Grandma Dotties Final Days

(Note to reader: IT'S A LONG POST... While it may seem just days after my short posting about my birthday, it really has been several months since what I’m about to talk about happened. I have to back post sometimes, so when I posted this it's actually September 18th, a week before her stroke last year, but I dated it back in July since that is how far behind I am with back posting.)

Everything began last September 2010. Click HERE to see posting.

Since I was only going to be able to be in town visiting with Grandma for a couple of days, I spent a lot of time at the hospital. When I first arrived there, I saw some other family members who spoke to me before I went in to see her. They let me know a little of what I was going to see. NOTHING could have prepared me for what I saw. I walked in the room. My parents were already in there talking to her. I only lasted a couple of minutes. Another family member walked in and I had to leave. I was crying. I didn’t want Grandma to see me cry for her. I wasn’t crying so much because she was in the hospital, but more for seeing someone who is such a strong, independent woman, be so… dependent. She could barely speak, only soft whispers. Her left side was paralyzed. I knew from things I learned in college that individuals can recover from a stroke depending on the severity. (My mom almost recovered fully from her stroke in 1996 although her equilibrium never did recover.) I also learned that the older a person is the less chance they have to live the same life they did before.

I knew she was never going to recover fully and certainly wasn’t going to be living at home by herself anymore. Not all family was convinced of that, but that’s why I was crying and why it was so hard to see her in that condition. I knew.

The next few days were great. She spent a lot of time sleeping, but was also awake telling jokes, hugging me, telling each other “I love you”, and just enjoying the time we had left.

Over the next few months grandma was living in a nursing home. A few weeks before her death she was moved to the place she passed away in and loved it. It’s a little hard to swallow that most of her last few months she was unhappy, but it’s exciting to know that at the end she was happy.

Fast forward to 2011. I got to spend my mom’s 66th birthday with grandma. See posting HERE.

During the visit in February, my uncle pulled me and my cousin aside and told us that he was ready to make preparations for he and I to take possession of grandmas car and truck. I knew she’d never drive again. Fast forward again to May. My dad and I had made arrangements to go down to Visalia to pick up her car. We were going to go down on Sunday, May 22. My dad made arrangements with my aunt on Monday, May 15th. She called him back on Tuesday and said grandma had taken a turn for the worse and we should go down sooner than Sunday, like ASAP, and basically say our goodbyes.

I was crushed. I wanted to see grandma again, but wasn’t convinced I was going to have the chance. I called my cousin Monica, my cousins wife, and asked if she heard the news. She hadn’t yet. She called my cousin Ryan and said he needed to make time to go to the nursing home that night. Family was able to visit with her. She ate soup. Monica’s son sang some Christian music. Grandma stuck her tongue out at Cameron (Our birthday angel). She was with family. And she was happy.

That night things turned. Around midnight my aunt got a call that grandma had had another stroke and had slipped into a coma. It was time.

My parents and I left to go down (this time I had Jacob with me) in the same car. My aunt was calling to find out what time exactly we’d be there. We were really in a time crunch. I tried not to think about it on the way down. But how could I not??? We arrived in time to change Jacob’s diaper and get him some water, use the restroom, and head over.

I had basically the same feelings as when I saw her in September in the hospital. I had to leave the room shortly after I walked in. It is SO HARD to see someone on their death bed! I couldn’t fully process what was happening. I just moved along with whatever was going on. The family that was in the room decided it would be a good idea to go the grandma’s church around the corner (the same one my parents were married in) to light some candles and say prayers for grandma to have a “safe release”. We spent a few minutes letting Jacob run around outside. My parents mentioned they were going to head back to the house, but I felt prompted to stay around. I just didn’t feel like I could go home. How could I even think about sleep when someone is having their last breaths.

My parents took Jacob back with them and my cousins and I went back to be with grandma. We knew the end was coming. My cousins, uncle, and I sat around her bed. We held her hands. We rubbed her leg. We kissed her gently on the face and told her we loved her. I heard both my cousin and uncle whisper to her “It’s okay grandma, you can go be with grandpa now.” “Mom, it’s okay to go.” All I could do was kiss and hug her and say I love her one last time. Her breaths got farther apart until she took her last one. It was over. Just like that… it was over.

I had only been in town for 2 hours when she took her last breaths. I believe without a doubt that she knew we were coming and waited for us so we could say goodbye. She knew.

I called my parents, but could not reach them so a family friend, who’s most than a friend, she’s FAMILY, lived a couple blocks away and went over to tell my parents. My mom stayed at the house with Jacob and my dad came to the hospital for one final goodbye. We all sat around sharing some stories about grandma and remembering what a great soul she was.

I love you so much grandma and you’re my rock. My birthday will never be the same without you, but I will find a way to enjoy that day once again. You can be with grandpa now and enjoy dancing together to some good ol’ fashioned 1930’s music. I miss you both dearly.

I will post more about her services in a future posting.

The photo below was taken one hour before she took her last breath.

The information below is off a website I found that maybe can help to understand the process of death a little better. I only copied some of the information I felt pertained to my situation. Maybe it will help someone else who’s struggling to find comfort with a dying loved one or understand the passing of another.

What to expect generally
Many people have never experienced being present when a person dies. The movies certainly do not give us a realistic picture of what to expect. Of course, much of the process depends on what is causing the person to die. However, there are some generally common elements. One nurse explained the last week or two as a process of the body shutting down, one organ system at a time. She used the analogy of cleaning a house in preparation for moving. In such a case, we typically clean each room, one at a time, and then close the door when we are done. The body seems to do the same kind of thing in preparation for death.

For instance, the first organ system to "close down" is the digestive system. There is really no need to keep processing food and nutrients if the body is not going to continue much further into the future. The patient, therefore, will begin to lose interest in food and will eventually stop eating and lose the sensation of being thirsty. As a result, he or she will also stop having bowel movements, and what urine is produced will generally be minimal and rather dark in color. (This dehydration in preparation for death may actually help to reduce congestion in the lungs.) The loss of appetite and thirst is essentially the body shutting down the digestive system and "closing that door."

Conscious awareness is often the next system to close down. It takes a lot of energy to follow conversations, speak, and track what is going on around you. At some point, this will be too much, and the person who is dying will become less and less "present." This withdrawal may take the form of sleeping a lot, or fading in and out of a coma-like state. Or, it may take the form of disorientation. People who are dying may see things that the rest of us do not see. Frequently they speak to people who are not really there, and it's not unusual for them to speak the names of people from their past who have already died.

While the dying may fade in and out of awareness, they do appear to retain their sense of hearing and their sense of touch until very close to the end. Holding hands, gently massaging the feet, or wiping the brow are all things you can do to help comfort a person who is dying. As well, because the dying continue to hear and understand what is said, even if they seem to be asleep, it seems to be reassuring to speak words of love and affection. (Many family members have been surprised, and even embarrassed, to have a loved one respond to something that was said under the assumption that the dying person was asleep and not able to hear the conversation!)

As a general rule, it is the heart and lungs that "close down" last. This usually involves a process of slowing down and then fading away. In the last few days the lungs begin to fill with fluids such that breathing is accompanied by a wet, crackling kind of sound. This congestion can be minimized by withholding fluids and "allowing" the dying person to become dehydrated. Although alarming to hear, it is a normal part of the dying process and does not appear to reflect pain or discomfort for the patient. (If you are worried that the patient is distressed, you can ask your physician for medications to help reduce any respiratory congestion, or a suction machine you can use to clear the passage ways.)

In the last few hours or days, both the heartbeat and the breathing pattern can become irregular. The dying can have periods when their breathing is quick and shallow, followed by periods when their breathing is drawn out. Toward the end, a person can go as long as 10-60 seconds between breaths. This does not appear to be distressing for the patient, but it can be exhausting for those who are present in the room as they wait anxiously to see if the person is going to draw another breath.

Common problems and what you can do

In addition to loss of appetite and loss of awareness, the person who is dying may experience other symptoms of the body closing down its systems. For instance, as the circulation gets weaker, they may develop spots or streaks of blue or purple, and their fingernails, lips, and toenails may become blue or gray. This is a sign that death is approaching. If the knees are pink or red and the hands and feet are warm to the touch, the death will probably not occur for several days.

Toward the end, although the hands and feet might feel cold, the body's internal thermostat may start to break down. The patient may feel hot inside and sweat profusely. Such temperature fluctuations are normal, and the goal is simply to do what you can to make the person comfortable. If the patient seems especially restless, try removing some layers of clothing or blankets. It may be that the covers are too warm.

Being with a dying family member
People in the last few days often drift in and out of consciousness. You and the person who is dying may or may not be able to talk much during this time. As a general rule, you will want to keep conversations short. If there are unresolved conflicts, this is not the time to process through who said what when. People at the edge of life have very little energy. However, they are often moved to express love and forgiveness, and to receive love and forgiveness. It can be very healing to simply let the dying person know how much you care, how much they meant to you, and the ways they contributed positively to your life. Other suitable activities include reading to the patient, praying, singing, quietly holding hands, or listening to music.

Some family members feel strongly about being present at the time of death. Indeed, many people who die speak in the weeks before of being afraid of dying alone. At the same time, it can be difficult to "let go" when all of your family is present. Some people seem to almost choose when they go and in fact "wait" until their close family members have left the premises before they die. In the last few days, it seems to help the person who is dying to be given assurances that the survivors will miss them but will manage without them and that it's all right to let go.

The moment of death
Unlike the movies, the actual moment of death is often vague and even anti-climactic. As mentioned before, there is a tendency for the breathing to become spread out and irregular. Sometimes there is a shudder or a brief sigh at the last breath, but often the last breath is as uneventful as the ones before it; there simply isn't a breath afterward. Lack of breathing and lack of pulse (heartbeat) are the sure signs that a person has died. Often the muscles in the jaw relax and the mouth will open slightly. The eyes, too, may open and stay that way. Sometimes there is a bit of fluid that comes out of the mouth, and for some, the bladder and bowels may release at the time of death.

After A Loved One Dies
After your loved one's body has been taken away, you may well feel a bit numb or empty. It is not uncommon to feel distant or removed from the situation. Sometimes it helps to talk with others, but you may feel more like spending some quiet reflective time alone. Many people have a mixture of feelings, including grief, anger, relief and guilt. All of them are quite normal.

Often people feel pressure to get on the phone immediately and start letting others in the family know about the passing. If you don't feel up to this task, it's fine to let it wait, or to ask someone else who is a little less impacted by the death to make the calls. While it may not seem like it at the moment, there is actually plenty of time to get done what needs to get done. Honor your impulses and allow yourself to process your loved one's passing in the way that feels most comfortable to you.