Love and Loss

Not a very original title, I know.

I have no specific plans for what I'll write as I begin typing this, so it's bound to be disjointed in the end. Sorry...

Just last month, we visited Grandma on her birthday in her little apartment at the assisted living home where she lived. We asked her all sorts of questions about her life.

When she was about three, her younger sister was born there in the family home. Grandma saw her aunt standing in the kitchen, holding a little baby and she thought her aunt had just taken the baby out of the oven like a loaf of bread.

She remembered when World War I ended! Yes, that's WWI, not WWII! She was just a little kid and she stepped out into the street in front of her house. All the neighbors were outside, happily yelling, "The Kaiser's dead! The Kaiser's dead!"

Her father suffered a horrible bout of the Spanish Flu that killed millions of people around the world back around 1918. He lived for another three years, but he never recovered, so a subsequent illness ended his life. Grandma remembered going into the room where he was lying in bed and talking to him. He must have known he was soon leaving Earth when he told her he wanted her to be a good girl. She said that for years after that, she thought that he was the one watching her from heaven instead of God.

Her mother made her and her sister wear sunbonnets on the two mile walk to school. However, her mother never knew that there was a certain tree a couple of blocks from the house where they would stash the bonnets until the afternoon walk home.

At thirteen, she claimed to believe in Santa Claus because she feared she wouldn't get her stocking filled if she fessed up.

A few years ago, I wondered if Grandma had struggled with her body image as most girls/women are prone to do, so I asked her, "Grandma, when you were a teenager, did you feel attractive?"

The little embarrassed smile I'm so familiar with crept onto her face. "Yes," she said.

Delightfully surprised, I said, "Really? What about you made you feel attractive?"

The shy smile continued to grace her face as she responded, "My shape."

Ha! I was so amazed to hear a former teenager say that they liked their body as a teen. I unabashedly asked if I could see pictures of her as a young woman, expecting to see a Marilyn Monroe look-alike with my grandma's head.

Looking at the pictures that she brought out, I saw that she had been a well padded teen, about 25 pounds overweight by today's standards. How wonderful to feel attractive and still be able to eat. :) Good for her.

Boys did indeed find her attractive. She said, once a young man came to visit and when he was about to leave, he went around kissing the entire family goodbye and she suspected it was all so he could kiss her as well.

She dated a bit and one night she kissed a fellow goodnight when he walked her to the door. Entering the house, her disapproving mother said, "When I was a girl, we only kissed a man goodnight if we were engaged to him."

"Well, Mother," she responded, "I guess I'm engaged to half the boys in town."

(Poor Great-Grandma May! I wouldn't enjoy hearing Delaney say that!)

There are so many questions I wish I had asked.

Last month, Grandma went to the hospital with breathing problems. They drained two liters of fluid out of her left lung. We looked at the nasty fluid in the bottles that the nurse had not yet taken away and she was right when she said, "That looks like something out of a spittoon."

That spawned another story. She said that when she was about 8, she would visit a neighbor lady. They'd sit out on the porch and talk while the lady chewed tobacco. The lady had positioned a spittoon several feet from her chair and she would amaze Grandma by accurately spitting into the spittoon every time. Grandma said she loved visiting that woman! (I wonder what her teeth looked like. :( )

Anyway, Grandma was in the hospital for a few days. A week after she was discharged, I took her to see her doctor for what I thought was a post-hospital check up. I didn't realize that he was going to make an announcement of such magnitude.

He told us that some testing had been done on the fluid taken from her lungs and that cancerous cells were found. Their presence in the fluid meant that it was stage four. He said that he could refer her to an oncologist, but he wouldn't recommend it because any subsequent treatment would probably end her life more quickly than the cancer itself. She agreed that she didn't want treatment.

After he left, I asked, "How do you feel about that, Grandma?"

As cheerfully as ever, she answered, "He didn't say anything that bothered me a bit. I've had a wonderful, long life and when it's my time to go, it's my time to go."

This pleasant response gave me the courage to ask her a few days later, "How would you like your memorial service to be?"

I took notes as she thought things through. She chose the place, the officiating pastor, the songs to be sung and she said she didn't want her casket to be there and she didn't want anyone to be sad. She emphasized this by declaring, "I don't want it to be called a memorial service. I want it to be a celebration service."

I'm glad that I asked her for input when I did, because soon after that she began to decline rapidly. My dad and I went to make plans for her burial and I had questions for her about how she'd like her gravestone to be, but when we got to her place, we could both see that it wasn't the time to bother her with such matters.

(A few days later, I picked out her gravemarker: black granite with a flowered border and her full name with "Loved by All" at the top. What a strange task, to choose the most substantial physical signifier that a person had lived at all. I felt deeply honored yet equally saddened.)

By last Friday, she was in a hospital-type bed in her bedroom. Seeing her there and how frail she looked, I thought that she would never leave there again. She was still determined to get things done though her physical limitations were immense and her mental limitations were growing.

I saw that on her lamp table, she had put together a bunch of cards and letters. Most were sealed, addressed and return addressed. In the stamp corner, she had written the date when she wanted that particular card to be sent. The final one is dated 12/30. She was thinking of others even at that point! She wanted to make sure that all of her grandkids and great-grandkids received a birthday and/or anniversary greeting from her in 2009. So thoughtful. That precious stack of cards is now in my house and I will send them out at the proper times.

At one point on Friday, she told me to bring her her checkbook. I felt a little odd doing so, but whatever she told me to do, I did. By this time, she couldn't see much nor write clearly, so she said I needed to help her sign some checks. My heart sank. I didn't want to tell her "no", but how weird of a situation is that?

She was as stubborn as ever and kept asking me, "What letter of my name do I need to write now? Is my pen in the right place?" I humored her by answering her questions as I saw a childish scrawl appear on the check. No one is ever going to cash that, I thought.

She clumsily flipped to the next check and started in on that one. Oh, no! Not another one!

Imagine my horror when a caregiver came into the room to give Grandma some medicine. There I was, hunched over a dying woman who hardly had the strength to wield a pen, talking her through each loop of her handwritten name on a blank check. Honestly, you guys, that's not how I roll...

The caregiver stood right next to us, ready to give Grandma the meds the second Grandma was done with the task at hand. I took advantage of having her full attention by asking Grandma, "What are these for, Grandma?"

"Give them to your dad," she responded.

"What do you want him to do with them?" I asked.

"Tell him to pay my expenses."

Whew! At least it was clear that the whole check-signing business was not my idea!

I stayed with her a few hours on Friday, but didn't return on Saturday, knowing that my dad and his wife would be there for at least a while and thinking that the hospice care she signed up for would be in full swing.

Oh, how I regret that. With hindsight, I will do things very differently if I ever have to go through hospice with a loved one again. Please take note: Find out what care exactly your loved one will be receiving so that you can make up for any lack. There are different levels of hospice care and when Grandma was evaluated on Friday she didn't need the most intensive care, but she went downhill very quickly over the next day. Although, she was being cared for, she would have been much more comfortable, I believe if she had gotten more attention.

On Sunday, I returned. Grandma was agitated which is quite unusual for her.

At first, she said that six different church groups had come in to meet with her. One was a Catholic priest who had offered her her last rites. (Grandma was never Catholic.) This story seemed strange yet plausible, but as she went on I realized she'd been hallucinating. She's always been a calm woman who has never been prone to exaggeration.

"Aimee, you need to go to the front desk and tell them that I'm still here. They think I died last Tuesday and they haven't brought me any food or medicine since."

Oh, God, help me...This was almost the lowest point of this entire experience. I had been there many times for long periods since Tuesday and had seen the care that she was being given. How do you convince a hallucinating person that what their brain is telling them is true is not true? Even if I somehow convinced her that it wasn't reality, who knows what her brain would tell her next. Also, how sad if one of her final interactions with her granddaughter was one in which her loved one didn't believe her.

I hurried off to the front desk so that her brain would see that I was trying to do something about her upset.

After that, I spent several hours with her, watching her sleep, feeding her little tiny bits of strawberries, bringing her water which she drank with a straw, seeing that her caregivers were coming and going to tend to her.

Monday morning was the absolute worst.

After dropping Delaney off at school, I went straight over to be with Grandma. When I came in, she was sleeping fitfully. When I smoothed her blanket out to make her more comfortable, she awoke with a start and frantically tried to tell me something. Her speech was very slurred at this point and I couldn't understand what she desperately wanted to tell me.

"Bring me paper," I figured out she was trying to tell me.

I did and she began to trace letters with her finger on the blank sheet. I wrote each one down as she went, but about four letters in, I realized it was hopeless and began to cry.

"Grandma, I'm sorry, but I can't understand you. " I wept and touched her hand.

She wasn't finished though. She wanted a pen, so I gave her one.

By this time, one of her caregivers was there and she and I watched together as Grandma carefully wrote one letter at a time. It took quite a while, but I eventually discerned that she was trying to write, "Been here since Saturday..."

Oh, God, help...she still thought she had been abandoned for days at a time, even though I had been there for hours the previous day and Dad and Donna had been there after I left.

I just cried and tried to reassure her that people knew she was here and we were all caring for her.

After her message was conveyed, she calmed quite a bit and began to sleep. I wasn't going anywhere. Every time she woke up, I wanted her to see me planted right next to her. At one point, she did wake up, hollering, "Pain!" This is a woman who has been on pain meds for years for her bad legs, but had never complained in my presence about actual pain.

Things settled somewhat after the hospice nurse came to evaluate her. She said Grandma was ready to be put on 24 hour care and that she would start on morphine immediately to ease her pain.

Everything was much better after that. Grandma was still in some pain up until the end, but I could see that she was sleeping much more soundly and she no longer seemed to feel desperate to communicate.

One powerful example of what kind of woman Grandma was involved her introduction of me to others. Ever since she moved in to her assisted living home, if a caregiver came into her room while I was there, Grandma would always introduce us to each other. She didn't look at the workers as servants to meet her needs, but as people to relate to and interact with. Therefore, I met a number of the people who helped Grandma with laundry, meals and transportation. She treated them all with respect and kindness, and she wanted me to know them as she did.

Even in her final days when she could barely speak, if there was a caregiver on one side of her bed and I was on the other, she would say to the woman, "This is my granddaughter," and to me, "This is Pam."

Here she was, dying, and yet she was still thinking about others and wanting to make them comfortable. If there was ever a time that it was allowable for someone to be focused on their own self, it would be then, and yet she wasn't. Amazing...

One of the most touching moments on Tuesday was when the ladies from her meal table came in to say goodbye. She had sat with the same group of women for meals over the past few years at the assisted living home so they grew to be quite close.

All very elderly themselves, they crowded around her bed, each approaching her one at a time. Grandma could barely open her eyes, but she nodded and smiled as each woman grabbed her hand and told her who they were. They said some things to which she responded, though unclearly.

When I walked them out to the hallway, I saw that all three of them had parked their walkers in a row along the wall. That helped me to smile through my tears.

Another thing that was very "Grandma Hazelish" was the fact that she had had a pedicure in the few days before her drastic deterioration. (She was always careful about her appearance, not in an uptight, don't-touch-me-because-you-might-smudge-my-make-up-sort-of-a-way, but rather because she simply enjoyed being pretty.) So the last week of her life, freshly painted red toenails peeked out from under the sheet at the foot of her bed. She knew she was leaving and she wanted to look good while doing so. Several people who came to see her noticed and smiled about it.

Tuesday and Wednesday, she mostly spent sleeping. Her only communication methods were barely perceptible nods or shakes of the head, raising of eyebrows and an occasional moan.

I held her hand, stroked her face and softly sang praise songs, hoping that the gentle interactions would be reassuring to her.

It actually reminded me very much of when my children were newborns. It was a sweet, quiet time in which very little happened for hours and hours aside from me trying to convey to a helpless person through touch and gentle sounds that they were deeply loved.

There was nothing else I would rather be doing for those many hours on those two days. I'm so thankful that I was able to be there and love her in whatever practical opportunity presented itself.

I left on Wednesday afternoon at 2:30 to pick my kids up from school, planning to return the next morning as soon as I could.

My dad called at 8:00 that night to tell me that Grandma had passed away fifteen minutes earlier. It was such a relief to know that she was no longer in intense pain and her brain was no longer telling her that she had been abandoned. She was now with her Creator Whom she had worshiped for decades.

This has been a painful and amazing week. I saw death in a new way. I feel like someone pulled back a curtain and gave me a view to a part of life that I'd never seen before.

I loved my grandmother so much and am so thankful for all the time I was able to spend with her.

Pretty Hazel

1911-2009