Wendy, your mom must be really cool!  Most of my work is in home health,
nursing homes and I do a little work for a couple of hospices.  I love the
hospice nurses.  I just completed a review of a large hospice looking for
areas where improvement could be noted.  I do these 'mock' surveys for a lot
of clients.  It is only in the Hospice ones that I can't find problems in
delivery of care.  More importantly, I always feel so good in a hospice.
Who would have thought that spending the afternoon reviewing clinical
records of terminally ill patients would be one of the most pleasant ways I
could find to spend a day!

Death is a part of life - not necessarily one I want to happen at the
moment, but still a part of life.  I would have never thought that death
could be as peaceful, beautiful as the first death I ever had as a nurse.
True story.  A woman in her late 80's was admitted to the CCU when I was
still in orientation right out of nursing school.  She was spry and
delightful and had opinions she was willing to share.  Later in the
afternoon, her cardiologist came to me and told me I could give her whatever
I wanted to make her comfortable - Lasix and morphine for CHF, she could eat
whatever she wanted and I could extend visiting hours for as long as her
family desired.  I thought the doc was nuts.  He said she had the largest MI
he had ever seen and there was no chance for this sweet patient.  I left
that night after watching Gone with the Wind with her in her room in CCU -
after all she didn't appear to be sick to me.

I got to work the next morning and she was breathing 40 times a minute on
100 percent oxygen. (Try breathing 40 times a minute or ten times in 15
seconds - it is exhausting.)   She was pale, diurphoretic and I thought a
little out there neurologically.  Her heart rate was very, very fast trying
to make up what it lost in strength by beating more often.  I went in to
assess her and thought she might like a little OJ reasoning her mouth had to
be dry breathng that fast.

"Look at the woman up there with her bare feet." she said to me as I
approached the bed.

"Sweetheart, there is no woman up there and shoes are required in the
hospital setting," I responded.  "Here, have some orange juice."

"You don't see the lady with all the lambs," she asked.

"No, we don't allow animals here,  I told her matter-of-factly.  "Have a sip
of juice,"

"Look at the man with the halo," she said with a peaceful expression clearly
out of sorts with her physcial condition.

Now, I wasn't about to deny the man with the halo so I just said, "Here have
a sip of juice."

A half hour later, she asked me to open the door for her.  She was looking
out the window.  I explained that the door was on the other side of the room
and it was opened.

"No," she said.  "I want to go through that door."

And she did.  Her heart rate went from 140 to asystole just like that.  In
all the years answering codes in the hospitals and cath labs I have only
seen that happen one other time.  Most people have a series of arrythmias or
a gradual slowing down until a heart rate becomes 'agonal'.  Only twice have
I seen, on a monitor, someone go from a fast regular heart rate to asystole.

I covered her with her crocheted blanket and called her family.  I am not a
very religious person but I have never been surrounded by such warmth and
peace as her family said goodbye.  It was sad - not tragic, not desperately
so.  Just sad.  And joyful.  And peaceful.

I will tell you this, had I not had another patient die in a more regular
fashion later in the week, I would have never stayed a CCU nurse.  The
emotional energy of that first death was like none I have experienced since.

So, death is part of life.  Regardless of spiritual beliefs, I want to be as
ready for my death as my first dying patient was.  I want my death to be a
part of my life and I want to share it with those who are special to me.

My grandmother died at home, too.  She broke her hip when she was 92 and
came to live with me when my son was an infant.  Talk about a mess.  The
infant and the old woman!  She became increasingly senile after the surgery.
In retrospect, I would not have had her undergo surgery.  She never
recovered from the anesthesia.  Up until the day she broke her hip, she
lived by herself.   Just before she died (at age 94), she started a
breathing pattern known as Cheyne Stokes which often precedes death.  I sat
with her and held her hand.  After she died, I called the coroner for legal
stuff and had the funeral home come get her body.  I sat in my son's room
while he slept in the middle of the night and opened the window.  For a
couple of hours, I sipped on wine and visited with my memories of Granny
Sarah - the woman she was long before the hip surgery.  Later in the week,
she was buried.

Next week, we will celebrate my Grandmother's birthday.  Yes, this is
retarded.  We always enjoyed her birthdays as a reason for the family to get
together and we didn't see any reason to stop just because she died.  Do
you?

I was at such a center yesterday and it was quite miserable looking
place and sick, sad looking people.

I guess that it depends on the person. I wuold prefer that I and my
loved ones do not suffer.

wouldn't we all prefer such death...

But, the likelihood of contracting a new cancer does decline after
70s.

How come her daughter was holding her hand, if she was asleep?

Sounds like your family has it all together, so to speak.

i