The Uncertain Process of Dying

 

‘I had become aware of how uncertain the process of dying is’

The Age. 10 March. 2018

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Photo: Shutterstock

My 96-year-old mother had a couple of full rehearsals for dying.

The last one was staged about four months before her actual death. I was woken by a phone call from her nursing home to be told that Mum had had a fall in her bathroom, vomited, lacerated her face, possibly broken her arm and had just left in an ambulance for hospital.

Nick and I tracked her down to cubicle 3 in the emergency department. Mum’s body lay flat and small underneath an inflated nylon warming blanket and all I could see was her gaunt face dominated by a large dark red gash on her forehead. Blood had trickled and dried down the side of her face. She had oxygen tubes in her nostrils and was attached to blipping and flashing machines behind her.

”Mum. We’re here.”

Her eyes flicked open. They were huge, staring and unfocused. I realised that over the years she had lost all her eyelashes.

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She came back into herself.

”Oh, Lizzie,” she croaked in an unrecognisable deep voice. She spoke slowly of what had happened to her in the night.

By mid-afternoon, she had been diagnosed with pneumonia and cleared of worse possibilities. The doctor liaised with the nursing home and organised for her to be nursed there. She suggested that we take her back in our car. We drove through endless suburbs in peak-hour traffic with my tiny mother slumped in the front seat in her pink fluffy dressing gown.

Back at the nursing home, she was settled in the recliner in her familiar room. The last of the afternoon sun shone on her lap, and if it weren’t for the abrasion on her forehead, it would have been hard to believe that she had not been there all day. We all sighed with relief and exhaustion.

The following morning I had a phone call from the visiting doctor, who described Mum’s pneumonia as serious. He discussed the possibility of palliative care should she not respond to antibiotics, and how that process would work. The words ”palliative care” struck a blow to my heart. However, my sister visited Mum later that day and reported that she was much improved.

By now, I didn’t know what to think. It was a repeat of an earlier dress rehearsal almost exactly a year before. Then, she had been taken to hospital with a complication of an ongoing condition. I received a night-time call from another careful and courteous doctor saying that Mum had confirmed her Advanced Care Directive that she wanted no interventions or investigations and was therefore content to be sent back to the nursing home.

That had felt like the beginning of the process of actually dying. She had already told me that since about her 90th birthday, she had thought that she was just filling in time. She was mentally bright but her body was crumbling about her.

Next day, I entered her room preparing for an ill, weak mother, but there she was, sitting in her chair, feeling much better and eating a banana.

My reactions to each of these dress rehearsals were similar: relief that she was recovering, sadness at her diminished degree of wellbeing, resignation that this was going to go on and on, frustration at the lack of conclusiveness, and weariness of having to endure the emotional stress of thinking that this might be the end, yet again.

About four months after the fall and pneumonia, I had a call from the nursing home saying that Mum was quite unwell with a temperature and a cough. We went to see her that afternoon and this was clearly different from the other illnesses. Firstly, she was actually in bed. She was very croaky and weak but amused by her hallucinations of my husband and my father building a cupboard in the corner of her room.

I was deeply disturbed. This was very different and shocking. The moorings were slipping. I sat beside her and felt my entire body sinking.

My sister visited next day, and reported that Mum was mostly unconscious. Over the next few days she sank deeper and deeper. We said our goodbyes and she died quietly, a week after that hallucinatory visit. I was content and grateful that after all the drama and pain of her dress rehearsals, the final act of her life had passed quietly and with dignity.

I had become aware of how uncertain the process of dying is. We control so much in our lives and we try to control dying, but ultimately it is the readiness of our own bodies and minds which makes possible that final, unpredictable moment of surrender. I was merely the onlooker as Mum navigated the waters of her last voyage.

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The Language of Ageing. #2

And then there are the ‘loves, darlings and sweethearts’.

We had met some friends for dinner at a restaurant and had barely settled, when we became the instant sweethearts and darlings of the young waitress.

She presented a beautifully stuffed zucchini flower.

‘There you are, darling. Enjoy!’

And later, after the main course,and after we had all been her dearest loves of the night, in a high voice with a big question mark in it, ‘Is everything alright, sweetheart?’

No! It wasn’t. I was fed up with all these endearments.

‘Look! I’m not your sweetheart or your darling. I don’t know you and you don’t know me.’

She just didn’t get it. ‘But I’m just being friendly.’

And immediately the service became very cold and rather brusque.

The Language of Ageing. #1

I started unloading my basket of shopping onto the counter at the IGA and said, ‘Hello’, to the young man behind the till.

‘How are we today?’

Fed up with having the ‘we’ thing again, actually, but…

“I’m alright, thanks. How are you?’

‘Good, thanks.’

Ping. Ping. Ping. He swiped the shopping through.

There was no one else up at the counter, so I thought I’d give it a go. He looked bright and perhaps able to get it.

‘Actually, do you realize how offensive it is to say ‘we’ like that to an older person?’ I asked with a smile.

He stopped, looked at me, blushed and exclaimed, ‘I am sorry,’ with a question mark in his voice.

‘Yep.  All my friends can’t stand being called ‘we’.

‘Um. What’s wrong with it? I didn’t even think about it.’

‘Well, it’s a bit patronizing.  It sounds as if I’m in a nursing home or something,’…  and you shouldn’t even use it there, I’m thinking, but didn’t say.  I’m staying cheerful and a bit jokey. I resist talking about ‘we’ being a plural etc.

‘Ohh yes.’

‘Actually, when you think about it, it’s pretty ageist language.’

‘Oh no! I am sorry. I didn’t mean it. Well, how will I say it then?’

‘ You could just say, ‘How are you?’ like you would to anyone. Actually, I think using the ‘we’ is a bit sexist too. I don’t think you’d say it to an older man by himself.’

‘Oh, no. It’s getting worse! I’m mortified.’

I really liked this young man. He absolutely got what I was talking about and was confident to talk about the issue.

I paid, picked up my bag and said ‘Goodbye. And thanks for listening to that.’

‘Good bye and thank you,’

Gosh that went well. Writing it sounds like a training exercise.

I see him from time to time and always enjoy responding to his knowing, ‘How are you?’

The Lady at the ATM.

 

A cold wet Sunday morning in a Dordogne village. We’d found the Parking and were walking up a footpath towards what we hoped would be some shops. We wanted to buy picnic provisions. Ahead was a woman in black pants and a pale blue parka. She walked steadily up hill, legs a bit apart for balance and shoulders bent. She stopped and searched in her shopping bag and faced the wall.

We caught up with her and stepped out onto the road to pass her. She turned to face us, looked me in the eye and spoke. She was holding a bank card in her right hand and moved it between me and the ATM whilst talking and pleading. Her eyes were a clear blue, her hair, whitey grey and tied back into a sort of bun, and she had a very pleasant smile. She was actually asking us to help her withdraw money. I was shocked at her trust in us.

‘Avez vous quatre nombres?’ I asked, counting out four fingers. ‘PIN number?’ forgetting  that the French call it an identity number, or something like that.

She kept on talking, holding her card towards us, smiling, putting the card towards the slot.

We kept on talking, going on about quatre nombres.

It was getting nowhere.

We had to say, ‘Pardon, Madame,’ and open our hands in a helpless way, and set off up the hill. She smiled a beautiful wide, curved smile, we smiled back and we all sort of bowed to each other.

We turned our backs and continued up the hill. My eyes stung and I burst into tears at her vulnerability and trust. I thought of Mum and wondered if this old woman also had macular degeneration and couldn’t read screens. I thought that she probably usually went into the bank and withdrew money over the counter. Maybe, this  Sunday she had run out of cash. Maybe she was genuinely confused about life. I thought about how hard it was to be old and how much harder if you were alone.

We walked about another block up the road and reached the square and some shops. There on the road was an old man in black, his back and legs curved into an S. His feet were in huge black suede, orthopedic shoes which he lifted barely off the ground, very carefully, one slow step after another. It took a long time for him to cross the road on a diagonal towards the bakery. Another old person finding an ordinary errand huge.

We bought some bread, found a green grocer and had just finished up when the door rang open and in came the lady from the bank. ‘Bonjour m’sieur et m’dame’ all round, for and from everyone and a very big smile for us as we left the shop.  That felt a bit better.