One Last Breath

 

One comment you often hear about grief is how different people grieve in different ways.  Well, not only do people grieve in different ways, they grieve differently for each loss, whatever that loss may be.  It can be a still, quiet kind of grieving over a long period of time.  Some people cry and cry, others do not.  Some take time away from things, other people jump right back in to work or school, finding comfort in ordinary tasks.

I experienced my first death when I lost my mother.  I was only 14, and I didn’t know much about life, let alone how to grieve for the loss of it.  I didn’t see her die, I was kept away from it.  The loss of my mother at such a young age was enormous.  It was terrifying.  What is death?  Where did my mother go, if anywhere? Why did she have to leave me?  What do I do?

I was off for a couple of days from school but eventually I had to return.  My home room teacher assigned someone to watch me, to make sure I was okay.   Other kids looked at me funny.  They didn’t know how to talk to me, what to say.  It was almost like I had some kind of death disease and they could catch it.  I remember coming home from school one day and just calling out to my mother, just to hear the sound of myself saying it. It took a lot of years to figure it all out for myself, and I took many paths trying to find answers to all of my questions.  Every year on the anniversary of her death, I would count back.  One year, five, ten years, fifteen years.  I would cry almost every time I added another year.

When I lost my Dad only a couple of weeks ago, my feelings were equally as profound, but not about the same things.  I am 56, not 14.  The world is a whole different place at this point in my life.  I’m not terrified, the way I was the first time.  I know what death is, and I know my father didn’t go anywhere.  He just died.  And it was simply time for him to leave me.  I’m not sure I was prepared, however, for what dying really looks like and watching him go through it.

I experienced the loss of many others in between the deaths of my parents;  relatives, friends, acquaintances. Almost every time, it would be like revisiting my mother’s death.  Not as intensely, of course, but something of it would remind me of being 14 again.  That fear would come back, that sense of how utterly vulnerable we are, and how it could happen at any time to any one. Where did they go?  What does it mean?  For a long time after my mother died, I was afraid to ask my Dad what it looked like to see her die. I kept envisioning some sort of terrifying, thrashing, screaming event, having only ever seen it in the movies.  It was always curious to me to see obituaries saying that people died “peacefully”.  What is peaceful about death? I heard people talking about it as if it were a kind of “high”, experiencing someone’s death.  I never got that.

Last year I think I had a sense that it wouldn’t be long before my father was also gone.  I remember I started to have anxiety attacks and heart palpitations to the point of going to the doctor, which is a rare thing for me.  I thought it was physical, and then realized it was about me coming to terms with the fact that my father was going to die soon too.  What was that going to be like?

When I went over to the mainland for the last time, I was relieved to hear the doctor say that my father would likely have an easier time of it because he had pneumonia in one lung.  He said “If there’s any easy way to go…”   Dad had been refusing medication and food for several days, and the nurses had begun to give him regular doses of morphine to keep him comfortable.  He was pretty much asleep most of the time, except for occasional twitches.  On the last morning, however, as soon as we got there I could hear that his breathing was somewhat more laboured than it had been the day before.   And by the late afternoon, he was twitching and moaning from time to time.  I was worried that he was suffering, so the nurse gave him another dose of morphine and said she would do so every hour from then on.  I asked her how long it would take the morphine to kick in, and she replied it would take about fifteen minutes.

It was the longest fifteen minutes I’d ever experienced.  And when we reached that goalpost, he didn’t stop struggling.  At one point he opened one eye, and seemed to be trying to communicate. We kept talking to him, trying to calm him.

Then his body suddenly seemed more quiet.  I wondered if he was breathing at all.  And that’s when it happened.  He took in one big, deep, final breath, and let it go.  I knew right away.  “He’s gone,” I said.  I remembered hearing about that at some point in the past, about a person taking one big last breath and then dying.  That’s how I knew what it was.  I ran out to the hall to try to find a nurse.  When a group of them saw me coming, they came running.

It took a long minute checking for a pulse before the nurse finally said “He is gone.”  The next few minutes and hours were a blur…we were trying to call people, trying to grasp it had actually happened, someone brought us tea and sandwiches, we made more phone calls.  I kept thinking about that last breath and how profound it was to watch him take it.

I spent some time all alone with him once everything else had been done and everyone was gone.  I tried to say everything I needed to, I hugged him and kissed him and hugged and kissed him some more.  I didn’t want to have any regrets.  I didn’t want to leave him.  But then I had to.

I was walking down the hall of the care facility a little while later when it hit me.  That last breath.  I remembered.

A few years after my mother died, I finally got up the nerve to ask my Dad what it was like.  He said it was not anything like the movies, it was very peaceful.  She was there one minute, and then she took one long, last breath, let it go, and then she was gone.

I love you, Pop.

IJ

From The Inside Out

As some of my readers know, my 91-year-old father has dementia, “probably Alzheimer’s” as his medical chart says.  In the last few months his health has declined considerably.

It’s not that this has been unexpected, of course.  But I more or less made the decision a few years back that I wasn’t going to “study” Alzheimer’s.  You might think that is counter-intuitive;  why not understand the disease as much as you can so you know what to expect?  A friend even loaned me a book, a fictional account of someone dying of the disease, but I chose not to read it.  It’s not that I am in denial, although in the very beginning when he was first diagnosed I had trouble accepting it.  I can see very well what the disease has done to him over these past ten years.

No, it’s more because I don’t want to be sitting here anticipating every symptom of decline in him.  I won’t drive myself crazy watching for signs that the disease is progressing because I worry enough as it is.  I just want to make the most of the moments when he seems his old self…those moments still do happen, but with less and less frequency.

I’ve been travelling to the mainland every three weeks or so lately, spending time with him when he is awake or just sitting with him while he sleeps.  He sleeps a lot.

About a week ago when I was there, I arrived around 9:30am to find him in bed, which wasn’t a surprise. The nurses let him sleep in because he’s “less grumpy” if he does.  He has become more easily agitated in the last few months, some of which has been calmed by low doses of a new medication, but he will still have outbursts every now and then when he’s confused or embarrassed or simply tired.  He is also physically very weak, his old legs barely holding him up whenever he moves around.  He has lost considerable weight because his appetite has declined.  It’s not that he isn’t hungry, but often he just gets confused when there is more than one thing on his plate.  He doesn’t know what to eat, as if there is some mysterious order to eating that he can’t figure out.  So he gets up and walks away.

He heard me when I entered his room, so I sat down on the edge of his bed.  I found him curiously engaged that morning and we held hands and ended up talking on a variety of topics for a good forty minutes.  It was uplifting for me, because he hadn’t been as talkative or interactive for a number of visits before.  His nurse came in to help him get up and dressed, so I left his room and waited for him down the hall.  He finally came out, fresh and dressed with his walker and the nurse beside him.  I walked with him to his seat in the dining area and watched him eat breakfast.  A few tables away, a resident was calling out, over and over, as many of them often do caught up in the fog of their dementia, not realizing where they are or what’s going on. Most of the time the other residents pay little attention because it happens so frequently, I suppose, that they stop hearing it.  Not all of the residents have dementia, but many do.

When my Dad had enough breakfast, we spent a little more time together in his room, and then I had to leave.

The following morning I went back, not expecting to have the same interaction with him, and at first it looked like I was going to be right.  It was a little later in the morning when I arrived, so I assumed he would already be up.  As I came off the elevator I heard someone calling out again and at first paid no attention, until I realized that it was my father’s voice.  I followed the sound, and found him sitting on a piano bench in the common area, his hands cupped around his mouth, yelling “Could someone please tell me where the hell I am?”  I hadn’t seen this behaviour in him before, so for a moment I was taken aback.

I walked up to him and gently took his hands in mine, bending down to be at eye level with him.  “Hi Dad. It’s okay.  You’re at home.”  “Where’s home?” he asked, a little surprised at my sudden appearance.  “Home is Rosewood.” I said, naming the care facility he’s been living in for the last several years.

“Rosewood?”  “Yes, this is your home.  Would you like to go back to your room?”  “Okay.”

I helped him up and held his arm as we walked gingerly back down the hall.  On the way, he suddenly said “Sometimes I feel so useless and stupid.”

I was surprised to hear such a revealing comment and tried to reassure him that he was not useless or stupid.  When we got to the door of his room, he expressed relief at recognizing it.  Once we were inside and sitting down, the conversation continued.  I said it must be scary to not know where you are sometimes.  He said it wasn’t scary, just frustrating.  I told him that he had dementia and that’s why he was having trouble remembering.  I’ve told him on other occasions that he has dementia, but of course, he doesn’t remember.  “Dementia?” he said and I nodded my head.  “It sounds too close to the word ‘demented’,” he smiled.  I laughed at that little hint of my old man who had always had a cheesy sense of humour.  He repeated the joke a number of times to his own delight.

“Sometimes I’m in a movie and I can’t tell what is real.” he said, revealing something again about the life he has been living.  And the conversation continued on in fits and starts over the next hour or so.  I didn’t want to leave or let go of this experience of finally hearing my father’s description what dementia is like from the inside out.  Finally, the topic changed to other things, family, the weather and more mundane subjects.  He was tiring, his eyes sometimes closing when we weren’t speaking, and I knew that the window of opportunity was closing too.

When I had to leave to catch the ferry home, we hugged and kissed and I told him how much I loved him and what a good father he is.  “And you’re a good daughter,” he said, “say hello to Michael and the girls.”  I know he doesn’t remember names very often, he often calls me by his sister’s name, but it was nice to hear that he still knows who we all are.

The next time I visit him, I don’t know what I will be able to expect, and I don’t particularly want to know.  But I will be happy with even just a moment or so, just a hint, of my “old” Dad.

IJ