My Mother’s Last Trip, IV

We didn’t, of course, know how short her remaining time was to be. But it is hard to make peace with the fact that she was able to experience hospice’s happy float for a mere week before she died. Instead, she spent the first 21 of her last 29 and 1/3 days enrolled in a mildly taxing regimen of post-hospital rehab.

The very idea of rehab for my mother was preposterous. But she’d had the right sort and length of hospital stay to garner a primo Medicare bennie: If she went on to a rehab round, Medicare would cover every aspect of her care for 21 days, including the $250/night room charge she would otherwise pay out of pocket. We may as well use the all-expense-paid days, everyone counseled; such a deal! We’d also gain time to plan mom’s hospice care–the months of hospice we thought she’d have–along with a strategy for dealing with our impaired and obstructionist father.

As a result, my mother, who entered the care center on death’s door, spent the first three of her last four weeks exerting herself each day with Janet, a plus-sized physical therapist of kindly disposition whose daughter and my sister’s daughter had once appeared together in a community theatre production of The Wizard of Oz. With kindly Janet’s coaxing, my mother weakly flexed her emaciated legs each morning; she fluttered her arms up and down; she gamely buttoned up a sweater. By the end of the second week, she pulled herself–her grip tightening on Janet’s doughy arm, her legs buckling–to a standing position next to her bed.

Her wheezy exertions proved of no real therapeutic value. But in those weeks in the care center, my mother did rally to an extent that seemed startling. The improvement was not so much physical, although she did manage to pull off the ambulatory triumph her therapists needed to satisfy the suits at Medicare; my mother had walked five feet, Janet exultantly reported at the 21-day care conference. No matter that it was at a painfully shaky and shuffling gait, and was accomplished with the aid of a walker; no matter that it required her oxygen tank to be pushed to the highest possible liter flow, or necessitated several rest periods to quell her panting enough that she could continue.

What really changed, for a time, was her spirit. She perked up so much that the hospice team was called upon to reassure me that, yes, she was as gravely ill as before, the prognosis was the same, a late-inning rally wasn’t uncommon, the game plan and the dismal life expectancy had not changed. The perking up was almost jarring. She had a bit of appetite again. She took an interest in surveying her dinner tray; her interest in its contents was fleeting—“I know, ish kibbibble!” the young aides would tease her—but she could be persuaded to eat a few bites of sweet potato and yogurt, and she tucked into each evening’s ice cream treat with genuine glee.

Her customary “hello, lovey!” greetings were back, along with her gift for gab; no matter that she repeatedly uttered the same sentences and posed the same questions; an endless loop. She again took an interest in things, even if she remembered nothing. The inauguration of Obama was interesting, and always news to her constantly rebooting mind; ditto the stories her daughter shared, or the small dramas she observed in the care center hallway. “Leave the door open,” she insisted to aides with a coquettish air, “so I can see what’s going on.”

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