Monday, October 28, 2013

The Last of the 'Garner Girls'

It's all over, now, but for the waiting.

Early last year, my mother had a stroke that seemed to open the way for Alzheimer's to wreak its havoc upon her mind. She had been having memory problems and other symptoms of dementia, but until then it had been manageable.

She was trying to cut up one of the quilts her mother had made by hand, decades before. She was trying to eat crossword puzzles. She forgot to turn the stove off after trying to make coffee--in an empty pot.

She was convinced someone was trying to steal her car and would go outside several times a night to catch them.

She was convinced that my nephew was poisoning her.

She's never looked so old as she does now, at nearly 83. Dealing with her husband's Alzheimer's took a massive toll on her. She'd already lost her two sisters and her father to it. My stepfather lost his mother to it.

Mom gradually improved after last year's stroke, moving from the hospital to a nursing home that smelled of paint and disinfectant. Every visit was painful. Her memory was shot, so we were on a constant loop of "Where am I?" and "When can I go home?" and anything else that occurred to her.

Several weeks later, she was showing improvement and moved to an apartment-like retirement home. In October, her doctors decided that she was well enough to come back home. Or maybe it was an insurance thing.

Mom was still prone to paranoia about her car, still convinced my nephew was up to no good, but she was manageable right up until early September. I don't know if it was another stroke (if it was, it wasn't a big one). She was combative. When she was taken to the ER, the nurses had to sedate her and put big foam mitts on her hands to keep her from pulling IV's and other tubes out. She kept trying to eat the blood oxygen sensor on her finger. And once again, every conversation was a series of repetitions.

Doctors asked why she'd been allowed to go back home (good question) and had her moved to a home set up for Alzheimer's care.

Less than two weeks later, she fell trying to get out of bed and broke her left femur in several places (where the HELL were the staff people who were supposed to be watching her?). She had to wait more than 24 hours before a surgery slot opened. The doc put a rod in her thigh from hip to knee. Now Mom faced several weeks of rehab.

Now, though, all that is past. A week ago she was rushed to the ER with a massive infection. Her white blood count was something like 64,000 instead of 4,000 or whatever the norm is. At first, the ER docs were talking liver cancer or leukemia, but tests came back for clostridium difficile, courtesy of that effing nursing home. They put out a warning to call in the family. Her organs were shutting down and the infection was everywhere, including her brain.

We okayed surgery to try to stem the infection; her colon was removed. But Mom didn't want heroic measures. No machines, no tubes. Do Not Resuscitate. We agreed that this should be the one big attempt to save her.

The last time I saw her lucid--as lucid as she's been these last few weeks--we couldn't touch her. Every visitor had to wash up, put on a paper gown and gloves, and wash again on leaving. She didn't want us to leave her. The next morning--surgery day--she had been intubated and sedated. She never regained full consciousness afterward. She would react to people in her room, but never gave a sign of recognition. That was Friday.

The docs had Mom's feeding tube removed this morning. Now she's just on morphine and antibiotics and saline. There's been no improvement. Could be a few hours, maybe a day. For what it's worth, I'd rather it be this way, a reasonably peaceful ending, denying the Alzheimer's its long, drawn-out destruction.

My stepfather used to tease Mom about her mother and sisters. Those "Garner Girls" were always a handful, he'd say, but never spitefully. They're all buried together. The last of them will be with them soon.

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