I had been trying to visit Grandma every morning as soon as the nursing home opened their visiting hours at 10am. I had a haircut appointment that I booked almost two months ago. I wanted to cancel it, but I thought I could benefit from some self-care time. By the time I finished, I hadn’t gotten to the care home until 11:25am. I was eager to talk to Grandma. The day before I had gotten into a big argument with my sister in front of her. We never knew if Grandma would be confused or non-responsive, but yesterday she was clear-minded and laid there in bed looking at us while we argued back and forth. She asked us why we were fighting and why I was crying. She told us in Chinese to just sit on her bed and make peace.
My sister said good-bye and left abruptly and my heart was beating as I thought and felt a lot of things. Grandma reached out for my hands and started telling me things...in Chinese. Although she could speak English pretty well, these last few months she reverted back to Toysan, her dialect of Chinese from southern China. I couldn’t understand everything and wasn’t really focused because I was still reeling from the argument with my sister. Then I realized she was giving advice and saying her good-byes.
She told me to stop fighting and to love my sister. She told me so many things...but I regret not paying attention. I thought I would see her the next day. She was 92 and had been saying she felt her time was coming to an end for over a decade now...but it was different that day. She told me to pass messages to people. She told me to tell her best friend May good-bye. She told me to tell my mother that she cared for her. She told me more things to tell more people that I didn’t understand or remember or focus on because I was in my head — but my racing thoughts ended with her reaching out for a hug. I cried looking at the clock saying I had to go pick up my son early from school. I would be back...maybe later that day or the next morning. She looked at me and reached for a hug again. I cried while giving her a hug and left the room quickly.
I later talked it out with my sister in the evening and was eager to let Grandma know everything was better. So, I arrived today on Thursday, February 27th at 11:25am. The caregiver Sandy told me Grandma had been sleeping all morning and still hadn’t eaten since yesterday’s breakfast.
I went into the room and she appeared to be in a deep sleep - breathing heavily. It resembled snoring without the noise, only the sound of air being forced in and out of her mouth. I greeted her roommate, Margaret who was bedridden and often awake in thought. Margaret could no longer walk and had glaucoma. She never seemed to look directly at me when we talked but was able to see shapes and movement. She was a pleasant woman who grew up in the south but raised her kids in San Francisco. Her son was just a year older than me. She and I had a lot of nice conversations about her life while I sat next to Grandma’s bed when she was napping.
That day, I held Grandma’s hand and told her it was me. She looked deep in her slumber. I called to her a few more times but it didn’t seem to wake her. I held her hand while she moved it around a lot, squeezing and pushing and pulling on it. I thought she may have been dreaming but on the off chance she could hear me, I told her my sister and I were good. In simple English, I said we made friends again, that I listened to her advice, that we love each other... and again, that I listened to her. I felt guilt and sadness and didn’t want the last thing she saw to be an image of us fighting and me crying. I wanted her to know my sister and I were ‘okay’.
At 12:06pm, I asked Sandy if they had vaseline so I could moisturize Grandma’s peeling lips. A few minutes later, the hospice care nurse, Anne arrived to check grandma’s vitals. The hospice social worker, Samantha, also arrived at the same time just to check in and offer support. Nurse Anne tried twice and wasn’t able to get a pulse but said Grandma’s oxygen was good. She asked if Janice was coming. Janice was the owner of the care home. She looked at me and said Grandma was showing signs of the beginning of the end and it could be that she may pass that evening or the next day. I was in disbelief. How could people pinpoint death so accurately?
I asked if it was because of the sleeping and pointed out Grandma had been kicking her legs a lot so she wasn’t really sleeping. In the past, at her hospital stays when she was incoherent much like today, she kicked because she had a bowel movement in her diaper and couldn’t verbalize it. Nurse Anne said she hadn’t eaten, was sleeping a lot and wasn’t able to be woken up, these are just some of the signs. I later learned so was a faint pulse. She said she would check her diaper and when she rolled Grandma to one side, Grandma let out a grunt and made a grimace. The diaper was clean but the nurse said her grimace meant Grandma could be in pain and asked if I could ask her if she was feeling any. I asked in Chinese if she hurt and there was no response, still sleeping. The nurse said she would call Janice, the owner of the care home to come at her earliest convenience.
The social worker, Samantha handed me a booklet called, ‘Gone from My Sight - The Dying Experience’ and I began to cry. She said she disliked the title of the book but it had information that described the signs of impending death. She and Nurse Anne encouraged I let out my tears rather than hold them in. They told me listening was the last sense to go so I could still talk to Grandma and she might be able to hear me. I thanked them and they said they would wait outside.
They left and I remembered Margaret was in the room quietly listening to everything from her bed. I turned to her and told her my 92-year-old Grandma wasn’t doing so well. She asked what was wrong with her. I told her Grandma’s heart, liver and kidneys were failing and she began telling me a story about her father who passed from liver issues. She said she and her brother were flying back to see their ill father and when they arrived, her brother told her that her father had already passed away but didn’t tell her so she wouldn’t be sad during the flight. She began to tear up over the memory. I appreciated her opening up to me.
I turned to Grandma. It was the 26th death anniversary of my Grandfather - her late husband. I didn’t want to upset Margaret anymore so I tried my best to speak in Toysan to Grandma. I had an intensive course learning how to speak the Chinese dialect. I never knew how to speak Toysan until these last couple months. When Grandma had spoken to me before, I could understand maybe 70-80% of what she was saying but I always responded in English and she understood me just fine. Now she didn’t even realize when she was speaking Toysan to everyone, even to people who didn’t speak or understand it...but it made her feel comfortable to speak her native tongue so I tried my best to speak Toysan to her.
I called her Ngeen Ngeen (meaning Grandma) and I said in my simple and broken Toysan, “Ngeen Ngeen, ngoy han nee, nee han ngoy.” (Grandma, I love you, you love me.) I repeated it tearfully. “Ngeen Ngeen, ngoy han nee, nee han ngoy.” (Grandma, I love you, you love me.) “Everybody loves you. Today, Yeh Yeh huoy, Nee huoy.” (...Today, Grandpa passed away, you can go too.)
I repeated it tearfully.
Grandma had been suffering for the last few months and I read a few articles online that said sometimes loved ones needed permission to leave. They need to hear that it is okay for them to go and everyone and everything would be okay.
I noticed Grandma had been clutching her blanket tightly so I held her hand and she grabbed it firmly still looking asleep. I told Nurse Anne who was sitting in the kitchen. She said Grandma might be feeling anxious. This could have been true because throughout the years, Grandma had said she didn’t want to die and wanted to live longer...but only in the last few months, she started saying she had lived a long life at 92 and it was okay if she died. Then the caregiver, Sandy later told me the night before, my Grandma said she didn’t want to die again and had recently called out as if she had seen her mother (my great-grandmother) in the middle of the night. I just held Grandma’s hand.
1:55pm - Aunt E and Uncle D arrived from their long drive across the bay. The care home owner, Janice also arrived. Nurse Anne advised giving Grandma a low dose of morphine to alleviate her pain. Low enough that it wouldn’t make her too drowsy and family arriving later that afternoon could still talk to her. Aunt E asked Nurse Anne what Grandma’s pulse and heart rate were but the nurse said that she had tried several times and was unable to get one. They tried again. 128/90 45 - a good pulse and after giving her a dissolvable pill form of morphine under her tongue, Grandma looked as though she was sleeping peacefully.
At around 3:00pm, my Dad and brother arrived. They went in to see Grandma who was still sleeping then they left the crowded bedroom to sit in the living room. I stayed in the bedroom with Grandma to talk to Aunt E who was sitting on one side of the bed. Minutes passed and suddenly, Grandma’s eyes opened half way. They were glossy, filled with water and she didn’t appear to be looking at anything, just a fixed gaze past us. A single tear fell from her left eye. My Aunt said we should get my Dad quickly. I ran out of the room but not before I grabbed a tissue to wipe the tear from her cheek.
We rushed back into the room and she had closed her eyes again but began sticking her tongue out like when you eat something that tastes bad and try to get the bad taste out of your mouth. Her tongue was white and had something that looked like a little bit of clear mucus on it. I took one of the lollipop sponges the nurse gave us to keep her lips and mouth moist, dipped it in a cup of water and started to swab her lips to clean the mucus from her tongue.
She stopped moving her mouth and settled back into a peaceful position. I checked to see that her chest was still subtly moving up and down. She had no longer been grabbing my hand tightly or breathing heavily like she was a few hours ago....it was just a peaceful sleep again. I decide to go out and sit with my Dad and brother in the living room. I sat down for just a minute and my Aunt came rushing out of the room saying she didn’t think Grandma was breathing. I quickly went back into the room and saw my Aunt was holding Grandma’s left hand feeling for a pulse. I grabbed her right wrist feeling with all my fingers. “I don’t know what I’m doing”, I said in a panic to the two caregivers who were already in the room. Sandy said, “She’s not breathing, look at her chest.”
I looked at Grandma’s chest and it was no longer subtly moving up and down. I shaked Grandma’s arm and called, “Ngeen Ngeen...” Again twice more then burst into tears leaving the room and the house to sit on the ground outside on the porch.
Grandma passed at about 3:20pm on the 26th death anniversary of her late husband. It was a special day for her to leave. I am glad she no longer has to suffer from the pain that her frail body caused her. While her body was weak, her will and might remained strong up until the end. I'll miss her.