Agitation

In my mind’s eye, Mom had a bad day Friday. She experienced more agitation than I have seen in quite awhile, since she became more withdrawn and immobile. I arrived just as an aide was changing her and repositioning her. I could hear her yelling from behind the closed door. Her lungs are strong, I thought to myself. I went in and sat, and as I had on Thursday, I cried a little. I thought and said to Mom, “I’m sorry this is happening to you. I’m sorry for all you’ve been through.” Though I have expressed multiple times that I want her suffering to end, that doesn’t take any of the sadness away. And that has taken me a little bit by surprise.

Mom was twitchy and her eyes were open. She vocalized a lot, and with little voice left, it sounded like groans of distress. I talked soothingly to her but I wondered if the repositioning had left her in pain. I asked the aide if she could have some medicine. He checked with the nurse, and said it was too soon – presumably for morphine. As time passed, and she tried to pull the oxygen tubes out of her nose repeatedly, I went to the nurse station to ask for Ativan. I stood there while two staff members kept their heads down, working. I imagine that when there are patients approaching all day long, this is a strategy to get work done. But it pissed me off. “May I ask you two a question?” I said. “I’d like for my mom to receive some Ativan. She’s obviously agitated.” “I’m in medical records,” one woman said. “I do speech therapy,” the other said. “But we want to help.” An aide arrived at that moment and said she would look for the nurse, and I thanked her.

I waited with Mom. I stepped out once to look down the hall, and the aide caught my eye. I waited some more. For those who have seen the movie Terms of Endearment, when Shirley MacLaine screams desperately at medical staff to give Debra Winger some pain medicine – well, I was about to go Shirley MacLaine on this place, with a staff I respect very much. I stepped out into the hall, and the nurse was walking toward me, mixing the medicine in a cup. Mom was so interested in the medicine that the nurse offered her some applesauce, and that seemed to make Mom happy. Even when someone has stopped eating, it’s OK to give her food if she wants it – I learned this from the hospice nurse later. Mom eventually relaxed, and I Ieft for a few hours.

Mom would not let go of the oxygen tube. She used her other hand to pull the tube away from her nose.

Mom would not let go of the oxygen tube. She used her other hand to pull the tube away from her nose.

When I returned in the mid-afternoon, she was agitated again, but had recently received morphine. So the nurse told me she expected Mom would settle down. We gave her some applesauce and fed her a high-calorie protein drink with a spoon. I did most of the feeding over time. Mom eventually didn’t open her mouth for the drink anymore. And then her agitation returned. She pulled at her sheets, flailed her arms, groaned nonstop. She pulled the oxygen tubes out of her nose countless times, and I returned them, to her dismay. I massaged her arms, hands, head and the side of her back that Ic could reach. The back rub provided brief relief, and she quieted. But soon she was restless again, and she occasionally cried out and grimaced. I couldn’t stand it. I was about to beg for more Ativan when the staff nurse and hospice nurse arrived. We agreed to start scheduling the Ativan at regular intervals to reduce the likelihood of more agitation. It’s discouraged if someone still walks, because it increases the risk for falls. That is not a concern here. Mom received morphine and Ativan and fell deeply asleep, finally. Her breathing was regular. Her heart rate had decreased to 91. I could finally leave.

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2 comments so far

  1. patwhite67 on

    Emily, I send my thoughts to you. I believe your mom knew your touch.

  2. airedoodledog on

    Thinking about you & just wanted you to know.


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