Updates on a Dying Mother - January 2021



My 99-year-old mother, Pat King, lives in the Abbeyfield Care Home in Reading.  She has recently become seriously ill and is slowly dying.  
Each evening I write and send an update on her condition to family and friends.  Below is the collection of those daily updates.


Friday 29 January.  This will be the last daily Update for a while.  You can read them all at http://www.johnling.co.uk/Mum03.html

 

Below, the final extract from Chapter 26 of my 2002 book, The Edge of Life.

 

Thank you for messages, support, encouragements, love, phone calls, cards, flowers – you are so kind.

 

With sincere gratitude,

 

            John and Wendy x


Thursday 28 January.
  Another day of paperwork and lists and phone calls …. and sweet thoughts of Mum.

 

Below, the next extract from Chapter 26 of my 2002 book, The Edge of Life.



Wednesday 27 January.
  We now have a date for Mum’s funeral – Thursday 11 February from 1pm at the Reading Crematorium followed by a thanksgiving service from 2pm at Carey Baptist Church.

 

Below, the next tranche from Chapter 26 of my 2002 book, The Edge of Life.



Tuesday 26 January.
  This has been a very quiet day – few phone calls and emails.  We are now in different territory.  It is the time for grieving.

 

Below is the first extract from Chapter 26 of my 2002 book, The Edge of Life on loss and bereavement.  I hope it is helpful.



Monday 25 January.  That inescapable day has finally come.  It is with profound sadness that we announce that Mum died, quietly and peacefully in her sleep, late on Sunday night, 24 January.

 

It is the day that Mum had often longed for – to go to heaven to be with her trusted Saviour and gracious Lord.  Now she is happy, her joy is complete – no distress, no tears, no pain, no weakness, no regrets.

 

Our hearts are heavy, but we rejoice in the memories of her lovely life.

 

Thank you all for your prayers, help, encouragements and love, especially during these last days.  Grieve well with us.

 

            John and family x

 

[The picture is of Mum on her 90th birthday in October 2011.  Details of her funeral arrangements will follow].



Sunday 24 January.   Alan called me this morning – no change in Mum.  She remains comfortable and in no pain.

 

The first hymn at this morning’s worship service at her church, Carey Baptist, was one of her great favourites, ‘To God be the glory!  Great things He has done!’  Mum has long agreed with that statement.  This evening – no change.  Mum is calm, in no pain and breathing steadily but lightly.  Another week begins.  We watch and wait and pray.

 


Saturday 23 January.
  This morning, Abbeyfield said Mum was deteriorating.  She was not responsive at all and her breathing was shallow.

 

Abbeyfield called Anna and asked her to come in and sit with Mum – she did for an hour or so.  Though there was little difference in Mum’s condition from yesterday, Anna noted that she was peacefully breathing.

 

Claire, one of Mum’s good friends from Carey, visited her about noon – she wanted to hold Mum’s hand. She found Mum unresponsive, nevertheless, she sang some hymns and read some Scriptures – who knows what the dying hear and understand?  She said Mum was so different from her last visit 2 weeks ago, but it was still a privilege to be there with her.

 

Abbeyfield confirmed this evening that Mum was now not responding – she didn’t recognise Anna or Claire.  But she remained comfortable as her carers sat with her and talked and read to her.

 

Surely, Mum is in the ‘suburbs of heaven’.



Friday 22 January.  This morning, Mum was ‘pretty much the same’, comfortable, sleeping a lot, but now without much recognition of her carers.  They are regularly checking Mum, talking to her and reading from the Bible and other of her favourite books.  Mum is now frail.

 

This afternoon, Anna went to visit her Granny for an hour or so.  When Mum heard her voice she opened and flickered her eyes.  Anna was surprised to hear Mum’s CD playing a recording of last Sunday’s services from Carey – one of the kind carers had set this up.  Anna found and read from Mum’s Bible and from another Christian book and from the verses of Mum’s Bible calendar.  The sunshine was streaming into the room so she partially drew the curtains.   Anna thought that Mum was at the most peaceful she had seen her in recent weeks.  How  we love to cling onto all these good reports.

 

This evening, unsurprisingly, no change.  So here is the big question for the weekend and beyond.  Why does God, having called Mum home, not allow her to die?  After all, He is sovereign.  Perhaps He wants us to enjoy more memories of Mum, to allow her to linger to prepare for her great transition to heaven, and for us to contemplate our own dying.  Rich lessons from my Mother.

 

Until tomorrow.


Thursday 21 January.
  I spoke to Roz at Abbeyfield this morning.  She said Mum was much as yesterday, sleepy, restful, with no pain and no distress.  However, her response to her carers was greatly reduced.  They continue to care for Mum as usual, turning her and moistening her lips.  When times allow, the carers sit with Mum and read to her.

 

This evening, there was no change.  Mum is stable and sleepy.

 

These last few days, I’ve often felt distracted.  I’m currently writing a piece on coronavirus which should have taken perhaps three days – it’s already day ten.  Yesterday, to help refocus my brain, I painted some wood and made some borscht.  It helped.  But what has been more helpful is to know that Mum has made her peace with God and as Roz expressed today, ‘She knows where she is going.  Your Mum has a strong faith.’  For such gospel assurances, we are thankful. 



Wednesday 20 January.  
There was almost nothing new to report this morning.  Abbeyfield said there was no change in Mum.  No pain, no food, no drink.

This afternoon, Mum was still calm and asleep.  But since Mum had not taken food or drink for several days, Abbeyfield wanted to know how best to care for her, so they had contacted Mum’s GP surgery for advice.  The latter sent a paramedic to visit Mum and to set up a video call back to a doctor at the surgery.  His recommendation was to take Mum off all of her oral medications.  If Mum has prescription needs, such as analgesia or sedatives, then Abbeyfield will contact the Community Nursing Team who will attend 24/7.  

We are one step nearer the end of this earthly life – dearest Mother.


Tuesday 19 January.  A quiet day.  This morning, Abbeyfield reported that Mum had had a very comfortable night  no tossing or turning.  She is stable, sleepy, breathing steadily, but not in pain.  Her regular care continues.  When the carers call her, ‘Pat’, Mum responds with a very weak ‘Yes?’

 

This evening, there is no change.  Mum is still stable and still responding faintly.

 

We think of Mum almost all the day.  There are towels in the bathroom she gave us, there are the memories of her kind laughter, the delicious food she cooked, the visits she made, her unstinting hospitality, her ready cheerfulness – if you knew Mum, you were blessed.  Now that strong woman is so frail.  I have shed my first tears of grief.


 

Monday 18 January.   I called Abbeyfield this morning and spoke to Roz.  ‘Your Mum is not very good, she is not responding to her carers.  She is not in pain, but restful and looks peaceful.’  The carers are checking her every 30 minutes and moistening her lips and turning her every 2 hours.

 

Anna visited her Granny this afternoon for almost 2 hours.  Mum was very sleepy.  Initially, she opened her eyes, looked, but made no response and fell asleep again.  Then later, Anna asked her, ‘Do you know you’re dying?  Do you know you’re going to heaven?’ to which Mum replied ‘Yes’ in a frail voice.  Anna prayed, recited some Scripture and then sang to her, ‘How great Thou art’ and ‘Great is Thy faithfulness’ - two of her Granny’s favourite hymns.  In addition, Anna went through all the members of the family, naming each and commenting on them.  Mum reached for Anna’s hand then went back to sleep.  When Anna left she said, ‘I’m going now.  Bye, bye’ to which Mum replied, ‘Bye, bye’.  Afterwards Anna recalled what a pleasant time it had been – Mum’s response, albeit limited, was so nice to experience. 

 

That’s Monday, onto Tuesday.
 


Sunday 17 January.


cid:57a40c9d-569f-465c-863a-e8279f1cb46d@GBRP265.PROD.OUTLOOK.COM

A poignant picture from yesterday of Anna holding Mum's hand

This morning, I phoned Abbeyfield – Mum is ‘settled’.  She is not eating or drinking and responding only minimally to her carers.

Kate was present and attending to Mum.  I asked that she phone me later.

 

This afternoon, I phoned Abbeyfield again.  Mum had had some abdominal pain so Kate had given her another 2.5mg morphine.  Now Mum is calm, stable and pain free.

 

Later still this afternoon, Kate phoned.  ‘Your Mum has declined since yesterday.  She is not interested in food or drink and she didn’t open her eyes.  I moistened her mouth.  Her blood pressure is dropping, but she is comfortable.  This is the end of life.’

 

She continued, ‘I am discharging your Mum from the supervision of the Rapid Response Team and handing her care to the Community Nursing Team which runs a 24/7 service.  If Mum needs assistance Abbeyfield will contact them.’  I thanked Kate and her colleagues for their care and willingness to communicate.

 

Until Monday.



Saturday 16 January. I spoke to the carers at Abbeyfield this morning – Mum was calm, but refusing food and drink, though taking her medicines orally.

 

Kate from the RRT arrived to see Mum and phoned me later.  She said, ‘Your Mum has taken a turn for the worse.  She is very drowsy.’  When examined Mum complained of abdominal pain.  So Kate gave her a 2.5mg dose of morphine with haloperidol.  This is a baseline dose which, if needed, will be titrated until the optimum amount for effective pain relief is found.  If required, a syringe driver will be installed.  In addition, Mum is still on cyclizine as an antiemetic and co-amoxiclav as an antibiotic.

 

Kate noted that Mum has recently had a habit of appearing very flat and then surprisingly lively – this did not happened today.

 

At noon, Anna went to visit her Granny.  She found Mum sleepy, quietly breathing, coughing a little, but saying nothing.  What a marked difference this was from last Saturday.

 

Today, Wendy and I have been looking through albums of pictures of Mum from her baby years, through family weddings, to her role as great-grandmother.  Little memories of her keep popping up.  What wonderful times, what a wonderful Mum.

 

Until Sunday.



Friday 15 January.  Mum has had a slightly deteriorating day at Abbbeyfield.  She has eaten and drunk very little.  Taking Mum off the saline drip to increase her oral thirst drive has not worked. The carers are offering her water every 30 minutes.

 

Good communications have been restored.  I had a long and useful phone call with Haley from the RRT – she was the one who bought Mum some chocolate buttons on Wednesday.  Yesterday, she found Mum bright, but today Mum is lethargic and she has refused her medicines.  Haley even tried hiding a pill in a choc button.  ‘Let me rest’, had been Mum’s response. 

 

Haley had taken bloods – the results may come today or tomorrow (Saturday).  All the obs. were fine, though her heart beat was a little fast, but the digoxin had stabilised it from 160 a few days ago to 100 bpm today.

 

I quizzed Haley about the imminent future.  Mum was currently comfortable and pain-free.  As the end approaches they have to hand anticipatory prescriptions for sedatives (midazolam) and analgesics (morphine) and buscopan to improve respiratory secretions in case they are needed.

 

Haley spent a happy 30 minutes with Mum.  She said Mum is ‘adorable’.  What a sweet epithet.

 

Haley phoned this evening with the blood results.  Mum has a urinary infection which they will treat with an antibiotic – Haley will deliver it to Abbeyfield this evening.  How they deliver it to Mum is another issue – orally or via IV?

 

Kate from the RRT will visit Mum tomorrow (Saturday).  She will contact me if there is any significant change in Mum’s condition.

 

Thank you for your continued support.

 
           

Thursday 14 January.  Another quiet day at Abbeyfield, though Mum seems to have got her circadian rhythm in a pickle – yesterday she slept during the day and was awake much of last night.  Still only little eats and sips taken.  Her drip finished early this morning – she’s now had 6 litres of saline – and the RRT want to encourage oral drinking, so this morning they detached the fluid line.

 

The only other change is in the anti-emetic medicine.  Mum was on metoclopramide, now she is on cyclizine – I’m unsure why the change because I’ve not been able to speak to the RRT.  I’ve specifically asked Abbeyfield to get the RRT to phone me tomorrow when they attend Mum – I need to keep the lines of communication open.

 

Overall, one of the Abbeyfield seniors told me, ‘Mum is sleepy but stable.’

 

Hang in there with us.



Wednesday 13 January.  After yesterday’s hurly-burly, a quieter day today.

 

Abbeyfield reported this morning (Wednesday) that there was no real change in Mum’s condition, though she seemed a little brighter.  She ate/drank a little for breakfast.  And she is happy to sleep a lot.  The Rapid Response Team had visited, and found little change – all her obs. were OK, though her heart was a bit fast, so they are working on that.

 

For lunch Mum had a couple of spoonfuls of soup and some yoghurt.  She said she fancied some chocolate buttons, so one of the carers went to the local shop to buy some – Mum enjoyed a few!

 

As I mentioned yesterday, Kate from the Rapid Response Team said she would phone me today with news from this morning’s MDT meeting.  She didn’t.  I didn’t chase because no radical changes to Mum’s care are expected.

 

Until tomorrow.



Tuesday 12 January.
  Dear All, this message is a bit long – bear with me.

 

Last night (Monday), Abbeyfield called Anna in to see Mum because she was sinking.  Anna arrived at about 19.30.  Mum was peaceful at times and then had laboured breathing and slurred speech.  Then she would start singing, ‘Oh dear, what can the matter be …?  Good question, Mum.

 

She and I managed a 15-minute, mostly one-sided chat, using Anna’s phone.  I was delighted to have the opportunity  I told her I loved her.  I told her she would soon be going to heaven.  ‘Yes’, she responded.  And I told her that Jesus had once comforted his disciples by saying, ‘In my Father's house are many rooms; if it were not so, I would have told you.  I am going there to prepare a place for you’ (John 14:2).  Who knows what the dying hear and understand?  After a bit, I said, ‘Good night’, and she said the same back to me.

 

Anna stayed on.  At around 23.00, Mum perked up no end, and was cheerful, but still with slurred speech.  How happy she was to see her bed carer come and get her ready for the night.  Anna couldn’t quite believe the changes in Mum’s disposition.   Her breathing became settled and she sucked up some water with a straw.  She fell asleep and looked peaceful, so Anna left at 00.30.

 

This morning (Tuesday) I phoned Abbeyfield and managed to speak to Kate, head of the Rapid Response Team, who was attending to Mum.  Mum was sleepy and not eating or drinking much. 

 

Two medical developments we were unaware of.  Mum’s drip is not an IV-drip in her arm, but an infusion into the subcutaneous fat of her tummy – it’s a safer way of delivery.  And she is being given anti-emetics to try and control her gagging and vomiting when she tries to eat. 

 

Is she in pain?  No, but, if and when she is, she is given paracetamol orally.  ‘How come she can swallow nasty-tasting drugs but not delicious food?’, I asked.  ‘I don’t know,’ chuckled Kate, ‘but that’s your Mum!’  In addition, she has been prescribed digoxin for her erratic heartbeat, which has now settled.  But as Kate said, ‘Your Mum’s heart is very tired.’ 

 

Moreover, Kate confirmed, that in her view, ‘Mum is not actively dying, but she is entering her last stages.  All in all, she is not improving.  Her life is limited, but she is medically optimised and adequately hydrated.’  ‘Would a move to a hospice help?, I enquired.  ‘No, no.  She is comfortable here and is being wonderfully cared for by the Abbeyfield staff’ came the reply.

 

This afternoon (Tuesday), David Magowan, one of the pastors from Mum’s church, Carey Baptist Church, went to see her.  I knew such a pastoral visit would do her good.  David reports, ‘I visited Pat this afternoon at Abbeyfield and we had a lovely time together.  I was masked and gloved and apron-ed but was able to sit on a chair by her bed.  She recognised me and we chatted together – she was asking about some of the folk at church.

 

I read from Philippians 1 (For to me, to live is Christ and to die is gain... and being with Christ which is better by far) and Romans 8 (no condemnation at the start of the chapter and no separation at the end of the chapter) and we talked about the joy and security that we have in Christ.  Then she asked if I would read her favourite psalm, Psalm 121, which I did and then I prayed with her.   It was a sweet time of fellowship together.  She expressed how much she loves you and is particularly thankful for Anna.

 

After 15 minutes or so, Pat was quite tired at which point I left.  She seemed quite content.  What a privilege to minister in situations such as these.’

 

Tomorrow (Wednesday) Kate is attending a MDT (multidisciplinary team) meeting where medical professionals from various disciplines discuss their patients, including Mum.  Afterwards, Kate will phone me with any relevant info.

 

Just before lunch today, Wendy and I went for our daily walk, something like 6,000 steps in 60 minutes, along beautiful Welsh lanes, passed all those pregnant sheep and by the river Rheidol.  The daffodils in the hedgerows are almost out and so was the sun.  It looked and felt like Spring – how beautiful is God’s creation.  Our minds are currently on the edge of life and death – we thank God for the gift of one and the defeat of the other.

 

Greetings to you all.


 

Monday 11 January.  This morning, Roz, the assistant manager at Abbeyfield, reported that Mum was stable and ‘over the hurdle’.  However, she ate and drank little for breakfast, though she did enjoy a high-protein yoghurt.  She will have her Covid-19 vaccination sometime this week.

 

The Rapid Response Team (RRT) member came – she changed Mum’s IV drip to the other arm for comfort.  In addition, she tweaked her medication to increase Mum’s BP, which was a bit low. 

 

This afternoon, there was still the recurrent problem of her not eating and drinking enough.  And it was reckoned that Mum was not up to taking a phone call today.  Though visits have now been curtailed, tomorrow afternoon (Tuesday) one of her church pastors, David Magowan, has been granted permission to visit Mum – that will cheer her.

 

Until tomorrow!



Sunday 10 January.
   
Forgive the catch-all format - it’s written for family, friends, ministers, Uncle Tom Cobley ….

 

Another roller-coaster morning.  Mum had taken a turn for the worse.  She was drowsy, but speaking.  She was eating and drinking a little.  But her pulse was racing and her breathing was irregular.  Maria from the Rapid Response Team attended and ran an ECG and bloods – the results will come later.

 

By the afternoon, Mum had perked up.  To control her heart beat better Maria put her back on one of the drugs that RBH had removed from her regimen last week  Mum had a Sunday sherry, a little of a beef meal and a yoghurt for lunch.

 

Later in the afternoon, Alan and I phoned Mum separately.  She picked up her phone and chatted quite lucidly for several minutes.  ‘How are you?’ I asked.  ‘I’m getting better, I’m getting on OK’, she replied.  We talked and joked even though she was often confused – she couldn’t, for example, remember that Maria had come and taken a blood sample from her (perhaps that is best forgotten).  

 

In the evening, Abbeyfield confirmed that Mum was OK, but that her condition was unpredictable.  A member of the Rapid Response Team is expected to see Mum each day this week.

 

And so the week has started quite well.  We wait and pray on.

 

Greetings to you all – thank you for your concern and support.


Saturday 9 January.  This has been a strange day – in contrast to the dire prognoses of yesterday Mum is somewhat improved  That’s according to both Anna and Claire who visited her today.  She is not eating, but she is drinking a little.  She is still on a drip.  Anna found her in bed ‘reading’ the paper!  Claire and Mum reminisced and Mum asked about their mutual friends though she was confused at times.  Anna said Mum perked up when she read from the Bible and prayed with her.  Anna rated her at 4/10.

 

So, who knows?  The mystery of Providence.  We wait and pray on.



Friday 8 January.  Mum is seriously ill.  She has suffered for many weeks from a C. difficile gut infection that has not responded to antibiotics.  She started to deteriorate significantly last Tuesday (5 January).  The Rapid Response Team was called and they assessed that she was dehydrated and recommended that she should be admitted to Royal Berks Hospital (RHB).  The ambulance came at 01.00 Wednesday morning (yes, that early) to take her.  RBH said she was not clinically dehydrated and sent her home at 05.00.  What a way to treat a 99-year-old – poor Mum.


I phoned her on Wednesday, but she was delirious and unable to answer the phone, even with the assistance of a carer.

All this was pretty unsatisfactory so on Thursday afternoon I phoned her GP surgery (Western Elms) and spoke to Sandra who read out some of Mum’s medical notes.  They have booked her into a gastroenterology clinic with a 2-week waiting list.  There was then talk about end-of-life care.


Thursday evening my brother (Alan, who lives in Torquay) phoned to relay a conversation he’d just had with Sylvia, a senior carer from Abbeyfield.  Mum is OK-ish.  She has eaten a little and drunk a little and she had recognised Sylvia. 

This morning (Friday), I had a long phone call with Roz, deputy manager, at Abbbeyfield.  Mum was a little better.  She managed a little breakfast – toast and juice.  Abbeyfield are monitoring her and giving her little sips of water every 30 minutes. Her BP was low, but she was chirpy.  Abbeyfield are still concerned about her gut infection – the antibiotics have not worked and she is now not on any.


Alan and I feel as if we have been in a bad place caught between the RBH, the GP surgery and Abbeyfield.  We have felt rather helpless.  Dr Elgonaid from the GP surgery is making a valiant effort to sort this out.  She had called in the Rapid Response Team and they had arrived, about an hour earlier than my phone call with Roz, and only left Mum late this afternoon.  They had put Mum on a drip to hydrate her and presumably monitored other bodily functions. 


In the meantime, Kate, the head of the Rapid Response Team, had called Alan.  Her assessment was that Mum is likely to die in the next few days.  Kate, or her substitute, will visit Mum at Abbeyfield on Saturday and Sunday and a doctor will attend on Monday. 

 

Claire Roberts, Mum’s great friend from church (Carey Baptist Church), is going to see Mum tomorrow (Saturday) at 11.30.  Our daughter, Anna, who lives in Reading, and who has been especially close to her grandmother over the years, is visiting at 14.00.  She hopes to squeeze Mum’s hand, give her a kiss and pray with her – what a good girl! 

 

Oh dear, this is not the good death that we envisioned.  Here we are trapped by Covid, unable to hold Mum’s hand and kiss her goodbye.  Our great comfort is that Mum has often said she is ready to go to be with her Lord and Saviour.  It may be so and soon.

 

With warmest Christian greetings,

 

            John and Wendy.


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