And then

 I woke up early Saturday morning to some coughing. Rich was sitting up and couldn't seem to catch his breath.

I took his 02 reading and nearly fell backwards with shock. How could he still be alive with a reading of 66? I turned up the oxygen concentrator to 3.5L and grabbed the liquid morphine I was directed by the nurses to use in case of what they call Panic Breathing. It is a term which identifies a cycle of rapid shallow breathing.

I administered the morphine under the tongue and gave him his rescue inhaler and set up his nebulizer on the hospital bed table that we had. I was able to bring him up to the mid 80's. 

I called the Hospice hotline and got the NP we'd seen last week. I gave her the low down and she said I'd done exactly what they'd wanted me to do. They also arranged for Tim [Hospice on call nurse] to come and do an evaluation.

Rich tried to eat breakfast. He was able to eat some cereal but gave up as it was too hard for him to eat and breath. He insisted on getting up then and having a cup of coffee in the kitchen. That didn't work out so well and I got him back into his bed after some bathroom mishaps.

He was so apologetic and I just shrugged. Things happen and by now it was just a thing, and nothing to get upset about. 

I'd called Rich's daughter and told her the situation. She responded that they were thinking of coming to visit on Monday. I responded with a curt reply. "Sooner is better." 

I got the "well we have to..."

I said, "Sooner the better. I have to go help your dad now."

I got texts from both grandkids that they were on their way in their own cars. His daughter called back and said she and her hubby would come.

Rich's buddy Steve also was on the way. 

Dennis showed up first and came in to see Grandpa. The poor kid was totally shocked. 

How do I even write this so it makes sense. Rich's daughter and hubby obviously thought that Hospice did not mean really mean....Hospice.

They figured Rich was just going to keep on going on like normal. Probably because Steve and I had been going to extraordinary efforts to take Rich fishing or out once a week as it was his fondest wish.

In Hospice, they encourage you to do the things that you really wish to do. We all pitch in to make Rich's 4 or 5 hours out on Wednesdays enjoyable for him. We do it to see the smiles and hear the laughter. Because we know that time is limited

and do what you wish with the time that is left.

When Tim arrived I sent Dennis outside and while Tim was checking in with the Hospice Doctor I went out to give orders. Rich's daughter and hubby showed up along with Ariel and Steve. I put Steve in charge and told him to keep everyone outside while the nurse and I did the assessment and the catheter.

Steve picked up Charlie and directed traffic and kept the family at bay while I worked with Tim.

The discussion with the doctor revealed that this was either an exacerbation of COPD or it was a progression. Progression = Functional decline. Rich had been in a slow decline but the recent 24 hrs felt like a drop off a cliff.

24 hrs would give us a better idea of what to expect.

After Tim left, I addressed the family in the yard with my rules. "You can visit Rich for 5 minutes or less if he is awake. One person at a time, no more." I'm sure I sounded bossy and stern. And I meant to be.

I had to get to the pharmacy and pick up a med 'stat'. So I left them standing with their mouths agape with Steve and Charlie in charge.

Much later I went to move our little pony to graze in another spot. Ariel walked with me. She commented, "Mom and Dad are so shocked and like, freaked out. They can't believe that Grandpa is this bad off." She huffed and rolled her eyes. 

"I told them that they could have visited him more often and then they would, you know, figure it out. Duh, no surprise for me. I've visited and talked with you. I'm sad to see Grandpa like this, but so glad I came out twice this summer to be with him."

I shrugged. She was right. "Well, they are here now," I sighed. 

His daughter and hubby got a room at the local motel to stay over night. Again I was surprised. They almost never stuck around overnight. Rich's daughter came up to me as they were leaving and said, "Gosh, how are you doing? I'm so worried about you!"

I had a couple of responses I was going to say, but kept my mouth shut. I had things to get done, like empty the catheter, set up a nebulizer, meds, and try to get my guy to eat something.

I have to give it to Dennis. He helped me sit his Grandpa up in bed and patiently sat with him holding him steady while he tried to eat a cookie. Dennis helped me set up the meds and do helped with the nebulizer, then assisted putting his Grandpa back to bed. 

Rich was confused and we had to go slowly. He asked, "Somebody was here and they did something to me? What did they do? Why? I have to pee."  

I explained the catheter again.

"Who was here? I can't...just let me sleep."

I helped him calm down and he fell asleep.

Dennis sat next to me in the kitchen his eyes welled up with tears. "I'm so...I just...I didn't...I don't..." 

I pulled Dennis into my arms and told him it was okay to cry. Real men do have emotions, real men do cry.

So now we wait and see if we are falling off a cliff or having a small progression.

Tonight feels like a Cliff Hanger.