Saying Goodbye

walk6miles

All the time I was establishing myself in my new-found career, I managed to keep one eye on my personal life and one eye on the declining health of my aging parents.

At one point fifteen years ago, all the planets "aligned themselves" and I made the decision to move to Florida in order to care for my Mom and Dad. I managed to find the right job, the right house, the right everything and things went well. I was there for my Dad's open heart surgery and subsequent frequent health issues.

I was not prepared for my Mother's rapid mental decline as a result of Alzheimer's disease; this was an 87 year old so robust that she was not on any medications whatsoever. Her daily walks became a nightmare for my Dad (who initially was too proud to ask for help). She began to wander aimlessly about the neighborhood the moment he took one of his frequent naps. Meanwhile, Dad spent at least 3 days a month in the local hospital as a result of his failing immune system coupled with ongoing cardiac and peripheral vascular issues.

At the age of 58, I was faced with an almost overwhelming decision: my Mother and Dad could no longer live on their own. I never hesitated to move them in with me (I am fortunate to have my sister and her husband nearby to fill in as sentinel when I went to work). Let me be clear, I agonized over the decision to give up my solitude and bring into my "nest" two elderly people who most certainly required the assistance and supervision of a nurse, but I did spend a great deal of time worrying over my shrinking level of solitude. I decided to obliterate my living room and turn it into my Dad's den - literally picking up the contents of his den and moving it into the my living room. This worked out very well for both Dad and me.

I cannot tell you how painful the surrender of my independence was initially. We started slowly, allowing a pattern to emerge. Up and about quite early on the four days I didn't work; breakfast together included the reading of the newspaper (my Mother always maintained an educated mind was a product of keeping abreast of the world's news). Sadly, I watched as that horrible disease eroded all of the personality of a Mother I loved and respected and left me with a frightened and unsure child who frequently came out of the bedroom my parents shared with such a paranoid facial expression that it became necessary to place alarms on all of the doors in the house and extend safety precautions even to the toilets (septic systems are susceptible to errant materials and inanimate objects such as jewelry and false teeth).

Breakfast completed, we napped until Mother stirred and the door alarm sounded. Every moment she spent awake had to be supervised. At one point, my Dad lost sight of her in one of the large superstores; she managed somehow to leave the store with a large cart filled with groceries (unpaid groceries - loose in the cart) - my Dad found her wandering and she gleefully told him she had taken her purchases to the car and asked someone in the parking lot to keep an eye on the cart (the good Samaritan never noticed the lack of bags; my Dad left the cart and groceries in the parking lot in order to avoid a scene and possible banishment from the store )!!

I grew up with a mother like June Cleaver - pearls and heels at the door at suppertime - waiting for my Dad to arrive from work. The children fed, homework finished, in bed early, behaved and most of all, respected and loved by two supportive parents. Dad was Ward Cleaver: work, work, work. The house was kept maintained; including the lawn; the male domain also covered the automobile and any scheduling of summer vacation getaways took Dad's schedule and desires into consideration.

Holidays were special. Very special! Carved turkeys, lighted Christmas trees; photographs of smiling relatives support lovely memories that as a family, we all treasure. We had something special; something rare. I think we appreciated this fact every single day.

Mother passed away quite suddenly after only 3 months in my home; Dad suffered a massive stroke six weeks after her death and although it was the most difficult thing I have ever had to do, I honored his wish to come home with Hospice. He stretched out his left arm to the sky; smiling despite his inability to speak any longer and went to my Mother's beckoning arms only four hours after arriving home. His winsome smile left me alone again; this time resentful of the solitude I had originally guarded so selfishly.

What has this experience brought to my nursing? A deeply felt empathy for my patient's and their families. In the critical care setting it quickly becomes easier to banish an over zealous relative to the waiting room when their questions become challenging. I am not referring to that first 48 - 72 hour period in intensive care; that settling in period when the nurse fights for the patient's life and the patient's needs are established. I am speaking to that long-term period of time when the patient makes one small step forward or backward and the family hovers and clings to every little twitch. Every critical care nurse recognizes it - the mother who rushes out to the desk to report that the patient has opened their eyes and gazed knowingly back at Mother. The sister or brother who tries to corner the nurse and get "the real story".

I have learned how important it is to not only meet the needs of the patient but that it is as important to support their family members in their emotional state. I understand all too well the pain of losing someone dear. I feel their pain, and that makes me a better nurse.

Saying Goodbye

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