My dad died on the 14th
Oct. 21st, 2018 07:06 pmMy dad died on the 14th.
The day before (13th), his difficulty swallowing pills made it necessary to switch him to a liquid oral morphine, which meant doses every ~30 minutes; a significant strain on the people caring for him, and harder on him because it was difficult to maintain a constant, effective dose. The night of the 13th was rough. On the 14th, they added diazepam (Valium) as a sedative alongside the liquid morphine. By late morning, they decided it would be better to move him into hospice care, where medications could be delivered via port, making them more direct and reliable, providing better pain management.
We moved him at noon. Travel in that condition is inherently risky, and the transport was high adrenaline (tearful goodbyes in front of the house, my mum and I trailing the transport vehicle to the hospice, miscellaneous anxiety-venting overreactions), but he got there okay. While Mum and I were going through the check-in process, the doctor hurried us into his room because his oxygen saturation was poor and she thought his time could be coming soon. There was another round of semi-panic, of people coming who had planned to not come; Dad's brother Pete decided to fly in, knowing he might be too late.
Then began the hurry and wait. Family friends brought snack food and various things that had been forgotten in the rush; like this last month, it had a weirdly elevated social energy during an otherwise somber event. The hospice itself was lovelygreens and natural woods, an accessible kitchen, open 24 hours; distinctly not medical. It felt like a space for dying, but not in a negative sense. When my mental health issues were first coming on in full, back at my first college, I had a little breakdown, was pulled out of class, and went to the nurses's office where they had private resting rooms with garish plaid blankets. That space to rest turned what was objectively the beginning of an awful period of my life into a small oasis of comfort, and while it fixed nothing in the long run, I'm still grateful for it. The hospice had that same vibe, that "things are objectively Horrible; we acknowledge that horrible and work to soothe it" vibe.
Waiting for Dad to die explicitly couldn't be a negative thingDad hadn't been responsive for some time but that that social energy is contagious, and fearing death doesn't help the dying; but to wish it were faster felt insincere. The long stretches of killing time were deceptively calm, but my heart would race whenever his breathing changed. It was exhausting. It got easier after friends and extended family left in the afternoon. The evening was dark and slow, private and calm. Allie watched TV and napped, Mum had her phone and I think an audiobook, I did what I do best and read. Later on, Devon brought me my PJs and a teddy bear. "Liminal" gets tossed around a lot, but to sit vigil over the transition to death qualifies; that faux-peace and fearful anticipation and quiet exhaustion.
His breathing suffered throughout the evening. At around 8pm, just the four of us there, I noticed that the dying process was beginning; the occasional pauses were becoming the norm. It was unhurried but surprisingly lingering; I was expecting a final breath or final spasm but there were about four. He died at around 8:08, but we sat with him through the end, waiting it out, taking our time, and didn't call the nurse until 8:20.
Because I knew the most about death/death care, thanks almost entirely to the work of Caitlin Doughty, I found the funeral home and knew what services were available. We opted for a direct cremation in accordance with his wishes; Allie and Mum are scattering his ashes in multiple meaningful locations. I also knew that we could view the body; no one thought they would want to, but we offered it to Pete, who didn't arrive until after Dad died, and he wanted toI volunteered to go with, and then Mum, and even Allie. The viewing was a good call. It reinforces the reality to see the body again, very dead and cold, and it gave Pete some closure.
Dad's death came with a profound sense of relief; it has been an awful month or so, and the final few days were even worse, and I'm grateful to see his suffering end. I've tried hard to ride that emotion, to make it my primary memory of his death so that I can avoid traumatic associations. Finally being able to step back from the overtaxing daily socialization has reinforced that, to an extent. But my relief is wearing off as the longterm implications begin to sink in. I feel like I've been coping wellbetter than I did with his diagnosis or treatment or dying processbut I suspect it belies a profound breakdown that I can barely see on the horizon. Or nothistorically I don't grieve like most people, I'm very out of sight/out of mind. Discovering just how fucked up I am will be a fun surprise for everyone.
I have two major takeaways aside from "cancer sucks a lot," which are these: One, that death advocacy is invaluable. It's hard to do during the event, it's particularly hard to transfer to others during a death, so inform yourself early and often. But any work is more than none: just knowing what to expect from the cremation process made it possible to communicate our options to my family. I didn't do as much as I could have, but what I did still mattered.
Two, that the stigma around suicide is so harmful and pervasive as to make assisted suicide inaccessible. Even where it's legal, no one talks about it. Even I had internalized it, and I've been fighting to destigmatize suicide for 15 years. I have a lot of lingering regrets which I'm trying to forgive, but I can't forgive that I didn't research assisted suicide, that I used "respecting his wishes" as an excuse not to think about it. What he should have done, and what I should have known to encourage, was to begin the process immediately and then opt out if he changed his mindbecause there's a waiting period and, by the time he realized he wanted it, it was too late. Research local laws, research suicide bags, get over social stigma and have awkward conversations. Make informed decisions possible. It's a lingering, awful deathwhich is a valid choice, but not the only one, and for fuck's sake it shouldn't be the default.
The day before (13th), his difficulty swallowing pills made it necessary to switch him to a liquid oral morphine, which meant doses every ~30 minutes; a significant strain on the people caring for him, and harder on him because it was difficult to maintain a constant, effective dose. The night of the 13th was rough. On the 14th, they added diazepam (Valium) as a sedative alongside the liquid morphine. By late morning, they decided it would be better to move him into hospice care, where medications could be delivered via port, making them more direct and reliable, providing better pain management.
We moved him at noon. Travel in that condition is inherently risky, and the transport was high adrenaline (tearful goodbyes in front of the house, my mum and I trailing the transport vehicle to the hospice, miscellaneous anxiety-venting overreactions), but he got there okay. While Mum and I were going through the check-in process, the doctor hurried us into his room because his oxygen saturation was poor and she thought his time could be coming soon. There was another round of semi-panic, of people coming who had planned to not come; Dad's brother Pete decided to fly in, knowing he might be too late.
Then began the hurry and wait. Family friends brought snack food and various things that had been forgotten in the rush; like this last month, it had a weirdly elevated social energy during an otherwise somber event. The hospice itself was lovelygreens and natural woods, an accessible kitchen, open 24 hours; distinctly not medical. It felt like a space for dying, but not in a negative sense. When my mental health issues were first coming on in full, back at my first college, I had a little breakdown, was pulled out of class, and went to the nurses's office where they had private resting rooms with garish plaid blankets. That space to rest turned what was objectively the beginning of an awful period of my life into a small oasis of comfort, and while it fixed nothing in the long run, I'm still grateful for it. The hospice had that same vibe, that "things are objectively Horrible; we acknowledge that horrible and work to soothe it" vibe.
Waiting for Dad to die explicitly couldn't be a negative thingDad hadn't been responsive for some time but that that social energy is contagious, and fearing death doesn't help the dying; but to wish it were faster felt insincere. The long stretches of killing time were deceptively calm, but my heart would race whenever his breathing changed. It was exhausting. It got easier after friends and extended family left in the afternoon. The evening was dark and slow, private and calm. Allie watched TV and napped, Mum had her phone and I think an audiobook, I did what I do best and read. Later on, Devon brought me my PJs and a teddy bear. "Liminal" gets tossed around a lot, but to sit vigil over the transition to death qualifies; that faux-peace and fearful anticipation and quiet exhaustion.
His breathing suffered throughout the evening. At around 8pm, just the four of us there, I noticed that the dying process was beginning; the occasional pauses were becoming the norm. It was unhurried but surprisingly lingering; I was expecting a final breath or final spasm but there were about four. He died at around 8:08, but we sat with him through the end, waiting it out, taking our time, and didn't call the nurse until 8:20.
Because I knew the most about death/death care, thanks almost entirely to the work of Caitlin Doughty, I found the funeral home and knew what services were available. We opted for a direct cremation in accordance with his wishes; Allie and Mum are scattering his ashes in multiple meaningful locations. I also knew that we could view the body; no one thought they would want to, but we offered it to Pete, who didn't arrive until after Dad died, and he wanted toI volunteered to go with, and then Mum, and even Allie. The viewing was a good call. It reinforces the reality to see the body again, very dead and cold, and it gave Pete some closure.
Dad's death came with a profound sense of relief; it has been an awful month or so, and the final few days were even worse, and I'm grateful to see his suffering end. I've tried hard to ride that emotion, to make it my primary memory of his death so that I can avoid traumatic associations. Finally being able to step back from the overtaxing daily socialization has reinforced that, to an extent. But my relief is wearing off as the longterm implications begin to sink in. I feel like I've been coping wellbetter than I did with his diagnosis or treatment or dying processbut I suspect it belies a profound breakdown that I can barely see on the horizon. Or nothistorically I don't grieve like most people, I'm very out of sight/out of mind. Discovering just how fucked up I am will be a fun surprise for everyone.
I have two major takeaways aside from "cancer sucks a lot," which are these: One, that death advocacy is invaluable. It's hard to do during the event, it's particularly hard to transfer to others during a death, so inform yourself early and often. But any work is more than none: just knowing what to expect from the cremation process made it possible to communicate our options to my family. I didn't do as much as I could have, but what I did still mattered.
Two, that the stigma around suicide is so harmful and pervasive as to make assisted suicide inaccessible. Even where it's legal, no one talks about it. Even I had internalized it, and I've been fighting to destigmatize suicide for 15 years. I have a lot of lingering regrets which I'm trying to forgive, but I can't forgive that I didn't research assisted suicide, that I used "respecting his wishes" as an excuse not to think about it. What he should have done, and what I should have known to encourage, was to begin the process immediately and then opt out if he changed his mindbecause there's a waiting period and, by the time he realized he wanted it, it was too late. Research local laws, research suicide bags, get over social stigma and have awkward conversations. Make informed decisions possible. It's a lingering, awful deathwhich is a valid choice, but not the only one, and for fuck's sake it shouldn't be the default.