TheBanyanTree: another hospice story

[Monique Colver]

This morning I find myself wondering if Cecil has made it through the night.
Last night, when I sat with him, he was in the process of dying, and it was
progressing as active dying does.

I met Cecil last night, when I was asked to provide a couple of hours of
respite care so his daughter could get a couple of things done. He was in a
recliner when I got there, deceptively sitting up as if ready to get up and
go somewhere, but when I took his hand in mine it was slack, and he didn't
seem to know I, or anyone else, was there. His breathing had already become
more shallow and pained, the "death rattle" present.

His daughter and I talked while we waited for her brother to make a couple
of phone calls, and she briefed me on his condition. Just several days ago
he was ambulatory and verbal, old but not dying, and then he suddenly
declined. That was when hospice got involved. She had moved here less than
two months ago to be close to him, since there was no other family in the
area. She'd been in the habit of picking him up at the assisted living
facility every day and taking him to her house, where she'd make him lunch.
On Sundays they went to church. Cecil was Salvation Army, she told me.

Cecil sat in the middle of the small living room in his recliner, his
daughter in a chair on one side of the room, I on a couch on another side,
and I kept glancing at him to make sure he was comfortable, at least as far
as I could tell. She told me that he'd started becoming more affectionate in
the past few days, suddenly going in for hugging and such, which had never
been the case with him before. A couple of days ago he'd brushed his
daughter's face with his hand and said, "I love you," something he'd never
said to her before, not in over 60 years.

She told me that if the other brother, Cecil Jr., came back, not to let him
in. He'd been volatile earlier, and he had some issues. He'd never fully
recovered from Vietnam either. I told her I would lock the door and keep
Cecil's environment calm.

It's difficult to know a person who's in the process of dying. Cecil wasn't
speaking, or tracking, and all I had to go on was what his daughter told me.
We talked about death and dying and how difficult it is, whether or not
one's ready. It doesn't matter, because you can never be quite ready for it.
Cecil had asked her, back when he was voicing these things, for an overdose
of something so he could get it over with. He was ready to go. But of course
that's illegal. Sometimes they're ready to go but don't know how.

His daughter warned me that while they were gone Cecil may want to move to
the hospital bed in the living room, or that he may even want to move to the
bed in the bedroom. He might want to take off his clothes, which consisted
of shorts and a shirt, and that the shorts stay on. If he gets into the
hospital bed without his shirt, keep the blanket from touching his skin by
hanging it from the metal bars that keep him from falling out. An attendant
brought his dinner. If he wanted to eat, he'd probably want the fruit. He'd
had all his meds for the time being. I looked at Cecil. He hadn't moved
since I'd gotten there, hadn't uttered a word, and I couldn't, for the life
of me, imagine him doing any of the things she said he might do.

We waited for the hospice nurse. She was bringing more meds and coming to
check on his condition. By the time Eileen's brother returned, ready to go,
she still hadn't arrived, and I told them to go ahead, and to take their
time. "What if we get back after 8?" Eileen asked me, as if I'd suddenly
disappear at the appointed time. "I'll still be here," I told them, "I have
nowhere else to go tonight, so take your time, get some dinner. "

Her brother told me he'd talked to Cecil Jr., and he'd calmed down, and it
was okay to let him in if he came back, and to please stay close by, but not
necessarily too close. They left then, taking Zach, the Welsh corgi who'd
been sleeping at my feet. I love assisted living facilities that let dogs
in. Cecil's previous one, the Waterford, hadn't been as generous.

They left, and I turned on the television to the Blazers game just in case
Cecil wanted to see it. It was the only thing he would want to see, if he
were to want to see anything at all. I sat on the couch with my book and my
journal, and I watched Cecil to see if he showed any signs of getting up and
taking off his clothes. He showed no signs at all, just the slow hitched
breathing.

The nurse arrived, apologetic and upset that she was so late, but she'd had
a difficult intake earlier that had put her behind. I reassured her, with
all my lowly volunteer authority, that it was quite all right. She wasn't
convinced, but she accepted my gesture in the spirit in which it was
intended. She checked Cecil's vital signs, which were showing signs that he
was indeed dying, and she took off his socks to check his feet, which were
indeed cold.

She asked me how I was. I told her I was fine. I have no fear of the dying.
I can't disappoint them, and if I do happen to do so, it's not a lingering
disappointment. I'm calm when I'm with the dying because they have enough
going on inside of themselves as it is. I think of dying, in these cases, as
a release, which is then not a bad thing. I suppose it's surprising that I'm
not scared of the dying because I'm scared of so many other things, but
there it is.

The nurse gave Cecil Ativan to calm him, just in case he needed to be
calmed. She watched him for a bit. She asked if I'd be okay if he died while
I was alone with him. I told her I'd be fine. If he died, I knew who to
call, and I'd sit with him while I waited for the professionals. It's not a
difficult job. She left then, after we hugged. I think she needed a hug.

A little bit later Cecil Jr came to the door, and after I introduced myself
he sat down on the floor next to his father's chair silently, saying
nothing. I moved away so they'd have some privacy, but kept watching Cecil.
It looked like his head was starting to slump forward, so I asked Cecil Jr
to help me recline the chair a bit so he'd be more comfortable. We did, and
it did look more comfortable, though Cecil was still not letting us know one
way or the other.

The other brother returned after a bit, sans Eileen and Zach, who would be
following along shortly. I told him about the Ativan, and that things were
progressing as expected, and to feel free to call hospice at any time, and
that hospice would be checking back with him of course.

Eileen called me later, after I'd gotten home, and wanted to know what the
nurse had said. I told her everything I could, and when she asked if the
nurse had said how long, I told her no, that he was actively dying, but no
one knows how long it will take. No one knows. The nurse wanted to stop back
in the morning, but then wasn't sure if he'd last that long. I didn't tell
Eileen that, she knew. I was out of my depth, so I reassured her that things
were progressing as they should, and to call hospice at any time and they
would get right back to her. I told her to call me if she needed more
respite or if there was anything else I could help with, and we made
tentative arrangements for me to come back on Sunday afternoon for a couple
of hours. The need for this seemed unlikely, but, like I said, no one knows,
so I told her that I would be there if I was needed, and if she needed
anything sooner, to let me know.

So now I wonder where Cecil is at. Is he here still, or is he there? I'm not
entirely sure he was even here last night as it is, though physically he
was. Perhaps he's just a bit closer now. Or perhaps he's gotten ambitious
enough to get up and take off his clothes.
M

-- 
Monique Colver