Death happens in so many ways, and many of us handle it in different ways. The first few times I knew of someone dying, I was either too young to understand what was happening or I was intentionally far removed from the situation. I remember trying to get on my tippy toes to see who was on the hospital bed, and I remember how pristine the room was with family crowded around behind these flimsy curtains. I also remember seeing someone I knew — a family friend — who used to be warm, loud, and welcoming just laying peacefully at a funeral. I was too young to process the entire ceremony or even the process leading up to death itself.

The first real death I understood and processed was when I was in my first year of college.  My grandmother was diagnosed with pancreatic cancer.  Every summer, I would go to Hawai’i to visit relatives, and this summer was no exception. The only difference was that now, my grandma couldn’t do the things I was used to seeing her do such as cooking us dinner, walking around, and running chores in the backyard. This time, I had to help my dad wash her on the couch, she had a bag attached to her so she could eat and use the restroom, and my father and I would have to clean this bag often. It was definitely a little hard to see, but it wasn’t anything I couldn’t swallow.  She was hardly tired.  I knew she was a strong spirit, and this wasn’t going to stop her boisterous attitude. By the end of that summer, she seemed to be improving, but just in case, I said my goodbyes. Not long after I flew back to California, she passed away suddenly, and I was not expecting it. Two months later, my grandfather passed suddenly, and of course, that was hard on me.  He was in amazing health when I had said goodbye to him. I’d spent every single summer with them since I was a child, and the period in which they passed wasn’t long enough for me to digest either of their deaths. It was a difficult rest of the year to say the least…

Around that same time, my other grandma was diagnosed with dementia and it progressed quickly each year. I made trips back home often to help my parents care for my grandma– feeding, clothing, showering, walking. It was a ’round-the-clock responsibility that we chose to take on as a family because my mom and aunt were nurses, and I don’t regret it.

Fast forward to ten years later. About four weeks ago, I got a phone call from my mother saying that my grandma had suffered a major heart attack, and the doctor said that before this, she had (over time in the past year) been having minor heart attacks. No one knew because my grandmother didn’t know what was wrong with her and likely forgot almost as soon as it happened so she never voiced anything. Since then, only 25% of her heart has been functioning.  I flew home the next day I received the phone call to help my mother because we were going to begin palliative care as the prognosis was essentially that she did not have long to live, and my dad had just had cataract surgery rendering him helpless as well. No other relatives were around to help care for my grandma. That week, I spent all day every day next to my grandmother. Feeding her, changing her diapers, bathing her in bed, brushing her teeth, taking her on walks when she felt well enough. On those walks, I’d walk her down the same streets she’d walk me every day for seven years to get to school. It was just us two, and I would stroll her in silence taking in the sunlight.  We both love the warmth of the sun.  Those were our moments, and I’m lucky I got those moments. At night, my mother and I woke up every 4 hours to give her medication and change her diapers. During the entire week and a half, she still knew who I was and was able to talk to me, and she seemed more alert than before. As soon as I got to the airport to go back to my new home with my husband, I fell apart. I cried the entire way home and well into the night in my husband’s arms. But I thought at least, I got to say my goodbyes, and she knew who I was when I left.  I didn’t need to go through the heartbreak again.

Then just a few days ago, my mother said she needed my help again because she needed to work. The day arrived, everything seemed just as it was when I left. My grandma was still eating, could sit up, and look at me. But as the night took over and my mother and I continued our four hour routine, we noticed my grandmother had taken a turn for worse breathing harder. At times, we saw her stop breathing for seconds at a time before we could proceed to rotate her. The only time she would open her eyes completely was when she was in pain and couldn’t breath. When my mother would walk out of the room to get water for her, she would look at me wide-eyed when it was just the two of us in this huge living room, and it completely broke my heart. I was so helpless.  She was telling me with her eyes, “Help me, I can’t breathe.” Just her eyes struck at my heart.  At this point, I had never dealt with death this closely, and I could have lost it then and there, but I needed to keep it together for my mother. When my mom walked back into the room and my grandma gasped for air, my mother knew she needed to give her pain medication, and it was the first time she ever needed to use it. By morning, my mother and I looked at each other and knew she was starting to actually go.

My grandmother, as of this morning, can no longer drink liquids or eat baby food. Instead, we have to brush a sponge filled with water to wet her lips and make it easier for her to suck on it. We grind her pills with liquid, and she can barely even take it. She can no longer speak, and her eyes roll to the back of her head and stay closed. Her breathing stops more often, and when she gasps for air, it pierces my heart every. single. time.  With her congestive heart failure, liquid is filling her lungs, and she can’t cough.  When she breathes, you can hear the gurgling. She turns her head left to right in agitation trying to breathe.

After only one day, my heart can’t bear it. I’m ready to collapse, burst in tears, and my heart is panging. But seeing my aunt and mom crying, I know I need to be strong. We know the end is nearer than we thought, and she could go at any moment.  I don’t know how I am going to be able to handle this or move forward. I’ve never dealt with death on this level. Providing hospice care for a family member is incredibly hard– having to watch them suffer like this every second of the day, getting worse every hour and you can’t take away their suffering. Having to provide comfort to them while watching them die. I would not wish this on anyone. I’m not ready to deal with this at all… I didn’t think heart break could get any worse. Just moments ago, I walked into her room to get something and that huge lump in my throat and the tears just hit me.  The piles of clothes she wore were on her bed, her wheelchair that she had used just a few days ago was there, she used to sleep in there, but her clothes… her clothes. As I walked back out of her room and into the living room to sit next to her and seeing her so helpless, I am losing it this second.

I can’t help thinking that she knew I would be back without my even knowing it, and she held on just for me to come back. But that breaks my heart even more. I don’t know how I will face the rest of this night or even tomorrow, but all I can do is pray.