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Blue Horizons to a Grey Dawn

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Returning to work in Health and Social Care after bearing and shepherding four children to maturity, including four and a half years living in the far east, her role was to help to make people’s lives after hospitalisation as comfortable as the system and their finances allowed. For people who could go back home or could afford care it was straightforward. She made it clear for herself she would choose to die at home.

Retirement came after those gruelling years of endeavour. After a few days away, a surprise party in the garden with a marquee on the lawn, a jazz quartet and a pig roast and friends from present and past, a new horizon. The freedom to travel when she liked with a partially retired husband to conferences and overseas assignments and overseas relatives. Now was the opportunity to take extended trips: a long trek in the mountains of Nepal; touring the USA from coast to coast; walking the trails and footpaths of Britain; the blue ridge mountains  of Virginia; the blue mountains of Australia and no need to worry about that case load when getting back home.

But things started to change: the Christmas party where she was missing the crack, as eldest son said, “Mum see the holes in the wall behind you where the missed arrows of our wit terminated”; walking with the Ramblers she had more than the usual number of stumbles; repeatedly forgetting her walking stick after the stop and no longer talking with other ramblers. On a couple of occasions she lost her way: could not find her way out of a shopping complex in Manchester while husband was lecturing; losing her way from the toilet at Heathrow needing to be helped by a security guard back to the waiting area.

Travel was now limited, and domestic activities delegated. Annual visits from expatriate daughter lead to concerns about changes noticed from year to year and resulted in, almost forced, visits to see the doctor initially resulting in reassurances of “it’s probably slight depression that comes with older people, take these”. Later, referrals for tests and scans revealed the dreaded diagnosis, Alzheimer’s Disease. Seemingly she was unaware of her condition and pleased to be comfortable and waited upon.

Over the following decade the ability to communicate verbally diminished to the point where she used only buzzwords, phrases, and made-up words. Finally, she lost the total ability to speak. Walking became less adventurous: she forgot how to negotiate stiles; rough surfaces became hazardous and so we only walked on paved surfaces, for shorter distances, and with many pauses, eventually resorting to a wheelchair.

Bodily functions became uncontrollable: eating was only possible with constant attention; washing and dressing needed full assistance. Difficulties in swallowing limited the form and frequency of feeding. Control of motor functions lead to being unable to stand and being hoisted from bed to bathroom to chair and back to bed. Finally, she became totally bedridden. Loss of ability to eat that, based on a previously decided medical decision not to force-feed, led in a few days, one grey November dawn, to a peaceful death at home in her own bed.

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