Monday, December 20, 2010

Death Becomes Her

I’ve spent the last 15 years working in the insurance claims business handling what are considered high exposure and complex claims including a fair number of cases involving fatalities. In that time, I’ve handled claims involving some pretty inventive ways to die. Most of those “interesting” deaths aren’t what you would consider to be peaceful. Fortunately for the victims, whatever pain they may have experienced while in the process of creatively exiting this life is mercifully brief.

Almost all of these fatalities are thoroughly documented with accident scene and autopsy photos. In the course of my career, I’ve seen photos of people who died as a result of gunshot wounds, unfortunate encounters with machinery, practical applications of the law of gravity, car accidents, roasting in an open fire and one unlucky soul whose head was crushed by a section of highway overpass girder. Some of these people died in the course of committing some stupid, epically Darwinian folly of their own creation while others had the misfortunate to be caught up in someone else’s grand misadventures. Others still were simply in the wrong place at the wrong time through no fault of anyone.

Most of these people never had to face the possibility of growing old, becoming infirm and eventually dying the allegedly peaceful death of dying in one’s sleep. All of us age; and, eventually, we all will die. Try as we might to avoid death, it is inevitable. The challenge all of us are given is how we will face it when it comes for us.

As you might expect, it’s kind of hard for someone in my line of work not to contemplate one’s own mortality from time to time.

For the last two years since I’ve been working from home full time, I’ve had a front row seat to the slow deterioration of a loved one at the merciless hands of time. This decline has been ongoing for sometime; however, I have only been a regular witness to the effects of advanced aging since my road warrior days commuting back and forth from Dallas to Houston every week came to an end in November of 2008.

The star of this one woman play is my wife’s 94 year old grandmother. I have only known her for a comparatively short time. I know from my photo album that it’s been at least 10 years, and it has to be less than 12 years. How about we just split the difference and call it 11 years?

The first time I met The Queen’s grandmother, a long time widow whose husband had died long before I met The Queen, was when The Queen and I took a trip out to California to visit her. The Queen and I had only been dating a year or two at that point. At the time, Grandma, as we call her, was still living independently in a 2 bedroom apartment off of Marengo Dr. in Pasadena near what used to be the campus for Ambassador College and the headquarters of the Worldwide Church of God.

Grandma had been a longtime member of the church going back to the 1960s. Before Ambassador College closed in the early 1990s, Grandma was something of a self appointed caretaker of the students who came from around the world to attend school there. She would regularly have students over to her apartment for Friday night ice cream socials where they learned that Bailey’s Irish Cream and other liqueurs aren’t just for coffee and froo froo drinks. Though she has, and had at the time, several grandchildren of her own, Grandma unreservedly adopted these students as her “grandchildren”.

This habit of indiscriminate adoption led to an interesting bit of confusion one night when The Queen and I were out in Pasadena to visit Grandma. The Queen and I decided to go out to dinner with people she had known in college at Ambassador who were also adopted grandchildren of Grandma. One of these adopted grandchildren asked The Queen how The Queen knew Grandma. The Queen replied that she was Grandma’s granddaughter. Our dinner companion, not realizing that The Queen was Grandma’s flesh and blood, reiterated her question a couple of different ways until we were able to convey to her that The Queen was, in fact, the daughter of Grandma’s daughter. Our companion was a tad embarrassed when she finally “got it.”

My memory of Grandma from that first meeting is of a feisty, active, petite little woman with a strong will. She had stopped driving several years before after having had an accident and deciding, wisely it is assumed, not to endanger the motoring public further. She managed without a car just fine for quite a while by walking to nearby stores or letting her many “grandchildren” assist her.

One thing that really stood out about Grandma was that you didn’t have to wait long to find out what was really on her mind as she would not hesitate to give you her opinion. If you were a little on the stout or stocky side, she would not hesitate to say, “Grandson/daughter, my you’ve gotten fat.” Some might find this rude (which it is to an extent), but that was just her way of being brutally honest. Of course, she wouldn’t be that brutally honest to just everyone. You had to get to know her first. I didn’t find out until recently, but The Queen told me that Grandma told her after that first visit that she didn’t think I was right for The Queen. She apparently changed her mind about me sometime before the wedding.

Fast forward a few short years to just before The Queen and I got married, The Queen’s family started receiving calls from California from concerned church members about Grandma’s health. I don’t know all the details; but, suffice it to say, the family was very concerned. It was important, and rightly so, to The Queen and her family that Grandma be taken care of properly. However, this desire had to be reconciled against the stark reality of Grandma’s pride and strong will.

Though Grandma had visited her family, including The Queen, here in Texas several times, she had made it abundantly clear that she had no desire to live there whatsoever. She believed that Texas was a ghastly place populated by hicks to borrow her words. She had adamantly stated her intention to live out her years and die in her native California on more than one occasion.

So, what is a concerned family to do? Well, for starters, I gave a couple of roundtrip reward passes on Southwest Airlines I had lying around to the cause. We sent The Queen’s mother out to California to “assist” Grandma. Ostensibly, this was for the purpose of having Grandma fly back with The Queen Mum to visit the family here in Texas for Thanksgiving. We didn’t tell Grandma that we had no intentions of letting her use the return ticket. I proposed to The Queen right after Thanksgiving which gave us a readymade excuse to have Grandma hang around a while longer. The Queen and I planned and held the wedding in just under four weeks. Not because of Grandma…we had been dating for six and a half years at this point, and we didn’t want to waste anymore time.

During The Queen Mum’s trip out to California to retrieve Grandma and continuing into her visit with us, we learned that she had become unable to take care of herself due to persistent back pain such that she had difficulty walking at times. I think this was due to osteoporosis as she has a very pronounced “widow’s hump”. At times, she looks like a petite, female Quasimodo. We also learned that this chronic back pain was interfering with her ability to cook for herself and take care of basic bodily necessities. While all this was going on, church members were carefully boxing up Grandma’s worldly possessions which were then stuffed into a U-Haul truck for the long drive to Texas.

Whether Grandma had a choice in any of this is a subject of some debate. My memory is that Grandma made the decision to remain in Texas on her own after being asked to stay; however, The Queen Mum insists that Grandma was told in no uncertain terms that she was staying here whether she liked it or not. I will choose to hold onto my memory as the truth even if it might be fantasy.

At the time, we did not expect Grandma to live much longer. Such was the shape she was in when she arrived. However, three square meals a day, physical help as needed for life’s basic necessities, and constant love and attention will do wonders for house plants and elderly people. Grandma began to regain her strength and vitality. She had an appetite that would put a voracious pack of teenage football players to shame and could eat people half her age under the table. We speculated that she might have a tapeworm. It became something of a family joke. So, we affectionately named it George.

Of course, it is now seven years later. So much for Grandma not living much longer. Remember what I said about her having a strong will? Her health has continued to trend steadily downward. For the first few years she lived with us, she made it her duty to walk out to the mailbox everyday to retrieve the mail. She enjoyed sitting out on the bench in the front yard to watch the world go by. She would get up every morning, kneel down on creaky knees and pray. She would read her Bible every day using a magnifying glass as her eyesight diminished. Her mind was still very sharp at this point.

Unfortunately, time has taken its toll. It started about three years ago when she stumbled and fell in the middle of the night. We think she was getting up to use the bathroom. Either her legs buckled under her or she tripped, but she landed on an antique wooden luggage rack hard enough to break the wood.

Though she didn’t break any bones in that fall, she was never really the same after that. She would still try to walk; however, we got her a wheelchair for when she couldn’t. Her hearing started getting worse to the point that you had to raise your voice to talk with her. She steadfastly refused to get hearing aids. She thought they were for old people. She began to be forgetful, lose track of time, lose track of little things, forget where she was. Most disturbingly, she would get up in the night to “go for a walk.” We had to resort to putting things in front of the door so she wouldn’t get out and wander the neighborhood.

Fortunately, she became too weak to walk without assistance ending our nightly barricades. She would still try to get up from time to time, but she was too weak to make it far. We obtained a hospital bed from another family member who no longer had need for it. Grandma would sleep, almost like a small child, with the rails up. There were times when we would find her calling for help after getting herself tangled up in the rails and bed covers while attempting some mission only known to her.

Unfortunately, with the weakness came an undesirable side effect…incontinence. At first, it was infrequent. It was embarrassing to her to have to need help from others. Then, it became routine, an accepted part of life.

We have muddled through as best we could this way, each of us doing what we could to assist Grandma while trying to maintain some semblance of a normal life for ourselves. This was not always easy as we’ve been dealing with The Queen’s mystery illness throughout the last four years as well.

In July, we thought we really were going to lose her for real. She had a nasty infection on her hand that had the potential to rapidly turn into a systemic infection. The Queen and I finally convinced The Queen Mum to take Grandma to the hospital. Despite some reluctance on The Queen Mum’s part, this turned out to be a blessing in disguise. The hospital got us set up with hospice and home health care. They come in four or five days a week now to help. They change Grandma, give her a sponge bath, monitor her vital signs and give us a small break from the pressures of caring for an advanced geriatric.

Grandma has continued to slip away from us. She is no longer the once proud woman we all knew and loved. She no longer truly lives so much as she simply exists. She sleeps most of the day whether in bed or sitting up in her chair. When she is awake, she is eating or being assisted with other basic needs. She is completely dependent on others for everything. If she recognizes anyone, she is unable to carry on even a simple conversation. If Grandma is aware of her current circumstances, she gives no indication to us. Perhaps that is for the best.

To be honest, I am amazed everyday when I see her still among the living. That may sound a little callous, but it is the truth. We, as her family, want what is best for her, whatever that may be. We do not wish that she would die, but we do pray that God does not to allow her to suffer and will allow her to pass peacefully when it is her time.

Having watched this process unfold in front of me has, undoubtedly, had an effect on me. I have always joked that I would like to live forever or die trying. Now that I’ve spent the last two years watching the slow decline of a loved one, I feel the need to change that philosophy just a bit. So, instead of just “die trying”, I will amend that to “I want to live forever or die quickly, painlessly and spectacularly while trying.”

5 comments:

  1. So, so sad. I worked in a retirement community for a while and I saw so much decline in our residents, especially, it seemed, after the death of a spouse, and it changed my philosophy on life that was very similar to yours. Witnessing it with those people was horribly painful. I can't imagine doing it up close with a family member.

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  2. Grandma sounds like an amazing woman and it's so hard to see them decline. I'm thankful that my own Grandma Mary didn't go through too much decline.

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  3. Candance, I don't think there is an amount of money on this planet sufficient to convince me to work for a retirement community, assisted living facility or nursing home. I've handled some claims involving nursing homes. They are always sad because the family was not ready to let go of their loved one and blamed everyone they could point a finger at when nature inevitably took its course.

    GunDiva, she was and, to in certain ways, still is an amazing woman. She amazes me everyday with her ability to just be upright and able to take nourishment as my father says.

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  4. I too watched as my grandmother slipped away much like you describe.

    It leaves undeniable and deeply entrenched memories, I watched my Father care for his Mom and even change her diapers. It revealed a side of him that I didn't even suspect existed. And proved to me that even a good man can be so much better than I ever knew.

    Your grandma sounds like an amazing woman. Hoping and praying Gods best for her and your family..

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  5. Mr. Daddy, you are absolutely correct that the process brings out the best, the worst and a lot more in people than they ever thought possible. Some face the situation and become more than they were before. Some refuse to face it and run away. I have always considered myself a patient person; however, between Grandma's dementia and The Queen's mystery illness, I've tapped depths of patience that I didn't know existed. My father in law has taken on much of the daily care routine with Grandma as his wife/her daughter/my MIL is having a difficult time dealing with her mother's condition.

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