Just spent four days at Ma's, which I'm committed to do at least every four weeks. It's getting harder now -- because of her pulmonary hypertension, her brain is increasingly affected by lack of oxygen, which mostly shows as extreme short-term forgetfulness. She can't remember which meal she's had, what time of day it is, and who's been to see her. There are long periods of quiet. Conversation consists mostly of someone asking if she is hungry, or thirsty, or needs to get to the bathroom, and her responding. She's still so good-natured and accommodating to virtually any request that her caretakers enjoy helping her.
So I sit and read or watch TV while she stares at the screen or (more often) naps. I think long and hard about "quality of life" when I'm with her. On one hand, she has a comfortable apartment, visitors who care about her, and doesn't lack for looking after. She knows who the key people are (her children, her immediate neighbors, and also the most regular caretakers, her doctor, the hospice team), she can enjoy the greenery outside, the sun filters in, and she's in a safe and homey atmosphere. On the other hand, she can't really do anything anymore. She led an astonishingly active life - traveling, gardening, churchgoing, tending to friends, reading, following Washington politics - and that's all gone, as is her house of 38 years, and many of her closest friends, whom she's outlived. Day by day, she gets more frail, more forgetful, and is slightly less interested - or rather, slightly less able to be interested - in the doings of the more robust. Things do enter her consciousness, but they don't stay long or grow in value.
After I left her I headed to New York, where after a couple of days of a regular work routine I found myself getting sadder and sadder as I thought of her diminishing world. Because that's what's happening - she is slowly departing this life. The vividness of the world is almost beyond her now. The texture of life is thinning. This awareness, for me, is a sharp reminder of how much I'm missing her already - and how much more missing is to come.