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My Mother’s Hands Print E-mail
By Larry Johnson   
Wednesday, 09 September 2009

My mother’s hands are cupped together, one hand gnarled and twisted tight by arthritis. She can’t walk the walk or talk the talk anymore. She is in her wheelchair or in bed now and is mostly mute. Her eyes often just stare distantly, looking down the road of her life and the journey to come.

A few days ago, a physician’s assistant at the nursing home Mom lives in called to ask about putting her under hospice care. It’s a good thing, he said, for someone with end-stage Alzheimer’s. This way, he said, Medicare will come in on top of what we are doing here and pay for some things — oxygen tubing, incontinence pads, an aide to help with her showers three days a week, and so on. Comforting things like that. Small things.

The truth is that Mom is toodling along like the Energizer bunny in general physical health and is not yet in the neighborhood of what most people imagine hospice care to be.

But what this brought to mind is the brouhaha surrounding the “end-of-life” counseling provisions embedded way on down in the language of several of the current healthcare reform bills. The truth will lie somewhere in the mundane middle between Sarah Palin’s “death panels” and President Obama’s remark that we “aren’t going to pull the plug on Grandma.”

What’s been left out of this equation is human nature. Some many months or years down the line, perhaps long after Obama is out of office, some lonely Medicare minion or insurance adjuster will take the leaky words of a rather vague policy and turn it into a standard operating procedure. Why? Because that’s the way he was brought up maybe, or he just sees the world in rigid terms of enforcement and paperwork or corporate profits.

All it will take then is a shrug of the shoulders, a raised eyebrow of suggestion directed to an old person of diminished capacity, or to a confused family huddled in conference, or to a venal relative chomping at the bit. Look, he will say, these drugs are really costing the government or my company a lot of money every month. We’re going to have to cut down expenses, the president said so back then, and there’s an easier way for everybody. Or maybe it’ll be a doctor influenced and under the sway of the drug companies, or a health care worker bribed by someone deep in the bowels of an insurance company. It’s only human nature.

We have a model for this already in the state of Oregon. There a medical insurer offered to pay $50 for a death cocktail for a dying woman rather than shell out $4000 for her “expensive” cancer treatment. My mother’s case is not so drastic yet. But it doesn’t take much of a mental leap to see how these little “comforts” suggested by the physician’s assistant can quickly turn on a dime into expenses that need to be scaled down.

Mom is far from needing hospice care, at least in the minds of my brother, my sisters, and me. We see hospice care as coming in during the last few days of life as vital signs go down, breathing becomes labored, nutrition by mouth is only a lost memory, and a few pain-easing medications might be warranted. And then the last breath comes and Mom goes home to God. Perhaps like my Dad, who sat up in bed right out of a comatose state, she will also sit up with her eyes open and a beatific smile on her face. Then she will fall back down peacefully on her pillow and into eternal life.

Mom is ready, she is fortified with all she really needs. As an only child and out of nowhere, she convinced her Baptist mother to let her go to a Catholic school. She converted on her own to Catholicism when she was twelve years old. She convinced my Dad to convert so they could get married before a Catholic priest. Toward the end of his life, he became fervently faithful. She read her Bible every night for decades until the words no longer made connected sense. But she was by then filled with the Word. She loved going to Communion until she finally forgot how to swallow the Bread, as she has forgotten how to eat earthly food. Before her mind dissolved into randomness, she made her Confession and received the Last Rites. We are grateful for all the grace-filled moments we have experienced in caring for her over the last eight years.

My hope is that her last moments will not be tainted or hastened along by a government bureaucrat or some insurance wonk looking to save some money, or some doctor trying hard to help pay off medical school loans by using Federal or corporate financial incentives for end-of-life care.

My mother, if she could know all this, would applaud our view of caring for her. But Mom’s life is in God’s hands now. It doesn’t need to be, at the end, in the hands of some stranger with unknown or questionable motives.

Larry Johnson worked for many years as a professional writer in the business world, as well as a film/video producer and director. He is currently a freelance writer and photographer, as well as an organic farmer, in Texas.

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Comments (17)Add Comment
0
Hospice - Good or Bad?
written by Elder Reader, September 10, 2009
Hospice care when properly conducted is a truly great good. I know that this is so because hospice nurses and their assistants provided respectful, kind, professional assistance to me and my mother in our own home. They did all that they could to assist us through not days but months of her dying. On the other hand, I realize that great evils such as the case of Terry Schiavo do occur. Family surveliance is the key. Should the state attempt to take control, that would be dangerous.
0
I LOVE YOUR MOM!
written by debby, September 10, 2009
what a beautiful tribute & loving song you have sung to us! thank you, Larry!
you are of course right-we are human BE-ings before we are anything else. that dignity can never be twittered away in any arena. i have no doubt that the Last Face your mommy sees while still in her body on earth will be the First Face she sees on the other side of this life.
May our Triune God & Holy Mother Mary continue to draw you all into deeper communion with each other even as you are drawn deeper into His love
0
Paranoia
written by Mike, September 10, 2009
The intellectual dishonesty of Mr. Royal and his collegues in this column is breathtaking. It seems that the conservative catholics that fall into line with big business and their GOP collegues are determined to preserve the inhumane nature of the current health care system. If they listened closely to the president's words last night, they would relaize the current reform initiative is not meant to ruin the insurance industry. It is meant to improve it by putting a human face on it.
0
...
written by Robert Royal, September 10, 2009
Mike: I'm not sure who you are arguing with. This column fears the inhumanity of government and insurance companies. I wrote a few weeks ago that I agreed with Obama that reform could do much good. Whether the proposed reform will work, however, is a different matter. Some of us think this much government, whatever Obama's words and intentions, will have unintended consequences. And then there's expecting to pay for it by efficiency and cutting waste and fraud, which no one believes possible.
0
cause no harm
written by Joe, September 10, 2009
was once in the Hippocratic oath.The health care reform can be called a Butterfly effect because with anything happen, in order to make a buck, something will be denied that will save a life or at least prolong it.
0
Greed!
written by Willie, September 10, 2009
The Hippocratic Oath has been rendered meaningless these days. There is even a revised oath for those planning to do abortions. Greed has caught up with healthcare and is finally killing it. Greedy insurance companies, trial lawyers and even some doctors might have to find a new avenue to satisfy their monetary lust. Is it a good thing we now have the government, that paragon of virtue with all its novel satrapies, getting involved? Reform is most needed but not without checks and balances.
0
Hospice not evil
written by Tapestry, September 10, 2009
Hospice is not an evil place, it is a comforting place for you and your family to go to as Mom's AZ takes her further a way from you.
It's certainly better than being in a hosptial setting or worse yet the convalescent hospital.
Please take the time to tour the hospices in your area, look at the total care, and the people who will be taking care of her, find a good place. It could be the right decision for you and Mom.
0
...
written by Marty, September 10, 2009
Hospice is a wonderful organization but they are really for end of life. My Dad, immobilized by Parkinson's, on a feeding tube, was picked up by hospice, but then hospice officials got mad at my Mom because she wouldn't follow their feeding schedule (she fed him when she thought he was hungry) and when he had an infection that could be treated at home she did. In other words, when no extraordinary methods were needed to care for him, she did it. They dumped her.
0
Something Else Left Out
written by Bill G, September 10, 2009
Something else that's left out of the death panel equation is that it applies to both ends of the life span. On the Catholic News Ageny website is a piece about a premature baby that was refused treatmenet by the hospital it was born in because it was born two-days short of the government-recommended gestational cutoff for being considered a treatable premature infant. The baby died while the mom pleaded with the doctors for treatment. England has death panels. Why won't we?
0
Things aren't always as...
written by Achilles, September 10, 2009
The scariest thing about almost everthing that Obama says and incongruently does is that the roots lie in sentimentalism, certainly not in Truth, and further still from coherant logic. He is the perfect reflection of our society that prizes form over content, beautiful lies over brutally ugly truths. Larry, a beautiful article without sentimentalism and a very serious foreshadowning of the inevitable. Thank you very much.
0
Misunderstanding Hospice
written by Bethanie, September 10, 2009
Although you have many good points about the "death panel" issue, you don't have an accurate understanding of Hospice. Hospice will enable your mom to have better, more personal care (and free supplies). Hospice isn't for someone right on their way out, but for someone who has 6 months to live and it is not uncommon for someone to go into Hospice and then leave Hospice (or be in Hospice for YEARS). Hospice doesn't mean you're giving up on your mom, it means you're giving her better care.
0
what next
written by Pat, September 10, 2009
I loved this article and I wonder what will come next. If we let them talk us into letting Mom go because her mind is no longer here than will the next generation say lets put Mom to rest before her mind goes. Will we end up in an old sci-fi movie and like Logans Run - In the 23rd century, In the domed city, men and women live in a society where you can only live until you are 30-years old. I hope not for I would not have had my last 2 children nor seen my 3 grandchildren. God Bless you Larry.
0
Oregon's system
written by Tom, September 10, 2009
It was the Oregon medical program--the State--that would not cover the (questionably effective) cancer drug but did send the lady a letter about the "Death with Dignity" coverage. Oregon rations care under the Oregon Health Plan.
0
Not all hospice is equal
written by Barbara W, September 11, 2009
There is good hospice and there is bad hospice. We experienced both with my Mom. We learned the hard way -- bad hospice will not hydrate, for example, defining simple hydration as "extraordinary" care (read -- Terri Schiavo) Good hospice -- Catholic hospice -- does what it's supposed to. We began referring to them as "kill" and "no kill" hospices -- like animal shelters. There ARE no-kill hospices. Ask questions!
0
I'm touched
written by Valerei, September 11, 2009
Hi Larry:

I loved your article. My sis and self (partly) helped our elderly parents to the very end. My father lived to the ripe old age of 93 and bed ridden for the last 3 years. He was devout to the very end.

I truly agree we are blessed and fortified.

Kind thoughts
Valerie
0
...
written by Austin Ruse, September 12, 2009
There is a general misunderstanding about Sarah Palin's death panel remark. It did not refer to the end of life counseling sessions rather to precisely what you describe; bureaucratic decisions on what will and will not be funded.
0
...
written by Frances, September 16, 2009
This article is exactly what I was trying to say while arguing the Obama care with a friend. We humans always push the envelope. . . and keep pushing. Thanks for a great article!

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