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Forbes Hospice

The Morning File

My mother's dignified, pragmatic death (with a touch of the enigmatic)
by Gary Rostein, Pittsburgh Post Gazette

"Chestnuts," Mom? Seriously? That's what you're leaving me to figure out after all these years?

Maybe everyone has some "Citizen Kane/Rosebud" type of deathbed mystery to unravel, or maybe it was my mother's revenge for my refusal to ease up in Scrabble duels once she lost her edge.

She had been suffering for at least eight months from breast cancer she'd declined to have treated with surgery, radiation and chemotherapy. Tired of life after 80 years, she didn't want any more hospital trips and doctors poking around -- usually to no avail, in her case.

A tough pragmatist, she admired the nurses and aides who handled hands-on care of people like herself. She rolled her eyes at the high-paid specialists recommending she pursue a 30 percent chance of living an extra year or two by enduring months of additional hell beforehand.
She had already given her five children a great gift by making every preparation for her death. She signed her living will years ago. She went to the funeral home to pay for the simple arrangements she wanted to top off her life of simplicity.

We visited the cemetery to reserve a mausoleum niche for her ashes. It was a box high off the ground, top right. The wall reminded my sister of the "Jeopardy" squares Mom spent so much time trying to answer. ("I'll take Cremains for $200, Alex.")

When still in her apartment, Mom started receiving in-home visits from hospice nurses. Great people. We hired a home aide to help with meals and housekeeping, but the aide mostly wanted to sit and talk about her own problems. She was dismissed. Meals on Wheels began dropping off lunches and dinners. The route drivers would stop and chat to be sure that Mom had some company. Seemed to non-chatty Mom that the drivers pined for the company more. Whatever.

"Whatever." That was one of her favorite expressions. It would sum things up well on her tombstone, if she was one of those tombstoney instead of nichey people. She probably repeated it to herself 100,000 times as a mantra as the cancerous mass became bigger and more painful while she wound up in a nursing home for three months of care.

No one ever likes their nursing home, no matter how good a job they do -- or try to do. From the day she arrived, Mom wanted out. But to where?

After her diagnosis, she'd spent a week living at Forbes Hospice while being evaluated. It's an island of serenity on the eighth floor of West Penn Hospital. She thought it was a great place -- private, quiet, caring, comfortable -- but you're supposed to be "actively" dying while there. If you've got more than a week or two to go, you're too healthy. Mom had to leave.

A brother out of town and I half-joked about how she might have liked a brave son to provide a pillowy goodbye like the one the Chief gave McMurphy in "One Flew Over the Cuckoo's Nest." I suggested he was more appropriate for that duty than I, since he had no wife and kids to suffer when he was sent to prison. He was still mulling it when Mom slid further downhill at the nursing home.

We summoned the residential hospice folks for another assessment. This is the opposite of attempting to get your kids into college by convincing the admissions office how wonderful they are. My sister and I cited her awfulness -- the sleepiness and pain, increasing delusion, the loss of appetite and control of her body.

To our horror on the morning of the assessment, however, Mom was downright ... perky. "What's wrong with her?" her children murmured to one another. "Can't she do something death-like?"

Miraculously, she was accepted. But once back at the 12-bed hospice, we were dismayed to find the empty rooms outnumbered those occupied. Great for the patients, in terms of attentive care, but many who might have benefited from a calm, personalized end seemed to be missing the boat.

It was my third night there with Mom -- the last one she did any speaking before seemingly willing herself to die -- when she mumbled something I couldn't hear over the new age music floating from a CD.

I leaned over. "What is it, Mom? What do you need?"

"Chestnuts," she whispered.

Huh? I'd never heard the word from her lips before.
"Mom, did you say 'chestnuts'?"

She looked at me, nodded, closed her eyes. A little more than 30 hours later, she was gone, without another word.

All in all, it was a good end, faced head on -- the way more people should do it, if they had Mom's practicality. All, that is, except that last word.

Gary Rotstein: grotstein@post-gazette.com or 412.263.1255.
First published on November 1, 2010 at 12:00 am

Read more: http://www.post-gazette.com/pg/10305/1099705-294.stm#ixzz1DIFNrNhy

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