There are several things about dying that increase the risks of constipation, an issue that is taken VERY seriously by hospice. A couple of those things are: a lack of mobility makes for sluggish intestines, taking narcotics for pain, and eating low fiber foods. My father did or had all three. Here’s what happened one day last fall when my mom was playing bingo at the Greek Church like she does most Thursdays.
I’m beginning to worry because my dad hasn’t had a good B.M. in a few days. The rule of hospice is to keep the bowels working so there is no impaction which can end up being dangerous, sometimes needing surgical intervention. Since my father is a hospice patient and has a DNR order, the hospital is not an option and we want to avoid impaction at all costs. It can also cause extreme pain for the patient.
Dad is weak and can’t stand up alone and it is very challenging to get him out of bed without someone helping me. For some insane reason I ask him if he needs to poop. He says yes. I know the best way for this to happen is to get him into the bathroom and on the toilet to have gravity do the work of bringing it all down. Miraculously, I get him up from his hospital bed in the family room and arrange him behind his walker. Pushing his walker, he shuffles toward the bedroom with me hanging onto his shirt so he won’t land face down on the floor. He’s so unsteady it’s shocking he doesn’t fall in the hallway and I hold my breath with every step he takes. Somewhere after we’ve turned the corner in the bedroom to head past the dresser, his legs begin to give out and he slides to the floor. Though he weighs less than I do, he and his body do not do what I ask and I could swear he weighs 300 pounds. When I pull, he pushes. When I push, he pulls. He fights me as the dementia kicks in and I feel like I’m with someone who is no longer my father, this is a stranger who will not do what I want him to do. He’s pooped in his diaper so I have to change him while he is lying on the floor. I do this by rolling him side to side, trying not to get poop on the rug. I am getting very upset and very angry and he laughs at me. I see he is bleeding from a skin tear on his tissue thin skin. There is blood on the yellow carpet. Great. I put a pillow under his head and try to figure out what to do. I attempt to lift him and he ends up sliding across the carpet. I go to the living room to look outside to see if either of our two male neighbors are home. Both their vehicles are gone. Crap. I can’t call 911 because he is DNR and I don’t dare take a chance of anyone wanting or trying to do any kind of heroic thing with him. I don’t want to call my mom because she needs bingo to get a break from all of this. I try calling her several times but she doesn’t answer. I also do not want to admit I can’t handle this. I am a new nurse and I want to prove I have what it takes. Stupid thinking but there it is. Now I am very upset. I am sobbing and somehow I’ve transported myself back to childhood and it’s all my dad’s fault, lying there smiling at me with sarcasm in his eyes. This is not a situation I am proud of but stress and helplessness have taken over my rational mind. I leave the room and go cry in the family room. I go back into the bedroom and try to lift him onto the bed. No luck. I do this several times. I am exhausted and I know my father must be as well. Every time I try to lift him and can’t, I go and cry and gather myself and decide to try again. It’s been about an hour and a half and I can’t believe I am unable to lift this feeble man. Finally I am able to heave him up on the edge of the bed and drag him onto it, his body resting across mine. This gives me hope. I maneuver him to a sitting position, pull him into his wheelchair and bring him back to his bed. I am spent. He is exhausted. I can see it in his face. Getting him back into his bed is a breeze compared to what just happened. I settle him into bed and apologize for losing my temper. I think he may have smiled. I probably leaned over him and said “time for a hug dad,” and “I love you.” Like I always do.
I attest to the title “Goodbye and Goodspeed” of this page because Lisa said this to our father very often… she wanted to give him the ok to leave when he was ready.
My sister must be an angel.
I often wonder what we would have done, what my mother would have had to face had Lisa not stepped up to care for our failing father at the end of his life. We’re all very thankful for the excellent Hospice nurses he had as well and I praise them too!!
Being that Lisa had just graduated from nursing school, naturally she had no income and had just raked up a gazillion dollars in student loans but she packed up her belongings and her dog and headed down to South Florida to rescue our mother from worry and give dad some serious TLC.
Everything about her being there was settling. One it gave our mother a chance to reduce the huge chunk of money she was spending monthly for our pop, two, Jody and I were thousands of miles away and three, Dad was about to receive the warmest, kindest and most sincere touch and love that anyone would only dream of.
IT breaks my heart to see elderly people in nursing homes with no family around, no visitors, only staring off into space, lonely, miserable, not clean & tidied up just hoping for some love. This would not be our father..no sir.
In our past, regardless of before Lisa was officially a nurse she’d always stepped into the role of family caretaker like when Grandma & Grandpa (at different times) were at the end of their years..it was Lisa who gave her undivided time and efforts to making their last years comfortable, enjoyable and filled with joy. Lisa was always a big comedienne so seeing our grandparents laugh was uplifting and satisfying…who knew Dusie could chuckle so hard?
Since nothing could exceed the joy our grandparents felt when any of their 15 grandchildren were in the room, having any of us there especially the nursing type chores as Lisa did must have given them a comforting and permissive feeling to slowly glide into their next realm.
Had our father enjoyed restaurants and going out (besides to the golf course) like grandpa Reggie did she would probably have fed him Salami Sandwiches on Rye sided with highly salted kosher pickles and as many as he liked, just like Grandpa got.
When our grandmother or aunt would screech..”the doctor says he cannot have this stuff’ she’d brush it off replying “who cares what his doctor says, he’s dying and he should be happy!”. Enough said.
My sister is all about giving; giving love, comfort and happiness and this is why our father died with dignity, being impeccably clean without one bed sore and and with a solid feeling that his family did exactly what he’d wished them to do. Also I feel that my father hung on longer than would be expected for someone in his physical & mental condition because of the feeling of pure love he felt from Lisa and her team of the Hospice nurses caring for him and our mother who stood by his side at every moment with patience and confidence that her husband was in excellent hands. If Lisa hadn’t of come, I think she may have had a nervous breakdown.
This is what I call a damn good nurse. A woman born to be caretaker… spreader of love, bringer of comfort. A modern day Florence Nightingale. My sister Lisa Marie.
Lisa, thank you for giving Dad what he deserved…It breaks my heart that so many elderly people spend the last days even years of their lives alone when in a state of dementia their caretakers think they do not feel or care but they’re probably crying inside and this is why they die sad and alone.
I am absolutely certain my father died a happy and content man. He literally hung on for many many months to get a little bit more of that Nurse Lisa love and a big fat daily hug.
Who wouldn’t?