What Did Grandma Die Of?

So what did my grandmother die of?

    I sometimes think that the recent Covid madness indicates that we are hitting peak mortality, where there is a pathological refusal of many in the population to realize that they are going to eventually die of something. It's the only reason that I can see for vast swaths of the population to champion the deaths of the very old and sick as though this were some type of avoidable tragedy. On some subconscious level they feel that death is not a natural part of life, that perhaps science and technology will one day save us from it. In doing so they created a world devoid of closeness and shared intimacy that was barely worth living, and stole the future from young people with the most to live for. All to save Grandma with policies that often killed her and who was never even consulted on the matter. I highly doubt many of them visited loved ones experiencing natural decline.

    People died before Covid came on the scene, of course. It turns out that death is a biological reality for every single living creature on Earth. So for those who are elderly with multiple comorbidities, I always wonder how much the sincere person knew of the dying’s circumstances after they were whisked away to isolation in a hospital. They might have died from Covid, or from the vaccine. They might have died from toxic treatments given to them like remdesiver or ventilators. They could have died as a result of their prior medical issues, with perhaps any old cold or flu bug sufficient to push their bodies over the edge as it were. Their death might have been hastened by isolation measures and inhumane protocol that made them feel that they had nothing left to live for. They could have died because God said that it was their time. Who knows?

    We all die of something. Defining what that something is can be quite tricky and political. Back in 2016, in the pre Covid era, my mother and I were taking care of my then 93 year old grandma at our house in Las Vegas. She was at this point dementia ridden, incontinent, rarely talked, and could only get around the house in a wheelchair. In short she was going to die of something probably sooner more than later.  

Shortly after Mother’s Day my grandma stopped eating food. Me and my mother both tried to entice grandma back into eating by literally spoon feeding her. “The airplane goes into the mouth.” I told grandma, as though she was an 8 month old baby, as I tried to get her to eat. It didn’t work. Grandma teased the food around her mouth as though it was a foreign object. Then her tongue would stick out and the food would dribble out down her chin. Her swallow reflex was going away.

I talked to my mother in law in Thailand about this. “Normally!” Mar assured me as my husband translated. She then explained that when her own grandmother was 97 years old, she likewise lost the ability to eat food. Her family in Laos told Mar to come soon to say goodbye. She did so, as grandma was surrounded by the loving embrace of family who made her comfortable in her closing moments on Earth. 

“Then her heart. It shock. She dead.” My husband Oh explained to me, after I asked what Mar’s grandma really died of. Grandma in this case died a very natural death in her home after a very full life. We all should aspire to such things.

        But we were living in America, and such an idea, although noble, could not come to pass. My mother and I debated about grandma’s situation for a few days. She still seemed to be able to drink water or juice in small amounts, but the whole not eating food thing was going to be a problem. I told my mother what Mar had told me about her own grandmother’s death. 

“We can’t do that here.” My mother said resolutely. She was absolutely correct. If grandma died at our house, there would be an investigation into what she died of. That was the standard procedure as I knew well from my father’s death at home two years before. If it appeared that we had withheld food or medical care, we could be charged with elder abuse. “We have to take her to the hospital.”

And so we did. They confirmed what we had already known: grandma’s swallow reflex was gone. They gave her an IV drip and put a temporary feeding port into her nose. Grandma seemed more cognizant than I’d seen her in years after this. “I want to go to Toledo!” She begged me to take her back to her hometown. It was the last significant conversation that I had with her.

My mother, being grandma’s daughter in law and not daughter, had no medical say in interventions. Decisions at this point were shuttled off to my aunt, grandma’s daughter, who wanted her mother put on a permanent feeding tube. We could no longer care for grandma at our home as this required too much work. We tried to argue to bring her back to our house, but the medical staff made clear that this would be very expensive for us and difficult. They meanwhile had a perfectly good skilled nursing facility soaking up Medicare dollars that knew exactly what to do. So off to the nursing home grandma went.

I am not sure if the extra 5 months of life this gave grandma was really worth it. Obviously it was worth it to the nursing home, who I am sure got tens of thousands of dollars and perhaps more from the arrangement. We quickly learned that grandma had lost all of her remaining mobility from her food strike and hospitalization. She could no longer stand or walk even a few feet. Her diapers had to be changed by rolling her from one side to the other on the bed. Quality of life for her was low.

My uncle visited her in the summer and my mother and I went to see her in the nursing home once or twice a week. It was clear that grandma was not long for this world.  We celebrated her 94th birthday in September as she looked on passively at us eating her cake. Her eyes alternated between zoned out to shellshocked and pleading. The nursing staff was good and gave us many updates. 

      We came to visit Grandma in the nursing home on October 3rd. There were signs posted in the hallway about a mass flu vaccination event for all residents and staff which had been held on October 1st and 2nd. Because medical power of attorney was held by my aunt and not us, I cannot say with certainty that grandma got her flu vaccine. But her family was very mainstream medicine, and grandma had never articulated any type of anti vaccine position that I know of. When my mother and I were caring for her she often had doctors appointments for this and that. Sometimes they had recommended a flu vaccine but we always passed as she was in there for something else like checking on her pacemaker. I have no reason to assume that she wasn’t vaccinated this time though.

Grandma was in bad shape on our brief visit. She had an awful runny nose which Mom kept on wiping with her handkerchief. My mother asked the nursing staff if they had any medicine for her congestion. They did not.

We were unsurprised when the nursing home called us the next day to inform us that Grandma had been sent to the hospital with pneumonia. They had already cleared the room of her things as they did not expect her to be coming back. I noticed then that the nursing home was very quiet. Grandma’s roommate was no longer there and based on a phone call I overheard the nursing room staff had sent another resident to the hospital.

The hospital ER was so crowded that grandma was on a bed in the hallway. “I’m sorry.” A nurse explained to me. “But we are really slammed right now.” Grandma was put on a ventilator that evening. We were informed that the end was near for her and so we went to say our goodbyes. They were taking her off the ventilator her body was shutting down in multiple directions. A day later the hospital called us. Grandma had started breathing on her own again.

“It’s a miracle!” A young nurse gasped breathlessly when we came back to the hospital. Grandma was in the hospital bed and nodded in recognition of me and my mother. We hugged her then. I wasn’t sure if I would label grandma’s ability to breath without mechanical assistance as a miracle, exactly. She couldn’t stand or walk or talk in any meaningful way, and her body was still shutting down. A miracle to me would be if my 94 year old grandma leaped out of bed and danced the whatoozee. 

After a few more days in the hospital Grandma was switched to Nathan Adelson Hospice. We knew she didn’t have a lot of time left, but in visiting her there I was stunned nonetheless. It was like somebody in billing had flipped a magic switch where Grandma now needed to be killed as fast as possible where before she needed to be kept alive by any means possible. 

“I’m thirsty.” Grandma whispered hoarsely to me, the last words I ever heard her say. I went to the desk outside her room.

“My grandmother wants water.” I explained to the nurse. “She said she’s thirsty.”

     The nurse got very huffy with me. “She’s not allowed to have anything.” She told me resolutely.

“Even water?” I questioned. “Or just ice chips?” I knew from a few illnesses that being thirsty could be one of the worst feelings in the world.

“Her body is shutting down!” The nurse yelled at me then. “You have to understand your grandmother is DYING!” Her words seemed too melodramatic and rehearsed, like the type of scripted thing she was taught to say to the rare younger crowd who bothered to visit their dying elderly relatives in these places. It pissed me off deeply. So because she was dying, she shouldn’t be allowed some basic dignity of last requests to make her comfortable? Grandma probably would have had a better time of things dying of a heart attack at home. We certainly would have given her water. We probably would have needed a good home hospice nurse for the morphine though.

I came back in the room as mother said a prayer for grandma, who seemed to be fading back into a morphine induced slumber. We left and the next morning the hospice informed us that Grandma had passed, as we had known that she would. Her death certificate was a mess of multiple comorbidities.

Of course the question is, if grandma had died in the post 2020 era, what do you think her cause of death would have been listed as? It certainly wouldn’t be tied to a vaccine she’d received that seemed to push her body over the edge, that I’m sure of. Do you think it might have been called Covid-19? I'd call it natural causes, with a lot of tinkering along the way…