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My elderly mom died in December at age 90. She was living in an assisted living facility in Florida, and I live in RI. She had some mild dementia, and had recently moved from the independent living part of her facility to the assisted living. Since then, she had had several falls. The last fall landed her in the hospital with a small brain bleed. She was delirious in the hospital, despite the fact that the neurologist PA said that the injury was "recoverable." At first, the care plan was to send her to the skilled nursing section of her facility but then, when there was a possibility that she might not be able to eat without a feeding tube, hospice was called in, as I knew my mom would not want a feeding tube and she had an advance care directive. It was such a grey situation -- there was no clear sense that she definitely *wouldn't* be able to swallow, but more a sense that she would have trouble even tolerating the test, though she did take pudding and applesauce. I was making decisions so quickly, and the pivot from skilled nursing to hospice brought such a sense of whiplash. I made the decision to send her to hospice, and she died very peacefully, with me holding her hand, three days later. I have been struggling so much with guilt over having, perhaps, sent her to her death prematurely. Also, in the last two years, I had not been able to have good contact with her, as she lost the ability to use the telephone without help, and I was constantly frustrated in my attempts to reach her through the aides who worked with her, and with the facility. My mom had never been much of a phone person anyway, and our main mode of communication had always been email, which she lost the ability to manage over two years ago. I had been trying to get her to come to live with me in RI, but my house would not accommodate using a walker, so we were trying to find a handicapped accessible house. In August, we found one and had our bid accepted, but the seller backed out at the last minute. My mom did not want to come to RI, and expressed this to me many times, though 1 time of the many times I asked her, she did say she would come. I always had the sense that she was feeling like she ought to come for my sake, but she had bought into this facility 9 years ago with a very clear sense that this was what she wanted. She had always been incredibly independent, and moved to Florida over 25 years ago for her "second act" after divorcing my Dad. She became an artist, was an avid birder and nature enthusiast, taught dulcimer, and had a fabulous life. We were close, but not in a talk-all-the-time way. But the last two years, I barely talked to her, and saw her only a couple times a year. So I was already in a state of deep anxiety and grief before her death. Mainly, I am torturing myself for both letting her die, as well as letting her stay in a facility that I believe didn't do enough to keep her safe. I believe she wanted to stay there, and tried to honor her wishes, but now I think I made an error, and should have insisted she come with me. Sorry for the long and disjointed message, but this is how my mind is trying to process all of this. I am heartbroken beyond belief.

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Sorry for your loss. Do not beat yourself up about it. It was her time. She lived to 90, she had a long full life and she was declining.

Grieve but do not guilt yourself into thinking if you were there with her more that that this would not have happened.

I wish you peace as you grieve your mother.
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casey22 Jan 23, 2024
Thank you so much for this. It is so kind of you to have taken the time to write, and to offer me this relief. I am so grateful.
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I’m very sorry for your loss, I still believe that losing a mother you love is a special kind of grief.
Many here are familiar with my mom’s story, she too had a brain bleed, from a stroke instead of a fall. Despite quick, excellent care, and the advice we took to place a feeding tube just until she could recover in rehab, after much therapy, no recovery ever came. She lived four completely miserable years unable to do anything at all with her body. Though she remained mentally intact, she couldn’t eat, read, watch tv, sit up unassisted, roll over, nothing. I still cannot fathom how awful it was.
I know from my dad’s later years that the falls are 100% inevitable. I’ve stood right beside him and he’d fall anyway. Don’t beat yourself up that this could have been prevented.
Your mother sounds like an incredible lady, who planned her later years just as she wished and left this world in a dignified manner without being tortured by a long, horrible ending. You can and should grieve, but no guilt, for you did nothing wrong. You honored her wishes, she was blessed to have you and knew you cared. She’s at peace, and now I wish you healing and peace in the days ahead
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casey22 Jan 23, 2024
Thank you for this. Thank you, thank you. It is so thoughtful of you to take the time to respond to me with such care and compassion. I am utterly grateful. And very sorry for the loss of your parents.
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Why do think that mom wouldn't have fallen if she were living with you? Nobody can prevent an elder from falling, not even a companion hired to stay with them 24/7! The AL was not at fault either.....her age was the culprit.....bad balance and weak muscles are to blame, nothing and nobody else.

My mother lived in a great AL and was happy there. She fell 50x during the course of her 5 years there. Then she went into Memory Care and proceeded to fall another 45x in less than 3 years. Sometimes the caregivers were WITH her when she fell. Sometimes I'd get 3 calls in one day that she'd fallen.

Hospice didn't allow your mom to die, or worse yet, cause her to die. They just didn't torture her poor body with feeding tubes and other extreme measures to keep that body alive. God took her, not you and not hospice, because her number came up.

You said yourself mom had a fabulous life! And a long life as well, how wonderful. And you honored her last wishes not to take extreme measures to prolong that wonderful life unnecessarily. We read stories here all the time of adult children praying for their parent TO die to be released from the pain and suffering of being kept alive too long. My mother was one. I prayed daily for God to take her, at 94, because she was miserable with advanced dementia which wouldn't get better. She'd cry for her mama and papa and her siblings every day and accuse me of hiding them in the closet. Should I have tried to extend her life in any way??? I was so relieved when hospice accepted her, and even more relieved when she passed 2 months later at 95. She was finally at perfect peace, as your mother is.

Stop torturing yourself for something you had no control over. Its ok to be grieving the loss of your mom, but not to blame yourself or anyone else for her passing. It was blessedly quick instead of some prolonged illness you both had to endure for years. In other words, the best possible ending to a beautiful and well lived life.

My condolences on your loss.
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casey22 Jan 23, 2024
Thank you so very much for taking the time to write this. It is so incredibly helpful to hear this, and I am utterly grateful to you. I'm so sorry for the loss of your mom, and all that you went through with her. Your wisdom is hard earned, and I thank you again for sharing it with me.
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You are off the rails on this, she could have fallen as easily at your home, in fact that is where most falls happen.

You didn't LET her die, she was where she wanted to be so leave it at that.

She had a right to live where she wanted to. For goodness sake she was 90, people do die at age 90, that is a long life.

My mother will 99 in Feb, she will die soon, it is called attrition, we are all born to die. My mother loves where she is in AL. Friends her own age, activities, she doesn't have to lift a finger, it is a win, win for her.

I am sorry for your loss, grieve at your own pace, but don't let the guilt thoughts obsess you, it will keep you stuck.
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casey22 Jan 23, 2024
Thank you for taking the time to reply. I may, indeed, be "off the rails," which is why I reached out, and I am grateful for the help I am getting here. My mom was 90, yes. . . but her death -- just two months after the death of my father -- has been hard for me, nonetheless.
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So very sorry for your loss. I lost my mom in 2021. She was 95. I felt grief and relief for her. She was ready to go long before she died.

When people would say to my mom that she may live to 100, her response was always, “Oh, gosh! I hope not!”

She had Parkinson’s disease and struggled with strength and balance issues.

Falls are inevitable! Physical and occupational therapy helped my mother tremendously but there comes a point in time when their bodies are wearing down.

Please know that accidents happen and try not to play the ‘What if?” game in your head. That is your grief talking.

Your mom wouldn’t want you to question yourself or feel guilty when you did nothing wrong. She would rather that you live in peace and be happy that she was content in her life.

There is an older couple in my neighborhood that moved wherever their son moved to. He moved quite a bit due to his job.

My neighbor told me that they loved it here and told their son, “No more moving! We like it here and we are staying here. We love you, your wife and our grandchildren and we can visit occasionally and speak on the phone.”

Your mom was like my neighbors. My neighbors love their independence and when they need assistance they want to go into a facility. Your mom did the same and she was happy. I admire your mother’s independent spirit!

Yes, we grieve but we can also celebrate the good times that they experienced their lives. Sounds like your mom lived a wonderful life.

Wishing you peace as you go through this next chapter of your life.
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I am so sorry for this loss.
I am 81. I have made my wishes clear to my daughter and so fear and dread a feeding tube that I have WRITTEN INTO the advance directive itself prohibiting it, dialysis, so other things.
I can only tell you I am very sorry for your loss, but I believe that your mother would never have recovered from the losses of the bleed in the brain, and that you did the right thing.
I can tell you were you my daughter I KNOW you would have done the right thing in getting hospice in there ASAP.
As my dad said to me in his 90s "Kid, stand between them and me with a shotgun if you have to".

Again, I am so very sorry for this shockingly fast painful loss of your much loved Mom. To me you were the hero in this for her, and did EXACTLY as she would have wanted you to. May the pride of that comfort you, and may your memories of her comfort you, and just to say, I am 81 and my folks are with me still. She will be with you until you, yourself, make the journey we all must take.
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casey22 Jan 24, 2024
This is so incredibly kind and generous of you. Thank you for writing. I am grateful for your perspective, your warmth and wisdom. You've given me such a gift here, and I can't thank you enough.
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I'm sorry for your loss and for your obvious grief and sorrow.

However--death comes to everyone, at some point. No matter where we live or what we do--we will all die.

Mom sounds like she had a great life. Embrace that and celebrate it! Not everyone gets a great, active life like that! And you obviously loved her so much. That love will go on long after her death.

We're facing a very long-drawn out EOL with my MIL and I can tell you--a quick death is so much more desirable than a long, depressing slide into dementia and misery. My own mom just got up one morning, and went back to bed and passed away. I cannot tell you how HAPPY I was, and am, for that great blessing. She didn't suffer.

MIL's situation is slowly taking the starch out of all of us family, kids and inlaws alike. It's beyond horrible. Please don't let your grief eat you up.
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casey22 Jan 24, 2024
Thank you so much for your reply, Your experience offers such valuable perspective, which I am so grateful for. I am so sorry for what you are going through with your MIL, and wish you all the best as you navigate this incredibly difficult time.
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You didn't let her die. She beat the life expectancy tables by 20 years.

Your mom got to do what she wanted to do, and there is no shame in that.
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casey22 Jan 24, 2024
Thank you for this. It helps so much.
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So sorry for your loss. The deterioration of communication is a common factor unfortunately too. It makes it truly sad. Please dont second guess yourself

I lost my Mom 3 years ago - she was living with family in England, and her final months were during the pandemic, so going to see her became impossible in her final year, and her ability to use phone, Video chat and email deteriorated to next to nothing. I felt sad about not being able to communicate in those final months. But I did the best that I could at the time.
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casey22 Jan 24, 2024
Thank you so much for this. I am grateful for your reply, and so sorry about your Mom.
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I feel for you and your grief, and I totally get why you are asking yourself the questions you're asking. We do our best for our loved ones and never want them to suffer or come to their end before it feels like it's time. I hope it is helping to hear encouragement from fellow caregivers that you did, and are still doing even now, what you could to support and honor your mom. My 88-yr-old dad recently decided to get off of the medical merry-go-round he's been on and he allowed me to engage hospice, too. His wishes are clear and I am committed to respecting them and seeing others do as well. That does not make this liminal time easy. Far from it. Appetite/taste buds have been an issue long before this decision, so he entered this phase already weakened by weight loss, some dehydration and lack of nutrition. That is all continuing now as he moves through this end-of-life phase. I have asked myself similar questions to yours over and over again...and eventually come back to the same answers. If only it was so simple as to entice him ti have a sandwich! He tried, and I tried, to make that part different for months to no avail. So now, he is actually getting what he wants. He doesn't want to stay in a body that isn't strong anymore.

Seeing him go is not at all what I want...and seeing him so thin and weak is beyond hard. I thought doing more of his personal care would be the harder part, but it isn't (just goes to show you what you can get used to). Ram Dass had a quote I love about how we are all just walking each other home. I feel like that is what I am doing with and for my dad now, and I hope you ultimately have your own peaceful version of that in your heart one day for your mom. I'm so sorry for your loss, and for the speed of everything. May her memory be a blessing.
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casey22 Jan 24, 2024
Thank you for taking the time to send such a thoughtful reply in the middle of what must be such a terribly difficult time for you. I so love that Ram Dass quote, and I am grateful for your note. I can tell you that, for me, the hospice part itself was the one entirely beautiful part of my entire experience with my mom. We were in a hospice house, and the nurses were incredible, and I was with my mom, holding her hand, when she died. The hospice route is such a kind and compassionate way to go, but it is entirely hard to watch the parent you love so much slip away. My mom was not eating either, and never woke up again once she got to hospice. They kept her comfortable, and I will never forget their care and kindness -- brushing her hair, making sure to moisten her lips, placing and folding pillows all around her so that she slept as if in a cloud. It is, indeed, a liminal space, and I found the need to write about it to try to "catch" it, or remember it, once it was over. I wish you peace and love as you help your Dad transition, and I hope you will read your own letter to me if you have any doubts about this, as your wisdom, and love for your Dad shine forth.
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My deepest condolences to you on the death of your beloved mother. How wonderful that you were holding her hand as she passed away. I’m thankful that I held my father’s hand too as he passed away after two months on hospice. But of course losing a much-loved parent is unbelievably sad and hard.

Thinking of you. 😊
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