One Step Closer (part one)

I don't know how I could think I would actually be able to get some work done today.  In only a few hours, the situation has become more critical, and it's hard to think about anything else.  However, I need to do something to keep from going to pieces, so I am trying to preserve some normalcy by doing laundry, taking the dog out, making coffee, and writing.

I work mostly at home.  That is what makes it possible for me to take on the responsibility of caring for my grandmother.  If I had a regular 9 to 5 job, I couldn't do it.  This is a blessing, but also a curse.  While working at home means I am available to see to Grandma's needs, it also means that 98% of my stress is concentrated in one location (I reserve the other 2% for frustrating clients and driving on the pothole infested streets that have plagued my town following a long, snowy winter).  It's hard for me to get away from the 98%, and when I do, I'm usually coping with the other 2%.

At about 1:30 this morning, I woke up to the sound of Grandma talking (or maybe moaning would be more accurate) in her sleep.  The only thing I understood clearly was the phrase, "Just one more day..."  I went to her room.  Her eyes were closed, but she was moving around restlessly, and I couldn't tell if she was awake or sleeping.  I touched her hand, and her eyes popped open. She said, "I'm okay, I don't need anything.  Turn the light on. Why'd you come in here?"

I should probably mention, Peggy is almost completely deaf.  In middle age, she had tinnitus - when I was a child, I remember her often complaining of "ringing" in her ears.  The hearing loss progressed slowly over the years - hearing aids helped for a while, but eventually even those became useless. Now, if you really shout, she might be able to catch a word or a phrase here and there.  But who wants to shout at your sweet little old grandma?  I know, despite having some theatre vocal training, I can't manage to raise my voice to the level where she can hear me without sounding angry, even if there's no anger in what I'm trying to communicate. So for the last few months, we've been "talking" with Grandma using erasable white boards.  We write everything for her, and she talks back at us.  Actually, she shouts, because she's totally unaware of how loud she is.

So this morning at 1:35 a.m., when she asked why I was there, the conversation went something like this:

Me (writing):  You were talking in your sleep.

Peggy: I was? What did I say?

Me:  I don't know - I couldn't understand.  (erase - blank slate) Do you need anything?

Peggy: No, I'm fine, I don't need a thing.  Where's my water?

She drank some water.

Peggy:  You don't need to keep coming in here.  I'm fine.  You should be sleeping.

Me:  It's okay.  I don't mind.

Peggy:  Just shut my door, then I won't bother you.  I want to go to sleep, I can't get to sleep.

So now it's decision time.  The doctor prescribed a morphine solution, to be given as needed if she was restless or in pain, but not more than every 4 hours.  She hadn't had a dose since 4 that afternoon, as she'd been sleeping pretty peacefully since then.  But this, in my inexperienced judgment, qualified as restless. Time for more meds.

I am not good with medication.  It makes me uncomfortable to give someone drugs.  I'm always afraid I'll make a mistake.  However, for several years I had to deal with giving twice daily subcutaneous injections of insulin to my (now late) great, diabetic cat Petruchio, so I've become a bit less squeamish.  The morphine solution is not given with a needle - you suck it up in a syringe, and then squirt it into the corner of the mouth.  It took several tries for me to get the right dosage in the syringe, as I was sleepy and my hand was shaking ever so slightly, but I managed, and gave her the dose.

Me: This will help you sleep.

Peggy: Good.  Now YOU go back to sleep.

Me: Call if you need something.

Peggy: I'm fine. I don't need anything. Close my door.

Me: (speaking, because I know she can read my lips on this one): I love you.

Peggy: Eyeball to eyeball?

Over the years, as her hearing as failed, this has been our "thing."  When I say I love her, she wants to make sure I am looking her directly in the eye - "eyeball to eyeball."  I know that's because she wants to see me say it, because she doesn't really hear it.  The only time I have ever refused to do this is when she asked me while I was behind the wheel of a car,  Believe it or not, that happened more than once.  It never seemed to occur to her that I should be watching the road, not looking her in the eyeball.

I bend close, our noses almost touching, and say it again.

Me:  Eyeball to eyeball. I love you.

Peggy:  I love you, too.  Now GO!

I shut off the light and walk out of the room.

Peggy: SHUT MY DAMNED DOOR!

I close the door, but leave it open a crack, just in case.

I am writing this down now because I believe it may be the last conversation I will ever have with her, and I want to remember.

Facing the Inevitable

I have known for some time that my grandmother is dying. She has been preparing for it for quite a while. Over the last year or so, I have heard her say many times that she was ready to go.  In the last six months, she has updated her will and written final letters to beloved friends and family members, to be mailed after she's gone.  She has given away treasured possessions and put her favorite jewelry in little boxes, carefully labeled with the name of the person who is to inherit it.  She has said, more than once, "I have had a good life - I don't know why I'm still here.  I am just waiting for God to take me."

Although I have known in my heart that there would come a time when Grandma Peggy would no longer be with us, I think I have been in a little bit of denial about how soon that end was likely to come.  Although Peggy has grown increasingly frail over the last few months, I still held some hope that she could somehow bounce back and recover some of her strength - that she might have a few more good years left in her.  All of that changed two days ago when she was referred to hospice.

If you're familiar with hospice, you probably know that in order to qualify for hospice care services, the patient has to be officially referred by a medical professional, and that the prognosis has to be "terminal in 6 months or less."  That circumstance, in itself, is a lot to process.  In the last 48 hours, however, our family has had to come to terms with the idea that Grandma does not have 6 months.  It is a matter of weeks, perhaps even days.

Yesterday afternoon the ambulance brought Grandma home from the hospital to the newly installed hospital bed - the last bed she will ever use.  I spent a fairly sleepless night, as I am compelled to check on her every hour or two, just to see if she is still breathing.  This morning, we'll have a visit from a hospice care worker, which will give me an opportunity to get some work done.  As I work from home, I won't be far away, but at least I'll be able to relinquish my role as primary caregiver for a short while...