On Tuesday, my Mom seemed to be having difficulty chewing and swallowing, and couldn't even keep her favorite treat, a small piece of chocolate, in her mouth.
This might be just a bad day, I told myself. Wait and see how she "behaves" with Donna and Linda on Wednesday.
On Wednesday, Mom's chewing and swallowing had become much worse, frightening my two sisters so that they consulted the Supervising Nurse and Nurse Practitioner. A Speech Therapist was called in to examine her. Mom was placed on a pureed diet - provisionally.
Today I talk to both the Speech Therapist and the Nurse Practitioner at different times. They both tell me the same thing: "I've observed your Mom today. Your Mom can no longer chew or swallow AT ALL, not even the pureed food. She can't swallow the thickened protein drink. I recommend that she no longer receive anything by mouth."
"What about a naso-gastric tube?" I ask the NP. The Nurse Practitioner replies
"I don't recommend that at all for someone of your Mom's advanced age (one hundred and one) and advanced dementia."
"Is she dying?" I ask. "Are her organs shutting down?"
The NP is both gentle and firm. "I don't want to have this conversation with you over the phone."
I wait the rest of the day for the opportunity to tell both my sisters in person what is happening. Wait, watching the clock, paralyzed by emotion. We meet for dinner at Appleby's. They both have expected to hear this. We eat some, play with our food. Grasp each other's hands across the table.
At dinner, we talk to the NP and set up a meeting to discuss everything with the NP at the nursing home early tomorrow. Tonight I call my social worker counselor cousin for his response. He went through this agony with his Mom just a year or two ago. He says, "Just the NP saying 'I don't want to have this conversation with you over the phone" suggests that your Mom is starting to die."
I call my children one by one to tell them.
"I think Gram has only a few days to live."
Their voices are choked. My occupational therapist son says "Her body is definitely shutting down." Which is helping me form my conscience. If Mom is indeed beginning to die, if that's what we hear from the NP tomorrow, we daughters can with a clear conscience not request artificial nutrition and hydration and let Mom die naturally and peacefully.
I can't believe I'm saying and thinking these things. This preparation is so surreal. So - monumental. So life-altering. Like preparing for birth.
I expect to spend all day tomorrow at the nursing home, holding Mom's hand, so in addition to the phone calls and emails, I water dry plants. (And tearfully remember carefully giving her sips of water.) I can't wash clothes - a plumber is coming tomorrow to fix our clogged sinks downstairs. Our house is a wreck because the painting isn't finished. I ask my daughter to stay with her brother if and when she comes to town for the funeral. I behave exactly as I have always behaved when I've gone into labor at home. Filling low soap dispensers. Checking clean underwear. Preparing to be away from home. Crying in between self-generated chores - this time from the pain of the labor of letting go when facing death rather than the pain of the labor that ushers in new life.
But - this is a labor that ushers in new life for my Mom. Over dinner, my sister Linda reminds us that lately Mom has been talking and laughing to thin air and saying "Yes, darling." Then lucidly - a miracle - has said to my sister "I've been talking to your father." She's been a widow far longer than she was a wife, and has missed our Dad every day. Surely he will come for her when it's time for her to go home to her new life.
I'll pray the rosary out loud for her tomorrow. Her soul will hear me. How fervently I'll say those words "Holy Mary, Mother of God, pray for us sinners now and at the hour of our death."
Amen. Let it be so. I believe. May this Death, this dark Mystery, this dark passage Mom is beginning to enter and undergo bring her into the Light of the Light of the World.
Please keep my family in your prayers until I write again.