December 30, 2024-January 1, 2025
The start of the week found David struggling a little to speak. He was sleepy and it was difficult for him to stay awake. On Monday, he ate a really good breakfast although he had some trouble holding the fork and the cup. He was able to tell me what he wanted and ate nearly every bit. He was still having difficulty moving around due to the ascites in his abdomen and also the edema in his legs and feet. I was able to help steady him and we had borrowed a rolly walker that was helping. We met his hospice nurse JP on Monday, and per David’s request, we also had a visit from the parish priest. David received the anointing of the sick as well as the Viaticum. This is something he asked to do. It was once referred to as “the last rites”. After the visit, I asked him if he felt at peace. He said yes. I am glad I made the call. His nurse, JP, advised to start watching the intake of food and liquid and to note how much is was sleeping. Intake was expected to decrease and sleep would increase. He was able to communicate but he was very tired after the visits, and I helped him to bed. It started to become increasingly difficult to help him up to the bathroom and back to bed by myself, so I had to wake up SL or her fiancée Adam to help. Each day brought different challenges and functions that seemed to be waning. He developed some worsening motor skill issues that I attributed to the hepatic encephalopathy. I was having to hold the fork or spoon for him and I could tell this was terribly depressing for him. I was having to go into the bathroom with him because he had a fall the night before. I know this was something he hated also and I could see it in his eyes. He still understood every word I said and would indicate the acknowledgment in some nonverbal way by sounds or squeezing our hand. On one of these days, he grimaced and I asked him what was wrong. He said “hurt”. I asked where. He said “pride”. This was heartbreaking and I tried reassuring him that no one in the house minded helping him and no one thought any less of him. I told him over and over with my arms around him lifting or supporting him, that I knew he would be doing the exact same thing and then some for me. His nurse and I communicated each day. By Tuesday evening and then Wednesday, David was having trouble drinking through the straw and also swallowing his meds. I discontinued all meds except the main medication and was able to get it down in apple sauce. My aunt loaned us a recliner lift chair, and with help, he was able to get to the living room and sit in the chair and look out of the windows and look at the Christmas tree. I feel like this did wonders for his spirit. He always wanted a recliner but over the years as we looked and looked at them, he could never commit. Either they were too large and puffy or too narrow and stiff. He remarked once that he was also sort of a couch man because he liked being able to stretch out or sit alongside me. The cats would pass in and out and a couple that usually sit with him stayed in the chair with him for a little while. I have read many times that allowing the pets to be a part of the passing helps them to understand what is happening. It was hard to watch though knowing he would most likely be gone soon. I told SL that they know way more than we do about things like this and know better how to cope. He seemed to like the cat snuggling and slept most of Tuesday and Wednesday pretty peacefully. I lay beside him in bed on Tuesday evening listening to the fireworks and rang in the New Year cherishing the sound of his breathing. I wished him a Happy New Year the next morning and he acknowledged he knew what I said. By Wednesday evening, he had eaten very little and had not been to the bathroom all day. His speech had stopped but he surprised me by taking my hand and kissing it as I was getting him comfy in the chair. He always knew I was a sucker for that and I just know he was doing it because it meant so much. Up until the final day, he would pucker up his lips any time I leaned close to him. It was small little things but these things meant something huge to me since he had been unable to really communicate clearly for a few says. I know what he was saying. I was constantly saying I loved him and it was ok to go. I told him he didn’t have to hold on and that we would be ok. A lie of course but something you sort of have to do I guess. Knowing all along though that David Gassett would let go when David Gassett let go and not one moment before. He would have had his reasons. I had a difficult time getting the pain medicine down by Wednesday night and knew I could not crush the extended release medication. I had to switch to the as needed meds and crush them in an attempt to get those in his system. I know he wasn’t getting all the dose this way but I didn’t have another option. I was unable to give the med for the brain swelling because it was too large and could not be crushed. This is certainly one of the many difficult parts about hospice. In the early morning hours of Thursday as I was laying awake next to him, I heard his breathing change to grunting noises as if he was trying to tell me something or attempt to change positions. I tried to calm him and let him know I was there by his side. I thought maybe he needed to sit upright or maybe try the bathroom in an attempt to combat the stiffness of laying so straight. By then though, he was so weak there was no way he could help me with the lifting and I had to have Adam’s help. We got him to the bathroom and then struggled to get him back in bed. I lay next to him listening to the rapid breathing and grunting noises just pleading with God or the universe to spare him any more suffering. I just didn’t want him to experience this final push. I immediately felt selfish for feeling so tired and weary and weak myself. He was worth staying up and comforting and whatever solace I could offer. By the time the sun came up on Thursday morning, it was clear he was in some sort of distress over whatever was causing him discomfort. Pretty good guess that now all the fluid seeping from his liver was really starting to press hard on his organs. I asked Adam and SL to help move him to the chair in the living room so he could stretch out in a different way. Once in the chair though, the grunting and noises became louder and more frequent. His breathing was deeper and harder. Again, I had trouble getting the pain medication to go down. I knew I could have called the nurse on call but I was pretty sure what was happening. I waiting a little longer and I called the his nurse JP and she told me she would be able to come right over after lunch. While we waited, the sounds just got more frequent and louder, so I called a dear friend of ours who happens to work at the same hospice and was home from work to come over and just take a look at him just to let me know what was happening. Me. Forever needing to know what was happening so I could understand. As if things would be ok if I just could understand. Things like this have made me miss my dad so so much. David is so much like him and they were always the ones that could explain calmly and succinctly what was going on. This friend of ours came right away, and after some sitting with him and observing and discussing the last time he had the Oxy, she suggested it was time for the morphine from the little box the nurses brought by on Sunday. I viewed this box as the final box. The one you went to when things were closing in and you needed the heavier things. I was instantly afraid of this little white box with the dosing written on it when they went through it with me. There was nothing much in it to be scared of except that tiny bottle of morphine. I know enough about cancer’s end to know once that starts, there is no intent of coming back.