Sunday, March 29, 2015

Can’t keep up with the pace of change – Hospice

The pace of change in Marcia continues to perplex and overwhelm me.  Less than 3 weeks ago Marcia was living comfortably at home, though under 24 hour supervision.  Sixteen days ago Marcia was in the hospital, which was the last time she was in our house.  Eleven days ago Marcia was in the sub-acute unit of Foothill Acres, a long term care facility in Hillsborough NJ.  One day later she was moved to the Memory Unit and 10 days later, we have decided that hospice care is the best option for her given her wishes and the state of her illness.


Marcia has not really eaten and she doesn’t drink much since she’s been at Foothill Acres.  In her first full week, Marcia has lost 6 pounds and in the 5 days since her last weigh in, she’s eaten very little, and some days, nothing at all.  She’s lost more than 20 pounds since January and more than 30 pounds since the fall.  Her sodium levels are dangerously high and the doctors ordered IV’s to help get her sodium levels under control.  The IV’s might work if Marcia wouldn’t pull the tubes out.  I watched them try to put another tube in, without success.  They could not find a vein that hadn’t already been punctured or bruised.  Marcia’s doctor called me at home to go through options for Marcia.  She said they could put in a pic line (spelling?), which would require hospitalization.  Pic lines are usually for lengthy use and could help with hydration.  But without other nutrients needed through food, Marcia would develop other complications without regaining cognition.  Marcia is suffering.  She’s suffering plenty both physically and mentally.  She doesn’t acknowledge me or other friends and looks like she’s in constant pain.  Walking is no longer realistic and I watch the nurse try to feed her and getting her to swallow anything takes enormous effort on the part of Marcia and the nurse.


Hospice means they will abandon the IV drips, will discontinue physical therapy, among other things. They will do all they can to make her comfortable with appropriate drugs.  I don’t know how much time she has left, but at this point I’m praying for God to take her quickly and painlessly.


Over the last four years, I have adjusted to the steady progression of her disease because the daily changes have been relatively subtle.  The last 3 weeks have been much harder on me because the changes have been so dramatic.  With the tremendous support of Marcia’s family, my family, and countless friends, I know this is the right decision.  But with each change is another, deeper feeling of grief.  Both grief and relief.


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