Posts under ‘family’

We are presently here in Temple, Texas, checking in on Mary’s mother who is in ICU following carotid artery bypass surgery. Tonight, I will do the midnight to 6am shift (most of which will be spent sleeping in the recliner behind the curtain by the window) so that she can have her needs met if she wakes in the middle of the night. (There’s nothing more miserable than having a nasogastric tube down your throat and nobody around to feed you ice chips when you’re parched.)

Overall, though, this “caregiving visit” is a relative breeze: time by the hotel pool, writing emails and blog posts on the hotel computer, chatting with my father-in-law and the nurses as we sit in the room passing the hours, or wandering this strange Texan town. Plus, it’s 80 degrees and sunny all day.

Beginning a leave of absence from nursing and being in such a hospital/medical environment could very well set off my stress buttons, but my role here is so minimal—so “nurse lite”, if you will—that it is a pleasure to be of service. My skills are helpful in identifying when, for instance, Mary’s mom’s oxygen saturation is getting low and she needs the cannula back on, or perhaps to listen to the doctor and translate some of the medicalese for her dad. Energy output and stress? Almost zero. Value? High.

Anyway, nurses serve a purpose in families, and my “nurseness” certainly does come in handy at times like these. As long as my boundaries are clear and self-care remains of primary concern, no harm done and all is well.

So, dear Reader, remember the end of Daylight Savings Time tonight, set those clocks back, gain that hour of precious beauty sleep, and enjoy your Sunday, wherever you fare.

From deep in the heart of Texas,

A Nurse at Rest

When someone dies, we take a breath and realize that a new chapter has begun. Where before we cleaned the commode and wiped a sweaty brow, now we sift through memories and personal effects. Where before we concerned ourselves with medications and symptoms, now we examine legal necessities and paperwork. While our loved one was living while dying, we were also living through their dying process, slowly letting go of the old earthly relationship as we opened to a less corporeal connection which loomed large in our future. As our loved one’s eyes began to focus beyond us in their softening gaze, we looked more and more closely for the subtle changes that might portend the end being near.

Once the body has been removed from the home and the hospital bed and other equipment as well, one must take stock of the space where the loved one lived and died, and accept that their physical presence in that space is now a thing of the past.

Next come the personal effects. A watch. A money clip. A ring. A necklace. The trousers hang in the closet, pockets still filled with the normal flotsam and jetsam of a life: wallet, keys, change, mints, candies usually carried for bank tellers and cashiers in stores, a handkerchief.

And then there are the clothes that hang in the closet, bereft of the body which once filled them. The shirts pine for a beating heart. The pants wish for legs to crease and bend them. The socks sit alone alongside the underwear and undershirts. The ties and belts dangle sadly like plants in a hanging garden. But a new life awaits them.

Food begins to arrive from caring friends and family. The phone is rarely at rest. Arrangements are made, and plans created. Activity is a welcome relief from the heaviness of mourning, yet too much activity can also preclude one’s feelings being actively felt.

On the physical side, one must ask simple questions. Are you eating? Are you hydrating? Can you sleep? Would exercise be a benefit to you now? A fine balance must be struck, whether it be emotionally, physically or spiritually. You walk a tightrope of emotional balance, and living friends and family offer guiding hands along the way.

Laughter, smiles, moments alone, moments in motion, the awareness of loss—they are all part and parcel of the unfolding of the days of mourning.

Today at 4:10pm, my beloved step-father left this world as we surrounded his bed to witness his final breaths. As he moved through the stages of the dying process over the last 48 hours, I became more and more certain that the end was drawing ever closer, perhaps more rapidly than I originally surmised it might. His struggle to allow his spirit to leave his body was truly like labor, and we were the midwives and cheerleaders along his triumphant road to freedom.

Just as it happens around the world at every hour under the sun, people came and went from my parents’ home over these last days, and we all played our parts in the unfolding drama according to our individual roles and skills. My step-father’s lovely daughters, sons-in-law, granddaughter, and great-grandchildren all added to the quality of the times shared under this roof, and his final days were filled with loving visits and calming energy. One visitor, a Stephen Minister by vocation, remarked that Spirit was “just pouring through the house”, and he praised our little home hospice with words of benediction.

Losing myself in the minutiae of my step-dad’s hourly care, I realized that my grieving process was being (somewhat necessarily) truncated by my self-imposed duties of conductor, coordinator, choreographer, and caregiver. Even as others found moments to cry, my reservoir was seemingly dry. But when the moment came and he took his final breath, we all huddled around the bed, and the tears and sobs came in torrents, releasing days of unexpressed stress and grief. It is said that “unshed tears will make other organs weep”. I wrung some organs dry today, so to speak, and now I can sleep the rest of the exhausted along with the rest of our family.

His death was a fine one, navigated with grace, dignity, and a collective benevolence of spirit. Now we can be certain that our dear loved one is winging his way to a place of deserved beauty and peace, and our efforts here on Earth sent him with enormous love to fuel his journey.

This is a time of contradiction and juxtaposition.

As Mary and I prepare to join her immediate family for a joyous July celebration of her parents’ 50^th wedding anniversary, we simultaneously prepare for what appears to be the relatively imminent death of my step-father from metastasized pancreatic cancer which is unresponsive to chemotherapy. With hopes that he can live to see their 30^th wedding anniversary in December, I also realize that his quality of life may decline to such an extent that prolonged survival may only spell prolonged suffering. There’s another poignant contradiction—life’s prolongation actually increasing suffering. It is a conundrum often faced by the family and medical providers of a dying person, if not also the person him- or herself.

Last week, Mary and I led another free public session of Laughter Yoga. It was a joyous and successful event, and many hearts seemed to open from the simple yet profound transformation that can occur when virtual strangers decide to laugh together in a spirit of willing childlike playfulness.

This week, we led a crisis debriefing session for the staff of an institution where a recent murder-suicide occurred. Rather than lead the participants through exercises to elicit laughter, we led this group through exercises and sharing to unburden themselves of the cognitive, emotional, and physical manifestations of being affected by a traumatic event, whether directly or indirectly.

How does one reconcile such contradiction in life? What is the magic formula that allows us to move from experience to experience, adjusting to variable conditions as we journey through those spaces?

I am honestly and simply struck and dumbfounded by the contradictions I see, and by the contradictions which inform and feed my life and the living of it. Do I have answers? Certainly not; only more questions, and a burning desire to learn how better to ride these waves.

This weekend, Mary and I are converging on my parents’ home, joined by my brother and sister. Major life changes brought on by illness often brings families together. As ageing parents’ lives are altered by the vicissitudes of illness, it is the offsprings’ responsibility to step up and do what needs to be done to support them in their hour of need. And so here we are.

My step-father begins radiation this morning at 8:30, perhaps at this very moment. He will also take oral chemotherapy for the first six weeks and then perhaps change to intravenous therapy thereafter. The only cure for pancreatic cancer is surgery, and this is not a possibility for him, at least for now, and perhaps never. These are the times when living five hours away from one’s aging parents is a painful and isolating experience.

Life-altering illness offers many lessons and will push one to the edge and beyond. Change is the only constant here, and there are so many with which one must cope. It is not only change which holds one in its grip, but the spectre of loss visits in guises both small and large. One might lose one’s hair from chemotherapy. The ability to drive, to eat whatever and whenever one wants, the ability to control one’s bodily functions may all be lost at any time in this complicated game. For every step forward, there can often be several steps back, a new aspect of loss appearing at any moment.

I would assume that the most devastating losses come in the form of the loss of independence and of dignity. Retaining independence becomes a major challenge as the body gives way, as symptoms preclude even the most basic of daily activities. And with the loss of independence, one may begin to feel a loss of dignity, of the self, of one’s place in the world. When the individual becomes weak, incontinent, unable to toilet him- or herself, unable to bathe independently, these are the losses in which the person begins to lose quality of life and a true sense of self, or at least a sense of the self as one has known it.

Anticipatory loss is another aspect of illness. As a form of grieving, this manifests as one faces losses which are only around the corner. Depending on the form of disease, one can anticipate further deprivation and change. In progressive neurological disease, even the most simple function may be on the docket. The powers of speech, swallowing, hearing, touch, sexual function—these too can be taken away and remain but a memory.

The most devastating of all losses may be the knowledge that one will eventually leave one’s loved ones behind. The worries and concerns may mount: Will s/he be OK? Will they be financially solvent? Did I do enough to prepare? Are my affairs in order? How much will my illness cost them, both emotionally and economically? Will my loved one be able to continue on without me? Who will care for them when they are sick or needy? Did I accomplish all that I wanted to accomplish?

Finally, beyond loss, one begins to look toward the future, one’s future beyond this world. One examines the spiritual questions on the table, reflects on one’s life, hopefully makes peace with the choices that have been made, and considers what will happen when the curtain closes on this earthly existence. The beliefs that have grown in the psyche and mind over the decades now come to bear. One’s faith—or lack thereof—makes itself known. They say there are no atheists in foxholes, and the existential begins to take on more and more importance as the material world recedes. This is the time when the outer losses lose the crucial impact which they once carried, and the mind turns inwards towards matters of spirit, of faith, of making peace with both life and death.

I have watched a number of individuals enter, travel through, and complete this process. For those who lost function of outward communication and became demented or aphasic, their inner peacemaking was just that—inward—and I have not been privy to their process. For those who retained their mental capacities and ability to communicate until the end, the observer and loved one can glean much more from the experience and in some ways share more in that journey.

When the individual entering this phase of life and letting go is an intimate loved one (like a parent) rather than a patient, that is where the poignancy of this process takes wing, and also where the pain can become more visceral. This is the place where my mind and heart now dwell, and it’s now my turn to walk this road as I have watched so many others travel with me as advocate and guide. The loss may be swift, it may be slow, but it is real, it is intimate, and its reality cannot be denied. I feel for my mother as she faces this gradual deneoument of her life as she has known it, and while I fear for her security and stability, I also must care for my own. This is no place for codependence and loss of one’s center. This is a time for groundedness, thoughtfulness, spiritual insight, sensitivity, and compassion for myself as well as others.

As a family, we have crossed that threshold of loss and letting go, and the path which we will follow together has been trod for millenia. May we do it well, with grace and humility, and come through the other side stronger and more healed, and may my step-dad’s losses and eventual passing be peaceful and as painless as possible, with suffering kept to a minimum. This is my wish for us and for all families who are on any portion of this universal journey of life, love, and death.

So be it.