Witness to a Demise

My Dad is dying.  Granted, we're all dying, some are just doing so faster and sooner than others.  My Dad is one of those people.  He's old enough to have died of old age long before now - he'll be 87 in November.  He's had hip replacements and high blood pressure and even a mild heart attack last year.  But he has cancer now, that started in his bladder, has spread to his lungs and his liver and possibly his lymphatic system, and is slowly ravaging his already fragile body.  He undertook a course of radiotherapy earlier this year, but it still spread.  He decided to forego chemotherapy, stating that he would rather "let nature take its course".  That's my Dad.  Ever philosophical, always realistic.  Never one for huge statements of emotion, dramatic gestures or extraordinary acts of inspirational courage.  Just your average, kind-hearted, calm-natured Englishman with reserved sensibilities and a northern sense of humour.

For the past year, I have watched my Dad's health steadily decline.  In October 2011, he suffered the mild heart attack that put him in hospital and resulted in him being fitted with a pacemaker.  He had already been advised of the likely cancerous lesions on his bladder that April, just six months before.  They had been unable to operate to remove the lesions because of his high blood pressure, stating that it would need to be lower before they would risk operating.  After the pacemaker was fitted, this solved the problem sufficiently enough for them to operate on his bladder during the same spell in hospital.  He suffered bouts of intense pain as he passed blood clots in his urine via a catheter and also had his bladder 'washed out' by nursing staff, via the catheter.  I witnessed his pain on more than one occasion and found it distressing, knowing that my Dad has never been one to complain unnecessarily with his ailments, or during his several admissions to hospital previously.  To see him virtually shouting in agony was very difficult.

During this spell in hospital, he lost quite a lot of weight.  Even once he was discharged and returned home, his appetite didn't return sufficiently enough for him to experience significant weight gain.  His heart had been damaged and weakened and he got tired more easily, required his walking stick(s) more frequently and wasn't as steady on his feet or as strong as he was before.  This was probably harder for him to come to terms with than it was for us.  He would still make reference to doing certain things, such as driving, as if it as still a feasible activity for him, when we all knew that it wouldn't be safe, or perhaps even possible.  He had a course of radiotherapy in March/April of this year and his appetite was further adversely affected.  When Mum went to the Philippines for three weeks in June, he thought it unnecessary to have anyone stay with him, but my sisters and I took it in turns to stay over and keep him company, make sure he was OK and cook him food nonetheless.  He later admitted that it was a good idea we had been there.

Over the past few months, his appetite has worsened and he has experienced sharp pains in the right side of his body - his shoulder, elbow, hip, groin and knee - that seem to come and go, alternating between the different areas, but always on the right side.  I made a conscious decision a couple of months or so ago that I would go back to trying to spend as much time at my parents' house as I could.  When Samson and I broke up in mid-August, there was no-one else competing for my time at weekends, so most weekends I have gone to stay with them.  Aside from spending time with my Dad while he is alive and is able to appreciate/acknowledge my presence, my Mum enjoys the company.  She is caring for him full-time and her life revolves around him - preparing food for his meals, assisting him with washing, dressing, getting down and up the stairs, going to the toilet, giving him his medication and so on.  Everything else has taken a back seat, even non-essential housework.

It's strange how the possibility (or certainty) of losing a loved one can bring the family closer together, or push them apart.  It highlights cracks in relationships, or mends them.  It reveals those who truly care for you and those who are too preoccupied with their own lives to offer their support.  I'm not sure what this situation has done for the relationship between me and my Mum, at least not from her point of view.  I don't know if I can necessarily say it has brought us 'closer' together emotionally, as such.  All I know is that I have a renewed and more profound appreciation and respect for her as my mother and as a wife, nurse, woman and human being.  I've seen love in action.  I've seen the stress she experiences, the relentless monotonous routine, the sacrifice of her own interests and activities for my father's sake.  She does all of this without resentment, without ever calling us to complain, without self pity.  Sure, she gets fed up.  She expresses her frustrations to me when I am there, her desires to undertake the activities she loves and enjoys.  But she just gets on with it.  I am full of admiration for her and gratitude for making my Dad as comfortable as possible in the latter days of his life.  I don't feel like I really do enough to help and often feel helpless.  But I try my best to perk her up, to allow her to be crazy and silly so she can let off steam.  I keep her company and let her do things to her schedule.  I try to ask questions and understand what Dad needs, or why she makes certain decisions, or what medication she gives him and when.  I observe the things she does to care for him so that I can do them too when necessary.  I'm just a presence I guess, so that she isn't always alone and feels she has at least a little support.  Whether it's enough, whether it helps her at all, I don't know.  But when he opted out of chemo, I decided that when he dies, I did not want to be riddled with the thought that I didn't spend enough time with him.  So I'm here.  Even though after some weekends I get back to my own home and feel emotionally drained, I'm still here as much and as often as I can be and can cope with.

At times, I've wondered if I'm being dramatic or morbid, thinking, "my Dad is dying," or telling people the fact that he's terminally ill.  But my Mum is the same.  She tries to be realistic and practical and has looked at funeral homes and thought about what she will do when it happens.  She wonders if people would think badly of her, as if she is willing it to happen sooner, but I know she is just being practical, as is her character.  She isn't in denial and I guess I have embraced that too.  My Dad is dying.  Me admitting it doesn't hasten it happening, just as me not talking about it won't make it happen slower.  It's the truth, a reality of my life and one that I want to accept and be able to deal with.  I have started to count it a blessing that we've had so much time to prepare and get used to the idea.  All my life I have been conscious that my Dad could die while I was relatively young.  Potentially, he could have died before I reached adulthood.  When my Mum had me, he was 56.  There is 25 years' age difference between them.  Growing up, people often assumed he was my grandfather.  When we went out together, me, Mum, Dad, Big Sis and Bigger Sis, we used to laugh at the thought of other people trying to work out our family dynamic (there are only 9 years between Bigger Sis and my Mum).  But even though I always knew that my Dad's death at a relatively early point in my life was a possibility, it's only recently that I realised I was not really prepared for it to actually happen.  I don't know that you can ever be 'prepared' to lose someone you love.  But knowing for sure that my Dad is dying and watching him slowly deteriorate has actually helped me start to come to terms with it.  I know that I will still be devastated when it happens and I am slowly accepting that he will not walk me down the aisle when I get married, but I will not be as shocked as I might have been.

In the past two weeks, things have got worse.  Because Dad was experiencing severe pain more frequently, he was prescribed painkillers administered in patch form, a small plaster that goes on his skin and slowly releases the medication over the course of a week.  The first dosage they prescribed totally doped him up, he kept getting a high temperature and basically slept for most of the week, rarely leaving his bed.  The reduced dose he is now taking is better, but he still gets feverish now and then, often at night.  An additional side-effect is that he gets confused and seems to hallucinate.  This past weekend, he talked in his sleep for most of at least 36 hours straight, making moaning and groaning noises with every breath and muttering to himself.  He was talking about things that weren't actually happening, taking his clothes off, arguing with my Mum and resisting her care. It was a little bit distressing at times.  But it's just how things are.  It's almost like I'm starting to grieve while he's still alive, because we are losing tiny parts of who he is every day.

I love my Dad.