Death and Dying, and Two Tears

Maxine Friedman died at 10:59 a.m. Central Time on Wednesday, January 18, 2017.

That was a little more than a month after she turned on her hospice care and about three hours after I dashed off a short piece about how, all of a sudden, she seemed determined to exit this mortal plane quite quickly. Little did I know when I wrote that piece just how determined she was as, throughout that early morning, one moment she wouldn’t be showing a given sign of impending death, and then the next she’d’ve gone through that sign plus the next two signs that came after it — going through her death transitions quickly indeed.

She is now in the process of actively dying, the hospice nurse whispered to me.

Not long after that, Maxine Friedman exhaled for the last time. As before, with but one exception mentioned at the end of this piece, I won’t go into detail here about those particular death transitions or her particular process of actively dying; you can learn all about the general lay of that land quite nicely online.

*  *  *

I flew a dawn-eye flight into Chicago on Saturday the 14th.

I arrived and immediately headed back towards her room.

As I walked the hallway I heard the hum of the air pump that kept her mattress inflated just-so, to counter all those teeny-tiny holes designed into the mattress to let a comparable just-so amount of air out, all the better to give a bed-bound patient a deluxe ride. The hum grew louder as I approached.

Hi Mom!

She smiled back at me the most wonderful smile I think I’ve ever seen from her: those blue blue eyes of hers, her mouth a little pinched and not all that facile, giving a different cast to her smile.

She was just shy of silent when she tried to respond (and would stay that way through to the end) but that smile spoke a love and warmth that I’ll remember for as long as I possibly can.

Once I settled in (dawn-eye flights do exact a price, no matter how many times you fly them) and got into the flow of the caregiving, it seemed pretty clear that she was nearing the end of her life. The previous month we’d been jarred — stunned, really — by the doctor’s assistant’s suggestion of a months-not-years time frame. Now it was looking like she had it in mind to skip over weeks-not-months and fully embrace days-not-weeks.

Sometime the next day I realized that she’d arrived at not-even-a-week, and I put out an all-hands-on-deck to my sibs.

At her caregiver’s suggestion, we kept the room well lit so she wouldn’t be disoriented if she were to open her eyes and look around. There came a time soon when that had happened for the final time.

Along the same lines, I decided that either the caregiver or I would be with my Mom at all times. That meant that I would sleep on that lousy joke-of-a-bed sofa-bed next to my mother for what turned out to be the final nights of her life, going to sleep in the wee hours of the morning, waking every hour and a half or so to check in on her, and then waking up at dawn because, hey, there’s plenty of time to get some good sleep some other time and I’d be seeing her for only so long.

Those wake-ups remain with me, as precious quiet moments she and I shared in the dwindling middle-of-the-nights of her lifetime.

Wednesday the 18th at dawn it was pretty obvious that she had a day or two left at most. And that’s when she started to sprint through her transitions. As it turned out, she had just a few hours.

*  *  *

I’m glad I was able to be there that much. It was, I believe, helpful to her and, I know, profoundly important to me.

I highly recommend that you, if at all possible, be fully present in that way when a loved one lays dying, for lots and lots of reasons, three of which I’ll mention here.

First and most importantly, people I trust and who are knowledgeable on these matters are quite certain that your loved one knows you are present and is understanding what’s happening in the room — maybe not in every single instance, but in most (e.g., perhaps not when your loved one is dying as a result of severe physical trauma, but quite likely in hospice settings). Assuming you and your loved one get along, then, your loved one would benefit greatly from your presence — much preferable to dying with only medical staff present.

Second, if your loved one is in hospice, and since hospice providers vary quite a bit, your presence might be needed to get the hospice provider to do the right thing. The hospice folks my Mom used came highly recommended by a favorite doctor, but they were much better at providing equipment and meds than they were at providing humans when we needed them (don’t even ask about how good they were at providing humans who knew anything about my mom’s case).

Third, experiencing the hours leading up to your loved one’s dying moment,and then experiencing your loved one’s dying moment, can be a very positive experience for you. It’s helpful to draw a distinction here between death and dying — between experiencing the fact of a loved one’s death on one hand, and experiencing the events leading up to and including a loved one’s dying moments on the other. Experiencing death happens when, for example, you see your loved one in an open casket and understand more directly than ever that the body s/he once inhabited is now uninhabited; cold, stiff, unmoving (though you might think you’re seeing your loved one’s chest going up and down just a little, taking breaths in and letting breaths out). You also experience death in the days and weeks after, as you realize over and over again that things you once shared with your loved one will now have to be shared, if at all, with someone else, and you find yourself regularly confronting differences — gaps even — in how you’re experiencing life. And the list goes on and on and on as your life is filled with constant reminders of your loved one’s death.

Experiencing the events leading up to and including your loved one’s dying moments is something else entirely. Experiencing dying is to see life leave a body — going through those steps I mentioned above and, again, will not detail here. But to accompany your loved one as s/he takes those irreversible steps is to experience something unlike anything else — the most sorrowful, and the most this-is-life-and-this-is-not-life experience possible. And if you’re lucky, it can be among the most loving gifts you’ll ever bestow upon your loved one — the ultimate I’m here for you, the ultimate I’ll be with you when the deal goes down. It’s your pronouncement that you will help your loved one traverse this difficult span, without looking away, without reference to self, and without any concern other than for your loved one’s safe passage/safe journey. Zero other concerns.

Do so, though, only if you are at least pretty darn sure that it’ll be good for you to experience a loved one’s moment of dying. It’s not good for everyone. You should expect it to really pack a wallop — to leave a mark that just might stay with you for the long run. And it’s definitely not good for young people. I leave it to you to determine whether a particular young person in your life should experience a loved one’s moment of dying. I was in my 40s the first time I directly experienced dying, and that was plenty old enough for me! But I’m not sure it would’ve been good for me to experience it when I was in my 20s.

*  *  *

Depending on how you count, my Dad had a decade-long exit from this mortal plane. His was a slow decline with the logical conclusion. By the time he exited he’d used up every single ounce of his life and was totally spent — in a good way. He totally ran through the finish line and then essentially collapsed. His official cause of death was failure to thrive, and that was indeed the case.

My Mom had an 18-month exit from this mortal plane, with a clear moment demarcating the moment her healthy life ended and her not-healthy life began. By most reckonings those eighteen months were difficult but worthwhile. Her world was pretty small during that time, but she gave and received lots of love, and was able to be at home with ’round the clock caregivers for all but a few weeks of that time. And when the time came, she, like my dad, required about four days to go through the process of dying, and then it was sweetly, peacefully, over.

*  *  *

I break now from my “no details about her dying” approach mentioned above to note one extraordinary thing my mom did in the final minute of her life: she shed a tear from her left eye — the caregiver and the two hospice folks and I saw it plain as day, and I dabbed it from her cheek — and then about half a minute later another tear flowed exactly the same way and it, too, I dabbed up.

I have to say that these tears have stayed with me, and given me quite a jolt, mostly in a good way but also in a pretty darn painful way at first.

How perfect is it that tears mark both happy and sad things in our lives? None of us will ever know for sure, but I think my mom was saying, Thank you kids for being here and taking good care of me, it’s been wonderful and oh my how I would like to continue in this loverly ol’ world of ours but alas it’s not to be so I bid you adieu, both fondly and sadly, both madly lovingly and closed-throatedly sorrowfully.

Mom, we will miss you very much. You were really something. And you wrote a great last chapter for yourself and for your loved ones. Thank you.

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Further Last Acts of Love

Four days before my father died I asked him, as I had each day during the past many weeks, whether he was happy to be waking up. He always indicated he was — he was not able to speak via words back then — until the Saturday before he died at which time he managed to utter a single word, no. It took him another four days to exit this mortal plane because, as we would soon come to learn, he had a last act of love to accomplish.

He was always a very verbal guy. Many thought he was a quiet one, but among loved ones he was not (they said much the same thing about my fave fab four, George).

My mother is proceeding differently. She has, quite determinedly, gone about her tasks of making her life come to a close — quickly gone through the transitions, they say — and had nary a word to say along the way. To paraphrase the nice line from the hospice booklet, she is no longer in need of the heavy, nonfunctioning vehicle that is her body, and will soon be free of it.

A woman of actions not words!

To be continued . . .

 

 

 

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Occupational and Physical Therapists: What Do they Do and Which is Which?

Baby boomers with elder parents rejoice! I am pulling elder parent duty this week, with lots of time on my hands (here and there anyway), and can answer some simple questions that will come up the first time you ever find yourself in a similar position.

*  *  *

After a big medical event, the occupational therapists and physical therapists — the PTs and the OTs — work with the patient in discrete chunks of time throughout the day. There are others Ts around (speech therapists, for instance), but the PTs and the OTs are the main Ts that’ll be coming through.

If you’re like most people, you’ll be confused about what the OTs and PTs do and which is which.

There’s a simple shorthand. Now, please use caution, Will Robinson, when using this simple shorthand, because, in my experience, most OTs and PTs are not in love with this simple shorthand, but it surely is a good place for you to start understanding what they do. The simple shorthand is that OTs are arms and PTs are legs, so OTs are more about fine motor skills and PTs are more about gross motor skills. Or if you really want to raise a ruckus and maybe get on the bad side of the PTs coming through, you can use this one: OTs are fine and PTs are gross.

Another way to think of it is that occupational therapists help patients get better at the things that occupy their time, such as brushing their teeth, combing their hair, etc., while physical therapists help them get better at doing anything remotely like what you would do in gym class (aka physical education), such as walking.

Either way, when they’re not around and you’re keeping an elder parent company, I’ve found that it’s a good idea to push your parent to do things on their own which they might not initially want to do. They want a drink of water from a cup on the tray in front of them? You can pick it up and put it to their mouth, but maybe you should think like an OT and ask them if they can pick it up and put it to their mouth? Gentle requests like that can get your parent into the mode of trying to push against the physical envelope in which they find themselves unhappily confined, and that in turn can help them start to feel a bit of empowerment and accomplishment. At least in my experience, even when they fail — and make no mistake about it: taking a sip out of a cup can be a very big deal after a medical trauma — they find something valuable in the effort.

PTs and OTs are experts at this part of the healing process and, in my experience, they as a group tend to be very lovely people — gentle, loving and caring, but ultimately forceful and wise about how to get patients to find profound healing powers dwelling deep down inside their traumatized bodies.

So yay for OTs ad PTs and thanks for doing everything you do.

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You Should Own Your Own Email Address, Not Rent It

We all prefer being in control, don’t we? After all, it surely beats not being in control, doesn’t it (certain Shades of Grey personality types excepted . . . )?

Why is it, then, that so many of us cede control of our email existences by choosing to rent rather than own our email addresses? That’s a major relinquishing of control, isn’t it?

I bring this up here because this blog is just about always about smartening up, and because there are smart ways and not-so-smart ways to put together your email life. At the extreme not-so-smart end of that spectrum you’ll find people merely renting their main email addresses, and at the other, yes-very-smart extreme of that spectrum you’ll find people owning their main email address. Down below we’ll take up that spectrum, beginning with a merely-renting approach that is so very not-so-smart as to fall all the way into the category of being just plain ol’ dumb, and then we’ll move on through various levels of renting that look more and more like ownership, until we arrive at the promised land of outright, unconstrained, all-encompassing Capital-P Capital-O Private Ownership. So please do read on to see how smart or not-so-smart you’ve set up your email existence, and what you might want to do to improve it, OK? And thank you for your interest.

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The Plain Ol’ Dumb Way to Set Up Your Email Existence: Using the Email Address You Have with Your Employer as Your Only Email Address.

The worst way to set up your email existence is to use the email address you have through your employer as your be-all and end-all — as your everything-all — email address.

Two big problems (at least two . . . ) arise when your everything-all email address is owned by your employer.

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First Week of January Test (2015 Edition)

The other day, in the wee early hours of the Monday of All Mondays, subscribers to my email list received, just like clockwork (just like calendarwork?), their FWoJT email (their First Week of January Test email).

This year the Monday of All Mondays — I speak here, of course, of the first Monday of the New Year, when many of us first go back into our normal day-to-day routine following the holidays — fell (and for many it did indeed fall) on January 5th, but it can fall on pretty much any day in the first week or so of January.

On that Monday of All Mondays, many folks first saw their FWoJT email as they awoke to lift their heads from their pillows to grab their phones to scan their email notifications (that’s the very first thing many of us do now upon waking, yes?) and were reminded that, as happens every year on that very day, Friedman was advising them to just go there —  to just go ahead and, for a brief moment, ask themselves how it felt to be back in their day-to-day routines after the holidays.

Moans and groans (and worse) went up across the land, along with, from the lucky few who have reached their Exquisite Balance, a few wahoos and giddyup-doggies and sweet-[deity or non-deity of their choosing]-a’mighty-I-am-happy-at-lasts.

I hope you found yourself among the lucky few!

* * *

If you haven’t the foggiest what I’m talking about, please take yourself back to that moment — role-play yourself back into the mind you inhabited at that very moment — and please read on, as The First Week of January Test email awaits you below!
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