Memories of mom’s final hours: Bertie Koenig
By her son: Rod Koenig
(COPD) Chronic Obstructive Pulmonary Disease
Through My Lens
I’m recording the account of my mom’s passing away from a
personal perspective through my own eyes with a desire to enrich the lives of
her loved ones and friends who read or hear this account. Perhaps it will inspire
support for anyone who will be entering into this experience with a loved one.
Something inside of me senses she would like this as a gift to others. Most
assuredly everyone present would have their own perspective of her final days
and hours. This account is flavored by my own limited perspective, but is at
least a memory I can cherish and share with others.
It was a Saturday,
October 14th 2017 that I received a call from my sister Karin. Our
mom’s health had taken a distinct downturn and her energy was very low. I heard
Mom in the background of Karin’s phone call chiming in with a short statement “I’m
dying” as if to clarify for both of us she knew her time had arrived and we
both needed to accept it. Karin, my sister who is a year younger than I am, is
a lady with an amazing capacity to compartmentalize as needed. She is able to spin
many plates simultaneously on the stage of life. She understands firsthand the rawness
of deep pain and emotional needs for herself and in others, family and even the
clients in her work life. Her life passion is to be in helpful service to
others and is often an advocate for people who are less fortunate. All people,
even a super-woman type as my sister, know they have limited capacities but
will push their capacities to the full extent if it means helping someone
genuinely in need. Beginning with this day, our mom was now needing full time
assurance somebody was near her. My sister embraced the task.
Karin was fresh into a significant career business transition.
Vulnerable feelings associated with any big transition in life were present in
her combining with the unsure feelings how to properly care for the serious
downturn of Mom’s health. But, she did her best to compartmentalize these
emotions and the necessary remote business correspondences. She knew everything
within her was going to be required to press through this work transition and
Mom’s transition of life. HolmesStress Point Scale was peaking for Karin.
Mom was a vibrant person
with an insatiable drive to be active and productive with her hands, if she
was able. In other words, she would not be inclined to pursue the meditative
monk lifestyleJ.
As I think about it, Karin is wired very similar, but with an extra dose of intellectual
capacity for a complex fast paced business world. Both ladies are known for
touching the lives of many people with gifts, good cooking, skills and service
in any way they are able. Recalling how my sister cared so tenderly for our Mom
during these final hours can choke me up with tears. Watching my sister compassionately
interact with her tearful broken hearted daughters at Mom’s bedside was as precious
as you can imagine.
Tears and emotions, deep emotions, are not a normal part of
my personality make up. I’m not insensitive by any stretch of the imagination
or known to be an insensitive person. I’m more of the personality type of a
loyal Golden Retriever with some Lion leadership traits. My role during the
final days and hours of Mom’s passing seemed to be more valuable as coming
along side to support Karin and be an encouragement for her daughters Kristy, Michelle and Julie who
is a young registered nurse that was invaluable to this story.
From my perspective,
the two female heroines in this story are especially Karin and her daughter
Julie. Like two intertwined strands of rope, these two ladies were able to
support each other amidst the unexpected strains suddenly placed upon them
providing full time care for their Mom and Grandma. Two mom’s: Karin’s mom and Julie’s
mom, required confidence they were supported and cared for by their daughters
in their time of extra need. Without a doubt all three of Karin's daughters were invaluable to her during this difficult time.
Karin’s three daughters have an amazing candid relationship
with each other, their mom and with their Grandma. What I observed in all these
ladies associated with Mom’s passing can best be portrayed as a beautiful, yet
raw bouquet of flowers. Grandma Bertie, Mom Karin, by birth order Kristy, Julie
and Michelle are ladies that have experienced virtually a lifetime together.
This amazing bouquet they represent is not a flawless set of beautiful flowers
that stereo-typically can be envisioned in a photograph. In fact, they are each a
beautiful flower who is acutely aware of their own internal imperfections caused
by injuries from others and some by their own choices in the past. But these
women, from Grandma to the youngest granddaughter have bonded with a great love
for each other, and the generational mom’s they all share!
I am deeply touched.
I spent time observing this bonded bouquet they share. I watched them experience
their deep emotions as the precious oldest flower amidst them was slowly wilting
away before their eyes. You see, Mom was a beautiful flower. She was cherished
by her only daughter, and cherished by her daughter’s daughters. For the last
decade of Mom’s life, these daughters were the primary flowers bundled close
beside her, sharing and supporting each other through the rawness of their
wounds in their personal journeys of life. These daughters were watching the rose petals
of the oldest sadly fade and struggle. It was very difficult, but very precious
to them. Each of them were by her side as they were able. It was their best
gift to her as she struggled in the fading process associated with COPD.
I left work at 8:30 AM Monday morning after informing my
boss and co-workers I was going to be driving to my mom’s place in Bellevue, WA
and the week ahead was a wild card for me as to when I would be back. It was
difficult to presume if Mom would pass quickly or take longer than imagined. My
commute allowed me time to process my anticipated journey ahead. Reflecting
back now, I had some accurate
perceptions of what to expect, but I was a bit stunned with the unanticipated
raw impact of the experience on myself and the lives of extended family members
as we watched the life of a loved one fade progressively before our eyes and
ears; seemingly too slowly for the conditions.
When I arrived, I
entered the back slider door. This was the common entry point used by her
friends and loved ones. I greeted Karin and Julie but needed to wait a few
minutes for a visiting nurse to finish and depart before I could greet Mom. I walked
over and knelt by her as she lay resting on her couch in the living room of her
one room apartment. Chaz, her beloved 9
year Pomeranian pet dog, lay at her feet. He is a huge part of her life and has
enabled her to keep herself together through her loneliness. Little Chaz has
two HUGE scars, one around his neck and the other around his rib cage as a
result of being viciously attacked by a neighbor dog on two separate occasions years
ago. He is amazing and typically walks on 3 legs because of an injury to one hind
leg. Mom’s favorite sleeping place was on the couch rather than her bed in the
bedroom. As I held her hand in mine, she looked so frail and transformed in
appearance since I last saw her. It was Mom, but not the appearance I last saw.
I had to remind myself as the sad emotions welled up within me that these
changes in her body were to be expected because of the dying process. I had to
do my best to see her as “Mom”, the person I know her spirit to be. Her response
when I said “Hi Mom” was somewhat amusing and reassuring in its own way.
When I gently greeted her, I wasn’t sure if she was
consciously awake or sleeping. I saw her slightly open her eyes when she heard
my voice so she could look at me. But then she opened them wider and with a reactive
clear yet groggy voice said “Oh God…oh, I thought you were Wes. You look so
much like Dad. I thought you were him”. At first this may sound like a deeply
negative response, but I understood what she was implying. She and I have had
many conversations the past 3 years, healing conversations, about her divorced
relationship with my dad Wes, how much I am like my dad, but also how much I
have changed into a different person. What caused her minor shock was my appearance.
I had just recently donned a new haircut style that reminded her of how similar
it was to my Dad’s. It was a bit of a comic relief to her it was just me at
this moment.
Immediate and
extended family relationships are complex and literally take volumes attempting to articulate how they intertwine.
Mom’s childhood was rough, abusive and unstable. Mom and Dad met at the age of
15, married at 19 and I was born when they were 20. When her love life attached
to Dad during her impressionable age, she had yet established an identity for
herself of who she was as an individual person. Her entire adult married life
of 43 years to my dad was an identity associated to him as “Wes & Bertie”.
Mom is a follower by personality. My dad is a leader by nature and more comfortable
as Han Solo or Lone Ranger than a leader of a group of people. Perhaps this is
the result of growing up as the youngest child and his closest sibling was 13
years older. In a basic sense, she was rescued by my dad from a bad situation.
In a long story short expression, their marriage relationship permanently
separated after 43 years of living together, and not due to either of them
finding another love. Both of them suffered greatly, leading up to and after
their separation. They had to find ways to survive and move forward.
Dad, by nature of his personality, was able to re-identify
who his new self was a bit easier. Mom however, by her nature of personality,
was clearly lost and struggled until her passing, although with great strides toward
embracing her new self and what it potentially was becoming. I will say, her
final two years was a beautiful transformation toward a self-awareness of who
she was becoming. In her mind, she no longer was lost. She was finally
accepting her unique identity from what she previously only knew as “Wes &
Bertie Koenig” to her new identity and uniqueness as “Bertie Koenig”. All of us, including Dad, loved to see her
spirit healing in her final years.
Once we all had a bit of a chuckle of mom’s reaction and
understood it was my new hairstyle that triggered the response, she quietly asked
me if I had told Dad she was dying because of COPD, and if he had said “I told
her so” yet. Remember when I noted family relationships are complex? Well, this
is an example. Mom started smoking at age 11, and continued all her years up
until she passed at age 74. See tried to quit but couldn’t hold to it. These
days smoking is not a naïve cultural phenomenon as it was when Mom was growing
up. Virtually everyone smoked. Camel’s cigarette ads even bragged more doctors
smoked Camels than any other cigarette. Today, people smoke decisively and informed
of the risks. Mom continued to smoke, informed of the risks, and this was always
a concern for Dad. It was common for Mom to attempt
to smoke secretly when around any family members she associated with Dad. Karin
is more associated with Mom, and I’m more associated in her mind with Dad;
especially after their divorce.
Mom’s mind was sharp
all the way up to her final moments. The last couple years she and I had
long phone conversations about life, details of our upbringings, about family
and extended family, philosophical perspectives of the non-tangible realities
of life, and of course about understandings of God and “the other side of the
curtain” where she knew at her older age she would someday enter. She wasn’t
diagnosed with COPD until her final months. I truly never saw any indication
Mom’s mind was diminishing, even though her body was clearly aging and becoming
weaker in her final years. She was amazingly sharp in her thinking and recall.
Knowing Mom’s mind
was as normal as any of us by her side was one of the heaviest burdens I felt
for her. Monday evening Julie set up her laptop so Mom could watch some
cute family childhood videos of Mom interacting with her grandkids when they
were very little. Mom was only able to open her eyes and watch a few moments at
a time but I know she was listening to the sounds of her younger grandma-self
playing with Karin’s little girls. I caught a glimpse of Mom with her eyes open
and attempting to smile at one particular funny part in the video. I’m sure if
she had the energy and lung capacity she would have been laughing along with us.
Julie and her sisters had the foresight to share with their grandma special
moments experienced together as they were growing up. It didn’t matter to them
if Grandma was for sure consciously listening or asleep under the drowsiness of
pain medications. They were giving her the gift of their special memories with
her. Very special stuff!
Another special occasion for me was when Dustin, one of my
twin sons, had the opportunity after a particular work assignment in Bellevue
to stop by and see his grandma one last time. I met him in the apartment
parking lot. This was the first time he was able to see his grandma’s
apartment, and it would be his last. Before we walked into her apartment, I
gently prepped him with an analogy of a Model A car that once used to be shiny
and functioning , but is now very worn out and discouraging to see. “Grandma’s
body, her ‘vehicle’, is going to look like this so prepare for the first
impression” I told him. I shared with him how it was impacting for me when I
first stepped into her apartment the day before.
We entered through the slider door, his cousin Julie who
hadn’t seen Dustin for quite some time, hugged him and she promptly woke their
grandma to say Dustin was here to see her. I could tell Mom was attempting to
open her eyes and greet him. She wanted to see his face. They spent a few
moments together and I gathered it was meaningful for both of them. After some family
group interaction, Dustin and I went for a walk and had some dinner together.
When the meal was paid for, he commented it was now the awkward time he would
have to say “Good Bye”. Knowing he was going to be saying goodbye forever was a
heavy realization. We returned to the apartment, visited with Karin and Julie a
bit and then I went to Mom’s bedside, took her hand in my hands, and told her
Dustin needed to say goodbye and go home. I nodded to Dustin to come over and
take her hand in place of mind. His grandma was not able to provide much
response as she was weakening by the hour. It was a moving moment for everyone
as Dustin rested his head down next to her cheek and told her goodbye, that he
loved her and he will see her later. His life will forever be touched by his
last evening with her and he will likely have an extra empathy for those who
lose a loved one. Me too by just by watching this spontaneous exchange.
Many details of my
experience and observation could be included to describe how each daylight and
evening hours impacted my life, as well as those where were present. Before I
move onward to illustrate the final hours preceding Mom’s slipping away, I will
share some specific poignant memories. These will be random for simplicity.
Her communication was reduced to a subtle groan and
difficult to interpret if she needed something, disagreed or disagreed, or was
just dreaming. For the most part she always looked as if she was sleeping.
Karin discovered that Mom was occasionally able to answer questions with a
“yes” by moving her eyebrows a little. Up until Thursday Mom could indicate she
needed to relieve her bladder, which was only about 3 times per 24 hours. Karin
and her daughters would do their best to help Mom sit up in the hospice bed provided
(which was delivered Tuesday) and assist her to do her best to use a bed pan (a
commode was delivered late Wednesday but ended up never getting utilized). I
always moved to another room whenever Mom needed dignity assistance by Karin, Kristy, Julie and Michelle. Hearing an oxygen machine run 24-7 has a strange effect on your psyche. Seeing
and hearing the nebulizer mask placed on her several times day and night. Sleeping
at night in the same room as Mom and listening to her labored breathing and groans.
See her body twitching. Unable to clearly interpret if she was dreaming or if she
trying to get someone’s attention. Although she always looked asleep, I knew
her normal mind was trapped inside and she may actually be conscious. Seeing
Mom so thin and frail and observing how the human body can emaciate so fast. Being
so glad for the morphine and other medications that were calming her anxiety of
not being able to get enough air to breathe. Watching her tiny shallow breaths
and long durations between breaths. For several days wondering how she can
continue. Wondering at any time if within the hour she would slip away. Watching
her sleeping body struggle the last 24 hours for every breath in a swallowing fashion.
Fascinated with how the spirit (Operator) decides when it is time to step out
of the body (Vehicle) when the body is clearly appearing to have completed its
useful purpose in this life. Considering how we as caregivers would also suffer
having to watch the dying process if the calming medications and oxygen machine
were not provided. How there must be billions of people who have suffered
without these medicines to provide comfort. Observing the difficulty Karin faced doing her best to keep the medications working for my mom on a
scheduled manner 24 hours a day when she could no longer swallow pills. Watching
the exhaustion in Karin and her girls and their resolve to always be present for
Mom’s care and comfort. How Kristy was able to stay with her mom and Grandma through the night when Julie and I needed to be gone. Seeing and hearing the outpouring of love by those who
came to visit Mom. Seeing and hearing the anguished cries of neighbor friends who
stopped by and observed her condition, especially as she lay there deceased,
who remembered visiting her just 10 days ago. Perusing through the few things
Mom owned and contemplating how these things must have been meaningful to her. Karin
and I going over details of Mom’s accounts, utilities and contacts and how we
think we should handle the follow-up. As siblings, going through Mom’s antique
cedar chest evaluating what to do with her collection of keepsakes (later that
day Karin and her girls were able to do the same and share the experience).
Discovering mom still had her own mother’s ashes in a small Urn in her cedar
chest. Wondering how long to leave her body in the room before calling
appropriate services alerting the need for Mom’s body to be taken away. Do we cover her or leave her as she departed. After
Mom was gone, I watched one of her best neighbor friends from Turkey lovingly place
a nice scarf on her head to enable her face to look natural and hold her mouth
closed. Observing how natural a loved one’s passing in their own home felt,
even as their body lay there for 4 hours peacefully amidst us until they were
taken away. The unexpected negative mental imprint on my sister and her
daughters as they watched the caretaker prepare to take Mom’s body away on a
gurney, but first tied an identification tag on her ankle. They may have associated
this with deaths on investigative TV shows. How the day after Mom’s passing
Karin and I signed appropriate legal documents at the funeral arrangement
services and were needing accurate information for Mom’s place of birth and
maiden name. Then, at that moment Dad
was prompted to call and we asked him if he knew the answers…seemingly as if
Mom had attempted to help us all get the details correct J. The providential timing of Julie’s prearranged
schedule from work that originally was intended to be available to provide
childcare for her half-brother’s kids but instead provided care and support for
her own mom and grandma. How my mom’s nursing care provided by her
granddaughter Julie was perfectly timed never having to leave her own mom alone
in this difficult role. How the new staff that Karin that leads at work were away
for scheduled training and not requiring her to be present at the office. And
so much more.
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I will attempt to describe my own personal experience and
observations of the final few hours associated with Mom’s slipping away. I
fully expected Thursday evening that one of us staying there that night (Karin,
Julie, Michelle and myself) would wake and discover Mom was no longer breathing.
I woke in the middle of that night, went over and looked closely at her laying
there in bed. In some ways she never did look to be in just the right comfortable
position. Her body was so thin, frail and lifeless. I watched closely to see if
her chest was moving with any breaths. I watched for some time and saw no
movement and thought “Oh my, this is it”. Then I saw her take a tiny swallow of
a breath, a long pause, and then another tiny swallow effort for breath. I
thought, “Wow, how does the body do this and keep going”? The word “TIMEX” came
to mind and how she must be a tough ol’ Bird. I smiled and felt deep compassion.
At the same time I was having to compartmentalize
my thoughts “This isn’t my Mom suffering consciously but it is only her body”. Otherwise,
it was too over whelming.
I woke Friday morning
to hear my sister talking to my Mom (or was she actually talking WITH Mom)!
Her interaction with her while assisting with medications seemed to have a
sense she was aware Mom was awake. Amazing in two ways. First, Mom was still
ticking along and perhaps actually more alert than normal; especially since I last
saw her struggling to breathe just a few hours earlier. Second, Karin in her
sleep-deprived condition was as tenderly concerned for Mom’s well-being as I
had seen her all week. It’s like watching and hearing a miracle in front of you,
but you are not sure because you have never actually 100 percent seen nor heard
a miracle in front of you, at least that you were aware was happening at the
very moment. But something felt different.
As it was, Mom’s
condition indicated more alertness and not decline. For me, I was
encouraged to observe this slight improvement, not because she was improving,
but because I sensed this was her last hurrah approaching the final finish
flag. I reminded my sister that I’ve read, and heard from others, this is a
common sign before dying patients let go. They appear to be improving and can
communicate more. I’ve since learned that the body’s eliminating functions can also
activate. An hour later, while I was sitting on the couch I heard Mom make a
distinct voice I hadn’t heard yet. I am including this next part because it sensitively portrays a hint of the candid reality that can be part of this process. I went to her bed side, took her hand in my
two hands and asked her to repeat what she said. Again, it was distinct and not
a groan. She was definitely conscious and this was not a dream. I barely
discerned the word “Pee” and “Pee Bed” and she was actually making some effort trying
to move and imply trying to get up. By this time all the girls rushed over as I
was assuring Mom she is okay, to let it go, not to worry if she was not able to
hold it, and that the girls had already prepared for her to be able to go with
pads underneath and they would take care of her. They all chimed in immediately
when they heard this was the situation. Mom was agitated and seemed concerned
about the uncomfortable embarrassment. I discreetly moved to the kitchen and
the girls smothered her with assurance, love and support. Up until this time
Mom was able to keep it all together and go when she decided. No wonder this
was clearly an alert on her part. With the girls at her side, Mom was in great care and support.
Remarkably, a visiting nurse was already scheduled to arrive
within the next hour and give Mom a warm sponge bath. It was to be her first
“bath” in week. Remember, this Friday morning Mom is more consciously aware
than she has been observed for a couple days. I suspect her warm sponge bath
felt like the best massage she’s ever had in her life! Karin and the girls also
put fresh new comfortable clothes on her. She appeared asleep again.
The visiting nurse (what
an angelic gift she provided) left and just then two more hospice staff
arrived to check on Mom as well as guide Karin and I with some assistance for anticipating
next steps for funeral arrangements and basic responsibilities that follow the
death of a family member. Michelle came inside after tidying
up Mom’s nice flower garden around her outside patio area. At this very time, I
was talking with one of the hospice support staff at the dining room table while
Karin, Julie, Michelle and the hospice nurse were at Mom’s beside. I could hear
Michelle telling her Grandma she took care of her flower garden and it all
looks great. The hospice nurse and Julie (who is also an RN nurse) were chatting
and attempting to check Mom’s blood pressure when the hospice nurse realized
Mom had slipped away without them noticing it happening. She turned to myself
and her assistant with some surprise to announce Mom had slipped away quietly. I
liked her expression “slipped away”. That was a nice touch and an accurate one.
The flood of emotions
at that moment immediately overwhelmed everyone present in different ways.
The two visiting staff expressed how powerful the experience was to be present
with a family when their loved one actually departed. They work in hospice
support for families, but one of them expressed to me she had never got to be
present at the final moments. Being present with us was very moving for both of
them.
For me, I was so happy for Mom knowing her spirit (Operator)
was now free from her worn out body (Vehicle) that she was trapped within, and
transitioning to her new future journey. I knew Mom feared all her life that she
would die from lung failure suffocation. No more fear. I also knew she prayed
often for the ability to die in her sleep without suffering. The emotions of joy
surpassed my grief of watching my own mother slowly pass away, knowing she
“slipped away” in her sleep as she desired.
During this whole week I captured some poignant pictures and
shared them via texting with my wife and kids who were not able to be present
so they could be touched by the authenticity of her dying process. I wanted to
quickly photo capture the moment and have us stand at the top of her bedside
symbolizing at 12:07 noon she began her new journey. Just as we were having the
hospice assistant take the picture, Kristy entered through the slider door. She
came to visit her grandma. She experienced an overwhelming wave realizing at
that moment her grandma had just passed onward a minute or so earlier and now we
were asking her to join in the photo moment.
The emotions that
welled up in my sister and her girls during those raw moments was palpable,
beautiful, and intense mixed with grief and joy! You see, the evening before
on Thursday, they had a similar intense bonding experience. That evening Paul, Karin’s husband who had just arrived that
evening back in town after being gone on an overseas business commitment, Kristy’s
longtime boyfriend Mike, Paul’s sons Derek and Danny, and Derek’s wife Ann were
able to gather in Mom’s small apartment around Mom’s bedside centrally located
in the living room and share life together as family. In addition, one of Mom’s
best neighbor friends was able to join in the family gathering. Mom appeared to
be sleeping the whole time, as usual, but undoubtedly was able to hear everyone
at times. It was this setting that there was one moment Karin and her girls
were alone by Mom’s bed and together experienced peak emotions. It was as if
they were a bundle of beautiful flowers grieving together.
That night the girls
were emotionally recalling with their Mom and Grandma some personal
struggles they knew were a part of their group relationship. It was enabling them
an opportunity to have assurance there was peace and forgiveness with Mom, with
Grandma. The rest of us were quiet, as this felt like a spiritual moment that
was occurring for Karin, with her mom, and the granddaughters with their
grandma. Very moving to say the least!
This may be my own imagination, but observing the “evidence”
of Mom’s quietly slipping away brings a smile to my spirit. Follow along with
me as what seemed to happen from my own perspective.
If you were going to
visit some place that was extra-special because of the people who were
going to be there, and the importance of the setting, wouldn’t you want to be
at your best? I once heard a top athlete say one of the mottos she lived by was
“Look Good, Feel Good, Do Good”. Mom
wasn’t an athlete, but she definitely would embrace this motto if she knew of
it. She preferred to have people see her dressed put together rather than
shabby. She was a lady who liked her home to look good. It made her feel good,
and anyone who came to see her or her home were made to feel good too. Her
plant garden outside was transformed to look good with the touch of her hand
and those who assisted her as she created it. It made her feel good and to do
good by sprucing up the landscaping of the apartment grounds to look good, much
to the chagrin of the property management who felt she was snipping away at the
landscape without their authorization.
Consider, Mom undoubtedly felt her hair was a mess, she was
not presentable, and might I humorously say she needed to relieve herself
before she could head out on her journey to the other side J. Being a tidy person,
I think she wanted to be presentable but was trapped in a body that was not
functioning right.
She may have felt the improved conditions enabled her to
feel ready to go. I suspect when her tummy felt better, her hair was combed, had a massaging
warm and soothing sponge bath, now wearing a fresh set of
clothes and her beloved garden was tidy, she was ready to move onward. I
wouldn’t be surprised if it gave her assurance we also had hospice present to
give us the support that we would need when she intentionally and quietly slipped
away without being noticed.
Knowing everyone was
at peace with her and she felt good about her situation, I sensed she felt she
could let go and step forward into the light Looking Good, Feeling Good, and
inspired to Do Good entering into her Creator’s presence.
P.S. Chaz lives with Karin
and Paul now, and 3 days after Mom passed he started walking on all 4 legs
