“Active dying” is a term used in literature about the process of dying at the end stage, the last 48 hours or so. It wasn’t an easy time for either Mom or me, with all due respect to St. Joseph.

Mom never lost consciousness, was never in a coma. That doesn’t mean, though, that she was engaging in conversation during her last few days — she wasn’t. Her last substantive, 2-way conversation occurred when Don arrived on Sunday night. She reacted with unquestioned joy, reacting, and speaking, with both him and me. On Monday night, she began a peculiar monologue about how she had to talk the next morning with me about sealing the house and where to put mouse poison in the basement. What she was saying was making sense, but wasn’t exactly interactive, and we never had the “next morning” conversation.

Mom’s verbal efforts during her last 48 hours were limited to reactions to my questions, responding (appropriately) with an “uh huh” or an “uh uh” to yes and no questions, and an occasional “I have to get up.” Her physical efforts were heartbreaking – valiant attempts to get out of bed so she could use her porta-potty, rather than relying on her adult diaper or bedpan. Her pride was paramount, and her attempts at physical activity caused me to sleep with her the last several nights.

On Wednesday afternoon, our wonderful Hospice nurse spent about 2 hours with us, helping adjust medication, determining whether Mom was in pain, and gently repositioning Mom to help make her comfortable. In hindsight, I think that our nurse believed Mom could go any minute, and was prolonging her visit to be there, to help us. She left about 3:00. I returned to the living room, did a bit of work, then after a few minutes returned to Mom’s bedroom with a book – I knew I’d be there for a time. Don did, too — he came in shortly after I settled in to offer to fix me something to drink. I think we both knew what was coming – as did Mom.

I sat with her, held her hand, and would occasionally ask her if she were in pain (“Uh uh,” she’d reply), or ask her if she felt alright (“Uh huh,” she’d say). I wasn’t successful at reading. Her eyes were closed, her breathing labored and noisy, her body otherwise still. When I offered her morphine, she’d suck on the dropper. I watched her pulse on her neck, her carotid artery. Her pulse began to slow; her breathing became irregular. Several times both pulse and breath stopped, and I’d think: “this is it.” Then she’d begin breathing again. Finally, she took her last breath. It wasn’t dramatic – it was simply the end of her active dying process. I sat with her body, gently holding her hand, talking to her, for another 5 minutes or so, then reported to Don that she was gone.

I’d already planned what I’d do next: Mom’s hair was a mess from a week in bed, and no one could see her in her nightgown. So I washed her, changed her clothes, putting on a favorite jogging suit, her “sweats” as she’d called them, and combed her hair. All the while, I talked to her through tears, telling her that I wouldn’t let her leave the house in a nightgown, with her hair a mess. Telling her that she’d fought the good fight, that she was so loved. Telling her that she’d be missed.

I know she heard me.