Endgame

 That was fast.

Mom went into hospice two and a half weeks ago.  In that time, she's been switched from hydrocodone to morphine.  When we were talking to the nurse about her pain, Mom mentioned that she didn't care for hydrocodone, but she did like morphine.  With a devilish little smile, no less.  The nurse laughed and said "We can do that," and Mom replied "Yes, please!"  She was started on morphine and was a bit more comfortable, but still had pain - so a few days later, her dose was doubled, giving her two extended release doses, and up to three doses (1 every 8 hours) of fast-acting morphine for breakthrough pain.  At that level, she was taking two out of the three breakthrough doses - and still having pain.  I asked her if she wanted to up her dosage again and she said yes, but she didn't want to turn into a junkie.  I told her - we're only giving you as much as it takes to get rid of your pain; we just don't know what that is yet - so she nodded and said okay.  Her dosage was doubled again, and she STILL has pain in her shoulder and back.  I'm not sure we will ever be able to make her pain go away.  

To be perfectly honest, if she were my dog, I'd have ended the suffering weeks ago and put her to sleep.  That, however, is not an option here, so we try to make her as comfortable as possible and watch her suffer.

She is not the only one suffering.  My dad is nearly going to pieces watching the woman he loves fade so quickly.  There is a flash here and there of Judy in there.  He asked her today if she remembered that she was married to him and she told him not to be stupid.  Pretty coherent for these days, but it was the only thing she said to him the whole visit.  He was wrecked when he got home.  I went to see him and we talked about it, then other things and he got back to feeling okay.  While I was with Dad, Matt texted me that Mom had fallen asleep on the toilet and he couldn't get her back in her chair.  Told him to pull the cord for help and an aide came and helped him get her off the toilet and into bed.  She was so out of it that he might as well not have been there.  That, of course, broke his heart.  John and Mary had similar experiences when they visited yesterday.  I try to keep everyone informed about her state, but I guess it's something that doesn't translate until you see it yourself.  I was with her yesterday too and I saw how far she's slipped.  I brought her three long-sleeved shirts, a clean cap, and some soft gloves for her hands that are always cold these days.  She was very pleased with  everything, but aside from the hat which she put on immediately, I'm not sure she'll ever actually use any of it.  I sat there and held her hand and she cried because in spite of all the drugs, she still hurts.  In trying to be proactive on her behalf, I find myself feeling nearly as helpless as she does because nothing I do or try seems to help much.

Adding to this, she's having a hard time standing up to transfer.  She's not drinking enough water and can barely keep food down.  What does go down comes back up.  Bless Mary for ordering her some new barf bags.  I will take them tomorrow and she'll be so pleased!  These weird little things make her happy.

All of this points to nearing death.  Drinking less and less water.  Not having an appetite and not being able to keep even soup down for long are pretty much hallmarks of its approach.  She sleeps A LOT, sometimes falling asleep at inopportune moments (like sitting on the toilet).  I'm guessing she has a week or two at most left in this life.

As her caregiver, this is so hard.  Part of me wonders if I caused this decline by putting her in hospice and trying to help her with the pain.  Dad says it was probably more just incredible timing on my part - that I saw it coming and did what had to be done.  But I have to say, the little girl that still lives in me and loves her mother so much feels a childlike guilt over something that wasn't her fault.  Adult me knew the end was coming.  Child me can't believe it's here.