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The Last 24

Updated on March 1, 2015
My grandmother, Alice
My grandmother, Alice

The Decision

To most others it was a typical day in October, nothing remarkable about the weather, nothing tremendous going on in the news. But for my family, it was a day that changed our lives. It was the day that my grandmother decided she could no longer fight the leukemia that had wreaked havoc on her body and quality of life.

We saw it coming. She was deteriorating quickly. She had only been diagnosed with leukemia just over six months ago but the changes in her health had decreased steadily. It was one thing after another, one close call after another. A true roller coaster ride in life and death. But can anyone truly be ready to face the day their loved one has decided enough is enough?

Of course we understood her decision, and in many ways we had encouraged her. She was told by her children that she didn't have to fight anymore. She was reminded that this was her life and health and that it was up to her to decide when she could fight no more. We understood how tired she was; how uncomfortable she was. We watched her fight for air and witnessed the inability to bring her oxygen levels up even with the maximum amount of medical intervention available to her.

So, when the day came that she finally asked her doctor's to stop her care, and hospice was invited in, it was a day that brought us peace that she was of her own will to make the decision yet sadness at the realization that we would soon lose the woman we all loved dearly.

It was after days of being air hungry that she finally expressed her desire to us and her doctor to stop her medical interventions. She wanted to be made comfortable, but she wanted to be left to allow her body to follow it's natural course based on it's current state and abilities. This resulted in stopping all the medications that were being administered to keep her going, and replacing them with a morphine drip for symptom management and anti-anxiety meds to help her nerves. Oxygen continued to be administered to assist with her breathing. She moved from meds meant to extend her life, to meds to make her ending as comfortable as possible.

When she made that decision, we were there...her children and me. My grandmother and I were very close and I grew up almost as a surrogate daughter to her-though my parents have always been my primary caregivers and loving parents. I was just lucky enough to have been raised with my grandmother as an active role in my upbringing. Soon after she made the decision, the rest of the family arrived; the rest of her grandchildren,her sister, sister-in-law, and extended family members that she was close with.

She was coherent and aware throughout the day of her decision, even after the morphine was administered. She was able to say her good-byes, though she had already started that process weeks prior. She truly wasn't afraid to die. She was braver than I was.

Her Final Night

I won't go into a lot of the gory details about the things that went less than right as it related to her medical care in the hours that followed her decision. After all, the time her and I shared are more important for me to remember. More important for me to share. What I will say though is it didn't go as smoothly as I had thought it would.

After she made her decision to start the morphine drip, it became apparent in the hours that followed that she wasn't going to pass in the middle of the night and we would have another day with her. Because of this and some other extenuating circumstances surrounding some of their own medical needs, my family members chose to go home and I stayed with my grandmother. It was important to all of us that she did not spend the night alone. And I can not say it enough: I am so glad I stayed that night; her final night.

While she was not afraid to die, my grandmother did question her decision to stop fighting. She worried that starting the morphine drip, which she knew was a step in her life ending, was in some way considered suicide. As a Catholic, she wondered if that meant she would go to Hell. She asked me if she should stop the morphine to save her eternal life. She knew she was sick and would not get better, but she began to think more about what came next. She was scared. She wanted me to tell her what to do.

I remember taking a deep breath and thinking hard. If I told her she was doing the right thing, I knew I would spend the rest of my life feeling guilty that I coaxed her into dying...I knew that's how I would remember it. If I told her to stop the morphine, I knew she would begin suffering again and the pain and discomfort she had been feeling prior to the morphine would return and she'd feel that torture again and I didn't want to be responsible for that. So, I simply stated the facts. She was not killing herself; she was letting nature take it's course. If her body was strong enough to keep her alive, she would live. If her body was too weak to fight the illness, she would pass; not because she killed herself, but because her illness was stronger than her body. She heard that and she thought about it. She decided to proceed as planned.

We held hands that night. We spoke about simple things. We had already said our good-byes prior to this evening. And so the night turned into a time where we just stayed by each other's sides. She lay in her hospital bed, and I sat propped up in a chair meant to be comfortable. She was in and out of sleep. When she woke, she looked to me to see I was still there. She offered me an opportunity to leave, worried about me and my children. But, she knew I needed to be there with her-as much for me as for her.

I watched her sleep. I listened to her talk through the process of facing her death. I held her hand. I kissed her cheek and I hugged her tight. I loved her and honored the special grandmother/granddaughter bond we had with one another. It was a night like no other, and yet, a night like many others I had shared with her as a child, where she comforted me when I was awake scared from nightmares when I stayed with her for sleepovers.

Saying Goodbye

The next day, my grandmother passed. We were all there. She left our world quietly and peacefully. We watched her take her final breaths as we stood by her bedside and said said our goodbyes.. She didn't say a word, didn't acknowledge she was leaving. But we knew. We saw the change in her physical being. She had a slight moment of discomfort before her body relaxed and her breathing changed. We witnessed her transition in front of our eyes and it hurt worse than any other experience I have ever had in my life. I went into denial as I believed I still could see her chest rise and fall with her breaths. I couldn't immediately accept that I watched the life slip away from my grandmother. That after all we had been through together, she left without anything monumental happening. It wasn't until my mom repeated to me several times that my grandmother was no longer breathing, that I finally accepted it. And as much as I knew it was coming, it weakened me to the core. I was forced to say goodbye, to see her lie there, motionless, lifeless. As much as I thought I was ready, I suddenly felt ill-prepared. But, there it was, she was gone. And she was peaceful, pain-free. As that realization sunk into my heart, saying goodbye became a little easier.

Her Gift

Had anyone ever told me that I would ever term watching someone I love pass away, a beautiful transition, I would have thought that person was totally insane. I never considered death beautiful. I had still been mourning the loss of my grandfather eleven years prior with great pain. Death to me was a painful parting.

My grandmother had one final lesson; a lesson that came from her passing. Death was not meant to be feared. It was one more transition in the journey of life. We all celebrate birth. Families come together to welcome that brand new baby into our lives. It's such a joyous occasion to be celebrated. Birthdays are celebrated, marriages and every other milestone that demonstrates we are alive and thriving are celebrated. Often times we look at death as an ending to this joy. But, my grandmother taught me in her passing, that death is not an ending, but another transition in the journey of life. Witnessing her peaceful passing from this place that I share with my other living loved ones, to a place that exists after death left me to realize there is nothing to be afraid of. If there was something frightening on the other side, would she have passed with peace? Would her body have relaxed and released all her discomfort? Would she have given in so easily after fighting so hard for so many months?

I believe whatever my grandmother saw from her side of the experience brought her comfort. She let go of her sick body and glided to the next existence that awaited her. An existence that welcomed her without hesitation.

I thank my grandmother for allowing me to be with her during her last 24 hours. Had I witnessed her struggle with the disease, her fights for breath, but never got to experience her last 24 hours, I believe I'd still be grieving her death through a broken heart.

I still miss my grandmother for so many more reasons than I could ever express, but I have peace in my heart and soul because of the gift she gave me. The gift to bare witness.

The Lesson

It seems impossible to know how we would choose to lose a loved one. I have found myself in these conversations in the past; losing a loved one suddenly spares us witnessing their decline. But losing someone suddenly may leave us feeling like there are unspoken words that may be spoken when you know death is coming. Honestly, if we had a choice, we would probably opt to never have to lose someone we love. But, that is not an option.

Our only option is to live and do what we must do to let those we love know what they mean to us. I was always told as a child that life moves fast, but I did not understand that until I became an adult. Life does move quicker than many of us would like it to. We live in a society and time where most families have two working parents, children are involved in various activities, the economy is tough on many of us and creates additional burdens of stress. And, because of this, life can pass us by without our noticing.

Find time to make moments to slow down. Tell the people you love you love them; remind them of the importance they have in your life. Make your time together meaningful. Cherish the laughter, brush over the difference and celebrate the love that lives in your hearts. We are all meant to cross each other's paths. We are not accidentally born into any particular family. It's a family we are meant to be a part of. While I recognize not all families are healthy, and distance is a must; for those who have the typically dysfunctional family, take time to understand what lessons you were meant to learn from one another and grow from them. Love with all your heart so that when the day comes and your loved one must transition from this life we live to whatever awaits them on the other side, you can take comfort that you lived and loved them authentically.

The Lesson: Do what must be done to live and love with a passion that does not leave you regretting unspoken or unexpressed love.


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    • Dana Hicks profile image

      Dana Hicks 3 years ago from New Jersey

      Denise I am so glad you found this helpful. I certainly see my grandmother's choice as a brave and honorable decision that was right only because it was what she felt was best. It was easier on us that she was able to make that decision for herself and that we did not have to make any difficult decisions for her. Even in the end, she protected us from hardship. Thank you for your kind words.

    • denise.w.anderson profile image

      Denise W Anderson 3 years ago from Bismarck, North Dakota

      Thank you for sharing this experience. I had often wondered how to deal with this type of situation, and whether the withdrawal of medical treatment could be considered a type of suicide. You have explained here beautifully that it is not. Rather, we are letting nature take its course, and allowing ourselves to be comfortable with the process.