Today (Wednesday) was the day Trish the visiting nurse came by. It was a time of re-assessment and we talked some more about mother's medications. Mother has progressively had a harder and harder time in the late afternoon, early evening hours, getting fidgety and quite uncomfortable. Also it is more and more apparent that the slightest bit of physical activity leaves her breathless and gasping for air. So Trish suggested it was time to start experimenting with the sublingual morphine to see if this might bridge the gap between doses of her regular meds. The Vicodin is at 1.5 the strength we started with and at a much higher dose of a couple of months ago.   

I discussed all this with mother and told her that tomorrow afternoon I would try the morphine as I wanted to be clear on the effect it had and be in a position to respond no matter what unexpected results might occur. After struggling a little longer mother requested, almost demanded, that I give it to her tonight. So at ten to 7, a little over an hour before her next scheduled medications I gave it  to her. Its a 10mg dose of morphine and its put under the tongue where it dissolves quickly and is absorbed almost instantly.   

Well not much happened. We kept looking for a change and while she was a little more settled it was hardly noticeable except that her motor skills suffered substantially. So at 8 I gave her the regular meds minus the Alprazolam (which further confuses the motor skills) and we went about our regular routine. After the personal hygiene and during the foot treatment mother became quite comfortable sitting still. By 8:30 she handed me the oxygen back and told me she did not need it tonight. But then on the way to bed she needed to go potty one more time and the walk back and forth to the toilet did her in again. We sat at the side of the bed with the oxygen for 5 minutes to catch her breath before I laid her in bed.   

Trish admitted today that she expected mother to have deteriorated a lot more by now. In other words she is doing better than most people in this situation. Having said that, I think it is clear though that mother's lung capacity is shrinking rapidly and I do need to get a handle on what meds it will take to make her oblivious to the oxygen starvation that accompanies that process. So over the next few days I will experiment a bit with the morphine and the patches to see what combination and dosages do the trick (at this stage). Stay tuned.   

Trish also mentioned that she used us as an example today while visiting another patient. The caregiver, in that case one of the daughters, is on the brink of burnout because she has not found the balance or properly engaged the rest of the family like we have. Trish said that our situation is exemplary and that many could benefit from our example. Trish re-iterated what Laura had mentioned to me earlier in the day; it seems that people often have the love and will to get started trying to care for their parents and then, not knowing the gory details of what they are in for, find themselves unable to cope when the reality finally hits. So I decided to let Trish in on our little discussion re the privacy of the website that Gaby prepared (all of course in the presence of mother). I thought it would be good to get a professional's feedback.   

Trish thought it was so wonderful and generous of us to share to such detail. She said that it would definitely help and encourage others to be there for their parents and if it helped only one family to prepare for this process more effectively and thereby avoid "caregiver burnout" it will be a great gift indeed.   

So on we go. We are proceeding along our chosen path with joy and gladness in our hearts. Mother has decided that she definitely wants to go home soon and that she wants to simply die in her sleep. Laura reminded us that if that is what she wants we must visualize it clearly before it can come to pass. So instead of thinking about mother's struggles I have chosen to think about the beautiful transition she will make while sleeping and how wonderful it will be to wake up one morning and find her gone without pain and suffering. I would encourage you all to do the same for her.

On a beam of light,
Thomas   

Thursday Morning Update:   
Mother slept from 9:30 to 2:30 in the morning straight through. That's five hours. We got up for our pee break, snack and I gave her the usual meds. Then she slept again until just after 6 this morning when she woke me to tell me that she has something important to tell me. She asked me to kneel down by her bedside and told me that she now has to go into her own bed. Just as she said that she realized that she was in her own bed but wondered how she could get up to fix dinner for everyone. When I told her that it was six in the morning she was quite startled and asked me how we could go to where we needed to go when she can't drive. Then she told me that we would have to ask our father's permission before I could drive the car. Slowly she started to realize that these were all experiences from another world and that here things were different.   

When she expressed concern about loosing her mind, I assured her that this was not the case and it was all quite natural. I told her that these dreams were god's gift to her to show her how her life streams run parallel and that there is not only just one existence and then its over. It made her smile to think that she could be so fit and active again. We sat on the bed with my arm around her and the duvet keeping her warm for a good half hour talking. She kept recounting more and more detail of her other life stream and I kept telling her stories to help her understand. "God did not make just one leaf on a tree or one flower in a meadow. God filled the meadow with flowers and like the bee that jumps from flower to flower, your soul, your consciousness can jump from one life stream to another". I compared the beginnings of life and the end of life and showed her how at both ends we have stronger connections to the other worlds, only at the beginning we can't talk about it but we sure sleep a lot. Sometimes we keep referring to "our invisible friends" from other life streams who are with us for a few years but soon that also fades as we focus on this life stream only. Now the time has come, as the transition nears, to pay attention to other life streams again.   

What a rich time indeed.