Dying By Degrees

I'm waiting for my father to die. I'm not sitting at his deathbed, holding his hand. I'm 360 miles away, awaiting a phone call that may not come for weeks or even months. He's in his mid-80s, and although the official death certificate will say he died of heart failure or pneumonia, the truth is he will have died because he was too tired to put in the effort it takes to stay alive.

He had several heart attacks and a triple bypass. Although he came out of the surgery quite well, there were complications. Many complications. For the next three months he went back and forth between the hospital and a convalescent home.

He eventually came home, but at his age, even small things take their toll. For each step forward, there are two steps back. His heart condition is complicated by the fact that his kidneys are failing and he's been on dialysis for two years. For a year, we've watched the nephrologists and cardiologists dance around each other as they've tried to regulate his drugs to improve whichever organ they are interested in. The nephrologists want to keep his blood pressure up so he won't crash during dialysis. The cardiologists want to keep it down to relieve the stress on his heart.

My father just wants to get on with his life, but that's proving harder and harder.

I watch from the sidelines. My parents live in one city, I live in another. Although I call my mother every day, it's not the same as being there. I've gotten into a routine of visiting every two months, a routine punctuated by emergency flights in for each of his heart attacks and for several other hospital stays. The trips in are difficult. Although we joke that the only thing my mother likes more than my coming in is my leaving, it's not a joke. The only way she can cope with my father's worsening health is to cling to a rigid routine.

It's difficult for my father because he knows he's deteriorating, physically and mentally. His thinking is slower, making decisions is more difficult, and it's a struggle just to get up in the morning. And it's difficult for me because my father is dying before my eyes. I call and visit, but now I've added crying to the list of things I do.

I'm doing other things as well. My parents expect me to take over the finances for my mother when my father dies. I am included in financial discussions, have met the bank manager, get copies of financial documents, and have power of attorney. I'm not sure I'm the best person to handle anyone else's money, but we have an understanding and I will honor it. The idea of honoring understandings is playing a larger part in my life. As it became apparent my father was dying, I talked to my mother about honoring his wishes. I didn't make a big thing about it, just slipped it into the occasional conversation.

Both my parents have living wills stating they do not want heroic efforts to save them if that effort means prolonging death rather than life. My father crashed during a dialysis session and was admitted to hospital. Although he recovered, my mother began to admit that one day he would be rushed into hospital and not come out again. That crisis left us all feeling more bruised. I've become more forthright with my mother about talking about what happens after. The first few times we spoke, she said it made her feel as if he were already dead and buried. So I backed off for a time.

But as my father's health has worsened, I've begun talking again about honoring his wishes. This time she couldn't hide from what I meant. A subtle change has taken place in our relationship. She has begun asking me to take care of more things, to speak to more people, to make lists of things for her to do.

She has begun preparing for his death.

I don't want to pretend I've been some paragon of virtue. I haven't. I'm angry at my father for dying, at my mother for relying on me, and at myself for being angry at them. When I call my mother and listen to her cry, it takes all my willpower not to yell at her or cry with her. I keep reassuring her that she's doing all she can.

I try to reassure myself as well.

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