Transitioning from one life to the next...

Nine months ago I was enjoying the trip of a lifetime in Ireland... over two weeks of setting my own agenda, going where the wind took me, and thoroughly reconnecting with my own hopes and dreams and goals.  I had never felt more "me" and to say I was empowered by the vacation was -at that time- an understatement.

Then the voice message came two evenings before I was due to fly home to Boston.  My brother's voice sounded tense and filled with worry.  "Hi, Jan. Could you give me a call when you get this message.  It is about 4pm out here.  Call as soon as you can. I'd appreciate it. Okay, bye."  He seemed to have totally forgotten I was away in Ireland. His "out here" meant the time of day in Seattle, Washington, so PST.  I was GMT in Ireland.  It was 4pm in Seattle... it was 12 midnight in Ireland and when his call came in I was fast asleep with no cell coverage until the next day.

My 85 year old mother had fallen and had been taken by ambulance to the hospital despite her protestations.  Since the 4th of July weekend of last year, I had been worried about her rapid decline in mental capability as was her friend who stopped in daily to help her around the house.  We'd accompanied my mom to her doctor to explain the deterioration we'd experienced and to let her know my mother's weight had dropped dramatically in the past four months.  That doctor visit she sailed through the short dementia / Alzheimer's testing administered verbally, much to the wide-eyed surprise of both my mom's friend and me.  Not convinced, I began doing online research and found that the same cells of your brain affected by dementia also trigger your hunger response.  My mother ate breakfast out of habit, but the rest of the day she simply had stopped eating.  "I'm not hungry!" she'd snap at me when I tried to ask her over the phone what she'd been eating during the week.  Before I left for Ireland I made her three weeks of food, labeled every one, how to reheat or prepare it, left a schedule taped to her refrigerator door, and asked her to promise me - hungry or not - that she would eat the food every day.  I even called her twice from Ireland to check in - noting she'd admitted she'd been sleeping a lot - and she couldn't tell me what she'd eaten that day.

With the news from my brother of her fall, I returned home a day early from Ireland and spent the first day back in Boston at home after having checked in with the hospital and my mom's attending physician.  No need to rush right there, they assured me... they were running tests and she wouldn't be checking herself out as I was her health proxy.

While I'd been in Ireland I had been able to have dinner with a dear friend and I had explained to him the health condition of my mom and my concerns.  "It is all a part of life," he said to me, "and as her daughter you are helping her transition from this life to the next. You'll do a fine job."

I held onto that statement for the past nine months like a lifeline.  "You are helping her transition from this life to the next."  I vowed to myself to do whatever I could possibly do for her to allow her to 'transition' with dignity and respectfully and made decisions with her, when possible, and for her as I believed she would have made them for herself had her mind been capable.  I was blessed in that, if there could be good timing, she was hospitalized just as a six week sabbatical from my job had been planned upon my return from my trip.

My mother's dementia robbed her of short term memory completely.  She always remembered me, which I am grateful for, but she never remembered that I had been with her an hour before, a day before, or the prior weekend before.  She did thoroughly understand important decisions needed to be made (for example we talked at length about her funeral and what her wishes were and how I was handling things at her home, with her finances, and her cat's well being) but yet she couldn't tell you if she'd done any activities with other residents that same day or if she'd had physical therapy an hour previously. She had no interest in reading, watching favorite television shows, or socializing with anyone.

The one thing she never forgot, however, is that she wanted 'to go home' to her own house and that the nursing home had better be just a temporary place until she was well enough to resume her independent living. The doctors and nurses suggested that allowing my mom to believe she would be going home 'someday' was not necessarily a bad thing.  They were worried about depression and so - whenever asked - I would say 'well, as soon as you're a little stronger, Mom, I think we'll be able to talk with the doctor about going home".

The past nine months for me were filled with many hours in the car between Boston and Saratoga Springs, New York.  During the week I was often on the phone twice with the doctor and nursing staff to hear their weekly report and then - over the weekends - I would arrive and spend time with Mom at the nursing home (she was blessed to be admitted to a wonderful home with caring staff), in the early months we would be able to go out to lunch or she was able to walk with help of her walker outside with me and we'd sit and talk in the sun in the fall weather.  We'd have lunch and dinner together usually on Saturdays and Sundays and then I would drive home.  Around Christmas time she lost the ability to correlate that when she heard the phone in her room ringing, that meant she should pick up the phone, answer it and talk with whoever was on the call.  If an aid or a nurse were in her room, I would be able to reach her - but it wasn't too long before I could only reach her during the week to 'check in' by calling the nurses' station and asking them to carry a portable phone to her room so we could chat.

I worried a lot. I fretted over decisions I had to make about testing for possible anemia and possible cancer of the blood.  I ate hospital food and began to think that I really liked the little plastic tapioca pudding cups.  I never exercised.  I stopped counting calories and fell back into old bad habits where food - late at night after driving home to Boston - was comfort.

Two months ago Mom lost the cognitive ability to remember to swallow food that she'd been fed and had chewed.  I spent four days with her over Memorial Day and was cutting up her food and feeding her when I realized this.  She wasn't swallowing.  The same day I spoke to the staff about calling in hospice after my cousin, who is a retired head nurse from a Florida Alzheimer's unit, suggested I think about it.  One of the charge nurses I had grown to trust and ask advice of, suggested the same.  Hospice came the next morning.

The four days over Memorial Day weekend were exceedingly difficult for both my mother and myself.  I knew the 'transition from this life to the next' was not far off.  My brother and sister were trying to plan when they would arrive to visit.  Mom and I did have some very good moments together during those days... I would sing her old favorite songs of her's and when I'd stop, she'd continue singing the verse... it was sweet.  We talked about my having gone to the family graves and having put flowers in all the urns, something Mom and I did routinely together for many years.  I showed her the photos of the flowers and she was glad to see them.  At one point we were sitting together and I'd been reading to her and she said to me, "You've been a good girl this weekend, Jan... thank you.".  I felt like I was ten years old and smiled at her, realizing that in her mind, perhaps that was about the age she saw me at in that moment.  "...helping her transition..." was always in my mind as I struggled with my own emotions of losing my mother.

On Monday of Memorial Day Weekend I left her room to drive back to Boston about 7pm.  She'd slept most of the day from pain medication that she'd begun earlier in the week but I'd stayed in the room with her, reading, so that when she woke up, she saw me there.  I'd explained to her that it was Monday and I would be back on Friday, only four days away.  Mom had liked that it was only a few days off before I would be back and looked at me quite clearly, her blue eyes very fixed on my face, and thanked me for doing everything that I had done for her.  She made it clear from her look and her tone she wanted me to hear her thanking me. I heard it and absorbed it and explained she didn't need to thank me, she was my mother, I was her daughter, and - of course - I would take care of her.  I leaned down and kissed her as she turned up her lips to me to be able to do that.  I told her I loved her and she said "I love you, too, Jan."  I smiled at her and slipped out.

On Thursday of the same week I had emergency eye surgery.  My eye doctor called the emergency room from his office and told them to prep the OR for me, I was on my way.  I cried in his office and explained I could not have the surgery, my mom was dying.  He explained that I had to have the surgery- that day!- or I could potentially lose my site.  Thursday and Friday I was face down into a special pillow to save my eyesite. Saturday morning I put on the eye patch my son had gotten for me at the pharmacy and drove myself to Saratoga to see Mom.

I stopped first at her house to pick flowers from her gardens to bring to her.  I was worried my eye patch would scare her and slipped it off (even though my eye was swollen shut) and put my glasses on and stepped into her room to see she was sleeping.  I put the flowers on Mom's bedroom dresser and stepped over to her bed to rouse her, saying "Hi, Mom... I'm here...", and leaned down to kiss her, hearing her breath as I lowered my face.

And then she was gone. I felt her presence with me as I called my brother, my sister, and my son from her room to tell them Mom had left us and that I was there for that transition.

My birthday was the following day.

I became acutely aware that my mother had spent nine months bringing me into this world and I had spent nine months helping her leave this world.  And the dates were a day apart.

It is now a month later. I had planned to take this week off from work as vacation as I usually do and decided, even though I have been out of the office with my mom's wake and funeral and my own recovery from eye surgery, that I needed this week to be here in the house I grew up in by myself to regroup and make a push to get a lot of estate business taken care of.

I have spent nine months pushing my health and my fitness onto a very back burner.  I knew I was doing it and could only do what I was emotionally and physically able to do in those months.  I rarely blogged, seldom tweeted, and was on the HLG Facebook page sporadically, at best. (Oh, and I started a new job in December!) But now I can turn my attention back to myself and regaining my health and losing the additional weight I gained while eating hospital food and fast food on the road. Could I have made better choices - absolutely.  Did I?  No.

And I was dreading writing this blog post tonight - as long and as soul bearing as it is - I dreaded it because I knew that this very act of blogging honestly tonight would lead me to be fully back and committed again to myself.  No more excuses.  No more 'putting it off'.

Commit and be accountable.  I am ready.  It begins now.

I have 50 pounds to lose to get back to my goal weight.  My intention is that I will hit that goal in nine months.  That is my pledge to myself and to you (if anyone has been able to read through this whole, very long blog post).  I need to get back into my fitness regime.  My arms are so pathetic again - but I know that if I have done it before, I can (and will!) do it again.

I am no stranger to hard work and perseverance.  I know what it takes to get the weight off and my fitness level up.  And I'm ready.  And I could use your support.  I would like to be able to support you, too, with the goals you've made for yourself, so let me know what they are in the Comments.  We can do this.  We're worth the effort and the determination it will take. Are you with me?

Dream. Believe. Achieve.
Jan / HealthyLoserGal 
My Mom (age 86) and me in late November, 2012


Richard July 5, 2013 at 10:45 AM  

Wow! You are such a strong, commited and loving daughter. My Grandmother went through this some years past. All she wanted was to be in her house. Keep up the hard work, stay the course on your goals. You've already shown in this last year a great ability to achieve so much.

LostnThought July 5, 2013 at 1:14 PM  

Hugs, hugs & more hugs to you my friend! I had no idea at the struggles you were going through. I knew you're mom was ill but I didn't know to that extend. And the whole 9 months ironic thing....chills!! How precious & sweet/bitter & painful all rolled up together.

I'm so here for you, with you and I also need your support! I have over 120 lbs to loose and I've gotten so far off track that it's just sad. I've let myself balloon up to 251 lbs and my health is so at risk now that I'm worried I've gone to far. I am determined to loose it all and get back to my pre-wedding weight of 130 lbs. My goal is to do this by Nov. 6th 2014 which will be my 15 year anniversary.

So here's to us/goals/health!! Lets grab life my the horns and kick some butt!!

Kat July 5, 2013 at 11:12 PM  

Jan, I am so sorry for your loss. Keeping you and your family in my prayers. Nine months are going to pass quickly and I will be here to cheer you on when reach that goal weight! <3

Melissa July 6, 2013 at 4:53 PM  

Jan - I am so sorry for your loss! {{{hugs}}}

Anonymous July 7, 2013 at 1:36 PM  

Jan, I am so sorry to hear what you have been going through, I did wonder where you were! My own mum is fighting lung cancer with only palliative care available. You are in my thoughts and I will be cheering you on to success, I have lost 42lb and have about another 30lb to go.

Susan H (@suzrenee)pagernt July 7, 2013 at 7:21 PM  

I just recently left my job as a hospice certified dementia practitioner, and I saw many of my patients and families as I read your block. You were exactly what your mother needed during her transition, and I'm so glad that you two were able to share those special moments. My prayers are with you as you make your own transition since your loss.

On the health front, I have let vacation, job changes, etc. lull me into complacency. It is definitely time for a reset, and I've got to go hard core and be responsible. I've Facebook'd, tweeted, and texted friends to ask them to join me and, if nothing else, to support me and keep me accountable. I am with you 100%, and I'm so glad to see you back online. You are always an inspiration to me, as well as a great supporter. Let's do this!