The Last Days

Life doesn’t always turn out exactly the way we would like or the way we may have planned. In fact, I would suppose that it rarely turns out in the ways we plan. It is this excitement and uncertainty of the future that gives us true meaning in our lives.

I would like to tell you of my mother-in-law Vivian and how some of those “unplanned” events changed her life.

Vivian had been happily married to her husband Albert for thirty-four years. They had retired and built their dream home in Kalapana Gardens, Hawaii. It was but a few short years into retirement before Albert passed away after losing to a battle with pancreatic cancer.

Vivian was blessed with a second chance at happiness when she married Tom, with wonderful expectations of living a long happy life together in Southern California. Sadly, after just a few short years, Tom also died from cancer.

Vivian then returned to her beloved home in Hawaii, looking forward to spending her remaining days nestled into the verdant beauty of the “big island”, Hawaii. She was often visited by her daughter, her grandchildren, family and friends. But this was also snatched away from her when the Kilauea volcano erupted and a lava flow covered over her beloved Hawaiian home.

Saddened and afraid Vivian came back to her beloved Washington State, to the comfort of family and friends. She bought a nice little home in Gig Harbor and settled in for a long deserved rest. She found a much needed companion in her lifelong friend Gil, who had lost his wife several years earlier. Together they found an appreciation, a helpmate, and a friend.

By now old age was encroaching on both of them, and along with old age comes the ravages of time. Gil became sick with diabetes, a disease which he could not control and was forced to move into an assisted living home. The ravaging effects from the stresses Vivian had been experiencing over the last several years began to take their toll on her health and she was now beginning to show the first stages of dementia.

Vivian and Gil had the support of each other and together they managed to cope with life’s ever increasing challenges and needs. But when Gil was forced to seek full time medical attention for his needs, Vivian had only herself to rely on. Family would stop over when they could but as the dementia progressed, she found herself alone, confused and afraid. Her daughter Sharon visited with her whenever she could; weekends, after work, or whenever there were doctor’s appointments that needed to be met.

As Vivian’s time and care requirements increased other family members were asked to step in and share with the much needed care. This worked for only a few weeks before it became apparent that it was becoming too great of a burden and presented scheduling problems for all involved. The dementia was increasing, and some of the side effects were becoming more manifest; wandering, sleepless nights, confusion, and an occasional outburst of anger. On one occasion while Sharon was spending the weekend with her mother, I received a call about ten-thirty on a Saturday night. Vivian was experiencing one of her anger fits and had come after Sharon with a butcher knife. Sharon was so frightened that she spent the rest of the night sleeping in her car out in the driveway.

The disease had now progressed beyond the point where any individual or family members could safely and adequately care for her. There was now a need for twenty-four hour care and medical assistance. She needed to be watched constantly for fear that she would walk out of the house and be unable to find her way back home. The fear that she would have another anger fit and hurt herself or someone else was always present.

It seemed best under the circumstances to have her admitted into some sort of facility where her physical, mental and medical needs could be met and where she could receive the twenty-four hour care she needed. It would now be Sharon’s task to find a suitable facility. Acting on advice from Vivian’s medical doctor Sharon moved Vivian into an Alzheimer’s facility right near her home in Gig Harbor. One that had the experience and staff required for an Alzheimer’s patient, one that we knew would give compassionate care, and one that was close enough so that we could monitor her care, and also be close enough for frequent visits by family and friends.

Preparations were made for Vivian to move in. She would need her own bed, dresser and bedside tables, and familiar articles from home that would comfort her and ease the anxiety of separation from home and friends.

Finally the transition was made and everyone took the extra effort required to visit with her and give her much needed love, support, and understanding. In spite of everyone’s effort, Vivian still felt abandoned. She felt as if she had been torn from her home, and to be put in this sort of facility was in no way anything she wanted or needed. It was many weeks before she finally reconciled herself that this was a necessary outcome. Even so, she would often glare at her visitors and ask them how they could do such a thing to her. All she wanted to do was just to go back to her home in Gig Harbor. “Wouldn’t someone please take her home”?

Alzheimer’s is not an easy disease for family or loved ones to accept. Why did this have to happen to her? She had always been so sharp, so loving, and so healthy. How could this happen. Vivian’s aunt Dorothy never could accept the disease. She just couldn’t stand to see her niece in that condition. When she did visit with her, Vivian could not recognize her; she would not converse, and she did not respond. The only defense Dorothy had against this ravaging disease was just not to visit her at all, except on special occasions, and then she would be depressed and devastated for weeks after.

The effects of Alzheimer’s disease can leave the patients loved ones with feelings of resentment and anger; or, through acts of kindness, devotion and service they can lift themselves up to receive a gift of love which is reserved for only a very few.

Alzheimer’s patients may live on for seven, ten, or fifteen years after first experiencing any symptoms. It can be a tremendous financial and emotional burden for a spouse or family member to try and be the sole caregiver for an Alzheimer’s patient in their home. Often the caregiver will suffer exhaustion, depression, ill health, and many times be the one who dies first.

Alzheimer’s patients’ eventually loose touch with their outside world and are left with only the solitude of their own mind. External stimuli lose their effect and most all physical activities have to be assisted or performed by someone else. This is especially hard on family, who find that their loved one is no longer “there”; no response, no recognition, no return of affection. It is very hard for a loved one to receive nothing from someone who for so long has given so much; love, care or even life to them.

The Alzheimer’s facility we had chosen for Vivian had about twenty-five full time residents, in all stages of the disease. There was “Marian”, a lady who walked around the facility most of the day asking “Where is Mr. Brown? Has anybody seen Mr. Brown? Where is Mr. Brown?” Marian was single and had been a teacher in the public schools. She had no family, and “Mr. Brown” was an associate who had taught in the same school as Marian had. He who would often take time out from his busy teaching schedule to come and visit with her; he was her only visitor.

“Ed” was another patient. He had been a successful artist. He didn’t say much, and would spend most of his time just wandering around. His wife would come by most every day to stay with him and give him comfort.

“Cal” had owned a very successful car dealership in California. His visitors consisted of several family members who would visit with him each day for an hour or so. Cal did not stay in the facility for very long. Because of his wealth, his family was able to arrange for a full time nurse and other help to attend to him in his own home on a full time basis.

With all the stresses and responsibilities of caring for an Alzheimer’s patient, one would think that there is nothing to be gained or even appreciated from such a situation. Nothing could be further from the truth. If a person is willing to care for, to love, and to appreciate another who has lost the ability to return anything in kind, there can be great rewards. Many times we would go to visit with Vivian and find her sitting motionless in a chair, staring blankly out the window. Or perhaps she would be eating, desperately trying to get her hand to function well enough to get the food up to her mouth without spilling it. These could be times of heartbreak and disappointment, or they could be jewels in the “last days” caring process of a loved one.

Often when we would visit Vivian we would find her seated in her favorite chair, a wooden chair with a padded cushion, placed just in front of an outside window. Vivian would be staring blankly out the window, with no expression, no movement. We would always hope that today, perhaps there would be some indication of recognition in her eyes; perhaps a smile would creep on to her face as she watched us approach. Sharon would go up to her and gently touch her hand. Sometimes there was no response, but other times she could detect just the slightest movement, some indication that her mother realized that someone was there, and that perhaps that someone could bring her some semblance of joy. As we would sit by the window with her, she would lean forward ever so slightly to feel the warmth of the sun on her face. As she felt that warmth her eyes would close, and a faint smile would cross her face. Sharon would not know what was happening inside her mind, but she could see that there was a sense of love and appreciation.

Exercise is something which the medical staff is always encouraging the patient to do. This usually means getting up and walking a short distance, or perhaps just moving the limbs to get the blood flowing. If we found Vivian sitting in a chair in the hallway, I often would take her by the arm and we would shuffle down the hall together. She would stay close to the wall, perhaps hanging onto a rail for support. As we walked she would be dusting off the wainscoting along the wall with her fingers, or if we came to a table she would stop, straighten the table cloth and then smooth it out with carefully measured strokes of her hand. These were wonderful times when it was just the two of us together. It felt good to be with her, helping her and watching her react to her environment.

It would always be a special treat for Vivian when someone would give her a facial. This was something that Sharon loved to do often. There is a special bond that develops when the parent-child roles are reversed. A parent supports and cares for their children all of their lives. When the child is grown, the care is more of an implied care; of approval, support, and love. During this end of life experience, the caring of a parent by a child or loved one can result in a wonderful opportunity which most people may never get a chance to experience. They can return, in some small way, an appreciation for those many years of caring and loving which they had received from the parent. The soft touch or stroke of the hair can bring those loving memories of childhood flowing back. Just as love and care is given to a small and helpless baby, that can now be returned to a parent who is incapacitated or incapable of reciprocating.

Through the facial, the power of touch breaks through the mental solitude or hostilities that an Alzheimer’s patient may have. As the fingers smooth on the lotion, moving in a gentle circular pattern along the brow, down the cheeks and across the chin, all the tensions or absence of awareness melt into a sensuous appreciation of being touched and cared for by another. Slowly Vivian’s eyes would close. A look of calm and appreciation would come across her face as her lips would show just the slightest hint of a smile. Her head would tilt back and she would move her face forward into the facial in a gesture of pure pleasure.

These are moments of pleasure and joy which are reserved for only a select few who will take the opportunity to care for a totally incapacitated patient. These are the blessings reserved for those who will freely give of their love and the sacrifice of their own time; for those who will go out of their comfort zone to help a loved one, someone who has cared for them all their lives, but whom now can do nothing but sit in a chair and gaze off into space. This is the reward which can come to those few who can see an opportunity to serve even when it hurts.

During Vivian’s last days, Hospice was brought into the Alzheimer’s facility to help with her needs. Their purpose was to ease the transition into death both for the patient and for the family. Hospice had notified the family that Vivian was down to her last days. The family made extra efforts to visit her whenever they could now.

On Dec 25th of 2003, the family had gathered round as Vivian lay in her bed. She was not responding and her breathing was labored. We were each supplying her with tender thoughts and loving words. Hospice had told us it would be just a few more hours now. Final words of love were given, hugs and tears were abundant, and then there was a moment of silence. While we all stood around the bed of our dying friend and mother, Tom, Vivian’s nephew-in-law, softly began to sing;


    You are so beautiful
    To me
    You are so beautiful
    To me
    Can’t you see
    Your everything I hoped for
    Your everything I need
    You are so beautiful
    To me

It was late. We were all tired after spending most of the day with Vivian, so one by one we said “goodbye” and returned to our homes.
Vivian passed away that night at 3:30 am. We had all gone home by then, but we all were at peace. We had loved her, we had cared for her, and we had said our goodbyes to her. Yes Vivian, “You are so beautiful to me”.



Gary & Sharon Hyde