She smiled with her whole face.

The last time I saw her she was in good spirits. She was happy and smiling and proud. Dad and I sat with her and visited for a while. She really couldn’t hear a word I said. We all talked anyway and smiled. We flipped through her fashion magazines and she showed me some of her newest purchases. It was a good visit.

Time had allowed many visits as of late. I had seen her frequently and every time she greeted me with that smile. That smile that spread wide across her face, caused her nose to crinkle and her eyes to sparkle. She smiled with her whole face.

This time was not the same. We found her curled in bed on her right side. Quiet. Still. Rales rising with every breath. She had been this way most of the day.

Given the situation I couldn’t just see her as a granddaughter, I had to see her as a nurse practitioner too. I was concerned with her posture and feared she’d had a stroke. I began to assess her, to touch her, to feel her, to love her. I got in her ear and started talking to her.

Initially, I found her to be enslaved to the dehydration, the pneumonia, the congestive heart failure. Her eyes did not see me. They were glazed with exhaustion and malady. As I leaned over her body our eyes met, and then, for a moment, the glaze fell from her eyes and there was a spark in her eye, there was life. She knew me. She smiled and spoke words to me.

I continued to assess her and she followed commands appropriately. I asked her questions and she answered appropriately. She was there. She said her neck hurt but otherwise she wasn’t in any pain. Her breath was heavy and the rales of pneumonia were present with every breath. But she was not distressed, she was not hurting, she was sleeping. She was waiting. She was ready.

I think on three things.

1. Don’t make fun of your family. Always support them.
2. Don’t make people feel uncomfortable in your home because you are afraid they’ll make it dirty. Homes were meant to be lived in and not shown.
3. Be thankful for what is yours. Especially people.

Each of these have profound meaning for me. Meaning that she defined.

I sat on her bed for awhile and rubbed and stroked her back. She responded to the movement of my hand. Comfort flowing both ways.

They asked me to speak to the doctor. We collegially conversed and he graciously made time to talk. I was pleased with her care, with him. We discussed hospice. He ordered hospice. She was admitted to hospice.

Within hours her breath did not rise and fall with the rales of pneumonia or the exhaustion of congestive heart failure. Her breath did not rise and fall at all. She peaceful slipped away.

Days later, I found myself at the funeral home hours before her service. I stood alone in the sanctuary with her for a long time.

“Oh, it’s you” she’d said. “You’ve come to save me” she’d said.