Status after 4-1/2 months (Mon, 7 Mar, 2011)

I was here at Rocky Point last October, about four and a half months ago, and even though I talk to mom on the phone almost every day, I was interested in seeing if anything had changed. Wow. She has declined quite a bit. The things I see the most are some verbal confusion--reaching for the right word and not being able to find it, her walking/balance, and her lack of appetite.

She walks VERY precariously, almost as if she is walking on ice and isn't sure of her center of balance. Sometimes she will start out walking in one direction and have to take a step sideways to get her balance before she can continue in her original direction. I asked her if she would be willing to consider a walker (again, since she refused last summer). She gave a kind of noncommital answer and said something about how they take up too much room. Then she said that she had tried the cane again and "got tangled up in myself." My feeling was that she might be willing to try a walker again, and in fact she confirmed it a few minutes ago...she would try it. I wish I had kown that before I left Seattle...a neighbor has a nice one that she isn't using and I could easily have brought it with me.

As for the verbal confusion, I have heard that in our phone conversations as well. She will try to think of someone's name or the name of one of her prescriptions or even the name of some ordinary object and be unable to dredge it up. It frustrates her and she covers by exclaiming that her brain is going. Other than that, she seems to be pretty clear in her thinking, and she is still able to reason as well as ever.

I got here yesterday afternoon, and I hadn't even been here for three hours when she looked over at me petting Jana and asked, "Will you take her?" I read between the lines and said, "You mean after you're gone?" She said yes. I was kind of surprised that she was so open about it. Even though we have talked many times about her death and what she wants to happen, she has never before brought up the immediate practical details. In the past 24 hours we have had several conversations about Jana, and mom even went through Jana's whole feeding routine, and showed me how she takes one tablespoon of Puritan canned food and mixes it with one tablespoon of Alpo and adds that to a cup of Beneful dry food and adds the glucosamine tablet and some beef broth, etc.

Jack had told me that when he was here a couple weeks ago her appetite was almost nonexistent, and she eats just a teeny amount of food at each meal. I have been seeing that as well. Last night for dinner her plate started out with a very small chicken drumstick and about a half cup of salad. She ate about three bites of the salad, and about half of the drumstick and then cut up the rest of the meat to save for Jana's breakfast. The Hospice social worker left a folder full of information for us, and one of the things was a very interesting article written by a hospice nurse (www.crossingthecreek.com). In the article he said that it is very common for people to lose their appetite as things progress. He said that caregivers should never try to make a person eat or drink if they don't want to, because their body is telling them exactly what is needed.

I know she is feeling that her transition is getting closer. The tone of our visit over the past 24 hours hasn't been sad or depressed at all...more like just matter-of-fact acceptance of whatever time is left. When the Hospice social worker was here, mom said that she doesn't WANT to go but she knows that we all have a certain amount of time here on this earth and that she wants to spend whatever time she has left here at Rocky Point, and not in some hospital looking at white walls. We talked specifically about the scenario of what would happen if she had a crisis (like the one last April), because if she is in Hospice care, their efforts would be focused on allowing her to pass on while keeping her as comfortable as possible, rather than rushing her to the hospital. She agreed and said that is exactly what she wants.