On Death, Duty & Dysphoria

On March 17, 2010 my beloved 89-year old grandmother was referred for hospice care. Her dearest wish was die at home surrounded by those who love her. Because she has been living with me for the past few years,
this meant that she would die in my house. On March 21, she got her wish.

I started this blog because I discovered that writing about the situation helped me to process the tide of new
information and swirling emotions that comes with being a hospice caregiver. By documenting my journey,
I hoped it would help me to cope with everything that happened in the days to come. It has.
I continue it now, both as a tribute her remarkable life, and as a means of coming to terms with her loss.

Everyone handles the death of a loved one a little differently. If you are dealing with a similar situation,
or if you are one of the many adult children or grandchildren faced (as I have been) with making end-of-life care choices
for an elderly relative, I hope these posts will help provide some perspective. Perhaps, in some small way,
my experiences will help you cope during your own journey.

Wednesday, March 24, 2010

Back to the Beginning

Many people have asked me how it happened that I ended up taking care of my grandmother at the end of her life.  I suppose it is a reflection of our society, where busy lifestyles, lack of time, lack of space, and financial considerations often force families to leave to others the primary care of their elderly relatives.  It's a difficult choice to put your beloved parent or grandparent in a nursing home.  Sometimes it's the best possible choice, both for you and for them.  Sometimes it's the only choice you can make.  Our family chose differently, but I cannot shine a halo over our heads and say that makes us better than anyone who chooses differently.  I do own my choice - I believe that, although it was one of the hardest things I have ever done, allowing Peggy to die at home with us was the right thing to do.

I think I can say that my relationship with Peggy is atypical of the usual grandmother/granddaughter relationship.  The reason for this dates back to the beginning - or rather to my beginning.  My father was a test pilot for the Air Force.  I never knew him because he was killed in an accident about five month before I was born.  He was my mother's high school sweetheart.  They had only been married about six months when he died, and she was stunned by the loss.

The way Peggy always told the story, when I was born, the doctor suggested that it would be good for my mother to go back to work (she was a teacher) as soon as possible. He felt that if she had nothing to do but stay home and take care of me, she would wallow in her loss and feel isolated and depressed.  In those days single parenthood was not as common as it is today, and my grandparents, with their strong traditional, Midwestern values, thought it would be better for me to grow up with two parents.  They offered to adopt me.  My mother wouldn't allow that, of course, so in the end, they decided to share me.

My mother and I lived with my grandparents for the first two years of my life.  Mom went back to work, and Peggy took a year off from her job (she was a secretary/bookkeeper at Younkers, a large department store in downtown Des Moines) to take care of me.  For the first year of my life, I spent more time with Grandma than I did with anyone.  Of course, I have no memory of this.  But I do know that, from the beginning, both of my grandparents regarded me more like a daughter than a granddaughter, and I had a unique bond with both of them.

When I was about two, my mother and I moved to a little apartment about two miles from my grandparents' house.  Although I was with my mother all week, I spent many weekends at Grandma's house.  I didn't know this at the time, but one of the reasons for this was that Mom had started dating.  When I was four, she re-married.  He was a teacher, divorced and sharing custody of his two children, and we moved to his house in West Des Moines, a suburb about 10 miles across town.

My relationship with my step-father has never exactly been warm and fuzzy.  I have never been quite sure why this is so.  Our interaction over the years ranges along the spectrum between cordiality and controlled hostility, depending on what is going on at the time.  We just never quite warmed up to each other.  Maybe he saw me as an inconvenience, something that stood in the way of his relationship with my mother.  Maybe he recognized that the bond I had developed with my grandparents was never going to be superseded by an outsider. Maybe he just didn't like me.  It really doesn't matter.  That's another bundle of baggage and I'm not going to open it up here.  Suffice it to say, it quickly became clear that he would not be taking on the role of "Daddy."  I have always thought of my grandfather as my true Father.

After my mother re-married, I continued to spend at least one night of every weekend with my grandparents.  Those weekends were absolutely the happiest times of my childhood.  When my grandparents retired, they became "snow birds", spending the winters in Florida.  The months without them were torture for me - long distance phone calls were expensive, and although I did get to spend an occasional vacation with them in Florida, it was never enough.

Grandpa suffered from asthma and emphysema.  As he grew older, he found it harder to breathe, particularly during the harsh Iowa winters, so when I was about 10, he and Grandma sold their house in Des Moines and moved to Fort Myers Beach, Florida.  After they moved, I began spending summers with them on the beach, and did so until the year I graduated from high school, sometimes bringing a friend from Des Moines along with me for part of the summer.

In August of 1989, when my grandfather was hospitalized, and eventually diagnosed with mesothelioma, the doctors told him he had six months to live. I was between theatre jobs, having just finished a season at a theatre in Buffalo, NY, so I packed up my belongings and went to Florida.  After Grandpa was well enough to leave the hospital, I stayed with them for a month or so, helping out as much as I could.  Finally, Grandpa said, "I'm not going to let you sit here and watch me die - go live your life."  Although I was loathe to leave, I took his advice and moved up to Orlando.  It was a good compromise, as there was a creative community there where I could get work, but it was also close enough that it wouldn't take me long to get back to Fort Myers if something happened.

Over the next few months, I made many trips back, as Grandpa was in and out of the hospital many times.  The last time I saw him was about two weeks before he died.  I was in the middle of stage managing a production of Midsummer Night's Dream in Orlando,  but I found someone to cover for me for a couple of performances and rushed down to see him, because the doctors were telling us that "this was it" - the only time in my career I've ever skipped out on a performance.  While I was there, Grandpa started to feel a little better, even getting out of bed to take short walks around the hospital corridors.  It was on one of these walks that I knew he was preparing to leave us.

We were walking through the hospital, Grandpa trying to hold the back of his hospital gown closed so as not to "flash" anyone his behind, and me, rolling the wheeled stand with the IV bottle that was connected to his arm.  The conversation went something like this:

Grandpa: "Now I've told your mother" (meaning Peggy)  "that she is not to move back to Des Moines after I'm gone.  She is perfectly capable of taking care of herself, and I don't want her to be a burden to any of you."

Me:  Don't worry about Grandma.  We'll take care of her.

Grandpa:  "I know you will, when the time comes, but the time is not now.  Right now she would just be a nuisance, sticking her nose into everyone's business all the time, and that's not fair to you.  So I made her promise, and I want you to know that in case you have to remind her of that promise."

I never did have to remind her.  Grandma kept that promise she made to Grandpa - she did not move back to Iowa until we asked her to do so, more than 10 years after Grandpa died.  All the time she was with us, her greatest worry was that she was too much of a burden for us.  Even at the end, she always tried to be as little trouble as possible.

So that is a bit of history, by way of explaining how closely my life has always been entwined with my grandmother's, and why I feel that taking care of her was, naturally (at least partly), my responsibility.  She took care of me at the beginning of my life.   It is only right and fitting that I should have chosen to take care of Peggy at the end of hers.  I loved her.   I owed her.   And, I believe, I have done right by her.

No comments:

Post a Comment