My archives might be a little outdated especially the older blogs. My links above are all new and current.

I have only positive things to say about Permission to Mother, an autobiographical account of a thoughtful mother and clinician who courageously writes from her heart, soul, brain, and personal experience; who is open to change in her views and opinions and is not guided by the safety of rules of any group or the status quo; she is guided by love and openness to the experiences life brings her and her family. Her process benefits her and those around her and those who read her words. And to add to that, the writing style and story telling ability here make it a very enjoyable read speckled with both the humor and seriousness of life. ~Laura Keegan RN FNP, author of Breastfeeding with Comfort and Joy

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Friday, December 3, 2010

Last Days with Grandma

I wrote this Wednesday. This is how I remember the last days. All due respect if I forgot details or don't tell them how someone else perceives them.

My Grandmother Pauline took her last breath today.

She lived in Orlando. She is 95. We share the same birthday and she is 50 years older than me. Each birthday I made it a point to go celebrate her birthday with her.

Living 2 hours away and a crazy-hectic schedule, I have often wondered how in the world I would get up there when the time came and if I would even make it.

Wednesday evening she seemed fine to her friends at her dinner table in skilled nursing. Thursday (my first of four days in a row) morning, the nurses called my mother and I, and said she was having trouble breathing and could they transfer her to the ER. The ER doctor called my mother 3 times as we were preparing our Thanksgiving dinner. By the time we sat down to eat, we already knew we would be packing and driving to Orlando. The good food was not really enjoyed and the abundant left-overs was packed straight into coolers. I got a pair of jeans and a few shirts together (and Scott and Max) and we drove. (I left William and David behind.I never leave them overnight, let alone 3 nights.) By the time we got there, Grandma seemed to be better than expected. She seemed to make improvements since the morning. Whew. She was social and enjoyable to converse with. In the morning she still looked good. BUT, doctor started talking PEG tube (feeding her through a permanent line to her stomach) because she was aspirating her stomach contents into her lungs and that is what gave her pneumonia. Doctor said that would keep on happening. This was really emotional seeing her stable, but seeing no potential and each hour bringing different news.

My mom and I researched our options. Hospice care. We knew the PEG wasn't going to happen. She was already confined to a wheel chair for two years since a hip fracture. She had a subtle case of congestive heart failure and probably some renal insufficiency. I couldn't see making her go through heroic and futile tests and procedures. We made some calls and appointments. Ironically by the time we  had a plan, Grandma seemed to decline again in just hours. (This was Friday afternoon).

Saturday we took advantage of a coherent period. We put her on the phone with my sister and cousins. She said, I love you Carrie. I love you Jason. I love you Geoff. She named each. I was touched. She mumbled a lot about bingo and cards. She loved bingo and cards, too! She recognized us in the room.

I asked her if she remembered the time she took me on the bus to the beach. Remember the bus driver looked at me and exclaimed. "An Angel! An Angel!" I was only like 21, yeah, I looked good, the only young person the bus driver probably ever saw on public transport in S. Florida (haha), but my Grandmother never forgot his excitement and repeated that story to me many times with a smile. And she smiled this time, too, when I reminded her. She loved to show me off like a proud puppy owner and this bus driver justified her bragging right. When I became a doctor (my grandparents dream), she would take me around and tell her friends, can you believe she is a "doctah" in her strong Brooklyn accent. So embarrassing.

During this coherent period on Saturday morning she talked to us more, but I could see her slipping away and agitated. Sunday was long as we waited for a Hospice bed. I was eager to see her transferred OUT of the hospital and comforted in hospice. Finally she was in hospice at 4:30. She was bathed and we could visit her some more. I didn't think she would talk to me. I thought she was to far away by now and too medicated. But she had one more alert period.

I told her that the time had come for me to go back home. It was so hard to leave. She squeezed my hand and said, "Stay more."
Sigh. Tears.
My Mom, and Scott were all sobbing and emotional.
I told her it was to hard for me to leave her and she might have to leave me first.
I told her it was ok to close her eyes and rest and go. You see she was still breathing hard. Although she said she wasn't in pain, I felt pain.

The hospice nurse gave her medicine to relax her and told us they usually sleep a lot after the hospital because they are drained from all the noise and disturbance. It was good to see her respirations relax and facial muscles relax. It was good for me to see the poking and prodding ceased. When I peaked into the hospice rooms of other residents they all looked peaceful. In the hospital did you ever notice that geriatrics sleep with their mouths open, arms restrained, struggling and often unintended, almost ignored (by hospital staff). Grandma was relaxed now. I feel like at some point then her spirit left us, but the heart would take some time to slow. Like when I toss the ball, I must let go, yet it takes some time for the ball to come to a complete stop.

That was Sunday  night. And her heart beat until Wednesday as she slumbered comfortable until her time. My mother and the nurses say she didn't stir. Gasped for the last breath.

I do feel like I was there for her need or was it my need? That doesn't make it easy, though.

Grandma was there for me as a little girl when she was able. My sister already did a great job telling that story here. I too eagerly waited for her to get off the train for her weekend stays on Long Island. I loved waking her up long before she was ready. I loved hearing of her travels to Mexico with her sister, Greece and cross country with her husband. She inspired me to travel.  When old enough she toured us through New York City. Later she moved to South Florida. She brought me on several day cruises and the infamous bus ride. When she couldn't live independently anymore she was moved to Orlando by my mother. Most of the 13 years she lived in Orlando, I lived with in driving distance and could pop in for short visits as she tolerated. For the first few years she was mobile and we could bring her to mom's house or out to eat. In the past two years it was short visits as she couldn't tolerate her routine being interfered with. She loved seeing me and the boys. Almost every time she saw me she reminded me I was an angel like the bus driver proved to her. She also always told me I was still adorable like I was still her baby, her first grandchild.

She is my last Grandma to go. She will be remembered and miss.

Pauline Markman-Deutsch-Aghas
October 8, 1915- December 1, 2010
Rest in peace....


fitncrafty said...

Thank you Denise for writing this out.. I am sobbing as I type, as I feel like I just spent those days with you, mom and Scott.
We were so blessed to have her in our lives and all the things she shared with us.
RIP Grandma Pauline! I love you!

Alisha said...

Dr. Punger this is a beautiful post. Thank-you for sharing your last moments with your grandmother. It isn't very often that we are able to hear about people's last few days here on earth in such detail and I think it helps us to have less fear about death and dying when we read about a peaceful passing such as this one. You grandmother sounds like such a wonderful woman and a terrific grandmother. I am so sorry for your loss and I am sending prayers for you and your family as you grieve.

Wife to the Rockstar said...

Crying hard. My Grandmother is nearing the end and so much of this reminded me of her.

Your words are so beautiful. I am so glad you are recording this.

Permission to Mother said...

Alisha, Thank you for your feedback. Even I like some re-assurance when I ventur eout on new topics.

Courtney, I was thinking of you as I posted. I was going to email you and point you in this direction. I am glad you found it on your own. Your grandmother is amazing. I think I met her at your mom's house(?) and read abot her on your blog.

Orlando Realtor said...

I don't know how I missed this post until now. Almost 4 weeks later. It was so well written Denise, in your style and words. I was present in that room all over again.

Permission to Mother said...

Mom, I totally understand how you may have fell behind on blog reading.

Courtney... How's your grandma?

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