Not too long ago a friend of mine talked about making a list of what behaviors would persuade him to move out of the house they’ve lived in for well over thirty years. That brought up the topic of when is the right time to move from active care to palliative or hospice care. These are all difficult choices. Sometimes they are more difficult for the living than the dying.
In the case of Louie, he had a good handle on how to manage the end of his life. He had a tough life in general, at least it looked that way from here. In the last quarter of his life he had reconciled with his boys, quit drinking, and quit smoking. Those were all good news for me.
He didn’t quit smoking soon enough. Emphysema came on, and with it the need for carrying oxygen all the time. Breathing was difficult even with the aid of an oxygen bottle. He developed sleep apnea and a few other medical issues that really messed with his sleep the last couple of years. I think the chronic fatigue got to him. After working part-time at the Campbell County Jail as commissary, he finally had to quit. His hobby became keeping track of all the deputies by listening in on the police scanner. He knew all the codes and all the officers.
He was very aware of the trajectory of his life, and started making plans quite early on. On one visit, I remember arriving at his apartment for a visit to find that most things with emotional value had a label on them. Guy. Linn. Eric. Chris. He had taken the time to think about everything he owned, judge its value, and tried to make a fair distribution.
Louie made a point of doing things when I visited. There was a nice county historical museum in town. He liked to go to the coal mines and watch the activity. When there was a county fair or rodeo we would always take it in. Every time we had to go out for dinner at one of the nicer places in town. These outings got shorter and more strenuous as the emphysema caught up with him. Carrying the oxygen was cumbersome. He couldn’t walk very far. Getting in and out of the car was just too much work.
Louie didn’t ask us to join him for most of his medical evaluations, but the time came when he received a diagnosis of something that would eventually take him out. He was never very open about what it was, to the point where I’m not sure even he knew what was in there. He didn’t want to go in for the definitive tests to get a specific diagnosis. He didn’t want any treatment to stop or slow down the disease. Life was getting too damned difficult, to the point where shorter was better. His world had pretty much become just that apartment.