Death Can Be Merciful

"Dad, you can go anytime. Mom is waiting." LaNay "Nick" Felsted passed away at the age of 93 at the Villa Maria nursing home in Fargo, ND. He had been living in our home up until six weeks prior to his death.

Nick becomes dangerous. We faced a difficult decision about our ability to care for him in our home. The last few months his care had become much more difficult. He was falling, was getting weaker, and couldn’t perform basic functions without getting himself into trouble. He had been diagnosed with dementia. One day he was trying to cut off his buttons with a pocket knife in order to undress. He wouldn’t ask for help.

My wife was being deprived of her sleep. A couple of times when he fell, Nick couldn’t get up without a second person to help lift him. One day in early November, he froze on the steps going to Adult Day Care. My wife managed to get him to a walk-in clinic and then the Emergency Room where he was hospitalized.

In the hospital Nick was disoriented and agitated. He lost all of his independence because of the danger he presented to himself. He couldn’t read or watch TV. He was not the same person. He had started a rapid decline in his mental and physical abilities.

Long term care. The emotional decision about whether to care for him in our home was taken out of our hands. The clear medical recommendation was for 24 hour care since he was a danger to himself in our home. We had no choice which helped alleviate the guilt involved in placing him in a long term care facility.

Darlene had been indoctrinated to believe that the care of her parents would be at home. Her mother had died at home, maintained by home health care aides who would see to her needs. Her mother in particular viewed nursing home care as a condemnation to a "terrible fate".

At first, Darlene held on to the hope that Nick would get his strength back and would be able to come home again. She also realized how relieved she was not to have the constant worry of his care. She gradually realized that it was the right decision.

Acceptance of care. Nick was used to the facility by virtue of his participation in adult day care there. He knew people. His friends were there. Staff who knew him. It was like a second family to him. The staff had gotten to know him when his personality was more intact. They had genuine affection for him. They accepted him as he was - an energized, gentle man with a sense of humor who liked female attention. He accepted long term care, didn’t complain and didn’t make my wife feel bad that he was there.

Nick was a little feisty with the staff at first. He once complained, "Come on, fess up, which one of you did it." One day he succeeded in getting the attention he wanted by calling out, "Hey beautiful. Come here." He quietly asked our 18 year son, "If you were in my position, how would you go about getting out of here?"

Some of our last memories included taking him from the care center to watch our son perform one of the lead roles in a high school musical, "Grease." He was alert and vibrant the whole evening. We celebrated his 93rd birthday with balloons and candles.

Rapid decline. He stopped walking with his walker. He stopped feeding himself. He slept more. He had difficulty showing interest in anything. He lost his will and fight to be independent. Every day was a roller coaster ride in terms of new losses to assimilate. The person my wife knew as her father was no longer there. There was pain every time she went to visit. Visits were tough on her emotionally.

The quality of life was not good. Nature had to take its course. But how long would that be? A month, a year, or years?

Hospice care. His condition worsened and it became clear he was in an "end-of-life" decline. Hospice was called in. Hospice provides expertise in helping people die comfortably and respectfully with as little suffering as possible. His medication was adjusted to provide more pain relief. There were a host of volunteers and professionals who assisted the care facility with the care - a hospice nurse, a hospice social worker, a volunteer coordinator, a hospice chaplain and a personal care assistant.

Nick lapsed into a coma on a Sunday evening and we thought the end was near. Instead he lived another five days. Volunteers came every night to be with him so my wife could get some rest. We were surrounded by loving people who watched him when we couldn’t. When he was dying the hospice volunteer pointed out the change in coloring and his shallow breaths. With his final act of life, Nick lifted his previously immobile left arm up to as a farewell gesture of goodbye to his daughter who was at his side talking to him and comforting him. It was a beautiful death.

The pain and struggle of the past 22 months melted away. My wife felt pleased and blessed that she was able to care for him. It all worked together to give Nick the care he needed: care in the home, adult day care, nursing home care and hospice care. We are grateful he did not linger in this life longer than he did. Death can be merciful.