When I called my aunt to tell her my dad was dying, I told her that the doctor had recommended a pacemaker but Dad’s living will forbade it so we didn’t do it. “A pacemaker?” she said. “Why didn’t you get a pacemaker? Pacemakers save lives.” The day I made that decision, Dad had been flirting with reality for a while already. His living will said that if he wasn’t expected to make a full recovery, I shouldn’t allow the doctors to use any “artificial means” of support. And I looked it up. Pacemaker was at the top of that list. But when I talked to my aunt, all the doubts came back.
But when I think about it now, I think about the whole picture. His first hospitalization happened when he slipped on some ice in his driveway and fell. He got himself inside and was having this “dream” that he told me about. Something in the “dream” told him to call “9-1-something,” and he wound up dialing 911. The ambulance came and took him to the hospital and they called me. When I spoke to the doctors, they told me that he was hallucinating from dehydration. He was severely dehydrated, and his kidneys began to fail, causing the hallucinations.
He stayed in the hospital for two weeks, and then they sent him to a rehab facility because he’d hurt his leg when he fell. He signed himself out before he could walk, and when he got home, he was crawling on the floor to get around. I’d talked to him when he got home and he told me how he was moving around, and he said he was eating. In fact, he said he was cooking a pork chop and had to go. I told him not to use the meat in his freezer because his fridge had broken just before he went to the hospital. His neighbor got it working again about a week later, but nothing in that freezer would have been edible. He said no, he’d had some meat the day before and it was fine.
I got to his house two days later. He had bad scrapes on his knees and feet from crawling on the floor, and the visiting nurse that came in the day before had called 911 because she found him in that state. He’d refused to go to the hospital. I got him a 24-hour aide, got him to the doctor and took over his bills for him. Before the aide got there, Dad was really “confused” (a medical euphemism for dementia), but when he started getting regular meals he got better. I left feeling like I’d saved his life.
About a week later, his health went downhill and he wound up back in the hospital. That’s when they asked me about the pacemaker. At that point, Dad was very “confused” and I did not expect him to recover. The day he went back home, he threatened his aide with a gun. I figured I’d made the right decision. Five days later, he went to the doctor, who sent him to the hospital again. They didn’t expect him to live but he “woke up” after about a week and they sent him to another rehab. He was ok for a few days but his body was giving up and a week later he died.
So I kept thinking about whether my actions helped him live or die. I like to think that when it’s your time, it’s your time, but being so close to this as the decision maker makes me think twice. But last week I was writing a health story for a parenting magazine and one of the things I researched was dehydration. What I found out was that kidney failure starts as a result of “the most severe,” dehydration — a medical emergency. So the first time Dad went into the hospital, when he hurt his leg, he was already that dehydrated, which means he wasn’t eating or drinking enough. So really, that hospitalization that I deem the beginning of the end, saved his life.
When he got out of the hospital, he was going down the same road. There was no pork chop. There is no way he could cook a pork chop on his knees in the kitchen. The stove and oven were too high to reach and I found his grill on the counter, pushed back against the wall. He was just going to get dehydrated again and go back to the hospital if he was lucky, die at home if he wasn’t.
So when I got him a caregiver I pretty much did save his life. At least I bought him some more time. And I got to have one last visit with him. I don’t know how I would have handled his death had I not gone to help him.
When the pacemaker decision came down, he was pretty far gone. A pacemaker would have extended his life of “confusion.” I’m not sure my aunt fully understood that. But I did. And I did the right thing. And nothing could have convinced me that “when it’s your time, it’s your time” more than his miraculous recovery during the third hospitalization. The doctors were telling me he had days or weeks to live, and then they couldn’t explain why he “woke up.” When he went downhill again, he was just hanging on, almost unconscious. I called him; told him that I’d filed his taxes because he was worried about them; told him how much money he’d accumulated in his lifetime because I knew how much that meant to him; and that I loved him. I also had both kids talk to him. A couple of days later, he died.
I still think that “when it’s your time, it’s your time,” but I also like to think that I helped him live and when it really was his time, by tying up loose ends, I helped him die. I may not have been the best daughter during his life, but I did the best I could during his death. And that’s all that I’ve got left.