The strides made in medical care over my lifetime are incredible. We have been able to prolong life through ever evolving drug discoveries and medical technology. Still, at some point, death takes us all. So for children of aging parents, the question is, how much technology and medical care should be used in the name of prolonging life in someone well advanced in years - someone unable to make those decisions for themselves? What comfort level should we aiming for? Are we OK with our loved one struggling in anxiety and anger with the paraphernalia used to pump in life-giving substances and extract waste?
What does it mean to allow a loved one to die with dignity? Does the level of alertness give us the clues to follow? Do we only make the hard decisions if someone is comatose?
I have been spending the past few days at my mother's hospital bedside as she continually fights with her oxygen mask. She has been incoherent and for the most part, unresponsive - we can't understand her - although she opens her eyes and nods to my questions. She has dementia, and her ability to speak has become much less recently. Though she understands some things, she quickly forgets I've told her that she needs the oxygen to get better.
This morning, she's more alert. Which makes her even more anxious about the oxygen mask, and now the intravenous as well.
Last night I spoke to a friend who has been visiting my mom for years...they had a close connection years ago, and she and her husband have been ever faithful to care for and about Mom. We talked about Mom's constant irritability with the oxygen mask. She said, "You know, your mom has the right to refuse the oxygen. She has a right to be comfortable." She said this with much love, as she referred to a visit they made with Mom at the nursing home, just before she entered hospital. She spoke about the peaceful look on Mom's face as they visited, even though she was unable to speak.
Her words give me cause for thought. How much do we fight with her to prolong her time in this, her 10th decade? Will removing the oxygen and IV give her a certain peace, or will she struggle then, even more, against breath and dehydration?
Her increased alertness also makes for her desire to get up on her own, and want to 'go home' - back to the nursing home. It's difficult to see your loved one tied down in a chair or bed - what's to be done? What is the quality of life for someone requiring sedation to keep their anxiety level down?
Is the struggle I feel more about appeasing my discomfort or hers?
My mother has always been a woman of faith - we are assured that when she takes leave of this life, she will be completely healed and living fully and joyfully in the next. This is no justification for any decisions that we make, but certainly colors how we look at life and death.
We will see how today goes and speak with the physician tomorrow. In the meantime, the dichotomy in my mind continues to churn, for there are no easy answers.
A writer's journey borne of curiosity and life experience as a wife, mother, friend, gardener and theologian.
Thursday, October 31, 2013
Friday, October 25, 2013
Faith and Fear - a daughter's view
I am reading Mary Gordon's Circling My Mother, a memoir set within a historical time frame that closely intersects the time period of my mother's life and mine. Reading this book gives rise to the question of who my mother was and is. Like her mother, mine, too, is afflicted with dementia.
As I read Gordon's probing evaluation of her relationship with her mother, it strikes me that much of my mother's actions may have been attributed to fear. This has never really occurred to me before. Perhaps I was always either too close to an emotionally charged situation or sadly, never had the inclination to discover what was behind her responses to certain situations.
She was afraid of horses, narrow mountain roads and my father's impatience with farm animals. She was afraid that bears would come get her when she and my dad went camping. She overcame her fear of driving by getting her drivers' license when she was well into her 30's. When we moved a province away, she was always afraid this was the last time she'd see us. During my growing up years, her greatest fear expressed itself in frequent lectures (with much sighing and rolling of the eyes on my part) about 'what boys want' and how unbearable it would be for her if one of her girls came home pregnant. She was determined that our family's reputation would always be untainted by that situation.
At the same time, she spoke of God's faithfulness, assuring us that he would always be with us - which was comforting - and that he always sees us (which was not always comforting). From my perspective, her greatest fear also translated into lack of trust in my integrity. At the time, it almost made me want to realize her greatest fear, to spite her. But the faith she nurtured within me also prevented me from following through. (I often wondered if she would have found it in her heart to be supportive in such a situation.)
This great fear of hers resulted in arguments about the length of my skirts, where I went and with whom (and when), and curfews. Today, I can see the wisdom of some of these restrictions. I was basically naive, and still tend to be blinded to the darker side of people.
Others would never have known she was fearful, since she was always full of jokes and trickery, and had a great sense of humor. She was hospitable and extroverted. School friends and neighborhood kids were welcome at our house. Another person at the table was never a problem. Later, she always played games with her grand kids, as she had done with us and our friends - she loved cards - especially crib.
It sometimes saddens me that my mother and I did not have the close mother/daughter relationship that would have allowed us to discuss any subject - openly and without judgement or defensiveness.
Like Gordon's mother, mine is more of the child now; she doesn't remember my name (although she recognizes me as someone dear to her), and she's unable to hold a conversation. She doesn't always remember what to do with a fork or spoon, and doesn't remember family names or relationships. On good days though, her sense of humor is still evident by the glint in her eyes as she does a 'happy dance' behind her walker.
I have long ago given over the tension that once existed between us and trust that a solid faith still resides deep with her - a faith that will not fail her in her last days.
As I read Gordon's probing evaluation of her relationship with her mother, it strikes me that much of my mother's actions may have been attributed to fear. This has never really occurred to me before. Perhaps I was always either too close to an emotionally charged situation or sadly, never had the inclination to discover what was behind her responses to certain situations.
She was afraid of horses, narrow mountain roads and my father's impatience with farm animals. She was afraid that bears would come get her when she and my dad went camping. She overcame her fear of driving by getting her drivers' license when she was well into her 30's. When we moved a province away, she was always afraid this was the last time she'd see us. During my growing up years, her greatest fear expressed itself in frequent lectures (with much sighing and rolling of the eyes on my part) about 'what boys want' and how unbearable it would be for her if one of her girls came home pregnant. She was determined that our family's reputation would always be untainted by that situation.
At the same time, she spoke of God's faithfulness, assuring us that he would always be with us - which was comforting - and that he always sees us (which was not always comforting). From my perspective, her greatest fear also translated into lack of trust in my integrity. At the time, it almost made me want to realize her greatest fear, to spite her. But the faith she nurtured within me also prevented me from following through. (I often wondered if she would have found it in her heart to be supportive in such a situation.)
This great fear of hers resulted in arguments about the length of my skirts, where I went and with whom (and when), and curfews. Today, I can see the wisdom of some of these restrictions. I was basically naive, and still tend to be blinded to the darker side of people.
Others would never have known she was fearful, since she was always full of jokes and trickery, and had a great sense of humor. She was hospitable and extroverted. School friends and neighborhood kids were welcome at our house. Another person at the table was never a problem. Later, she always played games with her grand kids, as she had done with us and our friends - she loved cards - especially crib.
It sometimes saddens me that my mother and I did not have the close mother/daughter relationship that would have allowed us to discuss any subject - openly and without judgement or defensiveness.
Like Gordon's mother, mine is more of the child now; she doesn't remember my name (although she recognizes me as someone dear to her), and she's unable to hold a conversation. She doesn't always remember what to do with a fork or spoon, and doesn't remember family names or relationships. On good days though, her sense of humor is still evident by the glint in her eyes as she does a 'happy dance' behind her walker.
I have long ago given over the tension that once existed between us and trust that a solid faith still resides deep with her - a faith that will not fail her in her last days.
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