Margaret's Last Few Days

Last Saturday (13th November) Helen phoned at 7.30am to say that Margaret was very weak and that she was coming home on the 8.00am bus.  I said that I would drive in asap to make sure that Margaret was not left alone.  She had spent all night clinging on to Helen's hand.  I think that Helen was awake most of the night and when Margaret was conscious talked to her to make sure that Margaret knew that somebody was there to care for her.

I arrived just after Helen's bus left.  She was going to have a shower and drop back later in the morning.

I found Margaret barely able to talk but she was pleased to see me and gave me a smile.  She hadn't eaten any breakfast and actually didn't eat again before she died.  Helen had devised a way of giving her water from a squeeze bottle and we gave her water and apple juice through out the day.

Margaret was very weak and the carers gave her a high care wash,  dressed her in a clean clothes and put her in her recliner chair. I sat next to her holding holding her hand and talked to her while she was awake.  By now she could only speak in a hoarse whisper.  Helen returned at 11.30am intending to have lunch with Margaret while I went home to get Louis.

As I said above Margaret didn't eat any lunch but was happy to see Louis and fed some of her meat to him.  Actually Helen placed the meat in her hand and she let it rest beside her and Louis took it from her.  Later he sat next to her and she rested her hand on his head.  It was her last contact with Louis.

I took him home after an hour.  Helen came home for a meal about 5.00pm and I ran her back about 6.30pm as she intended to spend the night with Margaret.  I was feeling very tired and Helen must have been exhausted.   I went to bed early and was awakened about 1.30am by the telephone.  It was Helen.  The night time RN had asked her to phone me and get me in.  Margaret had had some type of attack and was gravely ill.  She was gasping for air and required regular shots of morphine to help he breath.

I got a taxi in as I had had a couple of glasses of wine and don't like driving at night anyway.  I got in at 2.15am and Margaret was more settled.  She now could barely speak at all as she needed all her strength to breath.  She was communicating by lifting her finger to attract out attention and then we would determine  what she wanted by asking her questions and she would raise her finger when we hit on the correct question.

I left at 6.30am and walked the 4km home to get showered and to let Louis in the garden as he was in for a long day on his own.  I returned at about 8.30am to allow Helen to go home by bus.  By now Margaret was too weak to get up and was given a bed wash, a clean nightie and put back to bed.

Helen had dragged the recliner chair next to the bed and when I returned was lying in it fast asleep  holding Margaret"s hand.  I stopped to take a photo but she woke up and smiled at me.

Margaret's Last Photo

Helen went home for a shower and  I sat next to Margaret and held her hand.  She was concerned that Helen wasn't coming back an said to me, "Helen."  in a barely audible whisper.  I assured her that Helen would be back and said, "You do know Helen loves you don't you?"  She smiled and nodded her head.  I then asked, "You love her too, don't you?"  and again she smiled and nodded yes!!  This was the only good thing to happen all day.  We sat and I talked about Louis and asked if I should bring him in and she shook her head.  She really was too weak to pat him.

The rest of Sunday we shared the duties.  We both had lunch and an evening snack at the nursing centre before I went home to Louis.  Helen settled in the for the night.

At 6.00am Margaret's breathing became very painful to watch she was gasping for air and making terrible gurgling noises.  The RN faxed Margaret's GP to get permission for more morphine.

I got in at 7.00am and I don't think that Margaret realised that was there.  By now she hadn't drunk anything for many hours and was too weak even to respond to the squeeze bottle.  The carers used swabs to moisten her lips but couldn't get her to open her mouth.

Helen went home for a shower and returned after two hours.  Margaret was slipping in and out of consciousness.  She has spasms when she appeared to be choking and began to cough up mucus and I was afraid that Helen would return too late but she was back in time.  While Helen was away I talked to Margaret about the happy times  we had had and even the downright silly when she had to roller skate across a stage as she played a modern female detective!! I don't know if it helped as I got no response.  We also moved her bed so that we could sit either side of her.

She suffered all morning and both the RN and I phoned the GP for a response to the fax. but couldn't get passed the receptionist.  In the end at 1.00pm the Nursing Centre's Director of Nursing examined Margaret then he  phoned the surgery and insisted that the GP respond to the fax.

Margaret's GP arrived 10 minutes later in a terrible state as he had not seen the fax until the DON's phone call.  He examined Margaret prescribed a continuous feed syringe to deliver additional morphine and a sedative to relax her.  He said that she had about 12 hours to live.  He apologised to Helen and me about the mix up with the fax and was very upset. He had promised Margaret, who knew that she was dying, that she would not suffer and he had let her down .  He believed that she was too weak to be aware of her suffering but would have preferred to provide the extra medication much earlier.

The next three hours  saw Margaret a little more relaxed and we sat next to her and held her hands.  At about 4.00pm I was going to go home to feed Louis when Margaret had another terrible breathing spasm and was coughing up more mucus.  The RN tried to use a suction device to clear Margaret's lungs but was unsuccessful so she phoned the GP to get approval to inject a dispersant which was given immediately along with instructions to inject more morphine.

At 5.00pm the RN came in to administer the dispersant and as she rolled Margaret over to give her the injection Margaret gave a big twitch and stopped breathing.. The RN left the room while Helen and I held Margaret's hands.

At 5.05pm the RN returned with DON who declared her dead.  Helen started to straighten Margaret's head and make her look comfortable and the DON assisted her.  Together they laid her straight and tidied her clothes.  The RN and DON then left us alone with her as we said goodbye.

We left about 5.40pm and the Nursing Centre arranged for her body to be collected by the Funeral Director who would contact us tomorrow.

I then realised that I have one more chapter in Caring for Margaret to complete.  That is making arrangements for her cremation and scattering of her ashes in accordance with her wishes.

I will close this blog next Saturday