We thought the end had come this morning when the bath aide and Daughter Lisa and I were working on her.  She made some awful sounds and her eyes opened wide and rolled back, then she stopped breathing.  After only seconds, she started breathing again.

Poor Bathe Aide Zandra left during that time to let us be with her.  I grabbed a Bible and tried to read a couple of Psalms.  Words and tears mixed, mostly tears.  In a few minutes Mary Ann stabilized to a steady heart beat and steady breathing.

Zandra had pointed out some of the telltale mottling on the bottoms of her feet.  That was at about 9:45am.  We called Hospice Nurse Emily who came out to put a dressing on one of the sores that had developed.  Her blood pressure was low, and the oxygen saturation percentage was lowering.  Gratefully, her lungs were still clear.  Mary Ann again made clear with some scary sounds that she was not happy with being moved.  Nurse Emily indicated the obvious, that it would probably be before the day was done, certainly by tomorrow that the end would come. Emily  was here late in the morning.

We kept close track of Mary Ann’s breathing, which remained pretty steady.  Then we saw that in just an hour or so, the mottling had moved from the bottoms of her feet all the way to her hips.  When we called Nurse Emily about how to determine when to use the Morphine, I told her about the mottling.  She said she would be over at 2pm, an hour from that call.

Emily talked with us for a while and shortly after she left, Mary Ann took what turned out to be her last breath.  We were all immediately at her side.  I had found one of the books I used in the ministry and put it nearby.  I read a beautifully written Commendation of the Dying liturgy.  She died during that couple of minutes.

It is hardly necessary to tell you what came next.  After I gained enough composure, I called Nurse Emily to record the time of death.  Nurse Lisa came first since she was closer.  Then Nurse Emily came and did the official recording of the time.  Nurse Emily and Nurse Lisa prepared Mary Ann for the funeral home to take her.  We had all the time we wanted before they came.

Daughter Lisa and Denis let their two little ones (5 and 7) come in to see Mary Ann. I have worked with families with children often in situations like this.  Letting children satisfy their curiosity and ask questions is very helpful.  It is better to treat things honestly without giving them more information than they want or need.  They need to hear that it is all right for their Parents and the Grandpa cry, and that their Grandma is okay even though she has died.  They need permission to be sad or silly or whatever they need to do.

Granddaughter Ashlyn (5) was mostly excited that she lost her very first baby tooth this afternoon.  She is counting on a very generous tooth fairy.

Son Micah and Becky came in next with eleven year old Granddaughter, Chloe.  This is her first Grandparent to die.  She just needed to do some crying and be nurtured by her Parents.  There were lots of hugs.

Denis took the girls to the park for a while so that they would not be there when the funeral home took Mary Ann out.  They had an appropriate experience without that.

We made all the phone calls we could think to make.  We checked to see if the Funeral could be at 11:30am on Thursday at the church (Faith Lutheran Church, 17th and Gage, Topeka, KS).  It appears that the day and time are acceptable to all parties.

There were more food deliveries today.  There have been emails and phone calls as the news has begun to spread.  At about 4:30pm Pat from Penwell Gabel Funeral home and a helper came to pick up Mary Ann.  I have done so many funerals with them in the dozen years before I retired that they are more friends than they are funeral home staff. Our appointment is set for 11am tomorrow.  We will take the dress and the pictures at that time.  Son Micah is working on a draft of the obituary.

Lisa and Micah have each been doing their grieving in ways that work for them.  There have been hugs and tears.  Each of them has a Spouse who provides them with love and support without limit.  Is is such a comfort to a Father to see that.

Pastor Mike came over and spent the next couple of hours with us, just talking about Mary Ann and our life together, as well as what might be in store for me.  It gave me a chance to talk, something I do especially when I am dealing with my feelings.  It is my mechanism for processing things.  It served as a way to keep at bay the sadness that is sitting in my gut.

I have to say that the sadness is much different from the pain of these last couple of weeks as I saw Mary Ann decline to a shadow of her former self.  The horribly painful knot in my stomach, feeling her pain, untied immediately after she died.  I want her back, but I could not tolerate seeing her in that condition any longer.  I find myself talking as if I am just fine, while just under the words are tears and sadness and a dull pain — a new one, different from before.

She no longer is in pain. That is the best news imaginable.  In my faith tradition there is no doubt that she has transitioned to a kind of joy and peace immersed in love beyond human comprehension. For those whose view of reality does not include a similar spirituality, the release from the pain and suffering of the last couple of weeks especially, is a great good.

My hope tonight is that I will share a bit in her peace by getting a good night’s sleep.  Whether or not I can sleep is another one of those things over which I have no control.  I am really getting tired of all the things over which I have no control!

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 have tried to write about our experience honestly.  To do so has required my revealing the harsh realities of painfully ordinary people.  I could try to create the illusion that we are a saintly household above all the weaknesses and failures and missteps that plague regular folks.  I could try, but this blog is not fiction.  It is too much work to make up stuff and keep it all straight.

I got up this morning after a night of watching her, feeling for her pulse, putting my hand on her chest to be sure she is breathing, getting up and putting my ear next to her mouth to be sure I could hear the breath going in and out.  I was tired and grumpy and angry.  Why does she have to be so stubborn?  Why can’t she just let go?  What a jerk I am to be angry at someone who has suffered so for so long and is now in the throes of dying!  I just can’t stand seeing her weak and vulnerable and in pain.  She would hate it!  She is a proud and strong-willed person, not about to be found to be weak.  I am not angry at her.  I am scared and sad and in pain with absolutely no one to blame.

I suppose I could waste a lot of time and energy being angry at God, but pain and suffering are not God’s idea.  God often gets the blame for the bad stuff (usually perpetrated by people doing the opposite of what He has asked us to do).  God more rarely gets credit for bothering to give us the breath of life and everything we just assume is our right, belongs to us.  I can’t waste my limited stamina being angry with the only One who can actually help both Mary Ann and me as we pass through this transition in our lives.

I wish I could cry, but I think the tears are waiting until this is over.  Every day seems like an entire lifetime.  This morning I was grumpy and angry.  I went to the computer to find that one of the other two in our online Lewy Body Dementia Spouses group at the same stage we are in lost her husband finally this morning.  Here is what I wrote to her:

Doris,
My thoughts are with you.  We are still in that time that has extended beyond the fear of the end to a longing for it to be over.  Rest now from your and Philip’s winding, uphill, exhausting and exciting journey to this point.  I wish you well as you take the best of what Philip has brought into your life, discover who you will become now that he is not with you here, and find joy and fulfillment when finally the pain finds a quiet place to remain as your own adventure continues.
Peter

Somehow reflecting on her loss, helped me regain a bit of perspective.  My anger and grumpiness are just a function of feeling utterly helpless, struggling to accept something I don’t want to accept, already missing horribly someone who has been in the center of my life for decades.  Yes, we could irritate the Hell out of each other sometimes, but that is precisely because we matter so much to each other.

The lifetime lived today included treating sores (none open yet), inserting Tylenol suppositories, cleaning and turning bones stretched with bruised skin over them, administering Morphine before the three times of turning to lessen the pain revealed by her grimacing as we worked on her.

The lifetime lived today included good friend and former co-worker Jim and Joanna, hugs and conversation and prayer.  A full, hot meal appeared at the door, delivered by Shari, member of our little Spiritual Formation group that meets for a couple of hours weekly.  Good Buddy Jimmy came by bearing a gift and concern for us.

Today’s lifetime included moments with Granddaughter Chloe, lots of words and acts of support for one another between Daughter Lisa, Son Micah, Daughter-in-Law Becky.  Today included the return of Son-in-Law Denis and Granddaughters, Abigail (who now wants to be called Abby) and Ashlyn, both full of energy and grateful to be in Mom’s arms again after being gone so long.

In today’s lifetime our downstairs bedroom and family room have become a campground.  It is very good that our small town home has three full bathrooms now that we have finished the downstairs and many people in it.

During this lifetime, the one lived today, fatigue has been a constant presence.  The consensus was that it would be good for me to go into the bedroom with Mary Ann, shut the door and just rest. Grumpy Grandpa is not their favorite family member.  I did so at least three times in this lifetime, today.  It helped.  Nothing can remove the tired with which I woke up, but it helped.

Lifetimes include sunshine and storms.  Today began with rumbling thunder, and moments ago the power went off for a moment, turning off the computer and the oxygen machine.  Needless to say, both are working again.

This day’s lifetime will now continue into the night.  At least intellectually, I have determined that it is not necessary for us to be awake and with Mary Ann at the moment of her death.  We love her and she knows it.  We have cared for her and doted on her for days.  Micah asked Lisa how long she has been here.  It has been eleven days that this watch has been going on.  It actually started two days earlier. We would love to have the privilege of surrounding her at that moment.  It is, however, not necessary for me to try to stay awake all night checking her breathing.  While I know that intellectually, we will see if knowing that has even a shred of influence on my insides and my actions.

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.

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.

What will she wear, what songs will be sung, what passages read.  We talked about some of those things years ago when we filled out forms for a Pre-need plan at the local funeral home.  The major decisions are already made.

I have to admit that it is painful even to talk about such things.  It was fine to do so many years ago — not now.  I am refusing to allow it to sink in and touch my gut.  The pain is there, but it is an aching now.  I have tasted it enough to know that the pain will sharpen and overwhelm when it breaks open.  Certainly I will survive as have tens of millions before me.

Friends Mike and Judy came over to spend time with us today.  As always it was a good and meaningful time.  Mary Ann connected with their presence and appreciated it.  Since Mike is the Pastor who will preach at the funeral when it comes, we needed to talk some about that.

Later, Pastor Jim, who followed me as Senior Pastor of the congregation I served for a dozen years, came over to celebrate Holy Communion with us.  There were enough of us to feel like a congregation.  Pastor Jim provided a meaningful ministry through a service of Scripture, prayer and song.  With three Pastors, two Spouses of Pastors and one Daughter of a Pastor, we surprised Jim by knowing the words to the songs (multiple stanzas) by heart.  He didn’t have to sing solo.  We were a choir.

One of the songs we sang is “Beautiful Savior.”  Both Mary Ann and I grew up in the same congregation in Aurora, Illinois.  Every Sunday worship through all the years we were growing up ended with “Beautiful Savior.”  As we gathered around Mary Ann’s bed and worshiped, sang and shared the bread and wine of Holy Communion, there was a peace about what is happening.  Mary Ann was a part of it even if she was not able to sing out loud with us.

With that said, as Son Micah commented later when he arrived, “this is hard.”  It hurts.  It just hurts.

Mary Ann seemed to have a comfortable day.  Last night, I was up a few times to listen for her breathing.  I tried to move her a little to minimize the pressure sore problem.  This morning when Lisa and I changed her, she did not show much evidence of the first stage of pressure sores — just one red spot on her ankle.  It was a relief to me that she seemed to fare well last night.  She does not move at all other than a foot moving a bit once in a while.  That is a formula for bedsores.

One happy surprise was that while Lisa and I were rolling Mary Ann this way and that to change her and check her, it just caught our funny bone.  We started laughing and so did Mary Ann.  It was not audible, but had it been, it would have been a belly laugh.

Lisa headed off for church and a local Art Fair.  I read a bit, then started a new book, titled Broken Open, by Elizabeth Lesser.  It is subtitled “How difficult Times Can Help Us Grow.”  How is that for timely.  It was recommended by the online Lewy Body Dementia Spouses group.

I decided to move into the bedroom to read, just so that I could be with Mary Ann.  It was a pleasant experience.  She seemed comfortable.  I asked how she was doing and she responded audibly that she was okay.  We just had some quiet interaction.  I gave her some water.   I realized just how wonderful it is to be able to spend this time in our lives together at home.

Later in the day, Son-in-Law Denis, arrived to provide Lisa with support and help with the girls.  Denis and the girls will be going back to Louisville on Tuesday.  Son, Micah and Granddaughter Chloe arrived at about the same time as Denis.  This was around the time Mike, Judy and Pastor Jim left.

Lisa and I changed Mary Ann again, examined her for red spots and turned her.  It was disappointing to see some red areas, indicating the potential of pressure sores beginning.  I plan to phone the Hospice Nurse tomorrow about the possibility of a hospital bed with the self adjusting air mattress on it to help avoid the worsening of those spots.

One annoying element in the day was the waterfall simply stopping.  It just stopped.  No one did anything to it.  It just stopped.  I was able to get hold of Brad (through his wife since they were driving) who promised to come after his work tomorrow afternoon to work on it.  Brad installed the pondless waterfall.  I certainly realize just how important a role that addition to our home is now that it is not working.  We built the sun room so that we could see the waterfall!

While Mary Ann is, of course, very vulnerable, and anything could happen at any time, she still seems fairly strong.   She ate a small dish of ice cream this afternoon while lying in bed. The Orthostatic hypotension has been so bad that it is pretty much impossible to sit her up for more that a moment.  Her blood pressure drops and so does she.

We continue to take things as they come, grateful for what we have, hoping for a peaceful release when the time comes.

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 are really not liking this!  The four of us, Mary Ann, Lisa, Micah and I are in limbo.  Now we know more about the landscape of limbo, at least this one, but it is still limbo.

Mary Ann has not yet begun actively dying.  Vital signs are not falling into the pattern of those dying of physical illnesses such as Cancer.  That could be comforting, especially to kids who live out of town, hoping to have time to get back when the end is near.

Of course, it is not likely to work that way with Mary Ann.  Apparently, dementia patients often don’t play by those rules.  They may have solid vital signs up to the moment they die.  When the mind precedes the heart or other organs in precipitating death, it can just happen whenever it chooses. There may be no warning.  It just goes with the territory.

I have become accustomed routinely to listening carefully when Mary Ann is sleeping or unconscious.  I listen to see if she is still breathing.  There is a new level of awareness of how easily my listening could reveal that the end has come.  Even after Hospice Nurse Emily said that, I still expect there to be more preliminary signs that the end is nearing. Many of those in the online group of spouses with Lewy Body Dementia, have described a traditional shutting down when their Loved Ones died.

When Son Micah asked if Mary Ann was now on a trajectory of probably weeks, Nurse Emily said that what has been happening suggests that that is a correct assessment of her condition.  She quickly added the disclaimer, that things could change and Mary Ann could bounce back to better health for a time.

We talked about how much of what is happening might have more to do with the medicine than the disease process itself.  Nurse Emily reviewed what has been happening in these past days, noting that Mary Ann has not had many of her pills on a regular basis.  While the meds may be having some impact, the trajectory of the decline seems pretty clearly to be the disease process bringing her to the last stage of the disease.

In responding to my request for either some form that is easier to administer or permission to drop Mary Ann’s Crestor for cholesterol, the doctor suggested discontinuing it.  He said we could crush it if we wanted to continue administering it.  The truth is, I haven’t yet tried to give her any of her night time meds.  At this point in the process, Mary Ann’s comfort is the prime issue.  Any of the meds that will help keep her comfortable, have priority.

Even food is optional.  If Mary Ann wants some thing to eat, or will take it if put to her lips, she will eat.  If she indicates she does not want the food, that is her choice to make.  If she will take water or juice, we will be sure she has all she wants.  If she will not, that’s that. When at this stage in life, the body needs very little to sustain itself.  She will know what she needs and when — and if she wants to have it.

While she would not so much as take a drink of water most of the day today, late this afternoon, whe she started moving around in bed, Daughter Lisa got her up, helped her with personal needs, and started feeding her applesauce.  She ate about a cup of applesauce followed by a small piece of ice cream pie, followed by some water.  Lisa fed her the applesauce and I fed her the pie.  She was up for a couple of hours.  We are suspecting that the Granddaughters’ activity helped stimulate her to stay present with us for such a long time. I took her in to lie down when Nurse Emily came for the family meeting.

There is absolutely no predicting how this will go.  Mary Ann is not about to follow anyone’s expectations for the path she will take.  This will happen on her terms, and no one else’s.  God’s role was making her, not telling her how and when to die.  Gratefully, God’s love for her is without limit, just as it is for the rest of us.

With that said, those of us who love her certainly are in limbo.  It is too soon to begin grieving her loss.  She is not gone.  It was sort of odd to hear Nurse Emily speak to us words that I have spoken to hundreds of others in forty years of ministry.  She urged us to work through our feelings and when we are ready, to share with Mary Ann our love for her and let her know that we will be okay when she decides she is ready to go.  It is not urging a person to die, but giving permission to go when the time comes.

Mary Ann took a few sips of water when I went in at about 11pm.  I gave her a heart med and one that helps her sleep.  She seemed to manage swallowing them.  I will be very interested to see if leaving out so many meds will affect her sleeping pattern.  I hope we can find our way to restful nights as often as possible in what time we have left together.  That would be good for both of us.

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 simply could not get her pills into her mouth and swallowed this morning.  It is the first time this has happened other than many weeks ago when she slept through a few days.  She drank a couple of ounces of Cranberry juice as I prepared to give her the pills.  Then her lips sealed shut and she ceased to be responsive at all.  I was going to try to force the pills into her mouth, but when I determined that she could no longer drink the juice or water, I knew that I could not risk her choking on the pills.

Yesterday she stopped swallowing after swallowing her pills and eating a few spoons of yogurt. At lunch yesterday, she stopped swallowing after a few bites of food.  Last night she managed to swallow her night time pills.  Today, she stopped swallowing anything, including water for the entire day.  She got no pills, no food, no water.

She sat up some, with the saliva coming from her mouth much of that time.  Our Son, Daughter-in-Law and Granddaughter arrived in the late morning to spend the day with us.  For a while after they arrived, Mary Ann remained in the chair.  She was pretty much unresponsive, even to our Son, who can always get a response from her.

After a while I took her into the bedroom to lie down.  It became apparent that we needed a trip to the bathroom.  Our Son has been through helping his Mom with bathroom duties, so he helped with the project.  It was a comforting to me for him to have a first hand experience of just how difficult that task is.  It was hard even with two of us doing it.

After that, Mary Ann settled into bed for a long time.  I enjoyed the time with Son, Micah, Daughter-in-Law, Becky, and Granddaugher Choe (11yrs old).  We spent most of the day watching the large screen wildlife display provided by the sun room and waterfall at the back of our house. I realized I have little to talk about other than Mary Ann and the birds.

We talked about the current change in Mary Ann’s situation.  It has profound implications.  We have both signed Living Wills excluding a feeding tube.  If Mary Ann is no longer capable of swallowing food, we have just come to the end of a long journey.

Son Micah and Daughter Lisa (in Kentucky) talked on the phone for a while so that Lisa would be fully aware of what is going on.  She and the girls are due in this Wednesday evening to stay for a few days.  This scared all of us.  We are not ready for things to move to the last stages.

I phoned Hospice to talk with the on-call Nurse.  When she responded to the page, I explained the situation, voicing special concern that Mary Ann was not able to take  her morning meds.  The Nurse mentioned that in some cases meds could be given rectally (whoopee!).  She said she would phone the Pharmacist and check to be sure of that. When she called back, the Pharmacist had told her that the meds Mary Ann is taking are not ones that have been shown to be effective when taken rectally.  We could do it, but it would not be likely to do much good, if any.

It seemed reasonable to accept one day of no meds, but that certainly could not continue.  I concluded that I would make one attempt at giving them to her orally, and if that didn’t work wait until morning.  I asked the Nurse to connect with our Hospice Nurse in the morning so that we could talk through options.

It has been a pretty tough day contemplating what might be coming sooner rather than later.  I went in regularly whenever we saw on the little video monitor that Mary Ann was moving at all.  Each time I asked if she wanted some water.  At this point I am not sure of the time, but around the supper hour or a little later, she was moving some.  I went in and she took some water and swallowed it — the first time since the few swallows of juice first thing in the morning.

When I asked her a couple of questions, she was able to answer, “no” (more water? get up?).   Not long after that she stirred again and this time was willing to get up.  I asked if she was hungry.  She said, “yes.”

Then came a very pleasant surprise.  I should have known!  On a whim, when returning from getting some coffee, I picked up a Baskin and Robbins Grasshopper Pie.  Mary Ann ate every bite of a good-sized piece of that pie.  She swallowed every bite, and drank lots of water afterward.

She responded a bit to Micah after that.  The Kids headed back home.  Mary Ann soon went back to bed.  I decided I would act as if she had no trouble swallowing and follow the usual routine of telling her what I was doing, sitting her up on the edge of the bed, putting the pills in her mouth and giving her water to drink through a straw (the norm for how she drinks).  She swallowed the pills!

I did choose to reduce the Seroquel from the 150mg she has been taking since January, to the 100mg she was taking before that.  Since it has become absolutely clear that the Seroquel exacerbates the problem of hallucinations, and since one of its main purposes is to produce sleep (too much daytime sleep in the last days) it seems reasonable to try reducing this.  In some folks who have taken Seroquel, it has produced a powerful drugged state.  We are living pretty much at the end of our options, so I am giving it a try.  Of course I may regret doing so depending on what happens.  There is just no clear and standard approach to this form of dementia.  It is just too unpredictable with no consistent responses to medications.

One characteristic of forms of Lewy Body Dementia is that people can present with symptoms that cause Hospice or whoever is doing the medical care to suggest that the family be notified that the end is days or hours away.  Then the patient can turn around completely for no apparent reason and return to relatively full functionality.  With some folks in the online LBD Spouses group that has happened more than once.

I don’t know if we have just come back from the edge to have lots of time yet, or if tomorrow will bring us back to the edge.  When I got out of College and Seminary at 26 years of age, I knew so much.  Now at 67 I know so little.  What happened??

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 forgot to put the clothes in the dryer and it is well past midnight.  I thought I was going to just write a couple of sentences of update, but I don’t want to leave wet clothes in the washer overnight.  There will be items that need to come out of the dryer immediately and hung on hangers to keep from getting wrinkled while sitting overnight in the dryer. I will have time to write more than a short update.

When I was a child, I remember routinely finding a plastic bag of wet clothes in the refrigerator to avoid mildew until they could be ironed. The rest hung outside until dry — even in freezing weather.  In rainy or snowy weather they would be hung in the basement to dry.  By the way, Mom ironed everything, of course shirts and blouses and pants and skirts, but also sheets, pillow cases, handkerchiefs, T-shirts and underwear.  I am unable to run the iron.  It is an unfortunate disability that has no cure.

Today Mary Ann got up early and just headed out the door of the bedroom.  By the time she reached the door, I woke from REM sleep containing one of those pastor dreams in which there is a service that I am leading and I am not prepared, or something that I need can’t be found, or I have lost my place in the service book.  I guess I should thank her for ending the dream, but I certainly was not done sleeping.

I moved quickly and got her seated so that I could put on something and take her out for food and pills.  Almost immediately after eating, she agreed to lie down in bed for a while so that I could get a little more sleep.  She ended up sleeping for close to three hours.  I got about an hour and a half more of sleep.

After she got up, I gave her a sandwich for lunch.  Then came some reluctant intestinal activity, needing my assistance.  When that was done, she was very tired again.  She had fainted a couple of times before and after lunch.  She slept again, for about an hour and a half. Oddly, when she awoke, she was convinced that it was early in the morning.  It was actually after three in the afternoon.  She didn’t seem to believe me at first.  It took quite a while to finally convince her that it was not early in the day.

While she was napping Arlene came over with a plate full of fudge and candy she had made.  Wow!  Is that stuff good!  Later Glenn and Margaret brought over a plate of goodies.  They also are very good.  Yesterday afternoon, Don had brought over freshly smoked salmon and bread.  In each case we were the recipients of a wonderful gift of food and, in addition, some pleasant conversation — especially enjoyed by this retired pastor suffering from Diminished Conversation Opportunity Syndrome.

This evening our Kids from Kentucky (staying with us) took us out for an Anniversary Dinner.  Our little five year old Granddaughter, Ashlyn, was diagnosed with a Strep infection this morning, so she was not a happy camper today.  She was feeling well enough for us to go to Famous Dave’s and enjoy a nice meal.  I ran into one of the young people from the congregation I served here, reminding me just how much working with Youth meant to me over the years. (The majority of my 407 FaceBook Friends are Youth.)  Juli is a beautiful young lady inside and outside, with a heart of gold.  Her Mom is one of the Volunteers who stays with Mary Ann.

Dryer is done!  So will this post be done soon.

One interesting sidelight today is that Denis bought a Wii for the family.  They tried it out this afternoon.  They are going to love playing that, especially when they use it on their large screen digital television in the large family room at their house in Kentucky.  We tried to help Mary Ann do some bowling, but the coordination just isn’t there.  I have often thought about how beneficial it might be to have a Wii to help Mary Ann stay active.  She loves games.  I have been waiting for clear evidence that it will actually accomplish the goal.  It is too expensive to buy and then find out it is not helpful.

An update: Daughter-in-Law Rebecca’s Gall Bladder surgery went well today, and she is at home, feeling good (according to the last emailed report).  The email was titled “Weight Loss Program” using the removal of organs as the means.  She is a Corker!

Time to edit and get 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.

On Sunday it was a real joy to have all nine of us in this small immediate family together to eat and talk and open presents.  Each of us will incorporate corporate worship in the our celebration later in the week.  For that day our time was spent celebrating what the Lord has done in our little family. 

I am sure Mary Ann enjoyed the day, even though she headed in for a nap right when our Children and Grandchildren arrived.  After a couple of hours of preparation for the meal, Mary Ann got up to join us for a late lunch.

We now have a spotlessly clean oven!  We were able to reheat the Prime Rib that was “smoked” two days before in the oven that had Honey Crunch Pecan Pie deposits on the bottom to flavor the smoke.  This time there was no smoke!!!  That is especially good since our Son and Daughter-in-Law brought the ingredients for the Triple Fudge Cake they often make for family gatherings.  Yes, they brought ice cream to eat with it.

The directions for the self-cleaning oven made it absolutely clear that all the pools and puddles and burnt patties of stuff on the bottom of the oven needed to be removed before using the self-cleaning function.  I had, of course, figured that out before reading the directions, after having smoked both a pie and a Prime Rib.

Saturday’s preparations for the family gathering and meal on Sunday went reasonably well.  Putting together the grape salad (extremely good), and the cheesy potatoes was not difficult.  The combination of Mary Ann’s napping and a long lunch out in the mid-afternoon pushed the preparations very late in the day.  There were some other household chores.  As a result the present wrapping ended up going until 1:30am, long after Mary Ann had gone to bed.  It is at times like this that I really respect single parents who take care of everything themselves, including all the needs of their children.  It is surprising to discover how fast small and seemingly insignificant tasks can add up to proportions almost impossible for one person to manage.

Again, this is a sexist observation, but nonetheless true for me.  As a male Caregiver, tasks that my Mom did when I was growing up, tasks that Mary Ann did, enjoyed doing and did well, I have found to be very difficult.  They are not necessarily difficult tasks by themselves.  It is the comfort level with doing them that is the problem.  Shopping for Christmas presents, wrapping them, getting and sending Christmas cards, putting out Christmas decorations, as well as food preparation don’t come naturally to me.  They are just uncomfortable enough for me that I come up with all sorts of reasons to postpone dealing with them.  The Christmas cards are still in the unopened boxes sitting in a bag on the floor.  I should be working on that instead of writing this post!

Mary Ann enjoyed the day Sunday, but got very tired late in the afternoon.  There was a much anticipated Choral Eucharist at church last evening at the time we usually worship on Sundays.  It was clear that Mary Ann would not be able to manage the Service.  She was in bed for the night not too long after 6pm, the same time the Service started.

This time there was no option of my leaving Mary Ann at home with the family.  Our Daughter had surgery two weeks ago and could not help Mary Ann physically, Our Son could have helped with her, but he had to take our Daughter-in-Law home since she is having Gall Bladder surgery on Tuesday.  She was also very tired.  As a result, there was no one at the house other than me who could take care of Mary Ann’s personal needs.  I missed the opportunity to enjoy a wonderful worship, our choir and soloists, instrumentalists, bell choir, our Organist-Choirmaster, all of whom are outstanding.   The quality has always been far beyond what would be expected for Volunteers.  It always sounds very professional as well and meaningful Spiritually.  The Christmas celebration has a completely different feel as a retired pastor.  While we will attend church on Christmas Eve, the services with full choir and soloists come too late in the evening for Mary Ann.

Gratefully, what the celebration is about transcends any specific event in that celebration.

The Christmas celebration meal was okay, but the Prime Rib did not go over as well as I had hoped.  The rare look of a good piece of Prime Rib is not appetizing to everyone, especially little ones.  Thank goodness for Kraft Macaroni and Cheese.  Actually, our Son, Micah, and Granddaughter, Chloe, would probably not be alive today if it were not for Kraft Macaroni and Cheese.  Our Daughter, Lisa, found the microwave to be what was needed to get the red out.  She admits to having an aversion to meat that provides any visual evidence that it was ever part of a living animal. 

Today has been a sort of recoup day, with minimal activity.  Mary Ann again needed to crash for a about two and a half hours mid-day today, even though she slept well last night. 

Mary Ann continues to seem less functional and engaged, and more tired than in the recent past.  I am not sure about that since I am with her all the time.  One particularly bright spot was an email from Marlene, one of the Kansas City Crew, who took a picture of us on Friday.  Mary Ann was smiling.  It seems as if it has been an eternity since Mary Ann was caught smiling in a picture.  If I can figure out how to do it, that picture may make in on my FaceBook page. 

It is a very good thing to have our two little Granddaughters here at the house for a few days.  There have been plenty of Grandma and Grandpa hugs to brighten our days.  Our Daughter, Lisa, is deeply caring and her love for her Mom is apparent in everything she syas and does.  She is also a tremendous support to me.  Our Son-in-Law, Denis (yes, spelled with one “n”), is a man of great character, who is willing to do anything he can to help us. 

Whatever our challenges, our Children, their spouses and our Grandchildren provide us with joy beyond measure.

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.

Maybe this will be our new Thanksgiving tradition, barbequed ribs, pork and brisket with stuffing on the side.  The meal was tasty, lots of food, great desserts, both pumpkin pie and Baskin & Robbins Grasshopper Pie for Granddaughter Chloe’s birthday treat.

Mary Ann seemed pretty tired today, especially in the morning before the kids came.  She did not talk much during the day, but Son, Micah, got her to laugh a few times. He has a way of connecting with her that is fun to watch.

Chloe is, of course, a breath of fresh air.  She is warm and engaging always making clear to both her Grandma and her Grandpa that we are loved.  She is such a sweety.

Becky brings a brightness and positive energy with her that lifts us up.  She treats us with love and respect, always thoughtful of our unique circumstances.  She always provides relief from the cleanup task by insisting on doing it for us.  That gift does not come from some automatic domestic role expectation, it is an intentional and thoughtful act of generosity, offering me some respite from the task.

Chloe and I did a little bird-feeding together.  Micah helped with a clean up of some of the Cypress needles that had fallen into the lower area of the pondless waterfall installed last summer.  I described to them plans for a possible remodel to the back of the house that would provide additional indoor space with lots of glass so that we could enjoy the waterfall and the birds more than we can now, since there is no easily accessible view of the water fall from inside the house.  No decision is made on the project, but the decision-making process is in motion.

Later in the afternoon, Micah shared something he had been thinking about.  He has plenty of access to information on my side of the family in terms of health history.  My siblings are all living, and over the years he has had a fair amount of contact given the geography with cousins.

Micah noted that he has very little knowledge of his Mom’s side of the family.  Only Mary Ann’s Mother was still living when Lisa and Micah were born.  Two of her three brothers died, one of Lung Cancer and the other of Acute Leukemia, when Micah was almost too young to remember.  The third brother chose to alienate himself completely from the family at the death of their Mother.  It is pretty much too painful for Mary Ann even to talk about.

As a result, Micah did not have a chance to get to know her family other than her Mother.  The same is so for Lisa, although, since she is three and a half years older than Micah, she probably has a few more memories of her Mom’s brothers.

What developed from the conversation was the idea of our traveling back to Northern Illinois to visit with Mary Ann’s two deceased brothers’ families to hear stories about them that will help fill in that void of knowledge.  The email has gone out to see if there is a possibility of having a family gathering to reminisce and share stories.

After a nice time on the phone with our Daughter Lisa, who shares her brother’s interest in connecting with their Mom’s family, Mary Ann has settled into bed, and I have been thinking about Mary Ann’s family connections.  She loves and is loved by her family.  The death of her Father, a few weeks after we were married, the deaths of her two brothers (each one at the age of 51), being hurt so deeply by her other brother as that relationship was severed, and finally the death of her Mother, left Mary Ann feeling very much alone.

Her Sisters-in-Law and her Nieces and Nephews seem to love and respect Aunt Mary very much.  She is not only separated from them by geography (a ten or twelve hour drive demanding two days of travel for us to get there).  She cannot talk audibly on the phone, or react quickly enough to maintain a conversation on the phone.  Sometimes she can’t get any words at all to come out.  She hasn’t been able to write legibly for the last few years.  She cannot negotiate a computer keyboard or control a computer mouse.  It is frustrating to her and to those who long to interact with her.

I hope something materializes that will allow our children a window into Mary Ann’s family, and a chance for Mary Ann to feel part of a family of her very own.

Tomorrow afternoon is the first meeting with our Cardiologist after the trip to the hospital for Congestive Heart Failure three weeks ago.  He was out of town at the time of the hospital stay.  I delivered to his office a letter and attachment requesting consideration of a change in meds that might help with the fainting while not raising her blood pressure when lying down.  I intend to report on that visit in tomorrow evening’s post.

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.