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When our daughter was about five, she told me she really didn’t want to die, and in fact, didn’t think she actually would. Death was probably going to skip her. Sad to say, she kind of spoke for a lot of us.

Although it’s one of the few things we have no choice about, we Americans avoid talking about death, and are often unprepared when it happens to someone we love. I was. It’s the strangest thing. Going strictly by the numbers, being alive is an anomaly. People who’ve died far outnumber those of us living and breathing, and dying is one of the most normal things we’ll do. And yet, even when dry and technical details are taken care of, the wills, the caskets, etc.; the actual physical process is often a mystery.

My mother’s death in 2001 was sudden, and didn’t teach me much about death. The last time I saw her, she was unconscious, had a breathing tube and was tucked in, clean and quiet in a hospital. I wasn’t there when she breathed her last. I had no idea what happened, physically. Focused on the shock of losing her so quickly, I didn’t know what questions to ask, or what kind of help I might need if faced with the physical care of a dying person.

My dad survived the shock and grief of my mom’s death. He remarried and lived to the grand old age of 91. He and his wife had their own apartment and took care of almost everything themselves. He was tough and stoic. He waited, for instance until he was about 85 to try Ibuprofen (and found it very effective). His knees started to give him trouble when he was about 70, but declined joint replacement surgeries, choosing pain and his increasingly glacial gait over the risk of infection and the months he’d lose in recovery.

He seemed ready for the end of his life. His taxes were always filed on time, his will was up to date. He appointed an executor. He sold his car, and had a granddaughter teach him to use Uber and Lyft. He said, often, that when his time came, he’d simply stop eating and drinking, and didn’t want a lot of medical interference.

Still, when it got right down to it, he didn’t seem to understand what was happening. And because I wasn’t sure, nor was anyone else in our family, and because we didn’t want him to feel like we were hurrying him along, we didn’t take some of the simple steps that would have made his last days more comfortable. There were plenty of warning signs. Here were some of them:

  • A mild heart attack
  • A valve replacement
  • Falls that landed him in the emergency room
  • Trouble swallowing. He wasn’t too worried about that because ice cream went down fine.
  • His bed was uncomfortable, so he started sleeping in a lounge chair.
  • His feet and ankles became too swollen for shoes.
  • His doctor found a suspicious shadow on an x-ray — cancer? He wasn’t going to die tomorrow, he said.
  • Always a talker, in his last year he talked nonstop, sometimes even when he was asleep.
  • He started drifting off in the middle of a sentence. “Dad?” I’d say. He’d startle, focus, say he’d been day dreaming. And start talking again.

Despite all this, he carried on as if he’d live to 100, and our family did, too. This was, of course, fantastic. In fact, it’s how I want to go. Full speed ahead, and then boom, the end.

But because he wasn’t ready and we were used to letting him be in charge — his last few weeks were shadowed by anxiety, regret, uncertainty, pain and second guessing, much of which I think could have been avoided.

As he rounded his 91st year, a massage therapist he’d hired to help with aches and pains became alarmed. He was too weak she said. He should go to the hospital. We were surprised, because the day before he’d had a dozen roses delivered to his wife, and they’d celebrated Valentine’s Day with apple pie and ice cream. The massage therapist was right, though.

Off he went in an ambulance, with plans to return as soon as possible. He was admitted to the hospital, and promptly got a cold. The food, he said, was too terrible to eat. A diuretic left his mouth so dry he had difficulty speaking. An oxygen tube gave him nosebleeds.

After a week or so, he moved to a nursing facility, recovered somewhat and lobbied to go home. Doctors, nurses, rehab specialists told him he’d need a hospital bed. Absolutely not, he said. No hospital bed in the living room! He’d sleep in his chair. Nor did he want to hire someone to “sit around” the apartment, waiting to take care of his few needs when they arose.

He insisted on getting himself to the bathroom, and didn’t always wait for assistance. On one of those trips he fell. Back to the hospital he went, then back to the nursing facility. He winced in pain if you touched his feet. His meals went untouched.

He enjoyed visitors though, and, although he had trouble talking, when he did talk, he joked, and told us how much he wanted to go home. There were sweet and funny moments. A good sign, right?

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