Jack…

So it’s been 24 hrs and I can process things a bit more, and am able to write down everything that’s been happening in Jack’s life during the past 2 weeks to give everyone some clarity. I haven’t talked about this – or written about it – because I’ve been living, daily, with his rapid decline. Everything in my life went secondary for the past 14 days.

Now, with him joining with my mother, I can get it all down.

What started as flank pain, a fever of 103.5, and a bout of vomiting, landed Jack in the local hospital two weekends ago. I got a call from the nursing home at about six that friday night saying they were transporting him over.

I called the ER and spoke with the PA and the doctor on call who both told me that Jack had an antibiotic resistant UTI, ( I already knew this) and they’d done a cat scan and he had a blockage in the only kidney that worked on him – his left – and that they weren’t equipped to take care it so they were going to ship him out to another hospital. I asked that they not do that because the last time they shipped him to Connecticut and I had to drive 6 hours every day to make sure he was being cared for. I said it was unfair to do that to him and me, since I live in New Hampshire. The doc said, “Let me see what i can do.”

That was at 9 pm. I never heard anything again and finally decided to call at 4 am for an update.

The nurse on duty told me my stepfather had been transferred to Dartmouth in Lebanon at midnight and was surprised I hadn’t been called.

She may have been surprised, but I was supremely pissed. Supremely. I filed that little tidbit away along with my anger.

I called up to Lebanon and spoke with the ER doc who told me they were sending Jack for a urology consult in the morning but that he was admitted, they were giving him pain meds, and I could see him when I arrived, which I did at 9 am Saturday morning.

The urology people never arrived until after 4, which, by then I was long gone.

When the urologist called me, he gave me three options for Jack. Two required surgery and probably would do nothing more than give him a postop infection and a great deal of more pain. My thought was that he’d suffered enough. I opted for door number three: do nothing and let him go back to the nursing home. The urologist agreed. Jack was an 86 year old, demented man with one kidney that was failing. If it did and they were going to treat it, he was looking at dialysis.

There was no way on earth, in hell, or heaven above, I was going to let that happen.

He was classified as “Comfort care” from that moment on by the hospital.

Let me tell you, the hospital’s definition of comfort care: put the patient in a private room and basically forget about him. Which is what they did.

And I’m not exaggerating.

I went up on Sunday morning to see him. He was in a private room sitting at a weird angle in bed. He didn’t know how to right himself because he couldn’t reach the bed controls and didn’t know when anyone had last come in to see him, meaning staff. I got him repositioned and asked if he knew what he had for breakfast.

He didn’t. Then he said, “I’m so hungry. I don’t think I got breakfast.” When his stomach growled, audibly, I knew he hadn’t. One thing about Jack, no matter how lousy he felt, he always – always – ate.

I went out to the desk to speak to his nurse. I was told Jack had been moved because, as comfort care, he was getting the basic treatment they could give.

Their definition of basic, to my eyes was this: Jack was admitted there Friday night. It was now 12 on Sunday. He was wearing the same undershirt he’d been wearing when they transferred him from the nursing home -hadn’t even given him a hospital issue gown – no socks, no pants. He hadn’t been shaved and from the smell of him, not washed either. He’d been put in a room and forgotten. He wasn’t getting any care, wasn’t given any meds, and didn’t know what was going on.

Now, I could have complained. Wanted to, badly. But that would have only hurt Jack. So I did what my mother made me promise I would do and advocated for him. I called the nursing home from his hospital room and spoke to the head nurse on his unit ( an absolute doll of a woman) and the social worker-admittance girl for the home ( another peach of a person) and told them what was going on. They immediately set up a dialogue with the social worker in the hospital and got orders to transfer him back to Vermont. Since it was Sunday, this wasn’t going to happen until Monday morning. Okay, I got that. The wheels of progress on the weekends move slowly. I stayed with Jack for most of the day, made him as comfortable as I could, fed him his lunch when it arrived, and then left when he fell asleep.

He was transferred back to the nursing home by noon the next day and he was so happy to be “home.”

I went to see him the next day. He was very tired -more so than I’d ever seen him, but the staff had gotten him up in the wheelchair washed, dressed and looking good.

For the next week he was tired, twice when I went to visit him he wasn;t out of bed, telling the staff he just wanted to laze around. At 86, I couldn’t blame him.

Then, last Saturday night I got a phone call that changed everything.

Jack had been awake, tired, and slipping in and out of sleep all day. When the nurse went in to give him his dinner pills, he was unresponsive, moaning in obvious pain, and had a slight fever.

They called me right away and we discussed what was going to happen, care wise with him.

When I saw him the next morning ( which was only two days ago), he was comatose, his breathing labored, and his body twitching. I knew, the moment I saw him, the end was very near for him. The staff put him on a standing order of morphine to help with the pain. He couldn’t eat, drink, move. I sat at his bedside for a few hours, did about 10 decades of the rosary, and talked to him about my mother and his life. I kissed him goodbye, knowing in my heart I probably wasn’t going see him alive again.

Yesterday morning, at 5 am, I got a call that he had passed a few minutes prior.

Honestly, the first reaction I had? Relief. He was finally out of pain.

I am what is termed a cafeteria Catholic, which basically means, I believe most of the tenets of the mother church, but I believe it is a woman’s right to make her own medical decisions, and for people who are terminal to have a say in how they die.

If you don’t agree with me, that’s your choice. I just checked, and we still live in America, where we have the right of freedom of speech and ideas.

I’m telling you this because if you know anything about the rites of the church, Jack, as a Catholic, should have received the Sacrament of the sick ( last rites) prior to death. He didn’t. The Church claims his soul will reside in purgatory now and not go to heaven because of this.

I call supreme bullshit on that.

Jack, and everyone else who suffered through their final days and hours in my opinion, have their souls air expressed right up to Heaven, even bypassing St. Peter and his questions. Their mortal suffering is more purgatory than they deserve. Again, this is my opinion. Don’t agree? Okay.

The second emotion I had was gratitude: for the nursing staff who took such fabulous care of him, and all the people involved in his isolated life the past two years since my mother’s death.

The third? Happiness that he and my mother are together again. That’s all he really wanted. Just to be with her.

And he finally is.

It’s now Monday evening as I write this. I have to call the Funeral home to make sure the arrangements for his cremation are all okay. I don’t have anyone to notify about his death because Jack was the last of his line. He buried 4 brothers and a sister, all in their early 50s. Jack was the only one to last this long.

He died, penniless, having been put on Medicaid just last month. One thing he used to say has been repeating in my brain all day. “How can a person get to the end of their life after working like a dog and have nothing left?”

My mother was the one who managed the finances in their home. She was the one who planned for the day they would enter a long term care facility on their own dime. And I paid the monthly fee on that care until the money ran out, ridiculously, last month. Jack qualified for Medicaid and was placed on it. I never told him the money was gone when he asked because I knew how it would weigh on him.

Instead, he died – I hope – knowing that he was cared for, loved, and will be missed.

Best stepfather ever…and I wish I’d told him that more.

~ Peg