1. Carol returned home from her trip to Italy Wednesday night and Thursday morning she sprung up, bright and early, to visit Mom. Mom immediately recognized her and they had some good conversation and worked on getting Mom ready for her appointment at the uptown clinic with Dr. McDonald. I met Mom just as she was being wheeled by Misty, the vibrant CNA who schedules and transports Kindred residents in one of the company's vans.
The exam room didn't have space for all of us to be with Mom, so, since Christy and I have been with Mom over the last three+ weeks, we accompanied Mom.
Dr. McDonald last saw Mom on June 15th, a month ago. She seemed taken aback my Mom's decline since then. In the doctor's office, Mom fell asleep waiting for the doctor and was in a confused state when Dr. McDonald asked her some simple questions. Dr. McDonald turned her attention to Christy to see what her concerns about Mom were and addressed the question of how much Mom is sleeping. Dr. McDonald identified increased sleep as a symptom of Mom's life nearing its end and that we should think of Mom's sleeping less in terms of how much sleep does she need, but how much does she want, understanding it as a source of comfort and happiness for Mom.
This question opened to way for Dr. McDonald to level with all of us that Mom's condition continues to deteriorate and that our main focus should be on doing what makes Mom happy and comfortable. She recommended that Mom be evaluated soon by a hospice nurse. This means that most of our attention will be not on treating Mom but comforting her, helping make her remaining days as agreeable as possible. I should add that the doctor did not say Mom has only so many days or weeks or months to live, only that Mom is showing end-of-life signs and symptoms -- the increased sleep, loss of appetite and diminishing power of taste, cold hands and feet, and confusion, among other things.
Mom seemed to understand what it meant to involve hospice and agreed to hospice care without hesitation. Mom has always had high regard for hospice care, particularly when Dad died. She talked about her memories of Betty Mercado being Dad's hospice nurse. Mom and I both have very pleasant memories of Betty's care for Dad and of our conversations with Betty as Dad's life was coming to an end.
2. We returned to Kindred and, within ten minutes, an aide came to offer Mom a shower. I'm glad I was there because Mom thought she had just had a shower and didn't see why she would have another one. In time, though, Mom came to believe that her last shower was on Monday and agreed to have another one today. When the aide -- another woman named Misty -- came to wheel Mom away, she asked Mom how her doctor's appointment went and Mom didn't know she'd had one.
Mom came back from the shower refreshed and soon her beef pot pie for lunch arrived. Mom and I reminisced a bit about how Stein's used to sell Banquet frozen pot pies for some ridiculously low price like twelve for a dollar. That can't be right, but it's how we both remembered it.
Conversation with Mom invited me into her world, a world of imagined dinner parties and papers on the television and questions about people I didn't know, nor did I know if they exist outside of Mom's personal reality. I accepted the invitation, doing my best to answer questions I could answer ("Who drove my car last? Is the car in the garage?") and ones I couldn't ("Why did Terry's wife leave the party early?").
Around 1:00, Christy and Carol arrived at Mom's room and I slipped away and, before too long, Christy, Carol, and I met at Best Shots so we could review Mom's appointment and talk about what's next.
3. After lunch, I took a nap. I returned to Mom's room shortly before 5:00 and Mom was asleep and slept the entire time I was with her, until about 6:30. When one of the aides came in with her dinner, Mom woke up briefly and looked at me, puffed out her cheeks, and pretended to put her arms and hands around her own pretend Santa Claus belly -- she didn't say anything, but the message was clear: "they're trying to make me fat!" and she kind of laughed. I'd never seen Mom make this gesture before and it made me laugh, too.
Later, the aide returned and said, "Miss Mary, darlin', do you want your dinner?" Mom put her index finger in front of her lips and said, "Shhhhh", as if out of concern for her roommates who might be sleeping. This particular sleep that Mom was in was kind of playful sometimes. It also involved little hallucinations, including one moment when she called out, "Mikey! Stop that! Stop that, Mikey!" I listened and tried to think of a Mikey in Mom's life, but couldn't.
When I left Mom around 6:30 to join Christy and Everett for dinner, Mom was sleeping peacefully and didn't stir when I told her I was leaving and that I'd be back tomorrow.