Peace at Last

Mom passed away yesterday. Her longtime caregiver, Eva was with her. Eva had just finishing cleaning Mom and was brushing her hair and rubbing the back of her neck. Mom's hand dropped from her lap, her face turned pale and she stopped breathing. It's a sweet peaceful end to such an arduous journey. Mom was with her loving aide who she adored - and Eva loved her.
Mom suffers no longer. And those of us who loved her don't have to watch her languish any more. I hope the time comes quickly when I can think only of Mom in her vibrant, vital life, and diminish the dominance of her long journey to finally rest. 

Ready, Get Set, Wait

My rabbi, Les Gutterman, has called me a few times to check in on how things are going with mom.  My answer yesterday was that she is the same, just that there is less of her.  She is rarely awake.  She eats sometimes, maybe two light meals a day at the most.  On Sunday, all she had was a glass of orange juice.  But her appetite jumped back up today and she ate a sandwich. A few days ago, when she had lost interest in eating, it seemed like she wanted to let death to come take her.  But then she got hungry and figuratively took back her seat at the table. The ping pong, down and up, out and in is so hard.  We think we are losing her and then she will bounce back - talking lucidly on the phone or singing with the music therapist.  But mostly, she lays on her hospital bed, newly set up in her den, mumbling constantly, unaware of anything beyond her reconcocted history that plays round and round in her head.  Rabbi describes this time as "Ready, Set, Wait".  We are, we are, we are.

(Un)True Confessions

Sometimes Mom's conversations are so cogent and so in-the-moment, that I wonder if her dementia went away. But then, it roars back in weird and wonderful ways.

She told me on the phone that she had just spoken with her dear old friend who has been her best friend for over 60 years. Let's call her "BF". BF is the one person alive who shares the most history with my mom, in terms of people and memories and feelings and, probably, secrets. Mom said she had a delightful long call with BF, reminiscing about old times, about their dead husbands who had been business partners, about their dinner parties and travels and their wild partying friends. And then Mom transitioned to a serious voice, saying, "Today, I told BF something that I had never told her. In fact, nobody knows it". With my curiosity piqued, I asked, "What did you tell her?" Mom replied, "I only have one breast". (WHAT?!?) I know for a fact that she has two. It's not a topic that is open for interpretation. She has never had any health issues or any problems with her very healthy and formerly, extremely ample breasts. Now, they are shrunken and shriveled down with the rest of her body. But in complete symmetry. At that point, she was spent, stopped talking and was finished with our conversation. I hung up, puzzled. 

I called BF, who has all of her marbles, and with whom I speak periodically. I asked how the conversation went with Mom. BF gave a similar report - - fun to reminisce, laugh about old times, compare experiences about the paths their lives have taken -- all in all, a lovely, animated chat. Then I asked if Mom had said anything strange. BF replied, "Well, now that you mention it, she did inform me that she only has one breast. All these years, and I've even seen her naked a few times, I never knew that". I told BF it simply is not true. BF jumped back in, "See! I knew I was right not to believe her". So, even Mom's friend of more than half a century also got led down the lane of faux reality. Mom lures us into thinking that she is lucid, but then in a flash, she veers off the road.

Messy

She was diagnosed with colon cancer almost a year ago. She underwent surgery to remove a tumor that caused a painful blockage. Since then, she has never fully recovered from the surgery, making life a mess if you know what I mean. Her life is a constant reminder of the post-op insult of her bowels not returning back to normal. Thankfully, she doesn't know what they are doing or when. But unfortunately for them, her aides do. 

Daily Dose of Dementia

Mom's mind fascinates me. She seamlessly integrates today's reality with her childhood and then collapses her two husbands into a simultaneous moment, all while conducting a conversation real-time as though it's all happening. Her special blend of fiction reminds me of "Ragtime" where novelist E.L. Doctorow wove a story incorporating made-up people with real historical figures such as Harry Houdini, JP Morgan, Sigmund Freud and Henry Ford. But sadly, the tapestry Mom weaves with her imagination cannot cover her frustration or her anger.
Our conversation on August 12 started with her asking, "When is Santa coming?"
Me: "He usually comes at night, after everyone is asleep. Why do you ask?"
Mom: "I want to make sure that I have enough time to take Mama and Daddy to Buddakan [an upscale restaurant in Philadelphia that she has not been to for a decade; and her parents passed away about 40 years ago].
Me: "That's so nice that you want to take your parents out to dinner".
Mom went on to describe how the restaurant has a communal table where she intends to bring a lot of people including her two husbands [both deceased, not in her life simultaneously], plus somebody named Jim.
Me: "So you are planning a whole dinner party?"
Mom: "Yeah, we have and expression around here -- it's called "go fuck yourself". We say it when we invite a lot of people and entertain them, and then they never invite me back to anything. Oh when will this be over? I just want it to end".

Mom: "Spread my Ashes Equally over my Two Husbands" (Please)

In May, when my husband and I visited with Mom, she was eager to discuss her wishes on how to handle her death. Clearly, it was important to her to say what she wants. She has so much time to spend alone in her head, without any way to write down or even capture her thoughts. I imagine that it is a great relief to say it (and dump it) out so she no longer has to carry the ideas around. What she wanted to impress upon us is that she wants her ashes spread evenly over the graves of her two husbands -- my father and my stepfather. These many months she has lain in bed, she has thought a lot about her two husbands. She has done some comparing and contrasting (which I do NOT like to hear about), but ultimately, she came to the place where she decided that 50/50 was the way she wants to land.

For as long as I can remember, she has said that when she dies, she wants to be cremated. In fact, when she moved herself into the life care community where she now lives in Florida, she purchased a prepaid cremation service. She told me that fourteen years ago. I remembered the name (Neptune Society) so I tracked them down to see what's involved. The first thing that's involved is that they exist and are still in business as a cremation service. That is a good first thing. Second, they verified that she had a prepaid service that they were prepared to honor. All good. Finally, I asked how their service works. The representative on the phone told me that when Mom passes away, the hospice people call Neptune and they will come to remove the body. Then, the Neptune Society will conduct the cremation and will place the ashes into an urn. And then, very simple, the lady told me, I can just come pick it up. After establishing that I can't just simply pick it up because I live 1,400 miles away, she allowed that Neptune will Fed Ex the ashes wherever we direct. However, she offered an option. Instead of putting all of the ashes into the urn, Neptune will reserve a small amount of the "cremains" to create a sentimental memento for the family. If I supply them with a photo, they will place the photo into a picture frame sprinkled with some cremains at the bottom of the frame to make it very special. NO THANK YOU and EW! That is totally weird and gross.

I did some internet research and learned that "cremains"is a word that is just what it sounds like. But, I also learned, there is a whole commercial world out there cashing in on them. I discovered that the Neptune Society folks are way low on the creativity scale for fancy things we could do with Mom's ashes. Not for her, though, because she has expressed her clear wishes to lay them in equal amounts over the graves of her two beloved husbands.  

Since the cremains sector is rather outrageous, I'm posting here Mental Floss's "10 Amazing Things Your Ashes Can Do After You Die":

1. An hourglass - Lifetime Hourglass Urns will custom make an hourglass with your loved one's remains passing the time

2. A Vinyl Record - The British service "And Vinyly" presses ashes into vinyl and families can provide audio or have the company compose an original song known as "bespook" music.

3. A Diamond Ring - The company LifeGem uses the carbon to make fake diamonds, but even they say that engagement rings are a little creepy.

4. A Teddy Bear - Huggable Urns will custom fit a stuffed toy teddy bear around the urn

5. A Tattoo- Commerable Tattoos will sterilize the remains and mix them into tattoo ink to keep your dearly departed under your skin.

6. Something to Write With - The Carbon Copies Project turns cremains into a set of 240 pencils, each stamped with the name, birth and death years.

7. A Portrait - A number of artists will happily mix cremains into their paintbox and create a memorial portrait.

8. Stained Glass - You can have stained glass pieces bonded with cremains to create a memorial.

9. Human DNA Trees - An art venture called Biopresence claims to be able to transcode human DNA into a tree to create a leafy memorial. 

10. Fireworks - Companies such as Heavenly Stars Fireworks and Holy Smokes make pyrotechnics out of human cremains. 

Knee Pain Came From Nowhere and Went Back to Nowhere

Last weekend, when I called to say hello, Mom took the call (which she does not always do). She told me that her knee "locked up". I asked what that meant. She got right to her point, glossing over my request to explain what was wrong. She was mad - steaming mad. "I really want some comfort. It's really miserable. What do you want me to do? Lie here and writhe in pain?" 
She wanted to be taken to the hospital right away. I probed gently for more information. "Mom, I never heard you say that you were having trouble with your knee. What are you feeling?"
She shouted, or more like whined, "Pain is pain. I woke up this morning and had this". I asked how it compared to the pain she gets in her belly periodically. She replied, "With belly pain you get a little relief in between spasms of pain. With this, you can't breathe".  "Mom" I said, "when you have a lot of pain, you can get help right away". I reminded her that her aide can call a phone number 24/7 and speak to the hospice service. The hospice nurse will instruct her aide what to give Mom. Hospice has stocked the refrigerator in Mom's apartment with morphine of all types -- oral, injection, even suppositories. It's all bundled in a bag tucked in the corner of the fridge. Mom's reply to that? "Oh, nobody told me I'm on hospice now. Well, with this knee there is nothing wrong with me. It won't kill me. I wish it would. Just ask my aide to give me the pain medicine to knock me out".
I asked her to hand the phone back over to the aide. Discreetly walking out of earshot, the aide told me that this is the first she heard of the knee pain. Mom had already been awake, had moved from her bed to her walker, and sat at the kitchen table where she ate a hearty breakfast. She even had walked to the bathroom leaning on the aide's shoulder.  I asked what she thought was going on. The aide said that Mom was bored and looking for an outing - for something to do. The emergency room was as good a destination as any.
Mom has not mentioned her knee again.