Death and Dying

I think this might be a rambling post. I need a place to sort through the jumbled mess that are my thoughts. It may be blunt. It may be raw. But I hope to benefit from time on here typing. So here it is.

My grandma is dying.

She has dramatically lost weight. Her skin hangs off of her. Physically, she is a fraction of the woman she once was. The past couple of weeks have been heart-wrenching. I have burst into tears more times than I can count. I have been deeply sad over her imminent death and maddeningly angry over logistical hoops we've faced as a family to get our preferred care for her.

An incalculable blessing is that my own hospice team has been able to step in and care for my grandma. Some of the aforementioned logistical nightmares made this seem impossible at first, but in the end, the people I work with every day are taking care of my grandma as if she was one their own loved ones. The work that I have given my life to at the moment has reached out and compassionately touched my own family at a time of great emotional vulnerability. We do this for other families. Now we're doing it for mine.

This afternoon, my grandmother's breathing changed. It had become even more shallow and it seemed that her dying was going to happen within a matter of hours. All my family gathered in her room: her two daughters, their spouses, my brother, my cousin, my husband and me. I called my boss in tears and gave her an update. She informed my grandma's nurse who came out to visit, check in, and give us her opinion (to take with a grain of salt). She thinks my grandma may die by tonight or tomorrow.

At this point, I think most, if not all, of my family will see this at a good thing. My grandma's Alzheimer's has been so advanced that she's not been able to really *live* in quite some time. But now, her life has been reduced to gathering breaths in each moment. She can't engage with us. She can't speak. She can't process that we're there. But she's peaceful and comfortable.

I learned tonight that on this day, twenty years ago, my grandma's mom died on 1/3/93. I think it would be significant and meaningful if she died on 1/3/13. I don't want her to die quicker because of this, but I still think it would be serendipitous if it happened.

Because of everything that's going on, I've been so tired and drained lately. I feel sleepy most of the day, but have trouble falling asleep, then have a restless night. I think sheer exhaustion will win out soon and force my body to rest. But I don't see that happening tonight because I fully expect to be called in the middle of the night learning that she's died. My mom and aunt are staying with her. 

I have been very grateful to be involved and help where I can. Whether it's picking up food to bring out to the nursing facility, passing tissues to people who need it, hugging family members, or updating family and friends. A particularly poignant moment for me was when Dan and I went to Belks to help pick out the clothes my grandmother will be buried in. When I asked my mom if any thought had been given to that, she said "Grandma always said she wanted to be warm." We supposed she meant "dressed warmly" and my mom had thought of getting a warm nightgown and robe. I offered to search the stores for an outfit. My mom gratefully took me up on the offer. Due to the Christmas shopping season, finding a set that actually matched was more difficult than anticipated, but in the end Dan, my mom, my aunt, and I were able to find a very lovely pajama and robe combination that we all thought was perfect. The outfit was completed with a matching set of silky panties and warm fuzzy socks.

I know it may seem like too much information to mention the silky panties, but let me elaborate as to why I did. Short explanation: "Gilmore Girls." Longer explanation: One of the main characters, Lorelei, has taken over planning her grandmother's elaborate funeral service and, just when she thinks she's got it all planned out, she realizes she's forgotten to buy underwear for her grandmother. She rushes out to a store and has a wild meltdown with a saleslady. That scene was in my mind when we were shopping and, before I had said anything, Dan commented, "This reminds me of 'Gilmore Girls.'"

It's also been a strange thing to bring in the new year when my grandmother will likely die soon. I typically associate new years with hopefulness, promise, and untapped potential. The end of a year seems a more natural time for death to me, though I am fully aware that death has no set schedule. Still, it's been a sad and pensive new year so far.

Also mixed in with all my other emotions is a sense of sadness because my dear cousin is not here to say goodbye. She moved to Florida within the last several months and hasn't been able to be present when our family has gathered together in the midst of our common loss.

Another thought I've been having is about endings and "lasts." When a new child is born, their world is tumbling over with "firsts." First smile, first laugh, first bath, first crawl, etc. But as I've sat with my grandmother, I've been realizing that I am a witness to her "lasts." Perhaps the last bath she'll be lovingly given by one of our hospice aides. Maybe her last smile. Her last time opening her eyes. The last time she says anything. Maybe even her last breath. There's such a finality to it all.

I keep imagining her at different stages in her life. This has been spurred on even more because of the stories being told by my family members. I imagine her as a school child in class, with her friends, and playing. I think of her as a young wife married to my grandfather. I picture them as new parents, then as parents to girls of different ages. I've been hearing stories about her mothering style, things she said and did. I'm learning about personality traits I didn't get to know and experience for myself. I imagine her as a quietly strong women of great sweetness and hospitality; as a faithful mother, sister, daughter, wife, cousin, and friend. She has loved and laughed. She has made a family. She is my last grandparent in my adopted family. With her death, I feel like my parents are much more exposed. I told Dan today, "If I'm this sad about my grandma, how am I ever going to get through my parents' deaths one day?"

But I think I know the "how." I will get through because I have people that love me. People who are there for me and show me kindness and compassion. I will get through because I have loved my parents and been through so much with them. Just like I will survive my grandmother dying. And hopefully my parents and I will have many more years of memories to make yet.

Within the last year, when my grandmother could still talk to us (though she had already forgotten the grandchildren generation) my church choir went to sing at my grandmother's assisted living facility. At one point, my grandma was watching me sing and she leaned over and said something to my mom, which promptly made her cry. My intuition was correct. My grandmother had remarked, "I want that girl to sing at my funeral." She no longer remembered me, but my singing stood out to her in a way that made her want me to sing for her in the service honoring her life. And I do hope to be able to, though I'm worried I won't be able to make it through. But it will be okay if I have to submit to tears before being able to finish singing. I'm not sure yet what I might sing, but I think it will be one of the old hymns my grandmother loved.

Though she can't hear me when I've said these next things to her, I feel like ending this by typing her a message.

Dear Grandma,

I love you very much. We all do. You have always loved me just the same as the other grandchildren, even though I came into the family differently. Thank you for never making me feel less important than them. I will always remember your fairness, your sweet Henderson accent, your smile and your laugh; smelling your amazing vegetable beef soup when we'd arrive for a visit; getting to go into the formal sitting room when someone rang your front doorbell! Playing in your basement and backyard; going to family reunions with you, getting rides to dance from you; knowing that you were a wonderful mother because of the two beautiful, loving and compassionate daughters you've raised. Thank you for being such a foundational person in our family. We will miss you so much. I hope you find granddaddy and great mama and that you can all be together again.

Love always,
Kelley

On Call Calling

Part of my Residency Program is to work on call about once a week. Last night I had two calls. I was up from 3:45am onward. And while I'm exhausted and will be sleeping soon for who knows how long, I can honestly say that I feel like I made a difference in the visits I was a part of. And that feeling like I was a calming, compassionate person feels good. I hope the thought that I mattered to these people in their crises will help me rest well.

Peace.