Joan Seager, July 17, 1922 – July 9, 2011
For two and a half years I have been full time caregiving my mom, here in my home in Portland, Oregon—my mom being in her late 80’s, barely mobile, and with moderate dementia. It was more complicated than some arrangements since we are Canadians, and while Canada does provide national health insurance, there is a limit to how long citizens can be out of the country and still remain covered. My siblings and I long ago had made the decision that we could not take the financial risk of keeping Mums in the United States once her Canadian health coverage ran out: at that point we—she— would then have to return to Canada permanently.
She was winding toward the end of the out-of-country extension period, so I had purchased the plane tickets for this final departure. I had no real “plans” for how the future would unfold, but simply a commitment to care for her, which meant I had to leave my home and husband (and kitty) in Portland and live in a small one-bedroom, high-rise apartment with my mom in Toronto. One day at a time.
She had been on a wait-list for one of the nicer facilities in Toronto for three years, but it was still uncertain how soon or long it would be before she was called for placement—and when they did call, could I could actually break her heart (and mine) and leave her in a strange place with strangers, when all she ever wanted in her final years was to be with family?
As was my habit when an event or change in routine was pending, I would begin telling my mom about the trip (or hair appointment, or a family member’s visit) long before it occurred. Even though her short-term memory was practically non-existent, I believed that with enough repetition she had a better chance of remembering, and even if she didn’t ever recall, she was still very much alive and deserved to be included and treated like the intelligent, wise, and caring adult she was, regardless of the functions she had lost to Alzheimer’s.
It was about six weeks before our departure date when she carefully shuffled to the table for her usual salmon and mayonnaise on an English muffin breakfast, when I reminded her again.
“Mums, you and I are leaving for Toronto soon, and we’re going to live together in your apartment.”
“Why?” she asked.
“Well,” you don’t have any health insurance here, since you live with me in the United States, and we have to go back so you can keep your Canadian health coverage.”
“But I’m not sick,” she said plaintively.
“No, you’re not, you’re actually very healthy. Still, how do you think all this is going to end?”
“Doctors?” she responded, uncertainly.
“Yes, probably. Chances are pretty good that you’re going to need some medical care in the near future, and we have to have health insurance to cover that.”
The conversation took a momentary lull. Then I took a deep breath and spoke gently.
“You know, Mums, it would be a lot better for all of us if we didn’t have to go to Canada because I really don’t know what’s going to happen there—and I know how much you dislike traveling…It would be so much better for you, and for me, if you just went peacefully to sleep in your cozy bed here and didn’t wake up…”
Silence.
Then, with her refined British accent and characteristic stoical optimism she replied earnestly:
“I shall do my best.”
And so she did. A week later she had a minor fall, which precipitated her being confined to bed. Her appetite had been steadily decreasing and her sleeping markedly increasing in recent months; once in bed from the fall, she slept pretty much twenty-four hours a day and only roused when I woke her—for “feeding and watering”—as she would say. A few days later her appetite had dwindled to almost nothing and then her fluid intake began to decrease. I called home hospice.
Within three weeks she passed away, mostly peacefully, surrounded by her loving family, in what was now her own home, and wearing her favorite polyester, leopard-spotted pajamas with the breast pocket for her tissue.
And I can’t help thinking that this quite remarkable woman had managed to be captain of her destiny right to the very end, and in true keeping with her character, had given one final and enduring gift of love—the best one she had to offer in that moment.
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