Hospice


That was the question Son Micah asked.  He had not been with us at the time Hospice Social Worker Kristin answered some of those questions.  In forty years of ministry, I have become painfully aware of the process.

We will call Hospice.  The Nurse will come and make the declaration.  We will have all the time we want with the part of Mary Ann we can see, though life has left for another place.  The Nurse will call the Funeral Home to come and take pick her up to begin preparing her for the service.

We will begin going down the list of folks to notify.  I will not put anything on Facebook or the Blog until we have connected with as many as possible of those whom we intend to notify by phone or email.

When the funeral home vehicle arrives, we will send with them the dress, a picture to help them in their holy task of preparing her for viewing.  Once the Funeral Home folks have left, we will conclude the contacting, and try to begin processing what has happened.

We will set an appointment with a Funeral Director for the next day.  There will be an obituary to work out.  We will go over the plans we made many years ago.  Since we have those plans in place, we will not need to go to the casket room and make all sorts of decisions. They are already made.  We will need to write a check for the opening of the grave site into which the ashes will be placed the day after the service here.

One of the things I did today was work out a proposal for the flow of the service, the hymns and readings.  That job is normally left to the Pastor who will do the service.  Pastors are trained to do that, equipped to do that and experienced in doing it.  Since I served as a Pastor for forty years, Pr. Jim is willing for me to have input.  I finalized the hymns we prefer and did what I have done hundreds of times before.  I put them all together into a traditional Lutheran Funeral Service — admittedly, one with a little more music than usual.

It felt good to put that service together.  It did not feel good that the service will be for Mary Ann.  I couldn’t bring myself to actually write her name into the proposal I sent to Pr. Jim and Director of worship Young.  It just felt good to do something, something I know how to do.  Everything else is so completely out of my control, many of the things I am doing with Mary Ann are new to me, we don’t know from one moment to the next what will happen — it just felt good to accomplish something I am actually equipped to do.

We are all getting tired.  Sleep is tough to come by.  I get up at various times during the night to put my hand on Mary Ann to see if she is still breathing.  I wake up in the wee hours of the morning and just lie there, thinking and trying to doze a little.  The kids downstairs sleep fitfully, listening for my footsteps — reassured when they hear them and there is no pounding on the floor for them to come up.  Actually, I will also push the button Mary Ann used to push to get my attention when she needed me.  It is an electronic battery operated wireless doorbell system.

When I went out to run a couple of quick errands late this afternoon, Mary Ann’s breathing acted up, there were some odd and distressing movements, so the kids called and I came back quickly.  I appreciated that they called right away.  She seemed to settle down, but her breathing continues to be very shallow and a little less steady than it has been.  Otherwise, we remain in a holding pattern.  We keep hoping she will let go. It clearly is harder and harder on her when we move and shift her to avoid the bed sores.

Nurse Emily came and delivered some more briefs and adhesive pads for the red spots to keep them from becoming open sores if possible.  She reassured us that we are doing a good job of caring for Mary Ann.  When I asked about it, she said that when we see her in pain, it is better to give her the low dose more often than increase the dose.

I spend a lot of time talking with Mary Ann when I go in to be with her. I have talked about how fulfilling our life together has been.  Whatever we have done, we have been given the gift of wonderful children who have married good people, and produced beautiful, vibrant, healthy Grandchildren, filled with potential.  We could hardly ask for more.   It seemed odd when I realized that I fell in love with her shortly after I turned 19.  I am 67 now.  When I mentioned that to my Daughter, Lisa said she couldn’t remember back to when she was nineteen.  Mary Ann and I have had a lifetime together.  I have said that I have no regrets.  As I think about it, I do regret that we didn’t hug more.  She is too fragile for me to do it, but I just want to hug the stuffings out of her.  (There are no stuffings left to hug out of her — she is skin and bones.)

Don and Edie (and Son Zach) came by to drop off some orange sweet rolls — very tasty.  Don and Zach spent a little time with me talking about how to deal with the pump problem in the waterfall, the Calcium buildup.  Later, Volunteer Coordinator Mary brought by a Tuna Casserole, some of which we enjoyed for supper, along with leftovers from last night’s dinner.

In the evening, I ventured out for the fifteen minutes it takes to get a cup of coffee at PT’s and return home.  One of the owners, the one who travels to visit the locales and the farmers all over the world from whom they buy the coffee beans was there.  Jeff has a wonderful and caring relationship with all those with whom he works to provide the best coffee possible.  I have interacted with him on occasion since we arrived here in 1996.  He handed me his card and told me to call him if we need coffee brought to the house tomorrow.  He would arrange for it or do it himself.  Home delivery is not one of the services coffee shops provide.

Terry, one of Mary Ann’s three friends from childhood phoned this morning to check on her and wish her well.  All three of them and so many others have been checking on her, sending their love, and including her and the rest of our family in their prayers. This is a humbling experience for us — one we, of course, would never have chosen.  It is the capstone of Mary Ann’s life and an experience after which I will never be the same, hopefully a better person for it.

If you want to write a comment about this or any of the posts on this blog, look to the column on the right side of this page, titled “Recent Posts,”  click on the name of a post and you will find a box at the end of that article in which you can write a comment.  Clicking on the title of the post you are reading will accomplish the same thing.  Comments are appreciated.

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The Family has hunkered down now.  Daughter Lisa from Kentucky will stay for the duration with Denis and the girls coming when the time is right.  Son, Micah, Daughter-in-Law, Becky, and Granddaughter from an hour away (the Kansas City area), are now also camping out in the downstairs tonight.  We need to be close to one another and close to Mary Ann.

Of course we cannot know when Mary Ann will let go and head off for the next leg of her journey, or more appropriately said, the destination.  Her breathing is very shallow.  Last night I got up three or four times and went over to touch her chest to determine if she was still breathing.  We want her to stay longer and at the same time to just quietly breathe her last breath without distress.

Her condition seems fragile.  It is getting harder to find a position that does not put her weight on one of the red spots that have been threatening to transition into bed sores.  Hospice Aide Sonya came and managed to give her a bed bath, wash and blow dry her hair.  She was, of course, completely unresponsive during that activity.  Her fever was not very high this morning, but enough to warrant giving her a Tylenol suppository.  This evening her temperature seemed to the touch to be back to normal, so we did not give her the Tylenol.  We have only given her two of the lowest recommended doses of Morphine, since she has seemed comfortable most of the time today.

While there still appears to be none of the expected mottling of the skin, she seems fragile enough to die at any time.  It is getting harder to compartmentalize my thinking and feeling.  The kids seem to share that problem.  We go about our business as if we are accomplishing something, doing various tasks, talking with folks on the phone and those who came by today.  Then we walk into that room and look at the person we love and can’t bear the thought of losing from our lives here on earth, and the pain wells up, ready to break open.  It is hard to maintain the boundaries between the compartments in our lives.  When I am doing other things, outside that room, thoughts of doing whatever it is with her gone from here breach the boundary between the compartments.

There have been moments when pleasing gestures and gifts have lifted our spirits.  Last evening, Neighbor Harlene brought over food to us, so that we would have dinner tonight.  We already started on the chocolate chip cookies last night.  Later today, Janet and Joe, former parishioners, brought over some supper.  Both meals could be prepared with portions for tonight and tomorrow and portions to go in the freezer for later times.  I will appreciate having nourishment readily available after things settle.

Pr. Jim came by to spend some time.  I shared thoughts about funeral plans and he was very willing to help us have a service meaningful to us as well as any who gather with us.  We have the chance of having two wonderful vocalists sing at the service Carol and Kristen.  Carol has been a part of the congregation for many years, directing the choir for a large portion of those years, singing solos often.  Kristen (Carol’s voice student for many years) is based in Boston (has sung with the Boston Pops), sings professionally, and has as wonderful a soprano voice as I have ever heard.  Those plans are still in the works.  We will see what finally is possible.  We will talk with the Director of Worship about hymns and special music. In our tradition we are free to use joyful music rather than dirges at funerals.  We leave with a sense of victory rather than defeat.

Sister Gayle, Niece Diana and Friend Joy have agreed to team up to handle the logistics of a memorial gathering in Northern Illinois for all those who would not be able to travel here for the service.  The plan is that it will include food, memory sharing and a short worship service in an informal setting.

Then, at one point today, the doorbell rang and there was delivered a small vase of flowers, yellow roses, yellow alsternaria and white daisy mums.  Both Mary Ann and I enjoy having cut flowers in the house. We just love flowers outside or inside.  That vase of flowers perked our spirits.  Gretchen, who sent them, was in the first Confirmation class when I arrived in 1996 at the church from which I retired as Sr. Pastor two years ago.  She is soon to complete her thesis as Dr. Gretchen.

A foam wedge was delivered this afternoon to help keep Mary Ann in a position that avoids putting more pressure on the red spots that are threatening to provide serious discomfort.  We are putting Tegaderm patches on the red spots.  They are an almost transparent thin plastic patch that has just enough cushioning to give the skin a chance to heal when red spots appear.  If any of the spots transition to open sores, the Hospice Nurse will come and put a dressing on them.

I have taken a number of breaks from writing to go in and check on Mary Ann’s breathing.  I have thought about what it feels like to be in this time that some readers of this post have called sacred.  Pr. Jim noted a sense of peace when he has visited.  It is a time of very complex dynamics.  There is hardly a more sacred time than the last moments of life.  Death certainly is what helps define life. Someone observed that there is absolutely no difference in the amount of matter, the weight, the chemical composition of a body before and immediately after death.  There is one difference.  Life is gone.  Life does not have material substance, but look at the difference it makes.

These moments of transition certainly are sacred.  There is peace.  There is pain. The one does not diminish the other. Is it peaceful pain or painful peace.  At any rate, they are folded together into one sacred time in our lives, Mary Ann’s, the Kids and Grandkids, and mine.

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She was cold up to her knees.  We called Hospice; the Nurse just left.  I have been in many hospital and Hospice House rooms as the end approached and finally came.  Cold feet meant that the end was creeping up the body.

Her vital signs were good this afternoon when our regular Hospice Nurse made her visit.  The conversation then suggested that the week end, but not likely past the middle of next week would be the time of Mary Ann’s departure.  The fact that she is taking in no food or water played into that expectation.  She would not take even a straw full of water dropped into her mouth.

When we uncovered her tonight to change her, I felt her cold feet.  There is a light yellow hue (not jaundice sort of yellow) up to her knees, and to my touch she feels very cold.  The Nurse checked her pulse in her foot and it was still strong.  Mary Ann’s feet did not feel to the Nurse to be cold in the way they are cold when the dying process has reached the final stage.  There was no mottling on her legs, something expected when death is getting near. Her fever was back to almost normal.

The Nurse reassured us that given the signs, she was very likely to make it through the night. The thought that she might go tonight scared me.  Of course, it is hardly a surprise that her death is imminent.  My defense mechanisms are holding tight and trying not to let go until the end actually comes.  As a result, I am living in a holding pattern.  When there is not some change that tells my insides something else, they maintain the illusion that this will be going on indefinitely.  Every time I go in and look in her face, my insides waver — reality begins to overwhelm the defenses.  The cold feet and legs breached the defenses and started to crack open the dull pain in the belly.  The Nurse took the pressure off and the crack closed for the moment.

One of the spots from lying on one side was concerning this morning.  That red spot needed some attention, so when Nurse Emily came by, we asked her to check it.  She went back to the office to get a translucent dressing to put on the spot.  We will turn her more often tomorrow (morning, noon, supper time, before bed).

During the day three different times spread throughout the day, Mary Ann’s face indicated that she might be in pain.  Each time we gave the lowest dose recommended of Morphine.  Each time it seemed to help.

Hopefully there will be some rest tonight.  Today was a day with much less activity than yesterday.  I got a routine fasting blood test this morning at a nearby lab.  Somehow, a small chip managed to break off a spot on a lower tooth in the very front of my mouth.  My tongue spent twenty-four hours rubbing against that spot — no matter how hard I tried to stop it.  The pain in underside of the tip of my tongue forced me to call the dentist.  He filed it off the rough edge of the tooth so that for the moment the pain should subside  There will have to be more work done at some time in the future.

Last night when I first went to bed, I thought I would leave the light on and watch Mary Ann breathe.  Sometime just before 3am and realized that I could turn off the light I was using to see her body move with her breathing, since I was asleep anyway.  So much for that idea.

Somewhat reassured about tonight, I hope to get some rest.

She mouthed the answer, “Yeah,” but she may as well have shouted it from the rooftops.  I responded, “Thank for the best gift you could ever have given me.”  She has not moved her mouth in response to anyone or anything in about a day and a half.

Her eyes have been closed most of the time.  One eye has opened on occasion, but with little evidence there was much consciousness behind it.  When I came in to be with her for a bit this time, both eyes were open.  I wasn’t absolutely sure she actually seeing me until she mouthed her response.

Her fever is stable at the moment, only a degree and a half above normal.  It has been at that level all afternoon and evening.  We will still use a Tylenol Suppository tonight to try to keep it from rising by morning.

Today was a typically busy Wednesday, in spite of what is going on here.  The Spiritual Formation group met on the deck.  I realized again just how important that two hours weekly is for helping me keep my perspective and my spiritual focus.

During that time Volunteer Elaine came and read to Mary Ann.  Shortly before the end of the group meeting, Bath Aide Zandra came.  We figured out that she had been coming to see Mary Ann twice a week for almost eight years.  No wonder she has shed some tears.  Zandra did a thorough job on Mary Ann’s bed bath, hair washing, as well as changing the bed with Mary Ann in it.  It was good that Lisa came in since she is experienced and could lend a hand.

Hospice Social Worker Kristin came by for a while.  It was helpful to have her knowledge and experience available as we talked through what is going on here.  She confirmed what I already knew, that when death comes, the Hospice Nurse will make the necessary phone calls to get all the basic tasks accomplished so that the family can focus on their notification calls.

Landscaper Sheila came by to work on the garden and waterfall, doing clean up, adding a couple of things needed.  As a gift, she put some Petunias in a huge pot on the ground at the edge of the deck.

Marilyn, a member of the Lead Staff at the church from which I retired, stopped by to spend a few minutes with Mary Ann and some time with the rest of us.  She shared a reading and prayer with us, providing some words of reassurance about the Lord’s presence with us no matter how stormy our life may be at the moment.

Pastor Mike, who will preach at Mary Ann’s funeral (why doesn’t that get any easier to say), stopped by to spend a few moments with Mary Ann, and share some time with us.  We reminisced a while since our history together goes back to 1972.  He listened to stories about Mary Ann.

Then friend Jeanne came by to spend a little time with Mary Ann.  It was a difficult time for her.  Pastor Mike was still there, so we talked together about how hard it is to handle what is going on here.

I have to say, we started out with the refrain that we don’t like this, and as time goes by we are not liking it more and more.  That is an awkward way of saying it, but you catch my drift.  It is more and more painful to go into the bedroom and look at her pretty face, immobile and helpless — at the very same time it is more and more painful to be outside of the room and not with her.

I am glad to be able to feel that pain.  I don’t want it, but it is reassuring evidence that I am still alive and still care and not in denial.  It has always struck me that when someone has a paralyzed limb, one way to check whether or not it is healing is to stick a pin in it.  If the owner of that limb jumps in pain, the arm or leg is alive — healed.

Those who have been where we are, but for a much longer time, have often commented that after a while, they just can’t feel anything any more.  They go numb.  Good news brings little joy; bad news brings little pain.  They have to insulate themselves from their own feelings.  The ups and downs have worn them down.

We are still able to feel the pain.  I can assure you it is more than a pin prick.  Because we can still feel the pain, we still get to feel the love.

If you want to write a comment about this or any of the posts on this blog, look to the column on the right side of this page, titled “Recent Posts,”  click on the name of a post and you will find a box at the end of that article in which you can write a comment.  Clicking on the title of the post you are reading will accomplish the same thing.  Comments are appreciated.

I called the Hospice Nurse when I saw Mary Ann shivering at bedtime last night.  She suggested I take her temperature, and if it was over 100 degrees, she told me to give her some Tylenol (rectally, since she can’t take oral meds any more).  Her temperature was below that.  I covered her to help with the chills and eventually they subsided.

When I got up this morning, the first thing I did was take her temperature.  When taken under the arm it is necessary to add a degree to get the actual internal temperature.  It measured 102.8 plus the added degree, 103.8.  I gave her the Tylenol and phoned the Hospice Nurse.

When Hospice Nurse Emily came over, she checked Mary Ann’s vital signs.  The fever was a little lower than earlier this morning, but not much.  Mary Ann’s blood pressure was fine, her oxygen level was fine (she is receiving oxygen), her lungs were clear, her heart rate was up some.

Nurse Emily said that her heart is beginning to work harder.  The fever is often a part of the process.  Mary Ann clearly has begun actively dying.  Emily said it this way, “Probably not today, but I could be wrong.”  She added later in the day that she expects Mary Ann to be gone by Friday based on her assessment of her condition.

Those words were very difficult to hear.  Lisa, Micah and I keep telling each other how much we just don’t like this.  It is, of course, a good thing for Mary Ann to move to the next leg of her journey, free of all the problems she has endured here.  With that said, we still don’t like it.

The good news is that Mary Ann continues to appear very comfortable.  The fever has edged down a bit.  Mary Ann is not particularly pleased when we jostle her around and poke things in her bottom, but that is just part of it.  Other than those times, she rests peacefully.  Her breathing is not labored.  Her heart rate continues to increase.  Her normal is about 60.  When Emily checked it this morning it had risen a little over 80.  The last time I took her pulse this evening it was about 100.

We have spent the day talking about the funeral, whom to call, what to do back in Northern Illinois where we both grew up and still have family and friends.  The words come out of my mouth as if we are just making funeral plans for someone.  My gut is doing flips while wearing cement overshoes.  (I have no idea what that means other than that it hurts like Hell.)

I have had to finally start thinking about the afterlife.  Hers will be great.  Mine, not so much.  I started making a list of things that I will need to do.  Discontinue Lifeline, let the Bath Aide know not to come — very many more things like that.  What will we do with Mary Ann’s clothes (I can hardly stand writing this) and when.

As I am writing this I am trying to move inches along the path of coming to terms with what is happening.  This morning, long time friend, John from KC, called and offered support.  Later today, Volunteer Coordinator Mary and Parish Nurse Margaret stopped by, brought cookies and spent a little time with Mary Ann.  She, of course, does not respond at all any more, but it is very likely that she hears what is being said to her.

Son-in-Law Denis and the girls headed back to Kentucky.  Lisa has stayed for a few more days, depending, of course, on what happens when.  Micah, Becky and Chloe spent the afternoon and evening here.

We are in a time warp.  There is no sense of what this day is in relationship to other days.  Minutes seem like hours.  Days seem like an eternity — but not long enough to be with Mary Ann.  Sometimes we wander around the house.  Sometimes we eat.  Sometimes we talk.  Sometimes we sit.

We now have all the elements of the Comfort Kit that Hospice talks about.  We have Morphine if there is respiratory distress or severe pain.  There is none so far, other than the heart pain that subsided with the oxygen and one tiny dose of the Morphine.  We have Tylenol tablets for the fever and will receive Tylenol suppositories tomorrow from Hospice.  We have Ativan tablets and will receive Ativan suppositories tomorrow.  Ativan will be used if and when the agitation hits that often comes and the dying process moves along.

I just glanced at the last few posts on this blog.  I can’t believe how fast things are moving.  There are some things that are helping us as we move through this time in all our lives.  I have probably said them before, but I just can’t remember at the moment.  One thing that helps is that there is not so much as a hint of wondering about Mary Ann’s secure connection to a wonderful future.  We don’t have the tools to form a picture of it, but we have no need to do so.  Our faith life as a family allows us to relax and accept the gift of a future given freely by a Loving God.  There is no time that we need to spend with any distress about her future.

We have a strong family with no baggage, no unfinished business to complicate the process of letting go.  We accept that we are not perfect.  I have not given Mary Ann perfect care, but there is a forgiving Lord who frees me from that guilt.  Mary Ann has an estranged Brother, whom I have promised to tell that she forgives him.  The result of all that is that we have the privilege of feeling the pain and sadness, celebrating her impending freedom, all with a peace that winds through our grief.  There will be tears, sometimes uncontrollable, but no despair. We don’t have to like it, but will will live through it, hopefully stronger than before, more compassionate, free to live meaningfully no matter what comes next.

If you want to write a comment about this or any of the posts on this blog, look to the column on the right side of this page, titled “Recent Posts,”  click on the name of a post and you will find a box at the end of that article in which you can write a comment.  Clicking on the title of the post you are reading will accomplish the same thing.  Comments are appreciated.

The oxygen is now running.  It took the oxygen and only one very small dose of Morphine to relieve the heart pain this morning.  Since then Mary Ann has been in bed 100% of th time.  She did not want to sit up any of the times we asked her today. She seldom moves at all, but just lies still, with her eyes open most of the time.

Daughter Lisa and I changed her while she remained lying in bed.  At this point it is not so much how difficult it is to help her in the bathroom but how hard it is on her for us to drag her around that has led us to that approach.  Each thing in its time.  We now have briefs that tape on the sides.

Mary Ann did take some sips of water at various times.  Earlier today, she ate a single serving container of tapioca.  That has been the sum and substance of her nourishment today.

Words are few and far between and barely audible when they come.  We have given up trying to give her any medicine.  She just can’t/won’t take it.

Daughter Lisa was due to leave tomorrow.  She has decided to stay longer.  Our Son-in-Law Denis will be arriving tomorrow evening.  He will stay a day and then take the girls with him back to Louisville, KY.  Gratefully, he has a huge, very close family there, with lots of Sisters and Nieces waiting in line to help with the girls while he is at work.

Needless to say, I am relieved that she will be here at least for a while as this new reality sets in.  Lisa has been a Certified Nurses’ Assistant [CNA] and later an Administrator of a large multi-level Senior Care complex.  She is checking carefully for any red spots that could develop into pressure sores, making sure her Mom is shifted regularly.

Son Micah opted to come for the day today. He dropped out of a BBQ contest in which he was enrolled to spend the day here.  This is hard on both of the kids.  We are all helpless to do anything about this, so we just hang out together, staying close to Mary Ann.  This could go on for some weeks.  The kids will have the challenge of determining when to be here and when to be taking care of their primary responsibility to their respective families (who are wonderful and understanding).

I was planning on attending a wedding this evening and offering the mealtime prayer at the reception.  In fact, that was one of the reasons Daughter Lisa had planned on returning home on Sunday rather than Saturday, so that she could stay with her Mom, allowing me to be away from the house for the wedding.  When all those plans were made, none of us had a clue about what would be happening.

We  have seen a Guiding Hand in the way things have been playing out.  Mary Ann’s decline came on suddenly only days before Lisa’s scheduled visit.  The girls were scheduled for a sleepover with friends, so they were not here last night to be disturbed by the Hospice Nurse and the oxygen delivery.  When there are huge things that are out of control, it is not unusual to notice little gifts that come along the way.  They are signs that we are not alone in this journey.

Tonight’s wedding was the wedding of Christine and James.  Chrissy will soon be an ordained Pastor.  I have enjoyed watching her grow in her commitment to that service.  On occasion when she was in town, as she began and continued her training, we would talk over coffee.  Those conversations always stretched me intellectually and Spiritually.  She has been in Africa a couple of times trying to make a difference for good.  She has a view of humanity that is not limited by national boundaries or ethnicity.

I didn’t like missing the wedding, but, just as I mentioned in an earlier post when I had to miss Katie and Jacob’s wedding, while they spoke their vows I was doing what they were promising.

Time for some rest.

If you want to write a comment about this or any of the posts on this blog, look to the column on the right side of this page, titled “Recent Posts,”  click on the name of a post and you will find a box at the end of that article in which you can write a comment.  Clicking on the title of the post you are reading will accomplish the same thing.  Comments are appreciated.

We may or may not use them since the pain has now subsided.  Mary Ann had some heart pain tonight.  At first, one nitro pill seemed to take care of it.  Daughter Lisa was with her while I had a couple of hour break at a church event.  When I returned, Mary Ann said her chest still hurt.  We used two consecutive nitro pills about ten minutes apart.  She still said she had the pain.

At that point, I phoned the Hospice Nurse.  She suggested trying a third nitro pill.  She also said she would call the Medical Director.  She thought he would probably suggest the oxygen and Morphine.  The third nitro pill seemed to work, but the wheels are now in motion for us to receive the oxygen and Morphine tonight.  It is about 11:30pm as I am writing this.

Today had some tough times and some good times with Mary Ann.  The first activity this morning was at least a half hour of intense physical exertion in the bathroom.  It exceeded the terrible Saturday morning bout a couple of weeks ago.  There was a lot of production this morning when on the toilet stool (a good thing), but the fainting and form of seizure that results in her stretching out and stiffening all combined to make it harder than ever to handle.  I was dripping in sweat by the time it was over.  I did not call Daughter Lisa for help since I wanted to determine whether I would be able to do it by myself — probably not much longer.  I will need to figure out a way to take care of those tasks while she is still in bed.

The good times included a thorough cleaning by the Hospice Aide.  It was a bed bath with the addition of hair washed with shampoo and water in an inflatable basin for that purpose that I bought at the Munn’s Medical yesterday.  Sonya got her dressed and brought her out in the transfer chair.  She had the best hour or so we have had in many days.  She greeted Lisa and Granddaughters Abigail and Ashlyn.  She drank Cranberry juice, she ate tapioca and yogurt, drank water.  Then we rolled her outside to join Lisa in watching the girls use the little slippery-slide Lisa got at Target yesterday.

Neighbor Carol came by and spent time with Mary Ann, as well as Lisa and the girls.  After a while, Mary Ann needed to lie down again.  Friend Jeanne came by for a few minutes to see Mary Ann, as well as Lisa and the girls.  Mary Ann stayed in bed either resting with her eyes sometimes open, sometimes closed for the rest of the day.

At one point in the afternoon, she seemed to want to sit up, so Lisa helped her get up on the side of the bed.  Shortly, she fainted and shifted into the stiff as a board mode.  We got her back lying down.  Later, just before I left for the Youth Fundraiser, Lisa and I took her to the bathroom.  It went reasonably well, but ended with the stiff as a board mode.

…It is now about 12:30am.  The oxygen is here.  Hospice Nurse Lisa brought the Morphine and explained how and when to use it.  Her vitals are so good (other than the blood pressure) including the oxygen saturation percentage, that it seems unnecessary to use the oxygen right now.  If the chest pain returns, I will start it.  That is in accord with Nurse Lisa’s counsel.  The same is so with the Morphine.  I will give the lowest dose if she gets agitated, has trouble breathing, or the chest pain returns.

It was quite a flurry of activity, maybe not actually necessary at this moment since the pain subsided.  It is comforting to have helpful options available for the time that those options are needed.  Things seem to be moving both up and down pretty quickly.  Knowing Mary Ann, I will make no predictions on how things will proceed from here.  I am just along for the ride.

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