As a part time caregiver for my father prior to his death and caregiver to my sister in the years prior to her passing, I've taken note of a number of processes that seem to be the norm for someone who is preparing to pass away.
Sometimes that process can take years.
About seven years ago, one of my sister's close friends, an elderly woman she had befriended after moving here, was in her final years of her life. This friend had no one else in her life but my sister. Her husband had died many years before and never had children. The woman was, quite simply, old and frail and confined to her bed. She had several caregivers who came in to look after her, provide meals and the like. My sister used to visit her fairly regularly as the two of them truly enjoyed their banter.
Suddenly one day, the friend called my sister and told her never to visit her again. The woman pushed Pris away like a piece of old garbage and my sister could not understand the motive behind it all. Despite requests from the caregiver to still come and visit, my sister heeded her friend's request and never saw or spoke to her again.
My sister did something almost the same. She began pushing people away, all that is, except me.
In 2011, my sister suddenly decided she didn't want to celebrate holidays anymore. No more Thanksgiving, Christmas, Easter or July 4th holidays for her. She stopped decorating at Christmas, though she did continue sending cards to friends and still gave gifts only to my family and I, along with her annual donations to local charities.
She stopped joining us for Christmas or Thanksgiving dinner, even to the point of refusing a plate of food. She wanted to be by herself, eat what she wanted and not participate in any of the activities.
It broke my heart.
I'm the person that doesn't want anyone to be alone for the holidays, to not have gifts to open, people to be around on such family-oriented holidays. I hate the thought of someone missing the great food on these holidays and all the traditions that mean so much. For years we had kept up our mother's traditions and for my sister to not want them anymore puzzled me to no end.
I still prepared a Christmas stocking for her, and never cut back on my gift-giving. Every year I continued making my mother's Scrabble mix and brought Pris a can. On Christmas morning, since she refused to visit our house, all of us would bundle up and carry bags of gifts over to her and watch her open them.
She may have eschewed Christmas, but she got a huge grin on her face when she saw those bags of gifts come through the door.
Still, the pushing away of family and friends, holidays and traditions seemed to be part of her process.
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| My sister, left, and I on a rare day out at the Jesse and Frank James farmhouse in Kearney, MO. My sister enjoyed the fact that my writing had brought me into the James family world, so I took her out to the farm for a tour. This photo was taken just four months before her death. |
My sister was fiercely independent, especially where she had never married. She learned to do for herself and was proficient as a "do-it-yourselfer." She loved to garden and was always outside in the summer before 7 a.m. to pull weeds, cut back the flowers that had bloomed and keep her yard in good shape. She washed her windows on the same date each year and had lists of household "to-dos" that she followed religiously.
She managed to live alone until early 2013, though the six months prior to that date she really should not have been alone.
She kept a lot from me.
By pushing everyone away, none of us realized she was significantly dropping weight. Despite strict dietary standards, her triglyceride readings never improved and her diabetes was still out of control. Her diet was bland and boring so she didn't eat much.
A few years ago she began seeing a ghost in the house. It was a woman dressed in 1970s clothing – pants and a vest – who never spoke to her, but just ... hung around.
Pris also had a lot of dreams. She often dreamt about the same things or variation of the same subject. Prophetically, she was coming to terms with the end of her life, issues she had – anger and fear – her soul seemed to be preparing for the end.
It became clear as I watched my sister go through these stages, listened to her dreams, prayed with her, that when someone dies through the normal process – that is – has a disease or simply dies of old age (in other words, the person does not die accidentally or quickly), then their soul prepares for death.
I will never know everything that went through her mind in those last years and days, but I do know she was struggling.
I lived right next door to her, but had a job, friends, activities, and my own family – a husband, son, daughter-in-law, grandson and two cats. I was rarely alone or lonely.
My sister, who was used to being on her own, had to have been lonely and would not admit it nor let anyone "in."
Yet, God gave us free will, which allows us to make choices in our lives.
Some of us choose to eat all the wrong foods, thus resulting in a related disease late in life. Some of us choose to smoke cigarettes, cigars or chew tobacco, resulting in an illness or disease at some point. Some of us drink, do drugs or live in a perpetual state of stress, all of which, together or apart, causes disease and dysfunction.
The choices we make in life have consequences. Whether the consequences hit us late in life, or early in life, depends on the choices we make.
My sister had to cope with the choices she made, as well as the ones made for her. In an earlier column, I mentioned that my parents pushed her into her career field and she never forgave them. She chose to smoke cigarettes for 35 years and that same career field caused her enough stress as to contribute to her massive stroke 20 years ago. Yet, the same career field proved she was a savvy businesswoman who did an outstanding job handling her own finances.
As 2012 progressed, my sister really slowed down. With her weight at a dangerously low level, she became more unbalanced and unable to walk. Nevertheless, we both made light of it and she learned to adjust. She would walk out to her car and due to equilibrium issues, she would take three steps to the left and three to the right and then maybe walk a straight line. She was terrified of falling and so found ways to cope. Her little left/right dance was almost lyrical as she would move about the house and property.
She spent years and years planning her death and getting her affairs in order. Not only did she tackle all that beforehand, she also began going through her household and re-reading every book she owned.
She would read a book again and either give it to me, donate it or get rid of it. Her reasoning, as she told me one day, was so I wouldn't have to do it.
She managed to dust and vacuum her house almost up until she went into the hospital for the last time and did her best to keep her home and herself clean.
No matter how vigilant she was, however, she couldn't stop the congestive heart failure from finally putting its foot down and saying "enough is enough!"
In the last few months of 2012, my sister began falling out of bed at night. She attributed it to low blood sugar attacks, because her sugar would be low, but she also began injuring herself whilst falling out of bed ... and then not telling me for several days.
She also decided not to tell me about doctor's appointments, explaining that "they" never gave her the blood work anymore and she would not allow me to request them. I found a stack of reports neatly in a folder after she died – they told the whole story.
After years of holding the congestive heart failure at bay, in 2012 my sister's fluid levels began to rise and rise.
The lack of oxygen to the brain, the sugar readings out of control, the fluid collecting all over the body so as not to be acutely visible in one spot, all contributed to her health beginning to fail.
On Dec. 11, her 71st birthday, we went out to breakfast as was our custom. It was her favorite meal to eat out. It was always just us girls. She never got anything special – keeping to her diet requirements, she would order tea, scrambled eggs and dry toast. Still, she LOVED getting out.
She had another doctor's appointment the next day and failed to tell me, once again, the results. It turned out the blood work showed her fluid levels, already out of control at thousands of points over what is normal, were now in the tens of thousands.
I am convince Pris knew she was at the end. My job was so stressful during that year that she purposely kept her own health from me so as to protect me, especially during the holiday season. She knew I had a boss who would not be supportive if I had to take time off.
Christmas came and went and a few days before Jan. 1, I told my husband, after a lengthy visit with my sister, that I knew she'd just had her last Christmas.
He claimed I said that every year and that my tenacious sister had already well outlived the doctor's predictions from her first diagnosis. But I knew I was right, it was just a matter of when.
My sister's greatest battle lay just ahead and it would prove to be the most difficult, most painful and most heart-rendering of them all.
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