Feet First

“It is much more important to know what sort of a patient has a disease than what sort of a disease a patient has.” - Sir William Osler

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    Friday, May 07, 2021

    The New Normal

    The process of dying, I have come to realize, is a procession of "new normals"; much like aging, but at an accelerated pace. It's frightening to look back at what my aunt could do three months ago and where she is now: bedbound and unconscious. It happens in stages.

    - She went from needing assistance to walk, to a walker, to a wheelchair.

    - When she first came to stay she was able to go upstairs and to shower by herself. First she lost the ability to climb stairs. We cleaned out a room used as an office on the ground floor and she moved in there. Hospice provided an aide to help her shower; that came next. 

    - The bathroom. One morning she was standing brushing her teeth, turned around, lost her balance and fell (I was standing nearby and was able to catch her; no harm was done). After that I insisted that she have an escort to the bathroom. Then she needed full support. One morning as I was holding her she could not take one more step. After that it was the bedside commode. 

    - Being able to stand. For a long time she insisted on eating breakfast in the kitchen and going to her chair in the living room, but in the past two weeks she has been restricted to her room. Using diapers was the last taboo; she required three people to get her out of bed and on/off the commode and to dress/undress her as she could not support herself.

    - for the past week she has been minimally responsive, gradually becoming unconscious. The medications (morphine, lorazepam) have helped a lot. She fought their use for a while, as she had been a very successful member of a twelve step program for decades; but we kept explaining patiently that there was no reason for her not to use the medications. The pain finally convinced her to agree to their use.

    Now we wait. I believe she has only hours left. Helping someone to die at home is incredibly difficult but also rewarding (especially given that, had she been placed in a facility, she would have had no visitors or independence; I think she would have died much sooner). 

    I'm too tired to say anything else right now.

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