A Visit From the Hospice Nurse

Is Mom living or dying? How can I tell?

The hospice nurse Rachel* came by yesterday to take Mom’s vitals and to check on her health in general. When she was finished, she sat down with me and my sister Claire* in our sunny living room to talk about her findings.

We spoke of the weird and incomprehensible non-sequitors Mom has been making recently (“Is that the one we were talking about earlier, Ruthie?” as she points to an invisible item); her new habit of poking holes in her blanket; her persistent old habit of declaring that she is getting out of her bed NOW, in spite of the fact that she is simply unable to do so. We expressed our frustration over these things, and our hope that, since her fractured vertebra is healed, Mom will be able to get up and use the wheelchair to get around, use the potty chair on her own. Or maybe even just sit up from time to time.

“She would be a tremendous fall risk,” explained Rachel. “With her loss of muscle, poor depth perception, and her poor coordination, she would end up falling, which would not be good.”

Claire and I nodded. Mom cannot afford another fall.

“I took her vitals, and it looks to me like her organs are beginning to shut down.”

We stared at Rachel.

I said, in a measured voice, “I find that hard to believe. I mean, she seems okay to me.”

Rachel explained that Mom’s forearm measurement has gone down by 2 cm; her pulse is high and her blood pressure is very low. These are signs of organs shutting down.

I felt like all I could say was “oh.”

Because when she was in the hospital, the hospice people made sympathetic noises and had compassionate expressions, and explained that Mom was “shutting down.”

But she came home and is still alive two months later.

It’s not that I want her to hurry up and die. I just want to pace myself. I only have so much time, energy and attention to give. Shall I splurge this week, since Mom has “days”? Or should I eke it out in reasonable servings over the course of weeks and months?

How can I give Mom what she needs and still keep on task with my degree work? Keep up with laundry and other relationships? Take a walk daily? Where do I draw a line?

Every day the same question. Where is the line, and how do I find it?

Smitty the cat leaped delicately onto the couch beside Rachel. She scratched his head and petted his back. There we all sat, in the afternoon sunshine. It was so still and pleasant.

“Well, I’ll see you next week. Call me if you need anything,” said Rachel.

• *names changed for privacy