My Dad died on January 28th, 2017 due to complications after a fall. He would have been 85 years old this year. He and my Mom would have also celebrated their 65th wedding anniversary. This is the fourth in a series of articles written about his final weeks.
Article 6, Dad’s Death – 10 Life Lessons: https://goo.gl/SXh5NX
Article 5, Dad’s Death – The Aftermath: https://goo.gl/6YILxK
Article 4, Dad’s Final Days: https://goo.gl/k4PH63
Article 3, Dad’s End of Life Dreams and Visions: https://goo.gl/x2zvqA
Article 2, Dad’s Recovery: https://goo.gl/80ZBAc
Article 1, Dad’s Fall and Surgery: https://goo.gl/M7Xm65
SENSE OF DREAD
I woke up on Tuesday January 24th with a sense of dread. I couldn’t stop crying. I had no idea why. The day before may have been a positive turning point for my Dad, so why was I feeling this way? I left for the Hospital and cried the whole way there. I couldn’t figure out why. When I arrived Dad was fighting sleep again. Eventually he was able to close his eyes and rest. When he woke up, he was much calmer and wanted to watch a movie.
The pulmonologist came in around lunchtime and said Dad’s lungs were the same. Although they had improved significantly the day before, they we now going in the opposite direction again. He admitted no one really knew what was going on with Dad’s lungs. The fluid had subsided and he had no infection. The Dr. said he thought it might be Idiopathic Pulmonary Fibrosis (IPD). IPD is a disease in which tissue deep in the lungs becomes thick and stiff, or scarred, over time. The formation of scar tissue is called fibrosis. As the lung tissue thickens, the lungs can’t properly move oxygen into the bloodstream. As a result, the brain and other organs don’t get the oxygen they need. There was no cure. The Dr. spoke again about the only option left being to intubate and put Dad on a ventilator. He wanted to make sure the Hospital formally had the “Do Not Resuscitate” (DNR) on file. It sounded like there wasn’t much time. They just didn’t know. Anther day came and went.
My sister arrived the morning of Wednesday January 25th and said my Dad was calm. He ate and seemed lucid. I was planning to visit later in the afternoon because my youngest daughter was flying home. We decided together it was important for her to be with everyone. She wanted to help. We needed the help. If not physically then emotionally. Her Dad would pick her up at the airport and bring her straight to the Hospital. We told Dad that my youngest daughter was flying in to see him. He kept saying he didn’t believe it. When she walked into his Hospital room later that day, he recognized her right away and reached out for her. He began to cry and so did everyone in the room. He was so happy she was there.
My sister and I took the opportunity to get something to eat and catch up on what the doctors were saying (or not saying). When we got back to the room my daughter told us that my Dad had asked her to get him out of the hospital. He had also asked for a beer. Then his agitation kicked into full gear. My daughter got to see it first hand. Because Dad’s safety was an issue, the Hospital kindly provide him with a fulltime overnight nurse to stay with him. My daughter and I stayed until the night nurse arrived. Her name was Pauline. She was wonderfully loving and caring. I felt better knowing Dad would not be “alone.” My youngest daughter and I headed home. On the way home we called my son and suggested he also fly home. I didn’t want him to miss the opportunity of seeing his Papa before something happened.
On Thursday January 26th, my daughter and I were back at the Hospital before the morning shift arrived. That meant we got to see Pauline before she left. I asked her how Dad did. Pauline she said not good. He was combative, angry and tried to hit her twice. When I asked my Dad how he did, he said hadn’t been very nice to Pauline and apologized to her. It was all so sad. It just felt like we were going in circles with Dad’s physical and emotional health. No one had answers. How could the Drs. not know? I walked down to the charge nurse and said I wanted to speak with a social worker. I thought someone else could review my Dad’s case and offer their opinion. The charge nurse told me I would hear back in the next day or so. I wondered if Dad had that much time left. Once again we stayed until the night nurse arrived. Luckily it was Pauline again. Dad knew her and she knew him. I could only pray it meant he would have a better night.
It was now Friday January 27th. I really hadn’t slept much the night before. Dad had been in the Hospital over 3 weeks. It just didn’t seem like things were going in the right direction. As my youngest daughter and I were getting ready to head to the Hospital, the social worker called. She said it was our right to ask for options. She was working on getting us some answers. She said the Drs. were about to make “rounds” and Dad’s case was being discussed. She would follow up with us after the discussions were over.
Friday was a day that is hard to explain. Dad seemed to be in and out of lucidity. He really wasn’t eating. The Drs. thought it would be a “good idea” to give him a feeding tube. The nurses tried to put it in but it didn’t work and they had to pull it back out. That really upset him (and for good reason). Dad said, “Are you trying to kill me?” It really upset us too. It meant if he couldn’t eat he wasn’t going to live much longer. The mood was somber.
The social worker informed me that a Palliative Care team would be visiting Dad. They would talk to us about options. This was the first time I felt like someone was giving it to us straight. We were told he probably was going to die and we had the option of moving him home. We agreed the move itself may kill Dad so we opted to keep him in the Hospital. The Palliative Care team said they would meet with us again in the morning but it wasn’t looking good.
Later that day, my Dad’s personal physician and his wife called and asked if they could stop by to visit. I told them yes. It was the right thing to do because they had spent so many years caring for my Dad. Their visit really appeared to turn things around him. He was so thankful to see them. He got perkier and more lucid. They doted him. They rubbed his feet. Dad’s spirits were raised significantly. He stayed upbeat for quite a while. Their visit certainly had an impact on him. Our family will be forever grateful for their kind and loving ways.
By the end of the day, the Hospital decided that Dad needed another night nurse. Again it was Pauline. When she walked in at the start of her shift, Dad apologized to her for not being “nice” to her the night before. You could tell he knew what had happened. Pauline told me she did not take it personally because she knew Dad was not himself. I was grateful to her for understanding.
My son arrived about midnight. Dad knew right away who he was when he walked in. They embraced each other in a huge hug. Everyone cried including the nurses. My son stayed with Dad in what was to be his final night here on earth. My youngest daughter and I headed home not knowing how our world was going to change.
DAD’S FINAL DAY
On Saturday January 28th, my son texted me very early to say Dad had not had a good night. The medical staff didn’t think Dad was doing well at all. My youngest daughter and I got ready and drove to the Hospital. When we walked in to his room Dad said, “I am going to die.” I had no idea what to say back to him so I said, “Okay.” Then in true Dad form he said to me “What do you mean okay?” I said I meant it more like a question because I didn’t know what to say in response. That seemed to appease him. After all, how are you supposed to respond to a question like that?
Once I assessed the situation I started making phone calls to my Mom, my oldest daughter, my sister and brother-in-law. I told them to get to the Hospital ASAP. The Drs. felt it was “time” and they wanted to begin administering morphine to help Dad with his transition. It felt so unreal. Like a parallel universe. In the meantime, nurses filed in and out of the room.
At one point while my son, youngest daughter, a day nurse and myself were standing around my Dad’s bed, out-of-nowhere Dad started signing “Puff the Magic Dragon.” Not knowing what to do I started singing with him. Then everyone started signing. My daughter used her phone to play the song while we all sang. After repeating it for a few minutes, my Dad raised it hand to signal he had heard enough. We just all looked at each other. We will never understand why he picked that song to sing on his last day. It wasn’t something from his generation. It wasn’t even something he sang to my sister or I when we were little. I guess we won’t know why he chose it until we see him again in Heaven.
Nurses continued to run in and out. The palliative care Dr. came by and told us to let him know when we were “ready.” How is a family ever “ready” for something like this? My sister and her husband arrived. My Mom and oldest daughter walked into Dad’s room already crying. Dad knew were all there. He said “I love you.” We all had a moment to tell him how we felt. My Mom asked me to give the okay. We were “ready.” The nurses came in and started administering the morphine mixture. They told us we could decide when to take off Dad’s oxygen masks (yes he had more than one).
Someone suggested we play some music. My Mom said “My Way” by Frank Sinatra. My daughter brought it up on her phone. “And now the end is near and so I face the final curtain.” Geez. You couldn’t get any more appropriate. The entire room started to cry. The song played a few times. My Mom told my Dad it was okay to go. We all got to say our goodbyes. The nurses suggested we remove the oxygen mask. I took it off Dad’s face. My son tuned off the oxygen supply. The Dr. came in and suggested to me we increase Dad’s morphine so the family wouldn’t see him gasping for air in his final moments. He said it could be pretty horrific and not a memory any of us would want. I agreed and the nurses increased the dosage. Within 10 minutes we watched my Dad take his last breath. We watched his chest rise and fall for the last time. We heard the air go in one more time but never come out. It was peaceful. They annotated his death at about 1:37 pm. Everyone cried. Then cried some more. We are still crying.
Eventually there wasn’t much more anyone could do. I asked my youngest daughter to drive my Mom back to the house. My son and oldest daughter drove back together. The last thing my Mom needed was to be around while they got my Dad ready for the morgue. In addition, my son had been up for over 24 hours and needed to rest. My sister, brother-in-law and I decided to stay. We started to pack up Dad’s belonging. Many items we threw away. We really didn’t want some of these reminders coming home. Each of us sat with him and talked to him. I removed that stupid oxygen monitor from his finger. The one he had hated so much. I threw it across the room. He wouldn’t be needing that thing anymore.
The nurses came back in and asked if we were planning to leave. I told them that we wanted to stay until the Hospital mortuary picked up Dad. They said that was unusual but they respected our wishes. I wondered why that was unusual. Wouldn’t everyone want to know their loved one was safely taken away? Wouldn’t everyone want as many minutes as they could before they never saw their loved one again? I was proud we chose to stay.
After a short period of time, two nurses came into Dad’s room. They respectfully laid my Dad flat in his Hospital bed and said, “We are going to listen to your heart one more time.” I almost sobbed out loud. Then they told my Dad they were going to take out his IVs. I bet Dad was doing cartwheels in Heaven when he heard that! Everything was removed from my Dad’s body with such gentleness and love. It was beautiful to see. They placed Dad’s body in a white body bag and zipped it shut. The Mortuary representative arrived and together with the nurses, they place my Dad on a wheeled stainless steel cart that had a black tent cover over it. They laid the bag on the cart and covered it with a black tent cover. We walked with it in procession until the mortuary guy said we couldn’t go any further. We said our final goodbyes and walked to the elevator.
I often wonder how the patients in the rooms around my Dad’s that day felt seeing all the commotion. Especially when the black tented cart wheeled by with the three of us crying behind it. I guess that is how life is. Sometimes you make it and sometimes you don’t.
Sending you love, comfort and peace!