I have like, no joke, 6 or so drafts in my email of things I keep writing and then chucking. TW/CW parent death
I’ve been kinda having breakdowns about everything because, and I can’t stress it enough, going through all this stuff literally and metaphorically is extremely emotional. There are days where I’ll find baby pictures of my parents that I’d never seen before and just feel so gutted that life did not seem fair to either of them. Just seeing those pictures of them so full of hope and promise, basking in safety and love, I just want to reach back in time and keep them safe from the monsters they’d encounter. I was talking to one of my closest, who is in a similar life place as me, and she said, “being an only child and an orphan is rough at any age” which I hate for both of us.
Sometimes I’ll be going through my mom’s stuff and I will just kind of feel sick to my stomach thinking about what happened two years ago. I never wrote about hospice and I feel like maybe I should but that also feels like I’m invading her privacy. But I also kind of feel like it gives context as to why I’ve been such a mess throughout this? (Also Shannon, I am pretty sure it’s just you and me here which is not as bad as posting it on Facebook)
In the beginning of 2020, pre Covid, we’d been preparing to move back to LA that summer. My mom and I had talked about whether she wanted to sell her house and come with, and she thought maybe she did. She was also curious about the right to die laws in WA vs CA, as she was worried about dementia and if that day arrived she wanted to be able to end it. So I told her we’d work on it and talk to her lawyer but then the world stopped. I realize now she was probably seeing some small signs of slipping and wanted to get ahead of it.
Summer of 2023, while I was in Philadelphia, my mom, had a stroke or a series of lacunar strokes in her thalamus that left her cognitively impaired. Basically lacunar strokes are small and you don’t want to have strokes in your thalamus because that can cause basically everything to go sideways, so even if the stroke is small the effects can be monumental.
She was super delusional and paranoid and as the summer went on, it all got worse, the delusions became increasingly violent, any change in her daily habits would send her into a tailspin that would require tons of Ativan and late or all nights at her side, it was a nightmare for everyone. Because she’d had aneurism surgery in 1996 she could not safely have an mri (per her surgeon) so we were flying blind (An unsafe mri would’ve ripped the aneurism clips out of her skull) Because of the brain damage from her aneurisms and craniotomies (which I found the reports for, I don’t know why we had a copy but god surgery is brutal) she was already at a disadvantage and when coupling that with whatever Covid had done to her brain, it was a perfect storm we could never get out of. We tried rehab, she consistently failed out of everything and was deconditioning while in rehab. The head of the rehab LITERALLY said the most effective thing he felt he could do was pray for her and that he didn’t understand why she’d even been sent to rehab. She proved him right the next morning by forgetting she couldn’t walk, trying to get out of bed, falling and landing in the hospital. Again.
She had lengthy stays at multiple MGH/Brigham hospitals and they were all awful and basically no answers of expectations for anything getting better ever came up. It didn’t help that a lot of this was hit by the death month/july effect which just meant everything got dragged the fuck out because everything was a teaching moment for all the residents. After that it eas back to rehab which was a total bust.
She had a really strict advanced directive for the type of care to revoke if she ended up in a situation where she would not improve or have a meaningful quality of life, although I sometimes feel like “meaningful quality of life” could be debatable and unfortunately not something i could discuss with the person I needed clarification from who was often talking to her dead brother who was sitting next to me on the floor. Her dead brother who had come back to life because he refused to die or maybe she was dead and that’s why they were talking. I would sit there and smile and nod while all this was happening while just digging my nails into the palms of my hands.
She also had an MDRO which we could not knock out of her bladder no matter what we tried, which included surgical intervention and all of the antibiotics, oral antibiotics, iv antibiotics in hospital, lots of fucking antibiotics. Between the stroke and the constant UTIs her life just deteriorated and it deteriorated quickly. Her living will directed that if she ended up where she kinda seemed to be, to withdraw everything *including* antibiotics. I remember sitting with her when she was having the document written up, and finding it so odd she asked her lawyer to stipulate antibiotics along with surgery and feeding tubes, just because they seemed so minor in comparison. Little did I know.
When she entered into hospice, which was in my mind at the time just going to help us keep her in her assisted living situation and out of the memory care unit. Because of the MDRO my mom could not share a restroom with anyone, because she was highly contagious. The assisted living facility that she was at had shared bathrooms in their memory care unit. They had one open bed in a suite where the other patient was on a catheter so my mom would’ve essentially had her own restroom, but that other person was dying and once they died, we probably would’ve been on the hook for both bedrooms. Which we could not afford long term. But with the extra nursing care from hospice, we were able to keep her in the regular community where she had her own bedroom and her own bathroom. Dignity.
Even with that additional care things were just eo hard. Basically every night we’d need to go to give her supplemental medication, and she kept getting utis since dementia does not help with that so it just meant this repeating cycle of antibiotics/antibiotics bothering her stomach severely/3 days max of clear urine before her delusions would get way worse signaling the start of another wave of increasingly stronger drug resistance bacteria in her bloodstream.
So after the third infection in two months post hospice discharge where each infection had multiple week courses of antibiotics, I was forced to look at what was real vs what I wanted the outcome to be. I remember I had gone with my friend Barb to get my nails done in Boston, and Ethan called her and then texted me to let me know that my mom had tested positive for another uti. I remember standing on boylston street in the middle of the street when there was no traffic smoking a cigarette (my quit had a brief hiatus during this, I’m surprised I didn’t pick up drinking) wanting to put my fist through a car window just so I could feel basically anything other than what I was feeling in that moment because nothing could be worse than that. nothing. Just that awful fucking realization.
I sat down with her living will and her nurses and ethan and spoke to her friends about it and finally accepted we had done everything. At the best I could keep her alive in the middle of a failing body and a failing brain for maybe a few months where things would just deteriorate, I could stubbornly try live in hope or I could admit anything I’d be doing would just cause her more pain because there was no coming back from the ledge I was trying so desperately to get her back from.
So I withdrew her meds and started her on comfort care so she wouldn’t feel the last infection when it progressed to whatever would be the end. Honestly the stroke helped with some of that since the thalamus helps you process pain and she basically wasn’t feeling much. But yeah, I had to sit and watch her rapidly decline while knowing I could turn things around, and god I wanted to do that so badly, but I had to remind myself I was following her wishes, wishes she’d been very explicit about since 1996. I still carry a copy of her living will on my phone because sometimes I have to remind myself I didn’t dispassionately let my mom die and that this wasn’t my choice it was hers and as much as I hate it I was respecting her wishes and her autonomy. The last conversation where she was closest to lucid she could he she had affirmed this was what she wanted and that she didn’t see how she’d come back and didn’t want to be how she was.
It didn’t happen super quickly either, so basically every day was getting her whatever food she wanted (pizza was a frequent one, which she’d comment it had been so long since she’d had) or regional stuff off of Goldbelly. The last meal was lobster rolls and she seemed disinterested but had some. I had been cranky because wind had knocked down all our Halloween decorations. Ethan was worried about the not eating and clandestinely called to have a hospital bed delivered to the house that evening. Later that day we had an ambulance bring her home, and we all just hung out on the first floor. My mom slept pretty much entirely, Bones slept next to her basically the whole time, and then 6 days later she left while we listened to Adele, a later in life favorite of hers, and the other worst summer was over.
I know in my heart that I did what she wouldve wanted me to do. That is why I was her healthcare proxy and that is why she had a living will. I know she had wanted to pursue right to die if she had cognitive issues, I know she felt such horror and pity about my dad after his stroke before cancer stole him, and his mentation was significantly better than hers. I know all of this but it’s so antithetical to our drive to survive and to fix things and beautiful hot summer days just remind me of all of it and that’s BEFORE also going through all sorts of photos or medical records or legal documents.
I lowkey kinda want to find someone who hates me to be my healthcare proxy so that if or when I end up in a position I would find untenable that they would have no issue pulling the metaphorical plug and not end up feeling traumatized after. Because as much as I know I did the right things and that I did everything I could by her, there are moments where I feel immensely guilty. All the grief counseling in the world and that one is still gonna take some time
I’ve been kinda having breakdowns about everything because, and I can’t stress it enough, going through all this stuff literally and metaphorically is extremely emotional. There are days where I’ll find baby pictures of my parents that I’d never seen before and just feel so gutted that life did not seem fair to either of them. Just seeing those pictures of them so full of hope and promise, basking in safety and love, I just want to reach back in time and keep them safe from the monsters they’d encounter. I was talking to one of my closest, who is in a similar life place as me, and she said, “being an only child and an orphan is rough at any age” which I hate for both of us.
Sometimes I’ll be going through my mom’s stuff and I will just kind of feel sick to my stomach thinking about what happened two years ago. I never wrote about hospice and I feel like maybe I should but that also feels like I’m invading her privacy. But I also kind of feel like it gives context as to why I’ve been such a mess throughout this? (Also Shannon, I am pretty sure it’s just you and me here which is not as bad as posting it on Facebook)
In the beginning of 2020, pre Covid, we’d been preparing to move back to LA that summer. My mom and I had talked about whether she wanted to sell her house and come with, and she thought maybe she did. She was also curious about the right to die laws in WA vs CA, as she was worried about dementia and if that day arrived she wanted to be able to end it. So I told her we’d work on it and talk to her lawyer but then the world stopped. I realize now she was probably seeing some small signs of slipping and wanted to get ahead of it.
Summer of 2023, while I was in Philadelphia, my mom, had a stroke or a series of lacunar strokes in her thalamus that left her cognitively impaired. Basically lacunar strokes are small and you don’t want to have strokes in your thalamus because that can cause basically everything to go sideways, so even if the stroke is small the effects can be monumental.
She was super delusional and paranoid and as the summer went on, it all got worse, the delusions became increasingly violent, any change in her daily habits would send her into a tailspin that would require tons of Ativan and late or all nights at her side, it was a nightmare for everyone. Because she’d had aneurism surgery in 1996 she could not safely have an mri (per her surgeon) so we were flying blind (An unsafe mri would’ve ripped the aneurism clips out of her skull) Because of the brain damage from her aneurisms and craniotomies (which I found the reports for, I don’t know why we had a copy but god surgery is brutal) she was already at a disadvantage and when coupling that with whatever Covid had done to her brain, it was a perfect storm we could never get out of. We tried rehab, she consistently failed out of everything and was deconditioning while in rehab. The head of the rehab LITERALLY said the most effective thing he felt he could do was pray for her and that he didn’t understand why she’d even been sent to rehab. She proved him right the next morning by forgetting she couldn’t walk, trying to get out of bed, falling and landing in the hospital. Again.
She had lengthy stays at multiple MGH/Brigham hospitals and they were all awful and basically no answers of expectations for anything getting better ever came up. It didn’t help that a lot of this was hit by the death month/july effect which just meant everything got dragged the fuck out because everything was a teaching moment for all the residents. After that it eas back to rehab which was a total bust.
She had a really strict advanced directive for the type of care to revoke if she ended up in a situation where she would not improve or have a meaningful quality of life, although I sometimes feel like “meaningful quality of life” could be debatable and unfortunately not something i could discuss with the person I needed clarification from who was often talking to her dead brother who was sitting next to me on the floor. Her dead brother who had come back to life because he refused to die or maybe she was dead and that’s why they were talking. I would sit there and smile and nod while all this was happening while just digging my nails into the palms of my hands.
She also had an MDRO which we could not knock out of her bladder no matter what we tried, which included surgical intervention and all of the antibiotics, oral antibiotics, iv antibiotics in hospital, lots of fucking antibiotics. Between the stroke and the constant UTIs her life just deteriorated and it deteriorated quickly. Her living will directed that if she ended up where she kinda seemed to be, to withdraw everything *including* antibiotics. I remember sitting with her when she was having the document written up, and finding it so odd she asked her lawyer to stipulate antibiotics along with surgery and feeding tubes, just because they seemed so minor in comparison. Little did I know.
When she entered into hospice, which was in my mind at the time just going to help us keep her in her assisted living situation and out of the memory care unit. Because of the MDRO my mom could not share a restroom with anyone, because she was highly contagious. The assisted living facility that she was at had shared bathrooms in their memory care unit. They had one open bed in a suite where the other patient was on a catheter so my mom would’ve essentially had her own restroom, but that other person was dying and once they died, we probably would’ve been on the hook for both bedrooms. Which we could not afford long term. But with the extra nursing care from hospice, we were able to keep her in the regular community where she had her own bedroom and her own bathroom. Dignity.
Even with that additional care things were just eo hard. Basically every night we’d need to go to give her supplemental medication, and she kept getting utis since dementia does not help with that so it just meant this repeating cycle of antibiotics/antibiotics bothering her stomach severely/3 days max of clear urine before her delusions would get way worse signaling the start of another wave of increasingly stronger drug resistance bacteria in her bloodstream.
So after the third infection in two months post hospice discharge where each infection had multiple week courses of antibiotics, I was forced to look at what was real vs what I wanted the outcome to be. I remember I had gone with my friend Barb to get my nails done in Boston, and Ethan called her and then texted me to let me know that my mom had tested positive for another uti. I remember standing on boylston street in the middle of the street when there was no traffic smoking a cigarette (my quit had a brief hiatus during this, I’m surprised I didn’t pick up drinking) wanting to put my fist through a car window just so I could feel basically anything other than what I was feeling in that moment because nothing could be worse than that. nothing. Just that awful fucking realization.
I sat down with her living will and her nurses and ethan and spoke to her friends about it and finally accepted we had done everything. At the best I could keep her alive in the middle of a failing body and a failing brain for maybe a few months where things would just deteriorate, I could stubbornly try live in hope or I could admit anything I’d be doing would just cause her more pain because there was no coming back from the ledge I was trying so desperately to get her back from.
So I withdrew her meds and started her on comfort care so she wouldn’t feel the last infection when it progressed to whatever would be the end. Honestly the stroke helped with some of that since the thalamus helps you process pain and she basically wasn’t feeling much. But yeah, I had to sit and watch her rapidly decline while knowing I could turn things around, and god I wanted to do that so badly, but I had to remind myself I was following her wishes, wishes she’d been very explicit about since 1996. I still carry a copy of her living will on my phone because sometimes I have to remind myself I didn’t dispassionately let my mom die and that this wasn’t my choice it was hers and as much as I hate it I was respecting her wishes and her autonomy. The last conversation where she was closest to lucid she could he she had affirmed this was what she wanted and that she didn’t see how she’d come back and didn’t want to be how she was.
It didn’t happen super quickly either, so basically every day was getting her whatever food she wanted (pizza was a frequent one, which she’d comment it had been so long since she’d had) or regional stuff off of Goldbelly. The last meal was lobster rolls and she seemed disinterested but had some. I had been cranky because wind had knocked down all our Halloween decorations. Ethan was worried about the not eating and clandestinely called to have a hospital bed delivered to the house that evening. Later that day we had an ambulance bring her home, and we all just hung out on the first floor. My mom slept pretty much entirely, Bones slept next to her basically the whole time, and then 6 days later she left while we listened to Adele, a later in life favorite of hers, and the other worst summer was over.
I know in my heart that I did what she wouldve wanted me to do. That is why I was her healthcare proxy and that is why she had a living will. I know she had wanted to pursue right to die if she had cognitive issues, I know she felt such horror and pity about my dad after his stroke before cancer stole him, and his mentation was significantly better than hers. I know all of this but it’s so antithetical to our drive to survive and to fix things and beautiful hot summer days just remind me of all of it and that’s BEFORE also going through all sorts of photos or medical records or legal documents.
I lowkey kinda want to find someone who hates me to be my healthcare proxy so that if or when I end up in a position I would find untenable that they would have no issue pulling the metaphorical plug and not end up feeling traumatized after. Because as much as I know I did the right things and that I did everything I could by her, there are moments where I feel immensely guilty. All the grief counseling in the world and that one is still gonna take some time