Written by Ric Durham, Spiritual Care Manager, Hospice at Atrium Health
My mom, Jane Durham, was a retired registered nurse. Her chosen specialty was geriatrics, back before it was as popular as it is now. She loved her work with older adults and enjoyed a full career. When she retired, she enjoyed some “good years” before developing two chronic conditions. Married for over 50 years, my dad was able to be her caregiver as her mobility declined.
My mom took her own advance care planning very seriously. She and my dad completed their Healthcare Power of Attorney (HCPOA) and Living Will documents on their own. My sister is a reference librarian who helps people frequently with advance care planning forms and information, and advance care planning education is an integral part of my job, but my mom didn’t need to consult us. She had lived it as a registered nurse caring for people. No consultation, but plenty of conversation! She didn’t hesitate to let her family know the type of healthcare she wanted at the end of her life. She talked about it, making her wishes known. She made sure we all very clearly knew her mind and heart about what she did and didn’t want.
As her health declined, she was still able to make trips to dinner, church, and the hair salon. She continued to instigate conversations about what she wanted for her future healthcare.
In May 2019 as an 80-year-old, things began to get worse for my mom. At one point she told my dad, “Wallace, I’m dying.” Understandably, he didn’t want to wrap his head and heart around that idea, but she was still very clear: “I want to be at home.”
On May 25 a home health agency was to provide an in-home occupational therapy assessment, but my mom told my dad she didn’t feel like it. She was resting in her recliner while my dad made the call. When he returned, he said she had the most pleasant look on her face. He realized she wasn’t breathing, called 911, and began CPR – She had completed her HCPOA and Living Will documents, but had not worked with her provider to establish Do Not Resuscitate (DNR) and Medical Orders for Scope of Treatment (MOST) orders. First responders were there in seconds, but no pulse. Paramedics finally got a weak, thready pulse and transported to an emergency department (ED).
My sister, uncle and I met my dad at the ED. Staff took the somewhat unusual action of calling a palliative care consult in the ED. The doctor told us she wouldn’t survive. I said, “If she were able to speak, she would look at the IV boosting her heart rate and say ‘No,’ the IV boosting her blood pressure and say, ‘No,’ the ventilator and say, ‘No.’” My dad, sister, and uncle all said, “That’s right. That’s what Jane would want.” As the doctor stood with us and the medical equipment was removed, my uncle told stories from their childhood, dad told stories from their newlywed days, and my sister and I told stories from growing up. ED staff came in to hug us and thank us for the honor of being with us.
Grief is never easy, but as my dad has said, it has been better because we knew what she wanted and were able to honor her wishes. My mom would be pleased if she knew her story may help others. Not only her family, but other patients and their families, and especially teammates in healthcare. It would be one registered nurse’s way of continuing to live out her calling to care.
