Recap of thursday.

It started thursday about 2pm. I went to get grandma up from her nap. She just didn't look right. Her hands and feet were cold and purple and she seemed in pain. Terry, the hospice nurse was coming out for her normal appt anyway so I didn't call her and just I got grandma up and settled into her recliner. I gave her some of her pain medicine (Lortab liquid), it didn't seem to help much. She was moaning and it seemed hard for her to breathe, she was extremely restless and agitated. At this point, I knew things were going south quickly. There is a look a person's eyes get when they are dying. She had it.

Terry arrived and confirmed what I suspected...Grandma probably won't make it thru the night. It appeared that she had a GI bleed of some kind (based on pain and coffee-ground emesis). Terry got on the phone and started making arrangements for morphine, ativan and oxygen. Things to make grandma more comfortable. I called Mom and she came over. Meagan came and got Ian and Rosie. Terry had to leave for another client but arranged for another nurse to come in, Nadine.

I sat with grandma, watching. She was struggling to breathe and the mottling was all the way up her legs to her thighs. The meds and oxygen arrived. I gave her the first dose. It helped. She became less restless but her breathing was still really labored. My instructions were to give her the morphine (0.25 ml) and ativan every hour. as we approached the hour mark, she became more restless. I gave her the second dose of morpine but held off on the ativan. Again she calmed, and slowly her breathing became less labored until she simply stopped breathing. She passed at 9:09pm.

I have been the nurse who sat at the bedside as a patient died. I have been the nurse who gave the last dose of medication. But it is somehow different when it is your family. I know I did everything by the book and in grandma's best interest but the questions still come. It is hard not to question everything I did.

One of the hardest things to do was tell my grandfather. He has been slipping in to the alzheimer's abyss too but is still mostly aware. He had already gone to bed when she passed. After talking to my mom we decided to wait until morning to tell him. It was hard, even though he knew it was coming. They had been married 60+ years. I can't even imagine that kind of loss.