At some time between 12:50 and 1:25 PM (PST), Thursday, October 17th, my mother took her final breath. I know that’s the timeframe because that’s when I was out of the house for a one o’clock appointment. I knew in my gut that she would stop breathing while I was gone. In fact, I think she was waiting for me to leave. Maybe she wanted some privacy since I’d been by her side all morning, staring at her. Most people will say that she was sparing me from seeing her departure. But if I had to guess the real reason, she wanted me to leave so she could be lifted up by friends, family, and her ex-husband. Maybe I was in the way, holding up the process.
The weekend had been challenging, more so for me than Mom. She couldn’t eat at all; I was giving her tiny amounts of liquid with a syringe a few times an hour. I never stopped talking to her, asking her questions, “Are you comfortable? Are you hungry? Do you want applesauce or pudding?” I felt guilty enough giving her the morphine-lorazepam-Pedialyte cocktail, but now she was starving to death while in my care? No, she had to eat something. One tiny spoonful of warm protein bar mash, that’s all I wanted her to eat. I put the spoon on the edge of her bottom lip, she reflexively allowed it inside. I got the quarter-ounce glob past her lips – it just sat there. She made no attempt to move it over her tongue, through her mouth, or swallow it. Now I had to clear it out of her mouth with a damp sponge on a stick, so she wouldn’t choke on it. That’s it. The last food to pass her lips was a lemon-flavored protein bar made into a warm pasty goo.
She was no longer talking or opening her eyes. She just slept, but it didn’t look like slumber. You know when you watch someone sleeping and they look so sweet and peaceful, and you can tell when they’re dreaming in a REM state. That’s not what was happening, she didn’t just fall asleep, “Goodnight, sweet dreams.” No, everything about her lying there with her eyes closed and mouth hanging open looked wrong, stiff, half-dead. I began telling her that it’s okay to leave, she could go now if she was ready. I said stupid things like, “Don’t let the door hit you in the ass.” “Are you still here? I thought I told you to leave.” I hoped she’d open her eyes one last time and tell me to stop being a smartass.
On Monday things had shifted to another phase. She no longer responded to sound or movement. I had come up with several techniques for getting her attention and/or a reaction. None of them were working. I was stroking her hair which usually made her frown, a few months ago she would’ve snapped, “Stop touching my bloody hair!” Now I could rake my fingers through it as much as I wanted, and she couldn’t care less. There was zero response to my touching her. I held a limp hand that no longer curled around mine. I rubbed her shoulder and the base of her neck; her muscle tone didn’t feel right, it was too firm. Nothing felt right. I was going to call hospice and ask the on-call nurse to come out. But I took her vitals instead and decided I could wait for her regularly scheduled nurse to come.
Tuesday morning, I texted the nurse earlier than I normally would to ask if she’d make Mom her first stop of the day. Also, the HHA (home health aide) came early to give Mom a bath. They both examined her thoroughly and came to the same conclusion – Mom was beginning to transition; she would be gone in the next 48-72 hours. The nurse told me the signs they were seeing (which I had already noticed) and what was to come. She texted the hospice office and the Social Worker scheduled a visit.
Tuesday afternoon, I was watching Downton Abbey, working on a memorial slideshow, and getting choked up. This is it. She’s going this time. For real folks, this is not a drill. This is not a call to 9-1-1 or another trip to the ER. There was no uncertainty. Finally, after four and a half years, we had reached our final destination. I’ve lived the last two years with my mother, sleeping on a twin bed in a tiny spare room and… I kinda loved it. And damn it, I loved her and already missed her company. How did that happen?! How could I possibly miss the voice that had criticized me so harshly and so often? My emotions caught up with me. I called my niece and she came straight over. The second I opened the door and reached for a hug, I lost control and ugly-cried. We walked back to the bedroom and talked to Mom. My niece told her she loved her and said goodbye to her grandmother.
Wednesday was actually easier. Now that I had accepted it and cried about it, I was more mentally prepared. I wouldn’t consider feeding her; she wasn’t going to starve, she was just going to die. I swabbed her mouth, applied Chapstick to her lips, and gave her a few drops of Pedialyte throughout the day. I didn’t give her morphine or lorazepam, her body had shut down, she was in no pain or discomfort. Her diaper remained clean; I didn’t want to disturb her comfort to roll her around the bed. Even if she urinated it wouldn’t be more than a dribble. Her hair had been washed the day before, it was soft and fluffy. I brushed it out and styled it as best I could. She was wearing a heather grey t-shirt with blue, pink and purple butterflies on it. She was going to die in that shirt. If I had thought about it the day before I’d have dressed her in the hummingbird shirt, her favorite.
The hospice Social Worker was visibly saddened at the sight of my mother. They had a sweet British connection. She brought us Bisto gravy and McVities Digestives. They chatted about all things English. When I told her I made Yorkshire Pudding or Shepherd’s Pie, she knew what it was without explanation. Now she held Mom’s hand and bid her farewell. She asked if I wanted a pastor or priest. “No thanks, maybe some Patrón though.”
I didn’t sleep much Wednesday night and checked on Mom many times. I made coffee around four o’clock. I texted the HHA and canceled her scheduled Thursday bath. There was really no need, no point. The nurse sent a text to say she was coming earlier than usual. Within ten minutes I was showered and dressed. Mom was struggling to breathe; her skin was changing color and texture, she was very warm. I put some of her perfume (White Diamonds) in a defuser to combat a new odor that was filling the bedroom. And on this, her final day, her eyes fluttered open. One was half open, the other was a just a slit, but I could see her milky grey-green irises. They had transformed over the last decade from coppery-green hazel to light sage green to nearly grey, lifeless. They were unfocused, I thought she might be blind. She blinked when I reached over to stroke her forehead, so she must’ve seen shadows. I leaned into her line of sight and started talking. I should’ve recorded it because I have no idea what I said. I know I named everyone I could think of who was on the other side waiting for her, she would not be alone. Her ‘dear old mum’ as she called my grandmother, her elder sister and brother, a nephew who had died tragically young, her husband of thirty-four years, and even my father, her first husband. I named cats and dogs too. They were all waiting for her to join them. “I know how you hate to make people wait.”
The nurse arrived and took Mom’s vitals, her pulse was racing at 108 bpm, we could see the pacemaker fluttering beneath her skin. She had a slight fever (99.6F/37.6C) that would continue to rise. The nurse sat down, which she never does, and said she’d stay awhile. Mom suddenly gulped; we stared at her, waiting. A few seconds passed before she took a sharp intake of breath, complete with the ‘death rattle’. We joked that she was not going to die with both of us staring at her. She was too proper for that. The nurse had to move on to her next patient and said to call the office if I wanted the on-call nurse to come over. I didn’t.
I had a one o’clock appointment at the mortuary to make pre-arrangements, rather than doing the paperwork afterward. I considered canceling, then decided to tell Mom that I was stepping out for a little while. “If you want to leave while I’m gone… just know that I love you and I regret nothing.” She blinked a few times as if she understood. I kissed her hot forehead, now burning up at 103F/39.4C. I got a clean washcloth and soaked it in cold water. I laid it over her forehead and eyes, so she’d close them. I was choking, almost gagging.
I pulled out of the driveway at 12:50 and headed to the mortuary. I probably shouldn’t be driving, I thought. What if I get into an accident and no one knows that Mom’s at home alone – dead. I was wiping my eyes and nose; I couldn’t see very well. I realized Nanci Griffith was singing. I turned up the volume and tried to sing along. I was completely distracted and probably dangerous. I pulled up to a notorious four-way stop about two miles from home. It was known as “the four-way stop where Mom totaled her car” and would be for the rest of my life.
I checked-in at the mortuary and was overcome with guilt for leaving her. My mind was swirling with thoughts of her death, ‘She’s dying right now, alone. She wanted me to leave, I had to give her peace and privacy. I bet she died while I was at that fucking four-way stop thinking of her damn accident.’ I wanted to flee but didn’t. I pushed through, I signed here and initialed there. I was unable to focus on the pile of poorly copied forms. I was judging their quality and layout. I love designing forms, I could do much better. Why didn’t they have a damn computer or tablet for fuck’s sake?! And I was irritated by some of the ludicrous questions. Her highest grade level? What the fuck does that have to do with anything?! I had had enough. My grief and guilt were turning to rage as I sat there. If I didn’t leave, I might explode on this poor woman who was politely doing her job. I said I had to go, that I had a feeling my mother was passing. It was more than a feeling. I knew. I knew she was gone. I was home within seven minutes.
When I opened the back door I immediately smelled ‘that’ smell. I walked to the bedroom doorway and stopped. Her face was no longer pink. Her skin pallor shocked me, she was already a greyish yellow, kind of waxy looking. I came in and removed the damp washcloth from her forehead. The fever was gone, of course, but she wasn’t cold yet. I removed her hearing aid and the cannula, then turned off the oxygen machine. I was operating on autopilot. I tried to close her mouth as the nurse had suggested, it was impossible. I left the room and called my niece. I’m not sure what I said, “She’s gone.” or “Mom’s dead.” I don’t know. Then I called the hospice agency. I couldn’t make another call, I couldn’t speak. I texted a few close friends.
I went back into Mom’s bedroom and took one last photo of her. I had taken one that morning, I’d compare them later. Morbid much? Maybe. But I also have photos of my father in his casket, and my last cat as she passed over. My living cat was wandering around the bed, looking like she might jump on it. I picked her up and retreated to the living room. I unlocked the front door and sat down. My niece wouldn’t take long – you’re never far away in a small town. Mom’s regular nurse texted that she’d come as soon as she finished with her current patient. I cried with relief, actually happy for a moment. This nurse had been with Mom since the beginning of her hospice care when she was still walking with a walker, still sassy, funny, and charming. She had watched over every step of Mom’s decline and when the agency shuffled the nursing staff around, I fought to get her back. We had been on this road together and this would be the last time I saw her.
My niece arrived first; we hugged it out, then talked about contacting the rest of the family. She worked with her mother and mother-in-law at the family business. They’d figure it out pretty quickly if they realized she’d gone for the day. I called my brother. He was on vacation in Florida, about as far from California as you can get. I was brief and held back a hundred words. My niece and I debated on who should call my other niece, her older sister. There’s a much longer story there, some sadness, lots of regret, confusion, and a bit of anger. It was my job, my duty, so I made the call. And that’s it. That’s the size of our immediate family – my brother and his two daughters. I was grateful for that, knowing I had a long list of her friends to call, then Mom’s siblings in the UK, but they would have to wait until Friday because it was almost 10 PM in England.
The nurse took Mom’s vitals and declared time of death. Done. It’s official. She sat at the dining room table and called the mortuary. They asked a bunch of questions; my mom wasn’t in their system yet because the paperwork was probably still sitting where I had left it. She used the word “expired” instead of deceased or passed. ‘Today is my mother’s expiration date.’ I thought. The nurse texted all the appropriate hospice staff, began charting on her tablet, and wrote in Mom’s hospice binder, marking her last visit.
End of care.
Much more has happened between Thursday afternoon and now, Saturday morning. I’ve had meals with family and friends, and a few margaritas. I have mini-carnations in a vase on the dining table, from an old and very dear friend. I’ve had calls and texts from other hospice staff with fond affection for my mother and praise for my care of her. I woke up on Friday morning and made the calls to England. Once her siblings and two nephews were informed, I posted a favorite photo of my mother on Facebook and announced her passing. I was overwhelmed with posts, private messages, calls, and texts, even a lone email. I found out that a distant friend had unexpectedly lost her mother in June. And a friend in Colorado had just lost her thirty-year-old daughter last month. You just don’t know, do you?
I went through Mom’s well-worn address book filled with her familiar handwriting, notes, scribbles, and names scratched out. The newer entries were shaky and misspelled. I called her friends; many I have never met in person. “This is Jean’s daughter… with sad news.”
The hospital bed and medical equipment are gone. I brought a roll of black bags into her room and trashed nearly everything. I did the same in her bathroom – three drawers and two cupboards full of lipstick, make-up, nail polish, creams and lotions, combs and brushes, ancient rollers, toothbrush and paste, and who knows what all. There were many packages of pull-ups, diapers, and wipes, both open and sealed. In all, four large trash bags filled with the last pieces of her existence, her ‘face’, her public persona, and her DNA – all headed for the dumpster.
The following slideshow took months to compile, from our amassed photo collection, passports, polaroids from work, driver licenses, and even her ‘green card.’ I tried to come up with appropriate music to play with it, but my OCD took the reins and I couldn’t choose a dozen songs out of the 15,000 in my music library. It begins in England, 1935, she was two years old. It ends in early 2019, prior to hospice care. She had been to the hairdresser and had a pedicure, then we ate fish & chips for lunch. We had many days like that: hair, nails, lunch. Four years ago, I was annoyed by the bother of it all. But I gradually came to enjoy, if not love, these days ‘out and about’ as she’d say.