Difficult times lately

For the last several years my family has watched my father-in-law's health gradually deteriorate. He is 91 years old now. Up until about the age of 85, he was a very active man, attending baseball games with his many friends at least twice a week; driving his car all over creation; endlessly tinkering with his old, beat-up car every afternoon.

But he entered dialysis treatment the year he turned 85, and although he still drove and was active, being hooked-up to a machine for several hours, three times a week took its toll. And plus: he was old.
What really took him down however, was a fall which broke his hip in 2003. He recovered successfully to the point where he could walk and drive his car, again. This was terrific news. But if we were concerned about him driving at that age before, the concerns had only increased. Anyone who has been in a similar situation probably can tell you, it is not an easy thing to convince a determined American male that he should no longer drive his car!

One year later, he broke his other hip. This was bad enough on its own, but the day after this (now second) hip replacement operation, while still in the hospital, he fell out of bed and they needed to re-do the operation. Three hip operations in one year. This of course extended his hospital stay and led directly to the development of bed sores on his heels, which only led to an even longer stay. He was there about two months, I think.

Amazingly, he bounced back even from this fiasco. At least he no longer made overtures that he wanted to drive again. So we got rid of his old car. I began driving him and my mother-in-law to his dialysis treatments. She always goes with him now, and while he is in the center receiving his treatment she can 'talk story' with all her friends whose husbands are dialysis patients, too. They all look forward to seeing each other and for all intents and purposes, they form their own impromptu support group. If it were not for these people sharing their similar concerns with each other I wonder if my mother-in-law might have had a mental or emotional break-down.

In the last year he has had a bout with pneumonia, broke his arm(!) once, and fell (or rather slid off his wheelchair) and as his wife struggle to get him back up, he bruised his knee. Each separate incident initiating another hospital visit, if not a hospital stay.

He can hardly walk, now. Since my in-laws live on the second floor of an apartment building and there is no elevator, he therefore needs assistance to go anywhere, which I end-up providing. Circumstances have led me to being rather well-experienced at manipulating a wheelchair up-and-down stairs, through doorways and across rough uneven pavements, curbs and sidewalks. (The world seems remarkably easy to manuver in until you are in a chair that has very small wheels in front!)

But, of all things, it is the pulling- up and the easing-down on those stairs that demands the most acute attention from the wheel-chair, uh, 'driver'. It is not as physically demanding as it surely appears to anyone watching, because he is not very heavy anymore. (And btw, I don't mind the exertion since I need the exercise!) So it is more of a delicate balancing act than a feat of strength. One break in my concentration, and we both could easily go tumbling down end-over-end (and take anyone 'downstream' with us). Not a pleasant thought. I can walk and chew gum at the same time (yes, I tried it to make sure), but if I try to talk while easing a wheelchair with a 100lb man in it down a flight of stairs, step-by step, I have had my share of 'scares'. I might be an extreme 'minimalist' but at the moment before a stair-encounter, I say a little prayer to the powers-that-be!

My mother-in-law now devotes her life to caring for him, and the task is considerable. She is not young herself, and trying to keep track of his numerous medications, her own, and the thrice weekly morning preparations for the trips to the dialysis treatments all take their toll on her. He wakes up at all hours of the night and wants to talk about nonsense. Last night it was about 'saltwater' and 'fixing the pipes' for the neighbors dowstairs... From 2am until 4am. Lack of sleep adds to her stress.

A couple of weeks ago, the option of hospice care was broached by his doctor. In his condition as a dialysis patient, he can be expected to last about a week without dialysis treatments, so the decision cannot be taken lightly. In his age and condition, it would probably be shorter than a week. So, to put it bluntly: hospice is a death sentence. But my mother-in-law is at her wit's end. She's tired. We have to be very concerned about her health. A nursing home is, for various reasons, out of the picture. And, my father-in-law is very, very tired. He has in the past expressed such sentiments as, "What a life! I am useless. Good for nothing!" etc. That was years ago.

The other day when I asked him about what he thought of hospice (after describing what it was and what would happen to him — and believe me: it is a difficult thing to look someone in the eye and basically tell them "This course of action that we are discussing will lead to you dying..."; it is probably one of the most difficult things in life to do), he actually took my hand and his wife's hand and said "I have been here long enough."

In the end, the decision is for his wife to make. So I don't worry over it. I watch and do what I can to help. I love these people very much. But I can't help but think to myself (I can't speak for him, but he probably would agree with the thought): I would not want to die while hooked-up to a blood-cleaning machine in some cold dialysis room... None of us really has the power to choose how or when or where we die, and perhaps none of that really matters nearly as much as how we conducted ourselves in our daily lives.

...This doesn't have much to do with historical biblical studies — or ancient espionage, for that matter, (something I still have not blogged about, come to think of it) — but I wanted to post something and this is what has been on my mind for quite some time...