Dying

My grandfather died yesterday

On Sunday, July 30th, I was preparing to return to South Dakota from my girlfriend’s apartment in Lincoln, Nebraska. She had picked me up two days before in Omaha. My things were all packed as I called home — and was told that because of the heat on the highways it was better to leave early the next morning. I knew from the sound of the voice of the parents that something was wrong, and i guessed it was because of my grandfather’s toe surgery.

My grandfather had a growing sore on a toe for a number of months. A doctor during a checkup immediately before I left on vacation had said it had a “90% chance” of being infected — the skin was gone and the tendon was visible. The choice was between removing the toe and chancing an infection that would require the amputation of my grandfather’s lower leg. Amputation of any sort is scary, but my uncle had previously lost one to diabetes, so my grandfather was not too worried.

As I expected, the news was not good. My grandfather had nearly died Saturday night, his heart unable to take the ordeal of rehab. My quick-thinking uncle, knowing he needed a doctor and that the on-staff nurse was out of her element, called an ambulance. The ambulance brought my grandfather to the ER, and he was quickly checked into the hospital. The doctor who saw my grandfather Saturday evening gave him two days to two weeks to live.

On Monday morning the doctor suggested hospice, which was in another part of the Avera McKennan complex from his room. He was better than I thought he would be — sitting up, reading the newspaper — and we were relatively optimistic. Indeed, he was better than anyone thought, and the surprise of the nurses would come back to bite us. Hospice care is not recommended for patients with more than six months to live, but August 1st plus 6 months — he might make it to Christmas, to New Years, to my next birthday, maybe. My mother worried if my grandfather would be well enough to visit for weekend meals, and maybe holidays. How many hours could he be away hospice care a day, and would he have the stamina to do so? (Could he play pinochle again?) He drank tea, and juices, and ate all manner of fruit.

I visited him Tuesday and he was weaker. My grandfather was tired, laying in bed. The hospice wing was full, but a nurse told us that hospice care could be provided in another room. Then a doctor told my grandfather he had to leave. Then another nurse came by, and said he didn’t. Then another stopped, and said he did, because hospice care was not available outside of the hospice wing. My grandfather had faith in his daughters, my mother and my aunt: “My girls told me I do not have to leave, so I do not have to.” He was fully there mentally, and he knew those he could trust. My mother and aunt jumped the hoops, and we were assured he could stay in his room until a hospice room opened up — or at least, the weekend.

He looked better on Wednesday, not sitting up, but not just laying down. 20 minutes work had installed a sort of handle bar lengthwise over his bed, so he could pull himself part-way up with his arms. The “girls” (my mother and aunt) learned about the hospice waiting list, and determined the best way to proceed. If he was in a nursing home he would be at the bottom of the priority list for hospice, but he if was being given around-the-clock care at his apartment he would be at the top. The solution was obvious. Against very strong recommendations from the Avera McKennan nursing staff they announced that my grandfather would check at during the weekend. A hospital bed would be delivered Sunday or Monday, so I and my cousin had to be on hand to dismantle my grandparents’ queen, and bring in a twin for my grandmother, at the time. (Also on Wednesday my girlfriend’s card, bearing a scene from our recent pinochle tournament, arrived. The card showed her looking at her cards and sweating, me looking at my cards and pondering, and my grandfather breezily confident. It was true to life.)

Of course it worked. I visited Thursday morning, and his health was worse than Wednesday’s but better than Tuesday’s. He would move into hospice later that afternoon. I visited again after the move and was impressed by his surroundings. The ugliest part of a hospital room was gone — no bright light around his head, no sterile wall (instead a nice, fake wood trim), much more sitting room including two rocking chairs in his bedroom, and an adjoined living room with a sofa-sleeper, three plush chairs, and an accessible lazy boy. The nursing staff was nice and the atmosphere allowed more people to stay more comfortable for longer stretches of time. I left confident in the future.

I arrived Friday morning anxious to see him. It is too painful to describe. For the first time I can remember my grandfather was confused. He talked about my trip to China in the future tense — do they arrest young guys there? — and a second trip to China (which hasn’t happened) in the past tense. He asked if the bulletin board of cards in front of him were a bush, attempted to get up to walk, worried about the sick people who apparently were nearby, and made a few pointed comments about the value of work (some guys working harder than others?). He picked at his hands, swollen with fluid, and asked if I got the same itch from the fields yesterday as he did. Yet he clearly remembered one thing: my girlfriend. He talked about her brother coming to study in America, and her grandmother who was ill. And her aunt who was ill, as well. Of all the people he knew, my grandfather was thinking clearly only of my girlfriend. I assumed the worst and in too-many frantic hours my girlfriend was retrieved from Lincoln and we were at his bedside.

He was better, While at Avera my grandfather had begun taking anti-anxiety medication, and slowness in waking from dreams was a known side-effect. He mentioned his earlier confusion and tried to laugh it off while apologizing for it. A different brand was chosen without the side-effect. I learned that my grandfather had a dream about his cattle getting into corn stakes and contracting nitrate sickness — and that he alone was protecting them.

The weekend turned and things did not change. The hospice nurses were nicer beyond comparison to those had previously had — his only annoyance is that they brought him too much food every meal. He ate chicken noddle soup and said the important thing was that he wasn’t in pain. From believing he would live half a year as I had earlier in the week — to just a few hours as I feared on Friday — grandpa looked settled for a moderate decline. Another month, maybe two, perhaps. I left to bring my girlfriend back to Lincoln on Sunday. I returned on Monday, August 7th. He lay on his side. He was in pain.