Dad's wife died on Friday morning.
May. 2nd, 2021 10:55 pm![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png)
Trigger warning: Discussions of hospice, death, nuts and bolts of what happens when you have a corpse in the living room, etc.
Dad's wife (not my mom, my father's wife) died on Friday morning following several years of playing Breast Cancer, here lately with massive lung mets that were not responding to chemo. This was not a sudden or unexpected death -- it has been trudging resolutely in her direction since the turn of the year -- and while we miss her, watching her struggle desperately* to breathe for the last month and a half wasn't super fun either.
I think we knew this was coming in March, when she want up to the hospital for a scheduled chemo and they did a scan and then didn't do the chemo without a real explanation for why not. I wasn't there, only got a secondhand report from Dad of "They didn't do the treatment, just a scan. I don't know why they didn't do the treatment." But, I do know that chemo is predicated on having ... the right amount of toxic shit in you to kill the more-metabolically-active cancer while not-quite killing your normal cells. Chemo treatments are carefully spaced out to maintain this right amount of toxic shit. They don't want you to ever miss one or to even be like two days late because this right amount thing for chemo is pretty important. AND they don't have you on site for a scheduled chemo and scan you and then NOT DO THE FUCKING CHEMO TREATMENT unless they saw something on the scan (like, say, massive lung mets) that would indicate that further chemos would be a waste of everyone's time.
Anyway, after that, there was not any more chemo... just less and less ability to breathe. Previously, when Sue had filled up with pleural cavity fluid, the hospital had been able to drain it out so that she could breathe again. But they didn't do as well draining it this spring. It didn't drain as well. Her home nursing people were talking to her about hospice and she said she didn't know why they were talking hospice. (This was a conversation we had in a car together. I was driving her to... I think an eye appointment.) I said that studies had shown that people who did hospice were happier with that option than with dying in a hospital. And that medical people themselves opted for hospice if they had the option. And that they'd discovered that people needed to know about hospice BEFORE it was necessary so that they felt informed enough to make a good choice.
At any rate, throughout April, Sue got worse and worse on the breathing front. Doctors couldn't really do shit about it. By the 20th of April she went to the hospital for inability to breathe. And, on the 23rd of April they sent her home into hospice care. That, I know because I was at home waiting for the medical equipment.
She died at home, April 30th, under hospice care. If you ever have the choice yourself or might be in a position to offer some thoughts to others on their choice for whether to die in an ICU with beeping machines or to die at home, with palliative care and familiar surroundings and the company of family and friends... I urge you to consider the hospice option.
Look. Mortality kind of sucks. It does. Death is sad and inconvenient and stressful and messy. But, for some sorts of end-of-life, where it is clear that the game is over and we're all just waiting for the clock to run out, hospice is the way to go. You get to be at home. You get to see your people and be in your familiar surroundings. They give you drugs to make you more-or-less comfortable, insofar as that is possible for the dying. And you get hospice nurses, who are basically midwives to the dying. They are calm and informative and helpful... experienced at shepherding families through this event while not being so emotionally invested.
I've dealt with hospice twice, once with my grandma, who was dying of being 98 and this time with my dad's wife, who was dying of breast cancer with lung mets. On both occasions, the hospice workers have been absolutely fantastic, competent, compassionate, and helpful.
So, what happens when your person dies at home on hospice? You call the hospice nurse if one isn't there at the time. (The hospice nurses are only there part of the time. The rest of the time family or hired help must be there to stay with your dying person and see to their needs.) If, like I do, you live in greater rednecklandia, you sit in the living room with your father while his wife's corpse lies in the hospital bed in the middle of the living room floor and talk about... work. There is no crying. If you like, you can have some of Sue's peppermint patties while you wait. She won't be needing them anymore and Dad doesn't like them.
When the hospice nurse shows up, they can "pronounce a person dead" which is an official thing with a form. As well as the form, they'll have to make a phone call to the county coroner to report death and cause and so forth. This is why Sue officially died at 8:47 AM even though she was dead sometime between 3 AM and 6 AM in reality. Once your corpse is officially dead, the hospice nurse can call your preferred bodysnatchers (funeral home, cremation society, whatever) to come and get the body. The hospice nurse will discreetly mention to the bodysnatchers if the body is like 300 lbs and on the third floor so that the bodysnatchers know to bring enough people to carry the body out. As our body was maybe a buck ten and located on the ground floor, this was not an issue.
While all ya'll wait for the bodysnatchers, the hospice nurse will clean up corpse of urine/feces, put fresh pants on it, remove all medical stuff from the body like IVs or oxygen machines if that hasn't been done already, and assist in the destruction or removal from premises of the heavy duty narcotics like oral morphine.
After a while, the body snatchers will show up. Ours were nicely dressed in somber clothing, which I guess makes the living feel better -- I doubt the dead give a shit one way or the other. They wrist-tagged our body with her name (because I guess relatives would absolutely lose their shit if they wound up with the incorrect body in the casket for the viewing) and then wrapped our corpse in a sheet, neatly, and loaded it up on a... stretcher thing with slats that ran longways so that it would help hold the body straight. It had nice straps with buckles like a car seat to keep the body secure. And then they carried the whole shebang out to their sedately colored minivan (not a hearse, hearses are only for funerals) and (presumably) drove to the funeral home. I did not inquire whether or not they had other bodies stacked like cordwood in the back of the minivan, but I suspect that they don't stack them. It's probably a strictly one-layer operation.
*Before she died, Sue was on 10L of oxygen. The normal oxygen concentrator machines only go to 6L so when you get to 10L they have to daisychain two machines together to make enough air. And she still couldn't speak more than a word or two before having to catch her breath.
Dad's wife (not my mom, my father's wife) died on Friday morning following several years of playing Breast Cancer, here lately with massive lung mets that were not responding to chemo. This was not a sudden or unexpected death -- it has been trudging resolutely in her direction since the turn of the year -- and while we miss her, watching her struggle desperately* to breathe for the last month and a half wasn't super fun either.
I think we knew this was coming in March, when she want up to the hospital for a scheduled chemo and they did a scan and then didn't do the chemo without a real explanation for why not. I wasn't there, only got a secondhand report from Dad of "They didn't do the treatment, just a scan. I don't know why they didn't do the treatment." But, I do know that chemo is predicated on having ... the right amount of toxic shit in you to kill the more-metabolically-active cancer while not-quite killing your normal cells. Chemo treatments are carefully spaced out to maintain this right amount of toxic shit. They don't want you to ever miss one or to even be like two days late because this right amount thing for chemo is pretty important. AND they don't have you on site for a scheduled chemo and scan you and then NOT DO THE FUCKING CHEMO TREATMENT unless they saw something on the scan (like, say, massive lung mets) that would indicate that further chemos would be a waste of everyone's time.
Anyway, after that, there was not any more chemo... just less and less ability to breathe. Previously, when Sue had filled up with pleural cavity fluid, the hospital had been able to drain it out so that she could breathe again. But they didn't do as well draining it this spring. It didn't drain as well. Her home nursing people were talking to her about hospice and she said she didn't know why they were talking hospice. (This was a conversation we had in a car together. I was driving her to... I think an eye appointment.) I said that studies had shown that people who did hospice were happier with that option than with dying in a hospital. And that medical people themselves opted for hospice if they had the option. And that they'd discovered that people needed to know about hospice BEFORE it was necessary so that they felt informed enough to make a good choice.
At any rate, throughout April, Sue got worse and worse on the breathing front. Doctors couldn't really do shit about it. By the 20th of April she went to the hospital for inability to breathe. And, on the 23rd of April they sent her home into hospice care. That, I know because I was at home waiting for the medical equipment.
She died at home, April 30th, under hospice care. If you ever have the choice yourself or might be in a position to offer some thoughts to others on their choice for whether to die in an ICU with beeping machines or to die at home, with palliative care and familiar surroundings and the company of family and friends... I urge you to consider the hospice option.
Look. Mortality kind of sucks. It does. Death is sad and inconvenient and stressful and messy. But, for some sorts of end-of-life, where it is clear that the game is over and we're all just waiting for the clock to run out, hospice is the way to go. You get to be at home. You get to see your people and be in your familiar surroundings. They give you drugs to make you more-or-less comfortable, insofar as that is possible for the dying. And you get hospice nurses, who are basically midwives to the dying. They are calm and informative and helpful... experienced at shepherding families through this event while not being so emotionally invested.
I've dealt with hospice twice, once with my grandma, who was dying of being 98 and this time with my dad's wife, who was dying of breast cancer with lung mets. On both occasions, the hospice workers have been absolutely fantastic, competent, compassionate, and helpful.
So, what happens when your person dies at home on hospice? You call the hospice nurse if one isn't there at the time. (The hospice nurses are only there part of the time. The rest of the time family or hired help must be there to stay with your dying person and see to their needs.) If, like I do, you live in greater rednecklandia, you sit in the living room with your father while his wife's corpse lies in the hospital bed in the middle of the living room floor and talk about... work. There is no crying. If you like, you can have some of Sue's peppermint patties while you wait. She won't be needing them anymore and Dad doesn't like them.
When the hospice nurse shows up, they can "pronounce a person dead" which is an official thing with a form. As well as the form, they'll have to make a phone call to the county coroner to report death and cause and so forth. This is why Sue officially died at 8:47 AM even though she was dead sometime between 3 AM and 6 AM in reality. Once your corpse is officially dead, the hospice nurse can call your preferred bodysnatchers (funeral home, cremation society, whatever) to come and get the body. The hospice nurse will discreetly mention to the bodysnatchers if the body is like 300 lbs and on the third floor so that the bodysnatchers know to bring enough people to carry the body out. As our body was maybe a buck ten and located on the ground floor, this was not an issue.
While all ya'll wait for the bodysnatchers, the hospice nurse will clean up corpse of urine/feces, put fresh pants on it, remove all medical stuff from the body like IVs or oxygen machines if that hasn't been done already, and assist in the destruction or removal from premises of the heavy duty narcotics like oral morphine.
After a while, the body snatchers will show up. Ours were nicely dressed in somber clothing, which I guess makes the living feel better -- I doubt the dead give a shit one way or the other. They wrist-tagged our body with her name (because I guess relatives would absolutely lose their shit if they wound up with the incorrect body in the casket for the viewing) and then wrapped our corpse in a sheet, neatly, and loaded it up on a... stretcher thing with slats that ran longways so that it would help hold the body straight. It had nice straps with buckles like a car seat to keep the body secure. And then they carried the whole shebang out to their sedately colored minivan (not a hearse, hearses are only for funerals) and (presumably) drove to the funeral home. I did not inquire whether or not they had other bodies stacked like cordwood in the back of the minivan, but I suspect that they don't stack them. It's probably a strictly one-layer operation.
*Before she died, Sue was on 10L of oxygen. The normal oxygen concentrator machines only go to 6L so when you get to 10L they have to daisychain two machines together to make enough air. And she still couldn't speak more than a word or two before having to catch her breath.
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Date: 2021-05-03 08:47 pm (UTC)One of my best friends is a hospice doc -- she occasionally refers to herself as a Grim Reaper -- but everything she's told me and that I've read makes me go, no, REALLY, use hospice. I was so infuriated with my cousins' lack of getting their simultaneously dying parents into hospice (my uncle was dying of having a long-lie fall at 89 and my aunt was dying of lung cancer) until their last week or two of life. And honestly, I think at least my aunt would have been more comfortable with a good 6 months of hospice.