August 3, 2006
Saying Goodbye to Mom
The phone woke me at 3:45 a.m.
It was Joanne, the owner of my mom's board and care.
"Ellie, it's time," she said.
"Time for what?" I asked.
She paused and then said, "Your mother's gone."
Maybe I was still asleep -- or in denial. I thought, "Gone where? Back to the hospital?"
Joanne waited patiently until my ability to process information kicked in. This wasn't unexpected, but I felt unprepared --and robotic.
"What should I do?" I asked Joanne.
"Nothing," she said. "The hospice nurse is coming. I'm so sorry for your loss." My loss. My mother's dead. The words were like a newspaper headline about some distant stranger's life and loss.
I forced my body toward the guest room where my sister was asleep.
"Sue?" I whispered. She woke up immediately. "Mom just died."
My big sister opened her arms. I sat down on the bed, and we hugged each other for a long time. We didn't cry. We didn't talk. We just held each other, maybe trying to let reality sink in.
Sue and I had been like bicoastal co-parents for our mother over the past eight years. Once it was clear that Mom's memory was seriously starting to go -- when she got lost returning from lunch with friends or she couldn't remember if she'd fed her dog -- we agreed that she could no longer live alone.
Mom lived with Sue for two years. Then six years ago, when she was 82, Mom agreed to move to a board and care in Los Angeles.
She was terrified at being "left" by me in the care of strangers, and she couldn't remember why she was there. She was furious that she couldn't have her Scotch in her room. She ranted. She begged.
"How could you do this to me? Please take me home with you!"
I often drove home weeping, frustrated and guilty.
But for the past three years, with the right cocktail of medications, Mom settled in. Although she had no short-term memory, she still knew me, still had a great sense of humor and even an ability to give good advice about my love life. I felt very close to her.
On Mother's Day, Mom started to slip away.
She couldn't stay awake, was hardly talking or eating. She was hospitalized and diagnosed with a urinary tract infection, which, in older people can cause extreme confusion until the infection clears up.
Over the next three weeks, Mom was hospitalized twice, but she didn't improve. When I visited, I squeezed myself onto the bed, between her frail body and the bed rail, so I could be closer to her. We held hands, and I talked. She barely moved. She stared at me when I spoke but rarely replied.
One time, my boyfriend told Mom how much he loved me; she got tears in her eyes, smiled and said, "I'm so happy for you."
Another time, I told her a joke about President Bush, and she laughed so hard she started choking. I decided to stop telling her jokes.
The doctor said Mom might need a feeding tube. I asked her if she wanted one. She said, "No." I wasn't surprised. Her living will was very clear.
"I'm so sorry you're having to go through this, Mom," I said.
She didn't miss a beat. "I'm so sorry you're having to watch me go through this."
When Mom was discharged on June 7, I told Joanne I didn't want her going back to the hospital.
"I have to call paramedics again if she's unresponsive," Joanne said, "Unless she's under hospice care. Then I'll call hospice instead."
This was bittersweet news. Hospice would spare my mother further pain. And hospice meant Mom was dying.
I guess I started grieving then. I cried with my boyfriend and on the phone with my sister. Sue decided to fly out on June 13. I couldn't wait for her to arrive. The hospice nurse came and truly educated me.
"Your mother is in end-stage dementia," she said, "which explains her swallowing problems, decreased speech, constant sleeping and the increased risk of infection. Hospice care includes a hospital bed, all necessary medications and our examinations. It's covered by Medicare. I don't know how long your mother has left, but your sister should come immediately if she wants to interact with your mother."
Sue arrived June 9.
Mom seemed to know Sue, and when we both kissed her and said, "We love you," Mom responded weakly, "I love you, too."
These were the last words Mom spoke.
Over the next four days, Mom was kept comfortable with pain and anxiety medication.
The hospice nurse said Mom could still hear us, so Sue and I sat by her bedside, reminiscing about funny and important experiences we'd all shared. The ski trip where Mom had to drive through the blizzard. The Broadway songs we sang together. All the dogs we'd known and loved.
We told her we loved her and that she'd been a wonderful mother.
We also said that it was OK for her to go, that there was nothing else she needed to do here, that we would miss her and that we would take care of each other.
On June 13, at 3:45 a.m. Mom let go.
Later that day, Sue and I went through Mom's few things, cried a little and hugged a lot. I'm so thankful we went through this together.
The next day, we decided to celebrate Mom. We went out to lunch, saw "Akeelah and the Bee," which Mom would have loved, and we had a manicure, as Mom had done every week of her adult life -- until she forgot that it was something she did.
In her honor, we both picked Mom's favorite gaudy orange color -- one that neither of us would ever wear. We giggled a lot and agreed that we looked ready for Halloween. The manicurists clearly thought we were crazy, laughing when our mother had just died the day before. But we knew Mom definitely was somewhere, laughing with us.
For the past six years, my mother's often challenging journey and our evolving relationship have inspired much of the writing in my column. Although she's no longer here in my life, she's definitely still alive in my thoughts and memories.
I love you, Mom.
Ellie Kahn is an oral historian, founder of Living Legacies, at www.livinglegaciesfamilyhistories.com, and president of the nonprofit Living Legacies Historical Foundation. She can be reached at firstname.lastname@example.org.