5/3/10 Dream of Dad

I dreamed of Dad on Thursday the 11th of April, three weeks after his death. He was stepping out of the shower and then we were in a room, but one i cannot identify as any specific place i've been. By this time he was fully dressed, though there was no dressing done. Like so many dreams, the details seemed real and normal, not out of place or awkward, like seeing him step out of a shower might normally be perceived. I noticed that Dad seemed strong and vigorous and engaging and commented on how his condition had improved since we had last been together. Then i was confused and thought, "Hum, i thought you died. But you certainly have recovered and recuouperated from your last illness quite well." After a bit, i remembered clearly his death in his appartment and so wondered if he was really alive. I made some comment to him and touched him on his shoulder to confirm that he was real and not an apparation. He smiled knowingly, once he saw that i realized he had died and was just paying me a visit. It seemed that we had a short exchange of some sort, then he stepped out into the hallway and left. As he left, he said with a smile, "You'll see _________ in a few days," and was gone. When i awoke, i wondered if he was saying he would see him a few days, but three weeks later i still have heard no word about this other person.

CORRECTION ON DATE

Correction on Date of Memorial Service: I had posted the Memorial to be on Friday, April 3, but there is no such date. Please note the services will be

Saturday, April 3

Family Placing of the Urn, 10:00 at Mills and Mills Funeral

Memorial Service 11:00 at Mountain View Church of the Nazarene

3-29-10 Lodging Arrangements

If you are traveling in to the Olympia area to attend the Memorial, you can access a good discount at the Guesthouse Inn, Tumwater, WA off I-5 at Exit 101 (not to be confused with the Hyw 101 exit a couple of miles north). Call 360-943-5040 and mention the Friberg Funeral. They have a nice Deluxe Breakfast as well.

3-27-10 Gone to his Eternal Reward

Dad died Thursday, 3-25-10 at 9:21 p.m. Linda and I were privileged to be with him his final hours. The memorial details are as follow:

• Viewing: Friday April 2 from 1:00 - 6:00 pm at Mills and Mills Funeral Home and Memorial Park, 5725 Littlerock Road SW, Tumwater, WA 98512
• Family Graveside (Placing of the Urn): 10:00 a.m. Saturday April 3 at Mills and Mills
• Memorial Service: Saturday April 3 at 11:00 at Mountain View Church of the Nazarene, 940 Israel Road SW, Tumwater, WA 98501

Memorial Gifts: Please Donate to the Jesus Film in memory of mom and Dad. You can donate directly at http://www.jesusfilm.org/ or leave a card at the church at the memorial.

If you are considering flying in to attend the services, please contact me to get a Discount Reference Number.

So, Wednesday was the best day he had had in a long time, as far as communicating and knowing who i was (at least initially). Then Thursday i got a call around 1:00 p.m. saying i should come soon. He had had a good morning, eating a good breakfast with very little assist. At noon, he began his lunch OK but soon his caregiver looked over to see he was slumped over and turning blue. The hospice nurse was there visiting another patient and came to assist. They got him straightened up and breathing and he seemed OK. She left about 12:30 and at 12:40 he slumped and became unconscious; apparently suffering a major stroke. He never regained consciousness but was initially uncomfortable. The hospice nurse ordered an End of Life Medication Kit and I administered the morphine and lorazapam according to the instructions.

Eventually the comfort medications began to take full effect and he soon looked very peaceful. Then, his breathing became apneic, meaning he started having long spells between his breaths. First they were 6-10 seconds apart. Then the gaps became 30, then a minute. After only a few of those, he peacefully breathed his last. After a long day, from 12:30 until 9:21 p.m., his battle was over, and he was reunited with mom and the Lord.

Reflections over the last few weeks:

It has been interesting to see how this has all progressed so quickly over the last couple of months. I had been thinking he might be a good hospice candidate because of his frequent falling. Then Ken and Connie suggested the same. I scheduled a pre-hospice assessment appt. with his doctor. She didn't think he was ready but thought the assessment would set a good baseline for further evaluation. (Incidentally, she called me personally the day after Dad's death to express her condolences and even said, "I loved that man". She had only been his doctor since they moved down from Olympia a couple of years ago, yet endeared himself to her that much. I was pretty amazed at her comment.) Hospice did the assessment and enrolled him on the spot on February 27th. Then, a week or so later, the hospice nurse saw him at one of his better moments and said she doubted that he really qualified for hospice but would keep him for 6 weeks to see how he was doing. How thing change!

When mom died Dad was already well connected at Fisher's Landing and was very happy there but due to his wandering off sight and not knowing how to get back, they needed for us to find a new place, so we moved him in December of 2009. Hoodview is a really nice place, with a very caring Christian woman owner, Luba. But Dad found the transition hard. The usual careprovider in the home is not as engaging as Luba and did not provide the same nurturing and tender care Dad experienced at Fisher's Landing. We have had a practice, since mom died, of taking Dad out to eat or to our house every Sunday after church. A couple of months ago, for 3 or 4 Sundays, Dad would say "I would like to have a private place to talk after we eat." The first time was in regards to the care he was getting that was not as nurturing as he was accustomed to. We explored that with Luba and the other caregiver extensively and saw significant improvement.

Then Dad's Sunday discussions focused on life review (something people often do in their final weeks and months) as he reflected and grieved his pre-christian days. Unfortunately, as is common with dementia of various kinds, Dad was experiencing his memories as if he was actually back in those sinful days and i eventually began praying for forgiveness in the present tense instead of trying to tell him that was all taken care of in the past. That helped him and he moved on. The next Sunday it was assurance of salvation and even questions of whether the Bible was true. Scriptures and old hymns of the church alleviated his angst.

Soon one day in his room he greeted me with concern about "the kids". I soon guessed he was expressing his concern for the souls of his grandkids. We began to pray for each of them by name, first for Hugh's and then on down the line. It was an incredibly precious time. Then soon after that, Linda and i were again in his room and he wanted to pray. The three of us encircled in a prayer huddle and prayed again for his kids and grandkids. When we finished, he dismissed us and before we could get out of the room, he had knelt by his chair and was praying again. We captured that on film and i will try to post a picture. We did a lot of scripture and hymn singing and he sang along, sometimes with gusto and sometimes only faintly. The video posted earlier on this blog captures him singing faintly along to The Old Rugged Cross. It was the last time we sang together, i imagine. That was last Sunday.

Ice cream. Maybe we should have ice-cream at the dinner after the memorial. We always had to have ice cream when he was over at our house, when i took him to doctor's appts., etc. We found his journal A Father's Legacy that he filled out. Where it asks for favorite desert he listed ice cream, to none of our surprise. If you get your choice of deserts in heaven, i bet he is checking out the best heavenly flavors!

Best to you all and may God bless this legacy of love down through the years.

Merv

3-24-10 Always Something New

I visited Dad yesterday and today and found quite a change between the two days. Yesterday, it was all Tanya and i could do to get a few bites down him. He was all slumped over and resistant to being set up so we could feed him. Only by moving him to a recliner were we successful in getting food down him. I could not understand a single word he said the entire hour and a half i was there. Today, he was sitting up much straighter and actually engaged in conversation for a while, greeting me by name when i arrived. He agreed that sitting out on the deck in the sun would be nice so i wheelchaired him out and we visited. I asked if he was aware on other days when i could not understand him. He said yes. I asked if it was frustrating to him when he could not be understood. "Sure," was his reply. He didn't initiate much so i talked about my day a while and tried to engage him. Over a short time he began to fade and slump. Soon i could barely understand him. Eventually he said something about needing to go somewhere. Then he walked the wheelchair back about a foot and said i should take the car to Merv's. Ha! Don't know who i had become in his mind by then! He then said we should go in, that he was getting tired. I suggested that i could stay a bit longer but he reasserted that it was time to be wheeled in. When i took him in, he wanted me to park his chair in the TV room. Now that was a switch as he has typically not wanted to be in the TV room when family has been with him. Maybe he still thought i was someone else. Funny. I guess it would be fair to say there is always something new when i head over to see him. Until later ... Merv

3.21.10 Gpa & Merv "The Old Rugged Cross"

3-21-2010 Commendation

I sent in my Annual Pastor's Report today and gave an update on Dad. Jan Green, from the District Office, wrote back these words:

I'm sorry to hear about your father, sorry for you, not him. I'm sure he's ready to be wtih Jesus and yhour mom. God bless you in these last days... You were given a great heritage from the faithfulness of your parents. I always enjoyed seeing them at district assemblies and commiserating with your mother on the phone about all the work we both had to do to prepare for our events in the weeks leading up to NMI Convention and Assembly. I'll be praying for the entire Friberg famiuly during this time.

3-21-2010 Not much change

I had a nice time with Dad Friday afternoon, but again, he seemed to be a bit less responsive than on the 17th. Tanya told me Theron had talked to him earlier and i couldn't tell if he personally appreciated who it was. His comments are sometimes clear but so often are not. Today Linda and i went over together. We brought flowers and a Thank you card to Tanya from us all as she carries a huge load. Actually, today and tomorrow Luba is covering, but hopefully the flowers will still be nice when Tanya get there. Oh, i think, Luba is on until 8 pm only and back in the morning, so Tanya should see them this evening if i have it figured right. Dad and i always get ice-cream when we are out and haven't been out together for a while so we brought some in. He appreciated it very much. After we were done with our ice-creams, Linda asked if Dad liked having his recliner chair in the bedroom or would he prefer we move it back out into the TV room as Tanya suggests; he said he wanted more ice-cream! Funny!!! Sometimes Dad is obviously on target, and we know what he wants (Do you want more ice-cream? Yes!) Most of the time we just can't figure out what he is trying to say. He begins a thought but it evaporates before he can get it fully expressed. Today he said, "We need to point the tractor this way. It won't work that way. But i forgot my Bible ... " Then he added a few words i couldn't figure out and he was silent for a while. Luba pointed out that he as been passing very little urine and it is very dark; his Depends was spiled brown, not with feces but dark urine, when we changed him. After he had his ice cream he wanted water but only took two sips. He had a breakfast of maybe 25% of what was served and did down all his meds. He had no lunch; would just clinch his teeth and seal his lips. He has been doing more and more of that and is getting only a fraction of his meds. If he continues with that, his kidneys could stop and he would soon slip comfortably into a coma. But he did take two servings of ice cream so that should give him some calories for now. Well, blessings to you all, Merv

3/13--3-17 Couldn't travel

Zac and Kendra brought Breah over to see Great Grampa Friberg. He appreciated seeing her althgouth he didn't recognize Linda or Kendra and i'm not sure about Zac. But he did light up to see the Baby and i think he appreciated it as Zac's, as we had been talking about it quite a bit. It is getting hard to tell when he is on and when he is off, as far as appreciateing current reality as the rest of us experience it. We sang some hynms which was great blessing to him. When we were finished he by then had morphed the time together so he thought we were in a church service or convention of some sort. I'm again forgetful of what he said but there was no mistaking what he was experiencing. He often has been in this mode when i go to leave him. Today is a beautiful warm afternoon so i thought i would take him for a drive and get some ice cream. I found him sitting on the footstool of his recliner--but he was on the floor and it was tipped up on the back end. Visualize a recliner fully reclined and then push the leg rest down to the floor without first retracting the leg rest; the whole chair tips forward. That is how it was, with Dad's butt on the sitting half on the leg rest and half on the floor. He was not experiencing any distress but was confused and talking and praying about the car, the church and needing to pick up someone on the way to the restaraunt, something they would have done at district assembly . Tanya and i rectified the chair situation and i offered for us to go for a ride. He thought that was a good plan so i tried to put on his shoes but his feet we too swollen, so i put some slippers on him. (Zac, i pushed on his swollen foot above the toes and the detent the size of my thumb print remained for at least 45 seconds, when i quit looking and put his sock on. Isn't that called capilary fill or refill? Anyway, i didn't think it good that it took so long to fill. Tanya said the hospice nurse note that on her last visit and reported his doc.) Once i got socks and slippers on, with no little effort we helped him stand and started to head out of his room but could not get him to go on out of his room, even though he re-affirmed that he wanted to go on a ride. He said i should bring the car up! He litterally would not step across the threshold from his room out into the other room. I eventually suggested we sit for a bit and then we had a challenge getting him to go back to his chair and even more difficulty getting him to turn around so he could sit. He wanted to begin sitting as soon as i said, "Here's your chair." We eventually, manually turned him around and got his settled in his recliner. Tayna said he sometimes will not cooperate at all like that but if she leaves him, in 10 or 20 minutes he will be out shuffling around on his own! All of that to say, i doubt if we'll be able to take him out for rides to church or anything else any more. He will need to be carried out in a stetcher if he needs to go out, i'm guessing. I thought we would get him in a wheelchair, and then see if he could follow commands to get into the car. But this exercise demonstrated to me that we won't be doing that. Sad day! Well, best go. Merv

3-14-10 On his knees

Family It did not seem appropriate to take Dad out to church this morning and we went to the later service so did not have Dad over for lunch. I'm not sure if that will work any more anyway, but it could. So Linda and i went over this afternoon before i headed in to the hospital to provide night on call. When we arrived, Dad was at dinner and was having a bit of trouble so i helped him finish his desert. Another resident, Howard, said he found Dad on the floor in his room in the night and Tanya had to drag him out. Later Tanya said it was in the afternoon, not in the night. In getting that corrected, i failed to ask if she indeed had to drag him out. Howard also said Dad does not belong at Hoodview but at a place where they can better care for him, as it is too big a load for Tanya to do by herself. Interesting! I wished latter i had asked Mary Lou what her perceptions are in this regard. We eventually walked Dad to his room, which was a bit of a challenge but we made it. He said he had to go potty but when we walked in, he wanted to go through the room and out the other door. When i redirected him, he left the bathroom without using the toilet. Later he wanted to try again, had a very difficult time locating himself on the toilet and could not go once i got him properly seated. Dad was obviously in another time and place but we had a great time of singing hymns and reading scripture together. He would occasionally make statements that seemed incongruous to us but obviously responses to where he thought he was. As we sang, he would close his eyes and sing heartily. He picked up most songs by the second or third word. It was quite moving. Then, when we finished singing, we stood and he went to his mirrors and acted like he was leaving a meeting, church, or district assembly or something. We eventually redirected him back to his recliner. But instead of sitting, he knelt and began praying. I captured a picture of it. Eventually he stood, said good by and began praying again. Then he sat and i was able to hug and kiss him goodbye. i emailed the picture out since it is on my phone and i am at the hospital instead of at my computer, ie, the picture must first be put on my computer and then posted here, per my limited skills. The hospice nurse called me this morning and said that she is convinced Dad's changes up and down are not from med changes but from his advancing Parkinson's Disease (PD). She affirmed what we heard when Dad was first diagnosed: When managed well, PD often goes along with only minimal declind. Then things change and one can fail rapidly to a lower plateau or to death. She said he is not taking a case study pathway but doing it his own way, but she attributes all this to advancing stages of PD. I wanted to butt in and quote Dad, " Why be difficult when with a little effort you can be a real stinker." He certainly is being that!! Well, better go for now. Merv

3-12-10 Confused again

Well, the drama continues. The last time i talked with hospice, they said Dad seemed fine and they didn't think he would continue to qualify for hospice but they would watch him for 6 weeks. Ken and Hugh came over and saw Dad Tuesday evening and Wed morning, i think it was. Dad was way better than he had been on the weekend. Perhaps you two could write a bit to express how he was for you. I was not able to go over since until this afternoon and Tanya met me at the door to immediately express her concern that he was aggitated and confused all day, wandering, emptying his chest of drawers, hard to understand, etc.--as he has other times when aggitated. I found him in the TV room with resident John and Mary Lou concerned about him. ["Jesus, what's wrong with him?" was John's expression to Mary Lou as i walked up.] Tanya and i tended to Dad, got him to stand and walk out of the room with me as he was very aggitated and undressing. It was hard for Dad to navigate, as we walked, my arm holding him. He could not understand to turn when we needed to, could barely figure out how to get through the passage way from the dining room to the front living room, even though i was there, guiding. We got to the couch but he found it difficult to turn and sit at an appropriate spot on the couch and was at risk to fall as i was trying to get him adjusted to where he could sit on a cushion and not the couch arm. i finally got him settled, but he remained for nearly an hour with his head bowed to where he was looking in his lap or sometimes about 2 or 3 foot out in front. He often commented on places on the carpet like, "We really should have those lady's move," "Do you think they'll be ready?" and the like. Sitting there the entire time, i never could discern any context to his voiced concerns, partly because a large percentage was too mumbled to understand and partly just because there was no congruity from comment to comment. At one point, he began weeping. I wished i could discern what his concern was! We tried to sing a few hymns, something he usually likes, but he could not remember even the tune, let alone the words, although he did try to start a couple of songs but i couldn't figure out which ones he was working on. Eventually, he wanted to get up so i walked him to his bedroom, had similar difficulty getting him to lie properly in his bed, but eventually got him settled for a rest. Theron then called and while talking to him i observed Tanya and Dema getting him to the dining room with some challenge. When he finally was seated and bibbed, he dug into his meal and eat well. I then left. It is so interesting to see the huge swings. Today, he was bordering on being more like i experienced him last weekend, but not quite. I just dont know what to think of all this. They haven't adjusted his meds since last weekend so it shouldn't be a medicine reaction. I guess his baseline is just going to be all over the place. I welcome your comments. Merv

3/8/10 Better today

Luba reported that the hospice Rn thought Dad had a TIA or mini-stroke. This is in agreement with what folks were saying this morning at work, as i was asking around a bit. TIAs casue one-sided weakness, confusion and the like and usually resolve in about 24 hours; and Dad was definitely better by evening yesterday and even more so today. I was on call last night so off early today. When i got up to Hoodview, Dad was in bed, talking to someone who was not there. When i spoke to him, without even opening his eyes, he asked if it was me. That was a good sign. He got up and walked to lunch with only minimal assist. He ate his lunch without assistance. These are huge changes from what we experienced Sat. and Sunday. So for now, he seems to be more like he was when we placed him on hospice a week ago than what he was like over the weekend. i have service techs coming to the house this afternoon so was not able to stay for long, plus i need to recover from being up in the night supporting a family whose baby died. Merv

3-7-10 Why hospice?

That other post was getting too long and this is a different subject but perhaps needs some explanation. WE did not send Dad to the hospital since he was on hospice. While on hospice, Medicare will not pay for hospitalization or ride there except when needed for comfort care, e.g., compound fracture fallowing a fall. So a hospice Rn came out and said it sure seemed like a stroke, but could not authenticate that as a nurse. Dad has always been very clear that he did not want extraordinary care or even life lengthening care if his condition was significantly compromised. As Visitation Pastor at Mountain View, he was saw many persons whose conditions was similar to what he is like now. On many occasions (not just a few), Dad said to me that he did not want to have tube feedings, be sustained when he could not communicate, etc. He completed a POLST (Physicians Orders for Life Sustaining Treatments) Form in the presence of Dr Dumler and me. We discussed each segment and chose mid-range options, but with the understanding that they would be changed as needed to Comfort Care Only when appropriate. Many times in the last 6 months i have pulled that out, like when we moved from Fisher's Landing but a number of times since. Each time, i was not sure it was time for complete comfort care options. But a week ago, a full week before this event, i took him in to see Dr. Dumler again specifically to address his POLST. She was not sure he qualified but was very agreeable that a hospice consult was indicated per his decreased function and 6 recent falls and accompanying risk for significant life-limiting or life-ending falls. The hospice eval was easily conclusive that he would benefit from the frequent Rn visits etc and that he fit plenty of criteria for hospice care. A week later he has this event. (Remember that Mom died one week after being admitted to hospice service, for pain management!) Well, it's hours past bed time. I hope this has been helpful to some. Merv

3-7-10 Stroke?

Well most of you have heard much of the latest but i will post for the record. Dad seems to have had a stroke Friday nite or early Saturday a.m. Luba said he was not himself, could not talk clearly, could not stand, and leaned heavily to the left. Unfortunately, i did not hear about this until late Saturday afternoon about 5:30 or so. When i got there i found Dad, barely able to communicate and as discribed by Luba. I'm not a good historian anyway and all this drama has not improved my skills, which is to say, i can't remeber more of Saturday without some promptings from those i spoke to. Today, Sunday, Linda and i went over at 0730. We helped him to the dining room table but nearly had to carry him as his feet mostly dragged or stumpled along. I fed him breakfast as he could not do it himself. He ate nearly a full egg and part of a potato patty, which i interspersed with applesauce laced with his morning meds ground up. He could not seem to take the pills elsewise. We then helped him back to his recliner in the TV room. When we first arrived, he said i smelled like Merv!!! Hope that wasn't too bad. He never seemed to know who Linda was and his speech was mostly slurred but occasionally we could figure out something. We left around 1030. We got back in the afternoon--maybe that was when i smelled like Merv ???--He was mostly slumped way down to the left and not communicating. When Jan arrived he perked up and spoke clearly some. After a while it was time for dinner and he walked with two person max assist. It wwas a challenge to get him in his chair as he can't follow cues very well. But then supprise, he sat up and began to feed himsef. We were shocked. We left him to eat and Jan, Linda and i moved his desk out of his room and moved his recliner into his bedroom from the TV room. When we went back to the dining room to get him, he was alone in the room but talking to a supposed person in the vacant chair next to him. When we moved him to the bedroom, it was again a challenge and then Tanya (aregiver) and i tried to get him set down on the toilet which was a very difficult process because he was confused and uncertain what to do. Eventually we got that taken care of. He spoke many amuzing comments during the day like telling me that he and i should install a much bigger carberator! On what vehicle i couldn't figure out. But a big percentage of his verbalizations were unintelligible. What marks his change? Unintelligible speech, listing heavily to the left, not able to ambulate, much more confused. Some folks have some recovery after a stroke and perhaps he will. His being able to eat part of his dinner (he eventually needed help but started out self sufficient), could be seen as a partial recovery. Some history on his stroke symptoms: I took him down to Salem to see Aunt Marie before her surgery. On the way down we need to swing into a restaraunt for him to have a potty break. As he got out of the car, he could not stand and i had to nearly carry him into the restaraunt. But after releaving himself, he was able to stand, etc. Was this a mini stroke and quick recovery? I don't know. Then last Saturday Jan and Dad and i ate lunch together at Gustov's. He seemed quite good during the meal but could hardly stand as he got out of the booth. We had a challenge getting him out to the car but later he recovered from that as well. Perhaps he will show further recovery from Saturday mornings stroke, if that is what it was. Got to stop. Merv

Ken's 1st post 3/6/10

I've not posted on a blog before, so I'm just checking in. I'll give info on Dad as I find out more about his recent stroke. Ken

3-5-10 Spiritual Passion Unabated

Well, the other day Dad was wondering if the Bible really was true. I visited him on Thursday and got a different experience. On the side, on Tuesday dad had been quite agitated all day and said he knew i would come. Ooooo, now that puts a bit of pressure on! I better be listening to the Spirit. Thursday, when i entered Hoodview, Tanya said Dad was confused all day but not agitated like some days. I found Dad at his chair, alone in the TV room with the TV off. He had his bible open to the study section in the back and immediately handed it to me and asked for me to show him where we should look next. [Don't know what he had in mind there. He was presuming we were in the middle of something but i couldn't get him to identify what.] Others came in the room so we went into his room. He was wanting me to pray with him--it seemed like he thought we were at a prayer meeting or convention and he was carrying a great burden for all the family. He said between the two of us we has 25 kids to pray for! So we took turns prying for all his grandkids by family group. It was really quite precious. At one point he prayed all the g.kids would be "saved and sanctified," praying with great fervor. At other times he seemed to not understand where we were and wondered if i was staying for the night or would "head on back." [?] So, although he was lost in time and place, it was a very precious time with him, joining him in his life long passion of caring for the souls of his family. On Wednesday i attended a Chaplain's mini-retreat. It was booked as our monthly Joint Staff Meeting for all the Legacy chaplains from our 6 hospitals. Instead, the host chaplain had a treat for us, providing a time of reflection and sharing. They key question for reflection, after some warm up thoughts, related to how we were in that moment. I share that Dad seemed to be engaging in life review, a process often seen in hospice patients. One of the chaplains, a good friend, said she would email me a tale that resonated with her; she thought it might represent what Dad has been experiencing. I received this from her today. The Man in the Maze: A Native American Tale The man in the maze depicts a figure entering or exiting a maze (labyrinth). This represents a person's journey through life. The maze has many twist and turns, meant to represent the choices mad in life. The center is round and dark. This place represents a space in which the Great Creator leads each person, prior to his/her death. In this place, the person can work on reconciliation and resolution issues with others and/or with the Great Creator. AT the end of the person's time in that dark space, peace will reign in his/her life and he/she will then be blessed and helped by the Great Creator to pass into the next world. What are your thought about the Native American Tale in respect to Dad? To me, it reflects the introspection Dad is engaging in at this time. I don't think his life review process is to be worried over, but certainly tended to. Blessings to you all. Merv

3-3-10 Is the Bible really true?

I stopped by to see dad again today [Tuesday] and almost the first words out of his mouth were that he was having a terrible day. When asked why he said, "I'm just not sure the Bible is really true. Can we trust what it says? I never thought i'd have such doubts." I talked a bit and began to sing the old hymn "I Know Whom I Have Believed". Of course he joined right in. We couldn't remember a lot of the words and couldn't find his hymnal so stumbled around a lot but he sang it with great gusto. Then i opened his Thompson Chain Bible and read a number of scriptures about assurance. He was greatly encouraged by it all. It was then time to eat so he got out of bed and started for the dinning room. I stopped him, helped him get his pants on, etc. When i got him set down at his place, he said, You're so precious; you're my son, aren't you? It was an interesting and precious time. The hospice people were in on Monday and today the chaplain called to see if he should visit Dad. We had talked at a Chaplains's Association meeting a couple of weeks ago, so it was nice to have a knowledge of him. I assured him that Dad would love to have him come on a regular basis, but not on Wed. as Fletch comes nearly every Wed. By for now. Merv

2/20/10 Hospice Evaluation

Hi all.

This week I met with Dr. Dumler who agreed to write for a Hospice evaluation for Dad. She did not think he was ready yet but this would be good to establish a baseline. Jan and I met with Dad and the hospice nurse and social worker. It was very obvious to them that Dad is ready for hospice. They have a number of medication changes that Luba suggested and they agreed would probably be good; they will recommend these to the doctor. As a hospice pt, a nurse, chaplain, caregiver and social worker will be in the home, usually at least two visits a week from the nurse at first to get him established.

 

We also changed his POLST (Physician Order for Life Sustaining Treatments) Form to limit the chance for him to be placed on life support, etc if he should have a down-turn. I have been thinking for some time that this needed to be updated to honor his long-time declarations that he was very opposed to those for himself.

 

Additionally, Dad complained about poor treatment there. We spent a long time teasing out what that meant. It seems that when he does unsafe things and they have to grab him to keep him from falling (peeing on the floor and then slipping on the wet floor, etc.). In his confused state he cannot distinguish between what they are doing per his initiation and what he perceives as harsh treatment. We did not blow this off but sought to discern what really is happening. We all will be very alert to any further perceptions he reveals.

 

Got to go for now. I and I'm sure Jan would be happy to explain this more fully if you like.

 

Got to go now.

 Merv

Previous Comments 2-17-10

Hi sibs.

Thought I'd do a little rambling about Dad. The last few weeks have been interesting. I have had less potty issues with Dad of late while out with him and he doesn't seem to even bring up a need to go potty. I think he is less and less aware of that as he has so little control that it is no longer an issue. That sure is easier when out and about at restaurants, etc. where I was having to help him and then he would have accidents anyway, made worse by having his pants down. Jani can attest to that as well! So as long as his caregivers are changing him regularly, which is what I believe is happening, it is less stress, frustration and confusion for him--and me.

Confusion is his new reality. He is often aware that he has forgot something (like the next thought he was going to express), but I'm not sure if he is aware of his confusion. Again, way-finding is one big issues. He is just no longer aware of his surroundings. If we stop the car, he often can't find the seat belt to release it--he reaches for it, and not finding it, begins fiddling with other things he sees and feels. If we are standing somewhere and need to move, he doesn't comprehend where he should go and will not automatically go along with me but will head off in a different direction. When doing his swallow study follow up visit yesterday, he could not follow the therapists instructions to drink this, take a bit of that, etc. He would just take what looked good as if he were having a nice meal, in fact, his comments and actions clearly indicated that was all he was aware of doing. Other times, he thought he was with a doctor and began asking questions about other medical issues not related to the swallowing process.

At each of the last 3 or 4 times I've been with him, he has not known who I was at least part of the time. Yesterday, when I met him at the therapy clinic (Medicaid transports him and I meet him at his appt.) he said the same thing as last time, "I didn't know you would be meeting me." Both times I assumed he knew who I was but his comments along the way soon revealed he didn't know. When we got back from being out together for over 5 hours, he made some remark that prompted me to ask if he knew who I was. "You're Bill," was his response. Don't know who that referred to. He has two full closet door mirrors in his room and we were sort of facing them and he began to look at them. He said he liked this room but it was strange that there were two beds and desks. Then he looked puzzled at our images. I asked if he knew how they were. He said, "That's you, but I don't know that other guy behind you." When I said it was him, he looked as if that couldn't be. That's when I asked who I was and he said Bill.

I mentioned to Tanya, the caregiver, that I was thinking of covering the mirrors as it was confusing to him, etc. She said that she hoped we wouldn't as he often will sit in his chair in his room and talk into the mirror for a half hour or longer, having a conversation with the guy in the mirror. That was interesting!!!

Sometimes Dad seems to have his bearings about him and asks about the Zac and Kendra's baby or others, but before long, he reveals that his perception of things is different than mine. smile. He certainly does not know Linda when we are with her but other times mentions that I certainly have a great wife--a real keeper. He has been saying that for years. But now he doesn't recognize her as Linda.

Falling: Dad fell again yesterday, this time in his room and hit the back of his head. That makes at least 5 in the last month or so. He told me it happened outside, but was not consistent in his story. Later, when I saw Tanya, she said it was in his room.

Last, and of particular interest is that Dad has been engaging in Life Review the last few weeks as well. Three Sunday's in a row, he has been concerned about his past. So he is remembering clearly and reflecting on them. But he does not seem to appreciate that his sins are forgiven. I spoke of forgiveness and grace, shared various scriptures etc. and Dad said, "Well I wish we could know that was so." I assured him that the Bible was very clear in revealing that God has forgiven him and that he is safe in the arms of Jesus. He acknowledged with doubt in his voice and countenance, "Hum." This last week he perseverated about lying. Lying was bad and we couldn't trust people to tell us the truth. How can we know if they're telling us the truth? I then asked if he had a history of lying when he was younger. O yes, I was a great liar. It's terrible how bad I lied to my parents, friends, teachers. -- I then talked about that being in his past but that he had confessed all that and God had cast it into the Sea of Forgetfulness, never to be remembered against him again. He didn't seem convinced.

Since Life Review often occurs in the final months of life, all this is quite interesting and curious. Hospice if full of such stories during peoples' final months. It has got me wondering if we ought to be in dialogue with his doctor about Hospice. Many people in the hospital have wondered why we do not have him on their services yet. People now live on hospice sometimes for a year or two. The benefit is that nurses would be coming to Hoodview to assess his needs instead of relying solely on CNAs and family to call the doctor when they see red flags.

Well, there you go. Hope all this is not too distressing. Dad is fading and although I admit it is very exhausting to experience all this with him, I am thankful I have this time to be with him and will always cherish this time. But I must acknowledge that I would be very surprised if he is with us a year from now.

Love you all.

Merv