Holding the Net

by Melanie P. Merriman

  “Are you hungry, Mom?” I asked.

  She made a sound that I recognized as “No.”

  “Alright,” I said. “I won’t force you.”

  Letty heard me, and she came over to encourage Mom to eat a little more. Mom said something I couldn’t understand.

  “She wants something to drink,” Barbara interpreted for us.

  Letty got her some thickened juice. Mom finished all of it, and then we went back to her room, where she asked for water.

  Barbara and I sat with her for a while, offering her water and chattering to fill the silence. I talked about my work, my friends, and a book I was reading. After a while, we took Mom to the living room where she always spent her evenings, telling her we’d be back in the morning.

  On the way out of Homeplace, I asked Barbara if she had the makings for a Manhattan at her house.

  “Bought it all yesterday,” she replied, without looking at me.

  That was Tuesday.

  At 8:00 the next morning, Barbara and I stopped in to see Kathy, the Homeplace/Seasons Director.

  “How is your Mom doing?” she asked.

  “She’s very weak,” Barbara said, “but we’re hoping to take her to my house tonight for my famous beef stew.”

  “Is the hospice working out?” Kathy asked.

  “They’ve been great,” Barbara answered.

  “Kathy,” I said, “Can she stay here, even if she gets worse? I mean, is it okay? Can she die here?” I wiped away a tear. “I want her to be in her own place.”

  “It’s fine,” Kathy said, passing me a box of tissues. “This is her home.”

  Barbara and I found Mom in her room. She was dressed and propped up in her chair. I had planned on a quick “hello” before going to the gym, but as we hugged Mom and sat down, Tammy, the hospice nurse, arrived. She checked Mom’s blood pressure, pulse, and respirations, and asked her if she had any pain.

  Mom said, “Muh,” which meant “no.”

  “Mom, can you see all right?” I asked. “Your glasses looked smudged.”

  I took her glasses, breathed on them moistly, and then wiped them with my t-shirt. I put them back on her face.

  Mom smiled and said, “Let there be light!” clearly enough. We all laughed, and I gave Barbara a knowing look. See, my eyes said. She’s still in there.

  “This might make you kind of sleepy,” Tammy said to Mom as she gave her the 9:00 a.m. dose of liquid Lortab.

  “I’ll stay with her,” I said. “I can go to the gym later.”

  Barbara and I had brought two cars so we could go our separate ways. She returned home to cover a work call.

  As Mom drifted off to sleep in her chair, she called out softly, “Help, help.”

  “Mom, are you alright?”

  She nodded.

  “Did you know you were calling out for help?”

  “Muh,” she mumbled.

  I hugged her gently as she slept. I thought about all the times she’d lain down with me at night in my tiny twin bed to help me fall asleep. I felt sad, and inexplicably calm.

  When Mom woke up about twenty minutes later, she wanted water. I thickened it as Barbara had taught me, and she drank it through a straw. Then she wanted to go to the bathroom. I didn’t trust myself to help her now that she was so weak, so I found the nurse’s aide.

  As the aide wheeled her out of the bathroom, Mom said she wanted to lie down. She curled up on top of the bedspread, and I covered her with the crewel-work afghan she’d made twenty-some years earlier. It was decorated with fanciful mushrooms and vines, and edged with hand-crocheted fringe.

  “You did such beautiful needlework Mom,” I said.

  “I love you,” she murmured, as clearly as she could. Her words caressed me like a soft spring breeze.

  “I love you, too, Mom.”

  Once she fell asleep, I decided to run errands and go to the gym. I pulled up the bed rail and let the staff know she was napping. I told them I’d return in a few hours. Dena was due to arrive at noon.

  I drove to UPS and dropped off a package of tax documents for Mom’s accountant. As far as he knew, she had just signed her Form1040. I stopped at Target to buy more Pull-ups for Mom, spent forty-five minutes pounding on the elliptical trainer at the gym, and went to the house for a snack. While there, I composed an email to Bill, my friend who had postponed his Florida visit.

  Mom seems generally in good spirits, I wrote, and very accepting of help. Yesterday, she said she “feels old,” and “It’s hard to be old.” She is getting great care, and I’m so glad I am here to just be with her. I don’t know when the end will come, but we are all as ready as we can be. It may be months, but not many. Tonight, we will bring her to Barbara’s house for dinner.

  A short four hours later, my message would have been very different.

  I headed back to Mom’s at around 1:00 p.m., planning to drop off the Pull-ups, have a brief visit with Dena, and then go back home for a shower. Mom was up in her chair, and after hellos and hugs and I love yous, she drank some water.

  “She asked me to call both you and Barbara,” Dena said.

  Mom looked at me and I saw confusion, or maybe fear, in her eyes.

  “Mom,” I said. “What’s wrong? Are you hurting?”

  She made the sound that meant “no.” Then she gestured for more water.

  Dena made conversation, asking if I had been to the gym, though it was obvious from my workout clothes and stringy hair.

  “Yes, I know I need a shower. Probably smells like a good idea,” I joked. “Right, Mom?” I chose to see a little smile on her face.

  When an aide came and took Mom to the bathroom, Dena grabbed my hand.

  “She told me she’s dying,” Dena said.

  “Well, I think maybe she is,” I said. “What do you think?”

  “Sometimes she seems good, but not today. She’s always in my prayers.”

  Mom lay down under the afghan again. She continued to ask for Barbara, so I called the house and told Barbara what Dena had said. When Barbara arrived, Mom woke up.

  “I’m here,” Barbara said.

  “Good,” Mom said, then asked for water.

  After giving Mom a drink, Barbara asked her, “Is everything okay?”

  “Okay,” she said, closing her eyes.

  Dena, Barbara, and I sat together, watching Mom sleep, listening to her breathing and chatting quietly. I sat next to the bed, occasionally stroking Mom’s arm if she whimpered.

  After an hour, Barbara and I encouraged Dena to go home, assuring her we’d stay until Mom woke up.

  “You call if you need me,” Dena said as she blew a kiss to Mom. We nodded.

  Mom slept fitfully for another couple of hours, her regular breathing punctuated by frequent, very soft cries of “Help, help.” She woke every twenty minutes or so wanting water. Barbara read poems to her in a soothing sing-song while I stroked her back and legs.

  “Everything will be alright,” I whispered, hoping it was true. “There’s no way we can take her to dinner,” I said to Barbara. “I’ll go to the house to shower, and come right back. Then you can go home, finish up the stew, and bring some back for Mom.”

  “Sounds good. I’ll tell the nurses that Mom won’t be going to the dining room tonight.”

  As soon as I walked through the locked door out of Seasons, I started to cry. Ducking into the restroom, I locked the door and yanked out a handful of paper towels. I buried my face in the stiff folds, letting myself wail. My life with Mom was ending. She was moving on without me. I knew it was time, and I knew we would both be fine. I swam in a pure, clear lake of sadness—no islands of regret or weedy tangles of anger, no longing to alter the course. After a few minutes, I took a deep breath, washed my face, and walked to the car.

  When I got back to Seasons, Mom was sitting up in bed, wearing her nightgown.

  “Melly will stay here while I go home and get the beef stew, okay?” Barbara asked Mom. “We’ll all have dinner he
re in your room.”

  “Shoo,” Mom said, which we took to mean “sure.”

  I turned on the television and watched the news. I pulled the chair up next to the bed and held Mom’s hand. She seemed more awake, though her eyes were often closed. Each time I offered her water, she drank some.

  Barbara was back within half an hour, bringing the stew, bowls, and spoons. She’d prepared a special portion for Mom, chopped fine and thickened with tiny pieces of bread. Mom lit up when Barbara came in presenting the picnic, but when I offered her a spoonful of stew, she took the smallest bit on her tongue, chewed a bit and then let it fall from her mouth.

  “Do you want something else, Mom?” I asked.

  “Wal,” she said, her sound for “water.”

  “Maybe you’ll be hungry tomorrow,” I said, as I reached for her water glass and straw.

  After one more trip to the bathroom, the aide tucked Mom into bed. Barbara and I hugged her and she fell asleep. We stayed for an hour or so, nibbling on room-temperature stew. Mom slept quietly without waking or calling out.

  “Do you think we should stay all night?” I asked Barbara.

  “She seems pretty peaceful right now,” Barbara answered. “Maybe we should go home and get some sleep. We may need to start staying with her soon.”

  We told the night nurse to call if there was any change, or if Mom asked for us. Barbara and I both slept with phones by our beds.

  That was Wednesday.

  Chapter 24

  THE NEXT MORNING, I walked through the door to Seasons at 7:30 a.m. Mom wasn’t in her room. Maybe she’s feeling better, I thought. I hoped.

  Sure enough, I found her up and dressed in the dining room. But she wasn’t at her usual table. She sat in her wheelchair, by herself, away from the other residents. Instead of a plate of breakfast, a glass filled with about two ounces of pink liquid rested on the table beside her.

  I greeted her with a smile and leaned in for a hug. As she lifted pale blue eyes to meet mine, I saw something unfamiliar—sadness, or perhaps alarm.

  “How are you feeling?” I asked her.

  She mumbled a reply that I understood as, “Not so good.”

  As I hugged her, she was, for a moment, completely intelligible. “I think I’m dying.”

  “Oh, Mom!” I hugged her tighter. “I think so, too. But don’t worry. Barbara and I are here, and everything is going to be okay.”

  The truth had slipped out naturally, riding on a wave of extraordinary calm. Later I would wonder if all my hospice experience had led to this one moment.

  “I think I’ll take Mom back to her room,” I said to the nurse, who was administering medications to the residents at other tables. “She’s not feeling well.”

  “Well, she needs to have that medicine to relieve any pain she might be feeling.” The nurse pointed to the pink liquid, Mom’s Lortab.

  I promised to help her drink it all.

  “I’ll come with you,” said the nurse. “We thought she might perk up if we brought her to the dining room, but I guess not.”

  The nurse sat with us for nearly ten minutes, gently lifting the glass of pink liquid to Mom’s lips again and again. Where do they find these people? I wondered, and thanked God for bringing us to Seasons.

  After the nurse left, Mom dozed in her chair.

  “Help.” Each exhale carried the whispered cry, the very sound of her breath.

  I wondered what she was feeling and seeing behind closed eyes.

  I tried to console her with hugs, soothing words, and gentle rocking. I gave her water whenever she woke and asked for it.

  Later in the morning, Barbara relieved me so I could be on a conference call that I should have cancelled. I was back in the room by 11:00 a.m. Mom was napping on the bed, covered by her afghan. No need to use the side rails any longer. We wouldn’t be leaving her alone.

  “Tammy, the hospice nurse, was here while you were gone,” Barbara told me. “She said Mom showed nonverbal signs of pain, or at least discomfort, and she got an order for a low dose of morphine.”

  “Instead of the Lortab, right?” I asked.

  “Yes. I guess she thinks the morphine will work better. And she left these.”

  Barbara picked up a bag of little pink sponges, each stuck on a cardboard stick like a lollipop. I recognized them—mouth swabs to keep Mom’s mouth moist, if and when she stopped drinking. We were already smoothing ChapStick onto her dry, flaking lips.

  I sent Barbara home to get some lunch, and a few minutes after she left, Mom woke up. I carefully took her to the bathroom, noting how much weaker she was, and then got her settled in her armchair.

  “Dena will be coming in a little while,” I told Mom, taking her hand.

  Just as I turned on the television, Tammy walked in.

  “I’m back,” she sang. “And I brought you a milkshake.”

  I almost laughed out loud. Now I was on the receiving end of the hospice milkshake legend. When I had been in training for my first hospice job, we were told about hospice founders who would go out at 3:00 a.m. to fulfill a patient’s request for a milkshake. The only appropriate question, we were taught, was “What flavor?” Mom hadn’t asked for a milkshake, but Tammy knew Mom hadn’t eaten, and hoped she’d accept the frozen treat.

  Tammy offered Mom a spoonful. Mom shook her head, and then reluctantly sipped from the spoon.

  “Mom, do you want some more?” I asked.

  “Muh,” she answered.

  “That means no,” I translated for Tammy.

  “Try another spoonful,” Tammy cajoled.

  Mom again accepted it reluctantly and swallowed.

  “No more,” Mom said. And though it was garbled, both Tammy and I heard her clearly.

  “Thanks anyway,” I said to Tammy.

  “It’s okay,” Tammy said. “Just make sure she gets the morphine every hour. It will keep her comfortable, but it’s important that she gets it regularly.”

  Dena came at 12:30, bringing her usual breath of fresh air. We were all relying on Mom’s third daughter to help keep our spirits up. I left the two of them alone, and took a break to eat something and take care of a few emails.

  By mid-afternoon, Barbara and I were back in Mom’s room. Mom had laid down again, fully dressed, to take a nap. She slept on and off. She was restless, as if being tugged between this life and the next. More than once, Mom had said she was ready to go, but some part of her seemed to want to stay.

  “Please help,” she breathed, or sometimes, “Please, God, help.”

  No atheists in foxholes, I thought.

  Barbara and I took turns rocking her and reading to her—sometimes from The No. 1 Ladies’ Detective Agency, which I had pulled off her shelf to pass the time and calm my thoughts, or Now We Are Six, children’s poems by A.A. Milne that Mom had read to us.

  “We love you, Mom. We’re here to help you,” I whispered. “Everything will be all right. You can let go.”

  Every hour, we got the Seasons staff to give her the prescribed morphine, and asked for reassurance that Mom was not in pain. I had learned in my hospice training that involuntary vocalizations were normal at this stage of dying, but needed to hear it all again. Training was abstract. This was real.

  Mom was still asking for water. We would either crank up the head of the bed and give her some thickened water using the straw, or, more and more often, we offered one of the pink sponges soaked in water. She sucked them greedily, and we rewet them two, three, four times.

  Around 4:00 p.m., Barbara walked Dena out to her car. Mom was curled up facing the wall. I was hugging her, almost laying in the bed with her. She opened her eyes and looked up at the pastel-colored photo of Barbara and me as children.

  “Beautiful girls,” she murmured.

  “Love you, Mom,” I whispered, my eyes hot.

  Over the next hour, Mom seemed to grow more agitated, waking more often and drawing her legs up to her abdomen. She looked as if she were hurting.
/>   “I don’t think the morphine’s working,” I said to Barbara at around 5:00 p.m.

  Barbara talked to Letty. It turned out a higher morphine dose had been ordered. I called the pharmacy to find out when the medicine would be delivered, and found out they had not received the prescription. I was frantic. I got the hospice on-call nurse on the phone.

  “My mother seems pretty uncomfortable. She’s supposed to get a higher dose of morphine, but the pharmacy doesn’t have the prescription,” I explained.

  “Don’t worry,” she said. “I’ll check into it and call you right back.”

  Fifteen minutes later, she called to tell me the prescription had been faxed to the pharmacy, and the morphine would be delivered by 6:00 p.m. If a mistake had been made, they’d recovered quickly. I felt relieved. No wonder all the research I had done as a consultant for hospices showed such high satisfaction ratings!

  Even after the higher morphine dose at 6:00, Mom was still restless, more frequently moaning or calling for help. Barbara called the hospice and asked to have the nurse visit. I offered Mom some water. She refused, but sucked hungrily on one of the wet sponges.

  Thirty minutes later, Leona, the on-call nurse, arrived. Where Tammy was lithe and perky, Leona was comfortably rounded and calming.

  “I think your Mom is going through what we call a ‘transition’,” Leona explained. “We’ll keep giving her a little additional morphine until she is comfortable.”

  Then Tammy arrived, and the two nurses worked together to gently get Mom into her nightgown, making sure she was clean and dry. Still, almost an hour after Leona had arrived, Mom was not settling down.

  “We’re going to give her a little Ativan,” Leona said. “It’s for anxiety.”

  “I know it well,” Barbara said. “I take it myself when I need it.” Tammy broke the pill in half and placed one piece on each side of Mom’s tongue, where it would dissolve slowly. Over the next twenty minutes, Mom settled and fell asleep. It was 8:00 p.m.

  Barbara and I decided we would take turns staying overnight. “I’ll stay tonight.” I knew I wouldn’t be able to sleep anywhere else.