June's Last Day and Final Hours - October 2008
- Published on Thursday, 27 November 2008 03:02
- Written by Stanton O. Berg
I have always maintained a daily journal or log on the days and times that I spent with June while she was in a nursing home. Below is an identical copy of the journal or log entry that I had made on the last day I spent with June prior to her passing away early the next morning. I have shortened the names of the staff members (first names only) in order to provide some small degree of personal privacy.
Some explanatory additional notes have been added for clarity in order to tell the story - with a last note on Christmas 2008.
Wednesday October 22nd, 2008-Her Last Day
I arrived at 8:50 AM that morning and departed early evening at 6:20 PM. I left briefly in mid morning in order to permit me to send an email to the children about June’s condition. June had Aspiration Pneumonia, a common complication in late stage Alzheimer's. Caused by food or fluid getting into the lungs.
The day Nurse was Carolyn with Nursing Assistants Zippy and Beth. The evening Nurse was Dianne with Nursing Assistants Susan and Edward.
When I arrived June was sitting in her Geri chair in her room and was receiving oxygen. As usual June sat with her eyes closed and was non responsive when I talked with her and took her hand and kissed her. I sat with June in her room until Brunch time. I just held June's hand while we listened to music on her small CD player. I would occasionally assure June that I loved her and would always take care of her.
June's breathing concerned me. She would breathe rather deeply and rapidly for 8-10 cycles and then would breath slower and quieter for 8-10 cycles and then start the same breathing all over again. This she did for most of the day except during nap time when her breathing seemed more normal.
June had been given a Morphine drug called Roxanol (5mgs) just before nap time and it seemed to have an effect. The drug was to be administered every 4 hours. The effect seemed to wear off quickly. I talked with Nurse Dianne about this as well as Bev the Nurse Practitioner who came in later in the day. The decision was to increase the dosage and frequency and watch June for the resulting effects.
June will be given an EKG and if the results are normal, she will be given digitalis to slow her heart rate down. Her heart rate or pulse is very high at about 118 to 125.
Our son David came in late morning and stayed with us for a couple of hours. Julie our daughter was given some time off of her work so that she could spent time with June, David and I.
June ate nothing and drank nothing at the noon Brunch. Pam (a lady from Therapy who seems to have a special way with June) did her best to feed June a container of "Magic" (fortified nutrition) but June refused to accept it. Pam usually suceeds when no one else does. Pam has even come in on her days off (without pay) just in order to feed June. Pam tells how June resembles her own mother in appearance.
I thought I had nothing to lose by trying to give June some frozen Sherbet at the normal snack time. (1:30 PM) Much to my surprise, I was able to feed June a small container of Sherbet. Of course as normal, I would have to slide the frozen sherbet off of the spoon with the edge of my finger and between her lips and into her mouth. She would not accept any water. Sherbet does however have considerable water content. The cold and sweet Lemon flavored Sherbet apparently felt good in her mouth and it promoted June to chew and swallow it.
I tried to get a reading on June’s longevity from Nurse Carolyn, Nurse Dianne and Bev the NP. No one of course wanted to make any commitments. Carolyn seemed the most pessimistic. Dianne did not want to say much about June's chances. Bev said that in the past, whenever June had Aspiration Pneumonia she always bounced back and in three days would be back to normal and back to eating well. This time she said it is different. June was not bouncing back. The difference was readily apparent to me also. We had gone 6 days with no real improvement other than temporary periods of taking some food and drink.
After June's normal afternoon nap time, the staff got June up (into her Geri chair) for supper to see if June would eat or drink anything. June did not accept any of her normal food. She did however accept the contents of a container of frozen "Magic". Edward who is one of the more successful NA's with feeding June was persistent until he was able to get June to accept a small glass of apple juice and a small glass of water. He said she took one spoon of applesauce. I thanked Edward for his fine efforts. Edward had fed June her first supper when June initially arrived at the Benedictine over two and one half years ago. I recall being concerned at the time as June had never previously experienced a male NA. I need not have been concerned as June smiled and chuckled an obvious acceptance when she was first introduced to Edward. Every meal time involves periods of coughing and choking with both food and fluids. Coughing causes June to be fearful. Even during nap times she may have to cough up phlegm and this is preceded by a short crying sound as she feels the cough coming on. Because of the Alzheimer's she appears to not understand what is happening and becomes afraid.
June’s breathing again sounded uncomfortable this evening. Her rate of respiration was about 28 where the desirable is 16-20.
Jerry (friend) stopped by earlier and visited with June, Julie and I. Jerry was kind enough to volunteer to sit with June at night if ever needed.
I tried to find out from Bev, what the risk was if I were to go to the house to do this report, eat supper and to sleep for the night. She rightly said, she could make no guarantees but that she thought June would be okay for the night. I left my phone number with Nurse Dianne and plan to call as soon as I can get this report out. (Call made later at around 9:30 PM and no change reported.) Dianne is a nurse who routinely spends an extra 20-30 minutes with June every night before going off duty. She does this in order to be sure that June has a last glass of water or other fluid. Dianne the evening nurse knows how concerned I am about June's fluid intake and the possibility of her becoming thirsty at night.
It was a very lonesome ride back to the house. June lost her ability to walk in early 2006. Shortly thereafter, June no longer knew me. Although June has not known me for over two years, nor talked to me for the same time, I have become accustomed to June being an intimate part of my daily life. I have my daily routine of sitting with June during the day, holding her hand, (See photo below) kissing her occasionly, and going to the little chapel with June for prayers and quiet times. I always marveled at the warmth and the softness of June's hands as I held them. Often I would feel June tighten her grip on my hand. I would think and talk about the things we used to do together. I would tell June numerous times how much I loved her and that I would always love her and care for her. Now that this all seems about to go away, it is difficult to cope with it..
Note: Alzheimer’s is not a disease that in the late stages, it permits one to communicate and pass on messages of love and caring. Alzheimer’s is a disease of apparent mental isolation with no communications and little or no responses of any kind. For most of the last two years June was largely non responsive and sat with her eyes closed for most of the day. Although I would hold June’s hand and continually assured her of my love, I do not know if she heard any of the things that I said to her…I hope that holding her hand was some reassurance. Our youngest daughter Julie once told me that at times she wished her Mom June had Cancer instead of Alzheimer’s because then at least she would be able to communicate with her and tell her how much she loved and admired her. Alzheimer's also takes away the ability of the victim to make or leave a last message or words for the loved ones left behind.
Thursday Morning, October 23rd, 2008 - June's Passing
The next morning (Thursday) at a little after 7 AM, I received a call from Nurse Kim. I was in the process of showering and shaving preparatory to going to the nursing home for the day when the call came in. Once I heard who was calling I knew immediately what the message would be. June had passed away at about 7 AM. June and our life together had ended. I hung up the phone. For a few minutes I stood not knowing what to do. This was not when it was supposed to happen. I was supposed to be there. I remember saying aloud, "God tell me what to do!" Finally I was able to gather my wits about me suficient to make a couple of quick phone calls to some of the children with a request to call the others. I then drove directly to the nursing home just a mile or four minutes away.
After arriving, I hugged June and kissed her. I then simply sat with June amid tears, holding her arm and hand until the Miller Funeral Home came to take June away. I asked June to forgive me for not being with her when she left this world. I wanted so much to be with June in the last hour when her life ended here on earth. I had made a grave error in judgment. A failure that will linger in the back of my mind forever. I could not help thinking of the saying - "Should have, Could have, Would have, it is too late now." The saying now applied to me.
As June's children and grandchildren arrived, the sounds of their sadness filled the room.
I remember being concerned about June's appearance. I wanted June to look as favorable as possible to her children and grandchildren. After June passed away her mouth was left partially open. This condition which was certainly not normal, greatly concerned me. I wanted June to look like the mother and grandmother that the children and granchildren knew, loved and remembered. I tried to unobtrusively use one hand to push on June's chin to close her mouth. This effect was temporary and only lasted as long as the pressure of my hand remained. Later when the director of nursing, Kris appeared at June's side, I quietly mentioned my concern to her. Kris's attempts were also futile. I may have over reacted and thus placed more importance on this appearance concern than it should have received. I decided to abandon any further corrective attempts. June otherwise appeared peaceful, serene and displayed much of her normal beauty.
The Benedictine staff held a caring and sensitive bedside service (Led by Diane ) before June was taken away. (The silent men in black were already waiting patiently in the background.) In addition to the on duty staff, the service also included our children and grandchildren that were able to come to the nursing home on short notice. (Julie with her friend Geno, Steven, Gretchen, David, Daniel, Erik and Emily. Pastor David Glesne, our Redeemer Lutheran Senior Pastor arrived just after June had been taken away.)
I was told that Meicy was with June in her final moments. Meicy, a kindly caring NA who looks like the mother that she is, had just come on duty. Meicy is a patient little lady with a big heart. It is comforting to know that Meicy was with June as she departed on her final journey. I have often thought that Meicy could have been a Norman Rockwell drawing on the cover of the old "Saturday Evening Post."
June's long weary journey into the darkness of Alzheimer's has resulted in my parallel journey of almost 11 years with gradually increased grieving as I watched June slowly slip away. Suddenly the one long journey of grief ended and a new journey of unknown dimensions and length has begun....I miss June so much...
This last chapter in June's life is dedicated to Pam, Meicy, Edward, and Dianne, who are all committed, patient and caring persons - my dream team for June's care were all in place during the last hours of June's life - however it was not to be.
I did not realize it, the bell had already tolled for June and God had already prepared a place for her, a place where Alzheimer's does not exist.
John 14:2 (KJV): "in my father's house are many mansions....
I go to prepare a place for you..."
Christmas season 2008
Christmas was June's favorite of all seasons. June would always say how she wished Christmas would come twice a year. This will be June's greatest Christmas in many years and probably her greatest Christmas ever - a Christmas in Heaven! Imagine the scope and magnitude of such a Christmas. - Merry Christmas June! - I miss you sweetheart and love you very much!
(June and Stan's hands - Photo by Jim Gehrz October 2007.)
Postscript: On the day of June’s passing, I received a touching note from Mona Glesne. Mona is the wife of Dave Glesne, the Redeemer Lutheran Church’s Senior Pastor.
Mona appears to have possessed a special intuition, sense or perception of June’s imminent passing during the early morning hours of the evening before.
This is Mona’s note as received on 23 October 2008:
Last night after baking most of the afternoon and late into the evening, I couldn't sleep so I was praying. I prayed especially for you and June. It was about 1:30 am and I ended up in tears as I felt your upcoming loss and June's gain in heaven. I have been sensitive this month because we are approaching the one year anniversary of Dave's mom's death. I prayed that God would take her soon and that he would already be filling you with His peace and comfort as you begin your life with June in heaven and you still here. I wasn't surprised to hear of her passing from Dave late this morning. I will continue to pray for you as you walk these lonely days. May you be comforted by the wonderful memories you have of June.
Final Notes: June's funeral notice as published in the Minneapolis Star-Tribune can be found on this website on the drop down menu item "June K. (Rolstad) Berg - In Memoriam" under the label "In Memoriam" on the top blue navigation strip. Or simply click on the below link:
For the story of June’s favorite home at 6025 Gardena Lane and the poem I wrote about this home during a day of deep sadness, click on the below link: (This was June’s home for almost 40 years. It was constructed shortly after the previous home was severely damaged in a tornado. 6025 Gardena Lane was the first home the June participated in the selection and purchase of a lot on a small hill, helped with the design of the home and watched it being constructed. 6025 Gardena Lane had a special place in her heart.)