I met Dorinda in the driveway when she arrived on Monday, the 7th of April, and she told me she thought she had a way to finesse the move from Home Health to Hospice. I knew it had to be done.
Dorinda was one of those special angels of nursing who deal with people at the worst times in their lives. During these past weeks, I learned it takes someone with empathic understanding, compassion, nursing skills, and a caring attitude that is evident to both the patient and whoever that patient’s caregiver is for them to do their job well, and she was doing it well. They are, after all, dealing with people who are dying,
Dorinda had earned Joanie’s confidence in the weeks she had been taking care of her, and Joanie had come to trust her. Dorinda told me she was going to approach it from the angle that making the move from Home Health to Hospice was really to help me take care of her, since with Hospice they could do things they couldn’t with Home Health. I told her, to give it a go, and I just sat at the table in the dining area while Dorinda sat and talked with Joanie.
She told Joanie the reasoning behind making the transition, and assured her that she would remain as her nurse. Dorinda told her they would also be able to get some different pain medicine, in the form of liquid morphine, since she was having difficulty swallowing the hydromorphone pills we had been using up to this point. She also told her they could switch back to Home Health Care, whenever she wanted.
Dorinda motioned for me to come over and join the conversation. As I sat down, I took Joanie’s hand, and assured her we would do whatever she wanted to do, but I also said that any additional help in taking care of her would be welcome. I also reassured her that Dorinda would be here for her when she needed her to be.
Joanie’s voice was weak, and her eyes were a dull blue, not the brilliant, sparkling blue I was familiar with. She would nod her head when Dorinda or I would say something, then she began to speak in a quiet voice and said, “I’m scared of dying.”
There were no tears, just a sad look on her face that stunned me into silence. As we sat there, all I could do was hold her hand and muster a weak, “I know.” The words that came out of her came from a quiet voice that told me she knew she was dying.
I couldn’t say a word, it hurt so much. Dorinda, squeezed her hand, and in her gentle, confident voice, said she understood, and then she said something else that I don’t remember, but it seemed to resonate with Joanie, and she nodded her head.
Before Dorinda left, she adjusted Joanie’s bedding, and brushed her hair. Joanie always liked that. I walked her out to her car, and outside we stopped to talk, and she told me she didn’t think Joanie was going to last much longer. I told her I knew that, and then I told her what I noticed this morning when I was fiddling with her covers and noticed the pale, blue spots that had begun appearing on her feet and lower legs. I knew it was a sign of something, but wasn’t exactly sure. Dorinda told me it was mottling, and it usually appeared when the body was beginning to shut down. I asked her how much time were we talking about, she just told me it could be hours, a day or two, but not much more. Then she left, telling me someone would be by early afternoon with the necessary paperwork to make the transition to Hospice, and then they get the morphine over.
I walked back into the house. Joanie was asleep, so I went out back for a smoke to digest what had just transpired. I realized that I had decisions to make, and one or two had to be made sooner than later.
As I paced around the back yard that April morning, trying to put things in order in my mind, I began to feel as if I was betraying her by even thinking the thoughts that were rattling around in my brain. I had to arrange for a funeral home, call her pastor, make arrangements for a funeral, ask some people if they would be pall bearers at her funeral, whenever that might be. It seemed strange that I would have all of this running around in my brain, when she was still alive, and laying on a bed in our house, but I knew also that I had to do all of that.
Joanie slept most of the remainder of that morning, until around noon when she woke up and needed some water and some pain medicine. We had solved the problem of giving her water when Mary Pat Woodmansee brought one of those syringes people use to give children doses of medicine. It worked well for giving Joanie water since she couldn’t suck anything out of a straw. She managed to get the hydromorphone down, and along with the Atavan she was beginning to get sleepy again.
Before she drifted off, she motioned me close, and told me she wanted to see Pastor Sathre. This was the first time she had even mentioned having him come by. I had never asked her if she wanted to see him, for in my mind to do so before she asked, would be telling her I thought she was dying. I told her I would give him a call. I didn’t tell her that he had called asking about her a week ago. She didn’t need to know that, and wouldn’t have remembered if I did tell her.
Early that afternoon, I called Eastgate Funeral Home and set an appointment for the next afternoon, and called Pastor Sathre and asked him to come by around 1:00 the next afternoon. He said he would.
The Hospice nurse came by around 2:00 with the paperwork, and it was signed and the deal was done. She gave me the instructions on what to do in the event Joanie stopped breathing, who to call, and what to do with the morphine, which was nothing since they would handle that when the time came. It all sounded so clinical, and I remember feeling as if I was watching a movie, and wasn’t really a part of the scene at all.
Mikey Hoeven came by in the afternoon and spent some time sitting with Joanie, even though Joanie was in and out while she was here. Mikey asked me if there was anything she could do, and I did ask her if she could come by tomorrow afternoon and sit with Joanie while I met with Eastgate around 2:00. She said she would.
Orell and Cathy Schimitz stopped by early evening and spent a little while, and then it was quiet the rest of the night.
That night, as I sat in one of the chairs next to Joanie’s bed, Bailey jumped up on my lap an settled down for a scratch and pet session, and I wondered what they thought of what was going on. She and Brandy knew things were not ordinary, but all they could do was sit and wonder. Sometime, that was all that I could do too.