Who Mourns for Grandma?

For those of you who follow my articles in Central Florida Online, you are aware the subject material is generally, technical, analytical or news related in nature. Rarely, do I write about personal experiences, however, a recent visit to a small town in Southern Louisiana has compelled me to tell the story of what I witnessed while visiting an individual deemed to be terminally ill. What I saw and heard during that visit was indicative of some of the greatest acts of despicable human, behavior I have ever encountered and reaffirmed my belief in the hypocrisy of Christianity.

As she liked to be called by those close to her, Grandma was an eighty seven year old woman who loved life and her independence as well. About forty years ago, after undergoing a routine operation, she was given a series of drugs which left her permanently, crippled. The result was loss of muscular control in her neck and facial area with headaches from time to time. Subsequently, she recovered to the point she was able to live a normal life with all other body functions, normal. She was able to drive an automobile, cook dinner, wash laundry, plant flowers, participate in church and talk to people who would listen to her. She took great pleasure in keeping busy.

I had the good fortune of enjoying her company several times over the last three years. Her stories about her youth and family history were priceless. She considered herself to be a legitimate Christian and said she raised her son and two daughters to emulate her beliefs. Although, speaking remained physically difficult, her words were easy to comprehend, once you got to know her. I found her to be articulate, compassionate, funny and intelligent. Other than her affliction, Grandma was in perfect health. Her weight had always been within the desired range. She never suffered from cancer or heart related conditions. She never smoked, consumed alcohol or abused drugs. She exercised regularly.

I was recently informed, during the last few months Grandma was in and out of the hospital for treatment for dehydration. On August 5, 2010, I received information she was admitted to the Hospital as a Hospice Patient. I was told she had been delusional, her internal organs were shutting down one by one, she was presently, in a coma and her death was imminent. Without hesitation, I made travel arrangements and feared I would not get there in time before she passed away.

I arrived at the Hospital, late in the evening of August 7, 2010. When I came into her room, I was surprised to find her alert and coherent, yet weak from dehydration, lack of sustenance and under the influence of some type of drug. I would later determine this drug to be morphine, a common, but powerful pain medication. She opened her eyes briefly and was able to have limited conversation. I asked her a series of questions which she answered with brief responses. When her granddaughter spoke to her, she managed a smile and a few tears. She even made a satirical comment when I asked her if any church members had come to visit her. Clearly, she was aware of the individuals in the room, her granddaughter, her oldest daughter and me. About thirty minutes later, she went back to sleep. I was surprised to see someone who was presumably, in their final stages of death, alert with all their mental capacities in tact. As an engineer and writer, my curiosity got the better of me. I began to research into what was, actually wrong with Grandma. I contacted the duty nurse and she said, she was not familiar with Grandma’s case. She hastily read through some documents and claimed Grandma had fluid on her brain which incapacitated her. I asked her, why then, was she coherent and why the fluid could not be drained? She said, the fluid could be drained but could not explain her coherence. As it was late at night, she said, I could contact someone in the morning who could better inform me.

The next day, August 8, 2010, I visited Grandma in the late morning. Two of her granddaughters and their husbands, her son and his wife and her youngest daughter and her husband were present. Grandma was unconscious. I asked her youngest daughter why this was so and she said, she had been given morphine because she was in pain. The son’s wife concurred and said, Grandma needed the pain medication. Of course, morphine has the effect to render an individual unconscious and requires several hours for the effects to subside, especially in an older individual. The youngest daughter informed every one, Grandma was about to expire. I understood this to mean, it would happen within the hour. She did not appear to me to be dying. Others agreed. I visited a while longer and then contacted the nurse’s station concerning the morphine injections. The on-duty nurse told me it was administered because the family requested it via the assigned Guardian, Grandma’s son. I asked the nurse if she thought Grandma was in pain. She said she did not know. I asked her about why the fluid on the brain could not be drained and she said she had no knowledge of this condition. Then, I asked her, what was, actually wrong with Grandma. She said, she did not know.

Unable to obtain meaningful answers to my questions and contradictions from others, I asked the nurse to allow me to communicate with the doctor in charge. She said, this was not possible as Grandma was now in the care of Hospice and all medical personnel, previously assigned to her prior to Hospice, were no longer in charge of her care. She further added, the purpose of Hospice was to make the patient as comfortable as possible with the assumption the patient would expire during the assigned Hospice period. For Grandma, she entered Hospice on August 6, 2010 and the closing date would be August 13, 2010. During that time period, the son was responsible for determining what she should be administered and the course of action taken. I asked the nurse if Grandma had communicated her wishes to any one in the hospital. She said, no, but she had signed a D.N.R. I asked the nurse if she had any knowledge, hearsay or otherwise, as to whether Grandma was ever in any pain. She said, she had no knowledge of this. Finally, I located a supervisory nurse, I felt could answer some questions about Grandma’s condition and treatment.

This supervisory nurse said, Grandma was diagnosed with Encephalopathy, although she did not say which form of the disease Grandma had nor what caused it. She said, it must have been determined to be fatal in Grandma’s case, otherwise she would not have been placed in Hospice. Personal research indicated, this disease involved degeneration of brain function and organ failure which may have been caused by a bacterial infection or exposure to toxins. According to medical texts, the disease could have several forms, all of which may or may not be fatal. I asked the nurse if she had knowledge of Grandma being in any pain and if she thought Grandma was coherent during any of her shift work. She said, she believed she was coherent and not subject to any pain. I asked her opinion as a nursing professional, acknowledging she was not a doctor, as to whether she believed Grandma was going to die that day. She said, she did not believe she was going to expire any time soon, but believed she would eventually expire due to the lack of food and water, which the family said she refused. She said, without water, renal failure was imminent and the rest of the organs would soon, shut down as well. She said, she was present when Grandma was brought in four days ago and in her opinion, Grandma’s condition was stable, meaning she was neither improving nor becoming worse.

Because Grandma had been injected with morphine, I knew she would be unconscious for the rest of the day and early evening. I asked the nurse if Grandma could hear conversation in the room. She said, there was no way to know for sure, however, it was unlikely she would be able to comprehend events or conversation while under the influence of the morphine. However, when she was not under the influence, it was highly likely she could hear and understand every thing around her, despite her eyes being closed. She said, this is why it was important for visitors and medical staff to be careful what they say and maintain a tranquil setting when in the presence of a patient in this condition. Since her oldest daughter would stay with her throughout the night and she was clearly, under the influence of the drug, I saw no point in remaining and left for the day. I accompanied some of the family members to Grandma’s home. When we arrived, I was shocked to discover Grandma’s son and his wife picking out a dress for Grandma’s coffin and gathering photos for her funeral. It was extremely, morbid and what made it so disturbing was there was no indication she was about to expire.

The next day, August 9, 2010, I returned to Grandma’s room about 11:00 am. One of her granddaughters, her son and her two daughters were present. I told them I had very serious concerns about any chance for meaningful recovery or extension of her life because she was not provided food and water. The youngest daughter said, Grandma was refusing food and water, was delusional and did not know what she was saying. I asked the oldest daughter if Grandma had written any instructions or informed any one of what kind of care she wanted in the event she went into a coma. She responded, Grandma had never discussed this with her, however, she assumed, she must have told her son to allow her to die if she was incapacitated. I commented to the granddaughter and oldest daughter, this was strange to me because in most cases, a person leaving instructions of that nature would have informed more than one person. I found it unusual that most of the family was unaware of Grandma’s specific wishes, prior to her entering Hospice. I would later determine, none of her friends or other family members were aware of Grandma’s wishes either. The oldest daughter, also found it strange, since Grandma came to stay with her often and never mentioned it.

Without warning, the youngest daughter became angry and went into a rage. She made derogatory remarks about her sister and continued to raise her voice to the point of hostility. It was difficult to believe, the nursing staff, just outside the room could not hear the event. All of us told her to either control herself or remove herself from the room. Instead, she attempted to initiate a physical confrontation with her older sister. Again, I asked her to leave the room as I was sure Grandma could hear what was going on. She refused. Grandma’s son did nothing and the episode continued. I believe Grandma was aware of what was occurring because she turned her head away from the point of hostility. I tried to shield her from the noise, but it was impossible. I left the room to summon security. I went to the nearest Nurses Station and asked for Security to remove Grandma’s youngest daughter from the room. The nurse said I should not be concerned as this was a typical scenario for a Hospice Patient. She said family members often behave erratically due to emotional stress of someone dying. I informed her I was a trained observer and in my opinion, the actions of the youngest daughter were deliberate and intended to harm Grandma, not the result of emotional distress. She said she would look in on Grandma, shortly.

I was appalled by the apathy displayed for Grandma by that nurse. Later I determined, the oldest daughter revealed her desire to take care of Grandma at her home instead of leaving her in the Hospital under Hospice. Apparently, this was the origination of the youngest daughter’s hostility toward her sister. I spoke to the granddaughter and discovered the youngest daughter and her husband had a long history of engaging in hostility and verbal confrontation in front of Grandma and her family, both in public and in her home. At that point, I began to question whether it was healthy for Grandma to be left in the presence of these individuals. I developed the eerie sense the youngest daughter, her husband, the son and his wife were in a hurry to see Grandma pass away, for reasons unknown. Later, the nurse came into the room, but by that time, the youngest daughter left. It was apparent to me, the hospital staff was not going to intervene on Grandma’s behalf, should a future hostile occurrence take place, again, for reasons unknown. The son left for a business meeting, shortly afterwards.

The granddaughter and I continued to visit with Grandma. She was in and out of consciousness. The granddaughter was able to speak to her and gave her water via a sponge stick, from time to time when she requested it. She even fed Grandma a little of her favorite cheese cake, brought in the day before. Afterwards, I visited another nurse on duty and asked about Grandma’s condition. She said, Grandma seemed to be improving slightly, however, we should not become too optimistic because this phenomenon was typical just before death, that is, a patient appears to be making a recovery and then expires, immediately, after. She also informed us, it was unlikely, Grandma’s, apparent desire to eat and drink was because she wanted sustenance. She said, the taste of food and water activated the “pleasure response” areas in her brain and if she actually, needed sustenance, she would consume much more than what her granddaughter and oldest daughter had given her thus far. On the other hand, the nurse added, as she understood the illness, she found it remarkable Grandma seem to be improving and when she was not under the influence of the morphine, was uncommonly, coherent. I asked her if it was absolutely, confirmed Grandma had encephalopathy. She responded, there was no indication this was a fact but said, it was conjectured to be so, based upon medical tests performed prior, as she understood it. According to this nurse, Grandma’s condition did not appear to be indicative of someone dying from the disease. She said, she was not aware Grandma had experienced any pain up to that point.

Later, another nurse came into the room to record Grandma’s vital signs. I reasserted my concerns about Grandma’s lack of food and water. She said, as far as the staff was concerned, the D.N.R. was the only important, applicable instruction and their course of action was to make Grandma as comfortable as possible, administer pain medication if necessary and to allow her to have any thing she desired, such as food and water when she requested it. They said, this was part of Hospice Care and the Hospital Medical Staff was not allowed to intervene unless she was removed from Hospice. The nurse reported Grandma’s Vitals were 118 over 59 with a pulse rate of 120. She said this was excellent for her at her age. The pulse rate was a little outside the normal range but she said, it may be due to the off and on medications she had received and/or any number of other reasons. As far as she was concerned, Grandma was very stable, free from pain and her death was not apparently, imminent.

Around 12:30 pm, a Senior Hospice Representative came to the room to deliver a blanket for Grandma, donated by a local charity. She said, she was surprised and elated Grandma was making what appeared to be a slow recovery, however, she concurred with my belief, no matter how physically fit a person is, they cannot endure for very long without food and water. She agreed, Grandma’s death did not appear to be immediately, imminent and reaffirmed, only the designated guardian could authorize a feeding tube or nutrient I.V. I informed her I had reason to believe Grandma was coherent enough times to express her own wishes and she was not delusional as we were lead to believe. I told her I was not a Doctor, however, my observation indicated Grandma was suffering from lack of food and water and I believed her apparent delusional state was the result of dehydration, not the illness. Of course this was an opinion and I had no medical expertise to support this, however, I stated I did not feel it was always necessary to have medical expertise to form an opinion based upon acute observation.

I asked the S.H.R. what would happen if Grandma exceeded the time limit for the Hospice Stay. She said, under normal circumstances, the patient would be returned home or released to a Nursing Care Facility. Apparently, one cannot remain in Hospice permanently. The Hospice Rep. said, she had known Grandma for over twenty years and she would look into Grandma’s case more closely. A short time later, she left the room but remained in the hospital. I conversed with the oldest daughter and granddaughter and said, I thought every thing I had witnessed so far was very peculiar and in my opinion, Grandma did not appear to be in pain nor could I find any Medical Staff to confirm she was in pain. I told them my concern was for Grandma and it was becoming increasingly clear to me, she was not being given the opportunity to make her own decision about the last days of her life, if in fact, she was dying of a disease. I told them she had been without food and water for what appeared to be four days at the time and the longer she was under the influence of morphine, the less opportunities she would have to express her own wishes. The response was, Grandma’s son had power of attorney and from a legal standpoint there was nothing that could be done. The daughter decided to get some lunch as she had been with Grandma the entire night. This left the granddaughter and me in the room with Grandma. Her granddaughter continued to talk to her, intermittently.

Around 1:00 pm., Grandma awoke, opened her eyes and asked to get out of bed. I contacted the nurses station and immediately, two nurses came to her bedside. They spoke with her and we all heard Grandma say she wanted to sit in the chair. The nurses agreed, it was a good idea as she had been in what they described, an uncomfortable bed for more than four straight, days. They asked where she wanted to sit. She gestured toward an armchair and both nurses helped her get into the chair. They asked her if she was in any pain and she responded, no. After checking her vitals and making some observations of her, they said, she could stay in the chair for as long as she wanted to. They informed us, to be sure someone was with her at all times. They acknowledged, this was a remarkable event and an indication she appeared to be improving.

Her granddaughter pulled up a chair beside her and spoke to her. Her head was bent forward and the nurses did not seem to know how to react to this. The granddaughter informed them, there was nothing to be alarmed about. Grandma had this condition for over forty years and she like to sleep in a chair with her head bent slightly forward. She did this at home and in public when she and her mother, the oldest daughter went out for dinner together. Because of the condition, it was common for Grandma to use her right hand to support and reposition her head at various times to become more comfortable. She performed this before our very eyes which provided more support for the idea she was cognizant of her surroundings. In addition, when she ate food, some of it would fall on her chest. She would simply clean it up after she was finished eating. The granddaughter informed me, she thought the nurse’s lack of knowledge of this trait was odd since Grandma had this condition for many years. She said, it was strange the Medical Staff would not, already be privy to this information. Before they parted from the room, I asked the nurses if they believed Grandma was coherent and understood them. They responded, she was coherent and answered their questions to their satisfaction. I asked them if they thought she was in any pain. They said, she did not appear to be in pain. As a matter of fact, they asked Grandma if she desired any medication for pain and she responded, no.

At about 1:25 pm, while I was reading a newspaper, Grandma lifted her head, opened her eyes and turned toward her granddaughter and asked what was happening to her. Neither of us knew what to say. She repeatedly, asked what was wrong with her. She demanded to speak to her son. We told her he was not present. The granddaughter told her she was in Hospice and asked if she understood what that meant. Grandma asked why and what was wrong with her. The granddaughter looked at me to determine what response should be given. I answered Grandma and said, what I thought at the time was the truth and that was, no one knew for sure what was wrong with her. She wanted to know why she was so tired and where she was. We told her she had been in the Hospital for almost, five days. Her granddaughter told her she was tired and sleepy because she was not taking in any food or water and that was making her weak. Then, we asked her if this is what she wanted. We asked her whether she wanted solid food or an I.V. I contacted the nurses and they came back to the room.

While the nurses were present, Grandma asked her granddaughter for something to eat and drink. The granddaughter fed her more of the cheesecake and gave her orange juice and water from the sponge stick. Her granddaughter asked her if she wanted her hair brushed. She said, yes and she proceeded to brush her hair while holding short sentence, conversations. We asked Grandma if she wanted to get better. She said, yes and we told her she would have to tell the nurses she wanted to eat and drink more. When the nurses returned, she asked for her lunch. They brought her a bowl of tomato soup. It was decided, soft food should be administered first. If I had any doubts about Grandma’s desire to live, it was removed by this event. She was not delusional or mentally incapacitated. She was coherent and fully aware of who was in the room. At the same time, she was terribly weak from what I believe, to this day, was malnutrition and dehydration. The nurses said, she was making incredible progress and a reevaluation might be in order, should she survive three more days, which now appeared to be assured.

Immediately, I left the room and located the Hospice Representative who came to Grandma’s room earlier. We came back to the room and observed Grandma in the chair eating her soup and talking with her granddaughter. Although, I did not know it at the time, she filed a report indicating a request for reevaluation of Grandma’s condition and course of action. She told me Grandma was in incredible shape for someone about to expire from encephalopathy and she was delighted to see her eating and sitting in a chair.

At about 2 pm., Grandma’s youngest daughter and husband came into her room. It was obvious she was livid with anger when she saw the granddaughter feeding Grandma. The daughter began to antagonize the granddaughter and make inappropriate comments about her mother, which included her displeasure with the mother’s desire to take Grandma home with her. I became concerned because of the volatile incident that occurred earlier that day involving her and the fact I believed Grandma could hear this. Her husband did nothing to stop his wife from continuing the verbal assault. The granddaughter continued to feed Grandma. A short time later, I witnessed one of the most despicable and unchristian acts of human behavior I have ever encountered. The daughter began to chastise the granddaughter for allowing food to spill on Grandma’s shirt. The granddaughter explained this was nothing to be upset about as Grandma incurred this action while eating for years. She said she would clean her up after she finished eating. At that moment, the daughter picked up a hand towel, knelt down in front of Grandma and began violently, wiping her face, neck and areas where food had accumulated, while the Granddaughter was still feeding her. The act was so violent, Grandma reacted in pain and attempted to pull away from her.

To this day, it is the only time I could recollect observing Grandma in pain. The granddaughter told her she was hurting Grandma but the daughter continued, all the while expressing her anger toward the granddaughter. After she stopped, she instructed Grandma to “go to Jesus, go to Jesus”, along with repeating, there were previously deceased family members waiting for her. Grandma withdrew from the event, closed her eyes and remained in the chair with her head bent over. She stopped talking. Incensed by what I saw, I went to the nurses station and demanded Security be called to remove the daughter and husband from the room. The on-duty nurse did not comply. This was the second time I requested Security and there was no response. I pondered whether it would be appropriate to contact the local Sheriff’s Department for help, but decided against it for reasons, I later regretted.

When I returned to the Grandma’s room, I found the daughter sitting in a chair, still full of anger. I could not understand why she would be so upset. My common sense said she should have been delighted Grandma was becoming stronger. A short time later, I saw Grandma’s son coming toward the room. I was excited about relaying the news of his mother’s change in condition and thought he would be ecstatic upon seeing his mother sitting in the chair, eating solid food and drinking water. When he entered the room, I began to inform him of the remarkable events that took place over the past two hours. He ignored me and began talking about automobile tires with the youngest daughter’s husband. I was flabbergasted. How could someone who loved his mother completely ignore this astonishing news? His mother was making progress toward recovery and he was completely, apathetic about it. After a few minutes, I asked the son if we could talk privately, outside the room. He agreed and I informed him of the events which took place and how it was remarkable Grandma’s condition appeared to be improving. He acknowledged it was great news but his words did not contain any enthusiasm or excitement. We returned to the room. After conversing some more with the younger daughter’s husband, he asked Grandma a question which he justified as proving Grandma was mentally, incapacitated and ordered the nurses to return Grandma to bed. The nurses had planned to change her dress, so I used the opportunity to take a break and wait in the visitor’s area. The granddaughter remained in the room.

About 15 minutes later, I saw the granddaughter pass by the door of the waiting area. She was crying and extremely distraught. When she was able to regain her composure, she told me what had just occurred. By her account, the youngest daughter whispered to the two nurses, Grandma was in pain and requested the nurse to administer another morphine injection. Overhearing this, while on the phone with her sister, the granddaughter objected, saying she was not in pain and argued Grandma’s other granddaughter and husband were en route to the hospital. If the injection was administered, they would not be able to converse with her. When it appeared the injection was going to be given any way, the granddaughter told her sister what was occurring. Next, the daughter commanded the granddaughter to leave the room. She said she would not leave. At that moment, the daughter’s husband shouted at the granddaughter, got in her face and intimidated her into leaving the room.

Two nurses were present when this occurred and the granddaughter, en route to the hospital could hear every thing over the phone. The son, also present, did nothing to inhibit the hostility the younger daughter’s husband initiated against the individual who spent the entire day with Grandma, feeding her, talking to her and brushing her hair. I could not help but wonder what Grandma was thinking when she told me her family was a Christian Family. With Hospital Employees and family present at this incredible scene, Grandma had to endure one of the cruelest acts of hostility toward another human being. The participants who provoked the hostility had no consideration for Grandma. Surely, she heard every thing. I can think of no other form of disrespect and contempt for a mother who raised and loved her family. As the granddaughter was leaving, one of the nurses present, apologized to her indicating her remorse for their inability to help.

After hearing the testimony of the granddaughter, as to the events which had just transpired, I went to the nurses station and demanded Security come to the room and remove the individuals initiating the hostility. Again, for the third time, no security appeared. I told the nurse I was going to report this as abuse administered to a Senior Citizen in Hospice Care and the Hospital’s inability to protect one who was trying to provide compassionate assistance to their grandmother. When I went back to the room to gather some belongings, one nurse, still present with an injection apparatus in her hand, gave me the indication she was extremely distraught.

At that point, I came to the conclusion, Grandma was not in pain. She was being medicated for the purposes of depriving her ability to become well enough to express her own decisions, as to how she wanted to spend the rest of her life. I contacted the granddaughter’s mother and informed her there was no reason for me to stay any longer. I told her I believed she might get better if she could obtain food and water. Apparently, the son and younger daughter were not going to permit this and time was running out. That evening, I informed the granddaughter I would be returning to Florida the next day. I agreed to accompany her to see Grandma one more time and to ensure she had an opportunity to see her one more time, without interference from the youngest daughter and her husband.

The next day, August 10, 2010, the granddaughter and I arrived at the hospital. I decided to go first, leaving the granddaughter in the lobby to await my instructions to proceed. Before entering Grandma’s room, I spoke with the on-duty nurse who had appeared on previous shifts. She said, only the youngest daughter was present, along with a nonfamily, visitor. I told her I would say my goodbyes and if the daughter was in the room, I would ask her to permit the granddaughter to say goodbye to her grandmother, alone. If she would not agree, I would come back to the nurses station and call for a sheriff’s deputy to come to the hospital and assist us. She said, she would intervene if the youngest daughter did not comply and it was not necessary to call Security. Next, I entered the room, and proceeded to Grandma’s bed. I put my hand in hers and heard the youngest daughter angrily, state, it was not necessary for me to take her vitals. I replied, I was not taking her vitals but simply, holding her hand. As I did this, I told Grandma I loved her and I told her I did every thing I could for her. She squeezed my hand and opened her eyes. She would not let go of my hand. Eventually, she did and I turned to her youngest daughter and asked her to allow the granddaughter to say her goodbyes, alone with her Grandmother. The daughter agreed and as I left the she room, she uttered a sarcastic salutation.

Anticipating the youngest daughter would not honor what she said, I reiterated to the nurse, I expected trouble and what happened to the granddaughter yesterday, must not happen again. She said, she would not let that happen. I informed the granddaughter, arrangements had been made and of my communication with the nurse about potential trouble. I instructed the granddaughter to leave the room and contact the nurse if the youngest daughter initiated any trouble. I told her Grandma was conscious and could hear every thing in the room. The granddaughter proceeded to the room with a vase of roses for her grandmother. As soon as she entered, the youngest daughter refused to leave. When the granddaughter said she had agreed to this, she became volatile, so the granddaughter left the room and went to the nurses station. The nurse came to the room to find the youngest daughter hiding inside the room’s bathroom, refusing to come out. Eventually, she was able to get her to leave Grandma’s room where the granddaughter spent about ten minutes with her. She gave Grandma the flowers and said her goodbyes. Before I left for Florida, I informed the oldest daughter and granddaughter, I felt the youngest daughter and her husband should not be left alone with Grandma. I informed the on-duty nurse of my same concern.

The long drive back to Florida gave me the opportunity to consider what I had experienced over the past four days. I wanted to believe, Grandma was simply a woman whose time had come and the repugnant behavior of some of her family members were in deed, reaction to the stress of a dying, loved one. Unfortunately, there were too many inconsistencies to support this. The fact no one seem to know Grandma’s wishes except those who seem to be in a hurry to end her life, the confusion and contradictions concerning her illness presented to me by the nursing staff, the overwhelming hostility generated by certain family members directed at any one who tried to communicate and help Grandma and their refusal to embrace the reality of Grandma’s improvement with love and affection, the authorization of pain medication for someone not in pain according to observation and medical staff opinion, the insistence Grandma was mentally incapacitated while conscious when clearly, she was not, and most important, the open hostility initiated by those aforementioned family members in the presence of Grandma when they were aware she could most likely, hear the activity around her, therefore, perpetrating disrespect for her, presumably, in the dying phase was indication to me something was terribly wrong with this picture. It was inconsistent with the behavior of other “last moments with loved ones” episodes I was present for. I reached the conclusion, Grandma’s opportunity to say how she wanted to spend the rest of her life was taken away from her for reasons unknown. Encephalopathy may have eventually, claimed her life but there was no indication to me she was ready to die. Had she been given the opportunity to say so herself, I think she would have wanted to survive as long as she could and communicate with her love ones for as long as she could. Could I, in good conscious, ignore this and every thing that had occurred?

On August 11, 2010, I decided I needed to perform one last research task and that was to obtain advice, as to whether I should report what I witnessed to authorities. I contacted The Florida Dept. of Children & Family Services, The Florida Elderly Abuse and local Hospice Care Organizations for the purpose of obtaining advice as to whether I was over dramatizing events that took place or if those said events warranted further investigation. All parties stated, the events warranted an investigation. Not one individual disagreed. After much soul searching, I followed their instructions and I contacted the various investigative agencies within the Louisiana State Attorney’s Office. This was not an easy thing to do. I was aware of the repercussions some family members may have to endure as a result of the investigation. In addition, Grandma was a pacifist to the degree, she would not have been pleased with this action. The paradox is, by my actions, I may have dishonored her in the process of trying to save whatever life she had remaining.

On August 13, 2010, the granddaughter was informed by the oldest daughter, she spoke with the original doctors in charge of Grandma and there was a disagreement between doctors as to whether she should have been admitted to the Hospice Care. At the end of the day, Grandma had survived the original Hospice period and the oldest daughter planned to contact the son to see if Grandma could go home with her, monitored 24 hours per day by private care nursing. In addition, she informed us, Grandma was given additional, morphine injections. She said, over the past few evenings, Grandma was conscious some of the time. She would eat food and drink small quantities of fluids at various times, throughout the night. Her vitals were stable and actually improved slightly, after I left for Florida. She said, it was decided that a final decision would be made on August 16, 2010, with respect to her departure from the Hospital. I continued to express my concerns about withholding food and water from Grandma and the seriousness and consequences of dehydration. On August 16, 2010, according to the oldest daughter, Grandma began to deteriorate, rapidly. On August 17, 2010, Grandma passed away.