Dad’s 77th birthday was blessed with beautiful August weather. Mom and I stop at Kroger’s and pick out several birthday cakes for our visit with Dad, enough cake so everyone can have a piece. My father has spent the last four years of his life in the Eisenhower unit, a hospital ward for Kentucky military veterans with Alzheimer’s disease and similar afflictions. Several nursing aides help with the cake cutting and distribution, and soon the guys had an afternoon treat. Dad attacks his piece with both hands, and soon devours another slice. I wish I had known then it would be his last birthday.
The previous November, I was assigned a ten-day trip to Europe, flying as a United Parcel Service Airbus 300 Captain, with stops in Germany, Spain, and Italy. Each day I prayed for God to be with Dad, and help my father through the struggles of dementia. When I return home, Mom tells me Dad is in the Veterans’ Regional Hospital in Lexington, Kentucky, because he had suffered serious abdominal hemorrhaging and vomited blood. Mom was awakened by a 5 a.m. phone call from Dr. Dan, the Eisenhower unit neurologist, telling her Dad was seriously ill.
Later, Dr. Dan says it was a miracle the hospital surgeon was able to stop the bleeding, given the condition of Dad’s blood. Dr. Dan told me the year prior that there was something wrong with Dad’s blood; the white cell and platelet counts were dangerously low. A bone marrow test could tell us if Dad had a blood disease like leukemia, but the test is extremely painful and there was a chance Dad might not survive it. Even if Dad survived and leukemia was detected, I decided I wouldn’t force him to suffer through chemotherapy. At the time, Dad was eating well and responding to social activity, so we left things as they were.
That November, God is merciful and heals Dad enough so he can return to the Eisenhower unit and the people who love him. Dad’s mental condition begins to deteriorate, however, as so often happens when there is a sudden change in the physical health of a dementia patient. More and more, Dad does not acknowledge our presence. During visits, he stares at the wall or at an imaginary object in front of him, yet we occasionally receive an indication that Dad is still there.
During the Christmas party, Dad slowly eases Mom’s purse from her grip and gently rummages through its contents. I pray for more tokens of Dad’s surviving spirit. When I sit next to him, I massage his shoulders, hug him or caress his cheek. I whisper, “I love you, Dad.” I remember Psalm 139.
In the first few months of the next year, Dad gradually stops eating. Occasionally he eats a meal, but generally, he doesn’t want any food. Even the milk shake-like nutritional supplements are refused, so he begins to loose weight steadily.
In the late morning of Sunday, March 12, I receive a telephone call from the shift supervisor nurse. She says Dad is bleeding from the mouth, has a high temperature and is having trouble breathing. They are waiting for an ambulance to take Dad to the veterans’ hospital in Lexington.
I wonder if this is Dad’s last day. The supervisor recommends I wait for the hospital to contact me about Dad’s condition, and the minutes drag by as I wait by the phone.
An hour or so later, the emergency room physician at the hospital calls. She says Dad’s white blood cell and platelet count are unbelievably low and asks in amazement if I am aware of Dad’s critical condition. I reply that I knew his counts were low, but didn’t realize they were this low. Since Dad had stopped eating regularly and is having trouble swallowing correctly, he is suffering from aspiration pneumonia that results from the ingestion of food particles into his lungs. All this is classical progression of dementia combined with whatever was wrong with Dad’s blood.
The doctor asks for permission to give Dad a blood transfusion and treat him for pneumonia. I agree and Dad responds well to the antibiotics and blood transfusion. He is able to return to the unit a day or two later.
I learn from Dr. Dan that although Dad has recovered from the pneumonia and any other infections, the effects of the blood transfusion soon will disappear. Dad will again be susceptible to aspiration pneumonia and associated infections.
The good doctor-shepherd consoles me with his compassion for Dad and my struggle to understand the decisions I would have to make in the weeks ahead. Subconsciously, I knew all along what is coming, and working on the documentary and this book is preparing me.
Late Saturday night, April 15, another call comes from the supervisor nurse. The same things are happening to Dad as before; it is another bout of aspiration pneumonia, and he is on the way to Lexington. The next day was Easter Sunday, and something urges me to drive to the emergency room and be with Dad. During the two-hour drive, I pray for strength and ask God to heal Dad.
When I walked into the emergency area, I see what looks like a small boy lying in a bed with IV tubes sticking in his body and an oxygen mask covering his face. Coming closer, I recognize my father. How little he looks in that hulking hospital bed! Dad is sweating profusely and hacking with every breath.
The on-call doctor soon approaches me and asks for permission to treat Dad for the pneumonia in both of his lungs. This is necessary because of the “Do Not Resuscitate,” or DNR, order I sign for Dad every year. I stay several hours with my father, hold his hand and assure him that I love him, but there is no response. Eventually, the hospital staff stabilizes Dad and move him to a semi-private room in the hospital, and I returned home Sunday morning.
I visit Dad again on Tuesday. He is unresponsive, and his doctor is not sure if Dad can return to the Eisenhower unit at Thomson Hood. Dad is not recovering well from the pneumonia, and the doctor doesn’t know if anything else can be done. I mention the transfusion option, and he agrees to try giving Dad some blood.
Lying in bed Wednesday night, I feel a compulsion to pray for my father. I get out of bed and onto my knees, and I try to pray. I can’t find any words to offer God, so I ask the Holy Spirit to help me.
Suddenly, I feel a question framing in my mind; “What do you want for your father?” I reply that I want Dad to be healed enough to eat a meal and return to the people who love him. A peace comes over me, I return to bed, and soon I am asleep.
I visit Dad on Thursday, and I am astounded at what I see when I enter his room. Dad is sitting up in bed grinning at me. When I take his hand in mine, the grin turns into laughter. His ice-blue eyes twinkle as he gazes at me and then at the clock on the wall above his bed. Dad alternates his attention from me to the clock. Is he wondering what time it is? Or what month it is? Or what year it is?
The doctor steps into the room and says Dad has responded “surprisingly” well to the transfusion and antibiotics, and he smiles as he says Dad can return to Thomson Hood the next day.
When Dad arrives back at the unit on Friday, the nurses call me to say how surprised they are at the size of the meal Dad eats that evening. I thank God for answering my prayers. He teaches me lessons about prayer I’ll never forget: always obey urges to pray no matter when they occur; when you don’t know what to pray, ask the Holy Spirit to pray for you; and be specific about your requests and intercessions for other people before God. We know God’s purposes takes precedence over our plans, but I deeply believe He wants us to make specific requests so He can give specific answers.
Answered prayer is how God communicates with us; it’s an indication we are living the life He wants us to live and praying the prayers He wants us to pray. Just like everything else in life, though, we have to learn how to pray effectively, and this means studying what Christ taught his disciples about prayer and what God says about prayer. There are mysteries involved with prayer, but Christ says in Luke 18:1 that we should pray and not quit. We need to keep praying and let God take care of the mysteries. Don’t ever quit praying. If you pray through the resurrection power of Christ, the answers will arrive, maybe in unexpected ways. Remember, God answers our prayers the way we would if we had His power, knowledge and love. If you can find a prayer in your heart for some issue that is troubling you, then go ahead and pray that prayer.
The next week, I talk about Dad’s condition with Debbie, the Eisenhower unit nurse manager, and Dr. Steve, a new attending physician who has taken Dr. Dan’s place due to the good doctor’s health issues. They feel Dad is in a cycle of aspiration pneumonia because he can’t swallow food properly. The options are to insert a feeding tube, stop feeding him or continue feeding him and treat every cycle of pneumonia with antibiotics and blood transfusions.
“Dewayne, your dad is in the last stages of dementia, and he obviously has some sort of blood problem,” Dr. Steve says. “The transfusions only last a few days, and then he returns to the original condition. You might want to think about what to do the next time he has pneumonia. I know this is an incredibly difficult time for you and your mother.”
Dad is rarely eating, and he is unresponsive to the staff. I know how much he enjoyed eating, and how he enjoyed it even through years of dementia. I don’t think he wants to go on this way. I am praying daily for God to guide me in making decisions for Dad.
Initially, Mom wanted Dad to live, no matter what had to be done. After some more reflection and prayer, however, she has begun to see more clearly that Dad is in a desperate condition.
Eventually we decide that Dad should stay in the Eisenhower unit and not be transferred to the regional veterans’ hospital when the pneumonia returned. He still will be offered food and nutritional supplements. Dr. Steve agreed to treat Dad with antibiotics and pain medication, and not to give Dad any further blood transfusions.
Mom and I visit Dad again on Thursday, May 4th. Although he eats a meal occasionally, Dad continues to loose weight. Mom is shocked at how much weight he has lost since her last visit.
I sit on the left side of Dad’s wheelchair and Mom sits on the right. We each held a hand, and Mom silently weeps as I talk to Dad about the weather, work and how much I love him. He looks straight ahead and seems focused on a far-away object. I think he might be dreaming, perhaps he is watching a football game or is enjoying a fishing trip from my boyhood years. Feeling a surge of love for Dad, I pat his hand and say, “Someday in heaven, you and I will look back on all this and laugh!”
What happens next will live with me forever. It will always assure me that my father was always there.
Dad slowly turns around to face me, lifts his arm and gingerly places it around my shoulders. Gazing into my eyes, he deliberately winks his left eye and holds it closed for a few seconds. The look he gives me seems to say, “You’re right about that, Son.”
I tremble with emotion at this display of God’s mercy. I know now that there is much more going on deep in Dad’s soul than I can ever imagine. I know Psalm 139 and Hebrews 13, verse five, speak God’s truth despite the ravages of dementia.
As we leave that fair May afternoon, Mom says she doesn’t see how Dad can live much longer. She is ready for him to be with God.
* * *
May 15, 2006 is the Monday after Mother’s Day. On Saturday, I finish a 16-day work cycle and look forward to two weeks off from work. Around 9 a.m. on Monday, I begin to study J.Vernon McGee’s commentary on Paul’s second letter to the Corinthians, chapter five. The first verse of this chapter is on my computer screen: “For we know that if our earthly house, this tent, is destroyed, we have a building from God, a house not made with hands, eternal in heaven.”
Moments later, the dreaded telephone call finally arrives. Arlene, one of the nurses caring for my father, tells me he has a dangerously high temperature and is fighting to breathe. Dad has another case of aspiration pneumonia and this one is raging quickly out of control. Arlene thinks I should be with him.
This gloomy, rainy day will be the last I spent with my father.
Preparing for the day ahead, I remember how, 40 years before, Dad spent months restoring an antique automobile in our backyard. I remember the jalopy’s engine dangling precariously from a rope and pulley anchored to a sturdy tree limb. Our resident mechanic fussed and fiddled daily with the motor, and practically every other part of the rusting maroon sedan, despite Mom’s persistent pleas to wash up and eat a reheated dinner. Only reluctantly would Dad amble toward our modest, two-bedroom home, throw his work cap on the back porch, and feast on whatever tasty treats Mom set before him. He loved his cars, and always taught me to take care of them.
Opening the car door before the ninety minute drive to the hospital, I noticed the two rear tires were low on pressure. The corner gas station had an air pump and I decided to simply re-inflate the tires instead of investigating why they were low. Driving on the wet pavement to the station, I heard dad’s voice in my ear cautioning, “Son, get those tires checked before you drive in this rain.” Taking decades of his advice, I drove several miles out of my way to a tire store. Sure enough, there was a nail in each of my rear tires.
When I arrive in Dad’s room, a nursing assistant is hugging him with her lips close to his right ear. Armanda is softly singing a lullaby much the same way a mother would serenade her newborn baby. The bed is raised to a 45-degree angle, and Dad’s arms are draped around a hefty, red stuffed alligator lying on his lap. An oxygen mask covers his nose and mouth. The white cotton pajama top is damp with perspiration and loosely covers his chest. Taking Armanda’s place next to Dad, I hold his limp right hand and say, “I’m here, Dad. I’m spending the day with you. I love you.”
There is no note of recognition from him, no sign he even hears me. I notice his glassy left eye is staring at an angle to the left, while the ice-blue right eye moves normally. His skin is abnormally warm and my heart breaks to see how hard it is for him to force air into his lungs. Dad’s respiration is rapid, and I don’t see how he can fight like this for very long.
While watching Dad roughly gasp for each breath, I recall that fishing was our favorite father-son activity during my years at home. Most Saturday mornings from spring through fall we drove down a swayback mountain road to the bottom of the New River Gorge, crossed rickety Fayette Station Bridge, and parked near the railroad tracks. If we arrived early enough, we had the magnificent river and accompanying picturesque valley to ourselves. On a morning in May, the same month I held my dying father for the last time, we might see the West Virginia hills majestically rising through wispy willows of fog. Above the forest green peaks, a patchy blue sky promised a canopy of sunshine for our day together. We toted our poles and buckets of bait a mile or two along the railroad tracks bordering the roaring river, and soon could almost smell the fish swimming below. Dad picked out a dirt path leading to the boulder-lined water, and then guided me to a day of casting lizards, eating delicious and slightly melted bologna and cheese sandwiches, and occasionally catching a catfish or bass.
Lying on his deathbed, Dad desperately draws one quick breath after another. I delicately place my forehead against his forehead and look into his right eye, the one that still has life. After kissing his cheek, I can taste the salt from his sweat, and his skin has a slight soapy odor. A voice whispers to my soul, “Talk about the good times you had on the river. Tell him about that big catfish you caught on the last cast before sunset one evening. Let him remember again the trophy northern pike he hooked the night you fell into an algae pond. Laugh with your father.”
So, I swallow my tears, smile and tell my father fish stories. Praying for a reaction, I am disappointed when none comes.
The Comforter deep inside me then says, “Your dad aches to see the river. You must say he can go without you. Describe how nice the river looks today, and how blue the sky is above the mountains. You will be down behind him soon. Let him go.”
This is too much to ask of me. Needing time to think, I assure Dad I will be back and leave for a break from the deathwatch. Armanda enters the room behind me.
Walking up and down the hallways outside, I think about how many times I have paced the same halls over the past four years. Even though the professionals who care for Dad are affectionate and compassionate, I am tired of seeing Dad suffer. I wonder how weary he is of this ward after years of falling further and further into dementia. Gradually, a new prayer forms in my heart. After a few minutes, I ask God, “Oh Father, if I’ve ever had any influence with you, please hear me now. Please take Dad gently into your presence; please help him through this suffering.”
Returning to Dad’s bedside and again replacing faithful Armanda, I describe how beautiful the river looks today and how brightly the sun is beginning to shine through the fogbanks that top the mountains. I encourage Dad to take the next path; I will follow in a few minutes. The day was perfect for fishing. Over the next hour or so, I repeat the request. The doctor adjusts Dad’s medications. Later, nurses move Dad to a room closer to their desk as I trail behind.
Once he is in the new room, Dad’s breathing abruptly slows. I call for Leta, one of the supervisor nurses. She read his vital signs and quietly says, “It won’t be long now.” Leta removes the oxygen mask and tenderly caresses Dad’s forehead. I hold one hand as he haltingly draws a last gasp of air. I call out, “I love you, Dad.” As I watch his right eye, a single teardrop appears and trickles down his cheek. I know then he is gone, and I weep in both relief and grief. The tear is a gift to me from God; a sure sign Dad has been with me the whole time. I wipe the tear away and study it while I cry. I know Christ is wiping the same tear away in Heaven, along the river of life, and welcoming my father home with loving arms.
Father and Son
Dad in Korean War Uniform:
Company C, 64th Heavy Tank Battalion, 3rd Infantry Division
To learn more about the Eisenhower Unit, please read my Blog and “Stories by our Users” entries listed below:
Reveille/August 15-January 1 (Blog)
Bricks of a Different Color-January 4 (Blog)
A Show of Love-January 10 (Blog)
Moving Day-January 13 (Blog)
Introductions-January 18 (Blog)
Sharing Our Grief-January 22 (Blog)
Love Stories-January 25(Blog)
Trashman-January 29 (Blog)
Holiday Gatherings-February 2 (Blog)
A Conversation About Alzheimer's-February 6 (Blog)
Nursing Dementia-February 8 (Blog)
A Dementia Care Philosophy-February 9 (Blog)
Ministering Demented Veterans-February 12 (Blog)
In The Shadow-February 17 (Blog)
A Gallant Vessel-February 17(Stories by our Users)
Memorial Day-February 19 (Stories by our Users)
Medical Aide Man-February 20 (Stories by our Users)
Nephew Eddie-February 23 (Stories by our Users)
Baby Sister Savannah-February 23 (Stories by our Users)
Monticello Memories-February 24 (Stories by our Users)
My Comfort, My Shield-February 24 (Stories by our Users)
I’ve placed the music video from an earlier story, “Even Now,” in Related Files below.
Additional photographs are in my vault.