Mom got a bit of a spiritual scare yesterday morning...
...and, although I didn't catch it at the time, I think she spent the day trying to heal from it.
    When Mom awoke she took her cannula off. I had already heard her, through the sound monitor, rousing, so I was already in action. As I gathered the usual "things" (the BG monitor, the breathing treatment machine, the breathing treatment accouterments) on my way into the bedroom I heard her begin a coughing fit. I was pretty sure I knew what the problem was, as the only time she has a coughing fit, now, is when she's displaced or removed her cannula. Sure enough, she was sitting on the edge of the bed with the nasal tube part of the cannula resting in her hair like a crown, coughing desperately to catch her breath. My guess is that she'd had the cannula in her hair no more than a minute. I quickly replaced it, then, I delivered an impromptu sermonette (not the first time I've done this in the last month) about how important it is for her to keep that cannula in 24/7 and what neglecting this could mean. I tried not to be harsh but I also knew that if I wasn't stern her subconscious would retain none of what I said. The sermonette went something like this:

Mom, I know it's hard for you to grasp because your breathing capacity has declined so quickly (which is true; prior to 5/14/08 taking her cannula out caused only minor respiratory distress, which took awhile to catch up to her), but you can no longer go without the cannula in your nose. Ever. That's why I'm having you blow your nose with the cannula in, now. That's why, when I switch you between the machine and the tank or change out tanks I do it so quickly; so your lungs will only barely notice the seconds you go without oxygen. Mom, I know that this distress is a pretty new thing...but we have to pay attention to it. It was doubtful, before, that you put your life in immediate danger when you took the cannula out. It's no longer doubtful. Your lungs are so compromised that leaving the cannula out for just a very few minutes can seriously endanger your life.
I know, consciously, you aren't going to remember this, but I have great faith in your subconscious and I will underline that faith by continuing to remind you, a couple of times a day, at least, to keep that cannula in. You can no longer take a devil-may-care attitude toward your body, Mom, it's not working well enough for you to risk it, anymore.

    Her overt response was, as usual when I correct her behavior, to tell me I don't know what I'm talking about, she's just fine and fit to make decisions about what she needs and what she doesn't. Underneath this indignant exterior, though, yesterday morning I detected that this episode in particular scared her, despite the fact that she wasn't without oxygen long enough to lead to that hard, steady, incredible middle back pain, as has occurred a couple of times within the last three weeks or so. Maybe her subconscious mind put 1 painful incident + another + the incident yesterday together and she suddenly "got it".
    Anyway, our day continued fairly well; her initial (for the day) walk into the bathroom was better than I've seen for a few days, in fact, which I pointed out to her and on which I congratulated her. From that point on, though, she appeared to lose confidence and we spent the rest of the first part of her day wheeling. Then, even though she was emotionally prepped, pre-nap, for an evening full of one of her favorite dinners, an unusual dessert and a Hallmark movie she's been wanting to see, An Old Fashioned Thanksgiving, of particular interest to her because the ads for it mention that it is adapted from a story by Louisa May Alcott, and I'd successfully recorded for her, after her nap she was unusually hard to rouse, for no usual reason that I could detect.
    Lately I've gotten into the habit of crawling into her bed behind her and rubbing and scratching her back in order to awaken her pleasantly. It makes her giggle to have me scramble over her (she always sleeps with her back facing the wall) and the back work makes her sigh with pleasure. What better way to awaken? Well, last night, even this didn't work. She appeared to enjoy what I was doing but kept her eyes tightly closed and mumbled, every couple of minutes, "I don't want to get up," and "just let me sleep through the night," etc. Her usual Bedside Evening comments. But, last night, she mumbled them with a detectable undertone of, "I don't want to ever get up, what's the use?" Something told me, although, eventually, I'll probably have to adjust to this attitude, as it could overwhelm her and become intransigent the closer she gets to death, that last night was not the night to give in to it. I wish I could explain in detail why I thought this, as I imagine it would be useful for other caregivers who are tending their care recipients through their last days...but I can't. Maybe it was because, despite her insistence on staying in bed, she had moved her legs so that her calves hung over the edge in readiness to arise (I usually do this for her). Maybe it was something about the tone of her voice. I'll think on it further...but I'm not promising any results.
    Anyway, my instincts took over and, finally, I scrambled back over her to the side of her bed, embraced her with my arms and lifted the upper half of her body to a sitting position. She wasn't happy, but she didn't attempt to return to a full recline. After several more minutes of convincing her that getting up was a good thing (I considered a Bedside Evening but thought the better of it), we finally went through our post-nap ritual and, some time after 2200 she was seated in the living room enjoying both her dinner and the movie. A good hour into our evening she even said, "I'm glad you got me up," so, she remembered that she hadn't been in favor of arising earlier in the evening; and, I guess, my instincts, last night, were reliable.
    I was, however, still mystified about the incident and continued to mull it over as our evening progressed. Finally, not too long before Mom was ready to retire for the night, it hit me: Maybe the shortness-of-breath incident and my resulting sermonette had so frightened her that her spirit and been injured and she had, for some hours, lost her faith in her ability to continue. Her faith revived but, frankly, it took most of the day and my insistence that she take the evening as we usually take evenings to get her through the injury.
    She has, of late, been remembering, spontaneously, that she has lung cancer, although I'm not sure that she's been remembering, as well, that her health is declining at a somewhat more rapid rate over the last several months than she's used to or that she is considered terminal by Hospice and her body is slowly but surely showing signs that this consideration is proper. When the general subject of cancer comes up (usually on a television ad or when we're talking about family health) she is keen to discuss it, now. About a week ago she was feeling a growth at the base of her throat which she's had for years and which doctors have pronounced non-cancerous and asked if it was cancer. She's been experiencing some intermittent low back aches, which are completely usual for her and have been for years, lately. She was prompted to ask, yesterday, if I thought it was due to "[my] cancer". I assured her that it wasn't, as I'm clear that it's not.
    Yesterday, I guess, her concern piled up on her after the incident of respiratory distress and my sermonette, and I guess her spirit took a dive. It surprised me. I'm sure it surprised her, too.
    I sense, though, that this injury is temporary and will heal, although, of course, it may also put her in a slightly more serious state than she was prior to yesterday. My alertness to her feelings about her life and the nearness (or not) of her death are certainly heightened. We'll see how it goes, you know. But I wanted to record this because it seems this is a landmark in my mother's journey through the last part of her life. Although I'm sure she isn't at the I-just-want-to-die phase, and, who knows, we may never go through that phase, I think she may be realizing that she isn't going to be "getting better", that "this cold" isn't going to "pass".
    Ah. Fragile spirits in fragile bodies. Who's idea was this form of life, anyway?!?
    Later.
- posted by Gail Rae @ 11:32   email  this post