“He’s got a rattle now. It’s a death rattle. You should probably come soon.”
That was my Mom on Wednesday morning. She was talking about my 93-year-old stepfather, Ed. A year ago Ed was still driving and doing accounting work for family and friends. He was amazing – we’d go out in public with him and brag about his age to waiters and clerks. We’d joke about how it would take a meteor crashing down from the heavens to stop Ed.
But at the beginning of 2014, his kidneys had begun to fail. He’d tried dialysis three times a week, with disastrous results. Tired of constant vomiting and exhaustion, a month ago he opted to discontinue dialysis and proceed with home hospice care.
If you’re not familiar with hospice, here’s what it basically means: They dope you up so you can die as comfortably as possible. I know that sounds harsh, and I apologize to any hospice care nurses reading this (because in my experience they really are committed and compassionate), but it’s the truth. A hospital bed was wedged into Mom and Ed’s bedroom. Ed started to receive large doses of haloperidol and morphine.
He started to drift in and out of awareness. He occasionally had lucid periods and could still hold conversations, but those periods became shorter and less frequent. When I saw him last Sunday, he recognized me, started to greet me…and lapsed into a gray state in mid-sentence.
His breathing became more and more ragged, and he had to have breathing treatments every two hours. The nurses suctioned fluids from his mouth. He twitched a great deal. He’d once been a large, strong man. It was hard to watch.
On Wednesday morning, every breath rattled. Mom said she knew this sound; she’d heard it with other loved ones, just before they passed.
She and Ed live in a nice house just about forty minutes north of me. I was there in thirty-five minutes.
Ed’s daughter and his caregiver were both present when I arrived, as well as a nurse from the hospice group. Ed gained enough lucidity at one point to ask to see his daughter. She visited with him, then left, as did the caregiver; none of us really knew how long he’d last. The hospice nurses changed shift; the new arrival was a lovely, very young woman with a sweet temperament, one of those people you can’t help but like immediately.
The day passed. I sat with my Mom in the living room. We went back into the bedroom from time to time to check on Ed. The sweet young nurse read to him for a while. She played music for him. Around three he seemed to have fallen into a genuine, deep sleep.
At 5:20 the nurse came in, looking a little shaky, and told us she couldn’t measure a pulse.
We weren’t sure what she meant – was there something wrong with her equipment? Mom asked, “Is his chest still moving?”
She didn’t think it was.
We understood then. We got up and went into the bedroom. The instant I saw him, I knew he was gone. Color had already drained from his face. He was completely still.
The nurse went through routine tests. No heartbeat. No pupil response to light. His pallor whitened even more as we stood by his side.
It was clearly over.
I escorted Mom back to the living room. She started making phone calls, to his daughter, to the caregiver. The nurse called her superior at the hospice care. She was told to write a report, then wash and dress him, and leave in thirty minutes. Later, his body would be picked up by the Neptune Society for cremation.
The nurse looked concerned. As I mentioned before, Ed had once been a strapping six-footer; now a small nurse was expected to give him a final bath and change his clothing, with no assistance whatsoever from him. “Can I help you?” I asked.
She was relieved and grateful. We later learned it was her first day as a nurse.
I told Mom what we had to do and asked her what clothes he’d like. Ed had always been a dapper gentleman who knew all the women employees at businesses he frequented by first name. They all adored him. Mom and I were already dreading telling some of them about his passing.
Mom chose a favorite pair of black pants and a polo shirt with the name of his golf association stitched above the left pocket.
As we began to prepare him for the bath, the caregiver arrived (thank goodness!). She’d done this for Ed many times while he’d been alive. It was hard for her to do it now (it was hard for all of us), but appearance had always mattered to Ed and this was the last thing we could do for him.
Working together, his face was carefully cleaned, his mouth swabbed out, his hair washed with no-rinse shampoo. We gave him a simple sponge bath and changed his clothes. As we turned him, he rattled. The bottom of his body was still surprisingly warm.
We finished. He looked as good as we could make him look. His daughter and grand-daughter arrived a short time later. They said their goodbyes. The Neptune Society came at 9:30, and treated him with great dignity. He was lifted gently onto a stretcher, covered in a black cloth, and taken away. Everyone left.
Mom and I were alone. We hadn’t eaten throughout the day, so we had a late dinner, then, exhausted, stumbled off to sleep, passing his now-empty hospital bed.
Death seldom goes the way we expect it to. There’s no dramatic head tilt at the moment of passing. The police and/or coroner aren’t called; in this case, there wasn’t even the need for a final viewing by a doctor. Cause of death would be listed as “natural causes”. No one wailed in agony; we uttered a few quiet sobs, but the truth is we were relieved to see him out of the discomfort he’d suffered for months. My Mom in particular had endured weeks of round-the-clock visits by nurses and caregivers who gave him hourly medications and treatments, all while she tried to rest three feet away. People she didn’t know would arrive at midnight, and be there while she tried to sleep or shower. Mom’s like me – she enjoys a little solitude.
But we do what we must for our loved ones, whether it’s giving away our own peace or doing our best to honor who someone once was.
After all, we’ll all get our own chance at rest later.
