallow.

As detailed above, this is exactly what my mother went through in her final month of life. Her decreased appetite brought dehydration and weakness that only contributed more to her condition.

The person may begin to sleep the majority of the day and night as metabolism slows and the decline in food and water contribute to dehydration.

He or she becomes difficult to rouse from sleep.

The fatigue is so pronounced that awareness of immediate surroundings begins to drift.

Again, same as what my mother experienced. It's very understandable, since no nutrition is entering the body, that the body would begin to shut down.

For the last 2-3 weeks, sleep was 90% of her life, her speech was incoherent, and she appeared confused and disoriented.

She could no longer walk and was bed-ridden in the final days.

A decline in food intake and lack of energy leads to less energy, even for activities like lifting one's head or shifting in bed. The person may even have difficulty sipping from a straw.

The weakness is one of the hardest things to adjust to after a person has had a hearty, robust, and active lifestyle. To see a person go from that to a shell of their former self is heartbreaking.

My mother went from walking in August, to a walker in September, and finally to a wheelchair in October.

She went through breast cancer in the 80's, to remission; to lymphatic cancer in the 90's, to remission; to brain cancer in the 00's, and finally to death.

Once it grabs you, it refuses to let go.

As the organs begin to break down and fail, including the brain, higher-order consciousness tends to change:

* The person may not be aware of where they are or who else is in the room

* The person may speak or reply less often or may respond to people who can't be seen in the room by others

* The person may seem to say nonsensical things

* The person may be confused about time

* The person may act restless and pick at bed linens

Or, in my situation, the person simply shuts down and seems to crawl into a shell, never to eat or speak again.

Breath intakes and exhales become raggedy, irregular, and labored. A loud, deep inhalation is followed by a pause of not breathing, before a loud, deep breath resumes and again slowly peters out.

Sometimes excessive secretions create loud, gurgling inhalations and exhalations that some people call a "death rattle."

This is the scariest part, watching your loved one pass on to the after world. The labored breathing was the final stage of my mother's life and the hardest to watch, of course.

I don't want to ever go through that again but at least, if I do, I will know what to watch for and how to act.

As the body shuts down, the dying person may gradually lose interest in those nearby. He or she may stop talking or mutter unintelligibly, stop responding to questions, or simply turn away.

A few days before receding socially for the last time, the dying person sometimes surprises loved ones with an unexpected burst of alert, attentive behavior. This can last less than an hour or up to a full day.

Little going in means little coming out.

Dropping blood pressure also contributes to the kidneys shutting down. The concentrated urine is brownish, reddish, or tea-colored.

Loss of bladder and bowel control may happen late in the dying process.

I won't go into detail on this topic as I think it is understood as is.

As the kidneys are less able to process bodily fluids, they can accumulate and get deposited in areas of the body away from the heart - in the feet and ankles especially.

These places, and sometimes also the hands or face, take on a swollen, puffy appearance.

This is one symptom my mother did not have mainly, I think, because she had become bed-ridden and no longer on her feet.

In the hours or minutes before death, blood circulation draws back from the periphery of the body to help the vital organs. As this happens, the extremities (hands, feet, fingers, toes) become notably cooler. The beds of the fingernails and toenails may also look more pale or bluish.

I noticed this but wasn't worried about it. All one can do is keep the other person warm and comfortable as can be. A little prayer or two couldn't hurt, either.

Skin that had been uniformly pale or ashen develops a distinctive pattern of purplish/reddish/bluish mottling as one of the later signs of death approaching.

This is the result of reduced blood circulation. It may be seen first on the soles of the feet.

I did not notice any of this happening to my mother but then again I was more concerned with other things at the time.