Cab fare

Dad's hospice provider is morphing in some way and reorganizing with its sister company.  Dad is being transitioned to a team from a different office.  Maybe he will get to reject/eject a new pastor.  He will get a new R.N., but his bath aide will stay the same.

When my sister asked for an update on Dad's condition Sunday, she asked that difficult question, "So what will happen?"  The best I could tell her was that Dad will continue withering away, sleeping more and more, speaking inaudibly unless he is angry.  This could last months or years.

Monday afternoon Dad was in his wheelchair and studying the graduation photos I had tacked on his wall.  He had slept most of the weekend.  "I'm so glad I came along," he told me as he looked at the photos, perhaps thanking me for coming around to explain them, but maybe thinking he had been along on the graduation trip.  He acknowledged he "had to be introduced" to his family, and thanked me for writing names to go with the photos. 

Dad worked hard to sort out my sons, their wives, and friend-girls.  Then he propelled his wheelchair across the hall to the dining room for a cup of coffee.  He thought the coffee was too hot, and added three creamers while Tom Hanks hugged Oprah on the big screen tv.  Then he began asking me for taxi fare.

"I don't know why I am still here," he said.  I could take this as the intro to a profound dialog about life and death.  To Dad it is more of a complaint that I still haven't brought the car around to pick him up and drive him out of Dodge. Plus, I hadn't loaned him cab fare.

Last evening R.N. Brenda called.  I pussyfooted around that difficult question, "So what will happen?"  What is the prognosis for Dad?  He has been on hospice care since 3/4/11.  What changes has she noted?  

That question is so very loaded.  I finally phrased it by asking if Dad was leaving soon or just waiting for taxi money.  Brenda usually sees Dad at breakfast time, and finds him out in the hall in his wheelchair.  She says he always claims someone will be picking him up soon, (like those anticipating the Rapture).

Dad's major diagnosis has been changed from dementia to "adult failure to thrive".  The expectation is that Dad will continue withering with loss of appetite and energy, and that he will sleep more and more.  The first major infection will likely be more than his body can handle.  He might aspirate food particles and get pneumonia at any time. R.N. Brenda encouraged me to ask these questions more often.  What changes are noted by the hospice staff?  What is the outlook for Dad?

It's not easy to ask.  It isn't easy to find a cab after the rain starts.

© 2011 Nancy L. Ruder