April 21, 2014

Birthing Death - COPIES NOW AVAILABLE

Birthing Death is about: (1) the emotional experience of the primary caregiver in witnessing a dying loved one, (2) family disagreements over end-of-life care, (3) advocacy and legal tips to invoke even at the end of life, and (4) a re-framing of the experience--We are, in fact, helping to BIRTH our loved-ones into the Great Beyond as their body dies away.


From the back cover: 


Because she is an Elder Law Attorney, Geriatric Care Manager, and perhaps most importantly, a long-time (22 years and 27 days) caregiver, author Sue Fabian relays this human experience fully laid bare, hoping to lend a helping hand to those crossing similar bridges.  She also seeks to help readers understand that this is a most sacred moment--helping to birth your loved on into the next world through the death of their human body.  It was this core concept, along with reaching out for the lifelines of family, friends and spiritual helpers that helped her and will help you keep together head and heart.


Read this compelling drama and you will be more deeply equipped to insure the best medical care for your loved one even at death's door and survive this journey that will take you to the edge of your strength.  Take it into the special space of the "Waiting Room," where you go to catch your breath and seek some solace in sometimes suffocating grief.  Learn survival and advocacy tips and then become aware of the pivotal part you play in your loved-one's active dying, for what you do will continue to ripple forward in your life, and likely in your loved-one's life beyond the veil.


**********************************


ORDER INFORMATION:

$19.95 for single copy plus $5 S/H.  For each additional copy, $2 S/H.  

If you pay $20.00, excess will go to Gilda's Club of Metropolitan Detroit.


Please include mailing address.

SUE E. FABIAN, J.D., M.Ed.

ElderWISE Advisor/Advocate

Elder Law Attorney

​Certified in Gerontology


April 21, 2014

Birthing Death - 2nd Excerpt from Chapter 5: The Night Before She Flies

Mom's head settles back into her long-impressed pillow and my welling tears drip on her cheeks.  I am spent.  I linger with her for a while longer, laying my head back down on her shoulder until I can gather up enough momentum to gently pry myself away from my greatest love--Mom.  I just know this is the last time I'll feel her warmth.  I catch my breath, gather up my stuff, and leave.


With rivers of tears flowing from my eyes, I step onto the elevator to go home.  By divine timing, I run into Rev. Renee.  Immediately I share, "I think this is the last night I'll see Mom alive."  She looks into my eyes and with unspoken support puts her loving arm around me.


I learned later that Nelson remained until about midnight...He sends me a quick e-mail:  "Mom actually seems quite fine!  the apnea is gone.  She sleeps very comfortably.  If fact, to me she looks close to how she looked two nights ago.  Don't ask me how.  Even her face looks calm and healthy.  The nurse said that she too believes that om is close.  Her breathing certainly isn't perfect but it's nothing like it was this morning.  Just as I was leaving and after telling her goodbye and kissing her, her breathing seemed to change  She closed her mouth.  Might have even seen a tear.  


Be assured I covered her with love from all three of us.  If she leaves tonight, she knows that she leaves with our love as her tailwind."


Mom's death mask has now given way to love.  I lay my bones in bed, my head drops into the pillow like a lead balloon, and as tired as I am, I cannot drift away into blessed, relieving sleep.


SUE E. FABIAN, J.D., M.Ed.

ElderWISE Advisor/Advocate

Elder Law Attorney

​Certified in Gerontology

April 12, 2014

Birthing Death - 1st Excerpt from Chapter 5: The Night Before She Flies

Mom hovers close to death now.


As grieved as I am, I'm equally fascinated that as I gaze upon Mom's face, I can actually tell when her awareness is just beneath the surface and when she is far away.  It's her shuttling back and forth between our world and the next.  It's as though she is first sticking her toes in the water, pulling them out, returning "here" for reassurance and to make sure her kids are OK, then sticking her toes back in a little more as she becomes more acclimated to Heaven's waters.  She now spends more time over there.  But I can still tell when she manages to return here, however briefly.


Her eyes have been closed for days....Her face has now been overcome by the "face of death."  Her lower jaw has dropped and her mouth forms a big "O."  It's a scary, halloween-like look and hard to see.  After many moments of wanting to turn away, I begin to look upon her face, feeling like I am looking death right in the face.  My emotions are jangled yet I manage to keep looking right into her, focusing more on her soul than being distracted by her "mask."   


I keep at it, but it is not easy to take in Mom's transformed facial expression.  When I feel overcome, I sit down and read.  Sometimes I just need to leave the room and catch my breath again in the Waiting Room.


I return to her room and lay next to her.  I get even closer and begin whispering into her ear...


​     Mom, you are safe.  You are loved.  Dad will be there for you.  The club girls are holding your seat, awaiting your    

     moment to take your place at the pinochle table.  All those who have gone on before you will be there for you 

     too, Mom.  Your mother, your father, your sister, all your friends..they'll all be there, just for you.


My words are interspersed with silence, sending my love in every wordless way I know how.  My head is on her shoulder, I'm holding her hand and my body is pressing full length to hers.  Then I continue...


      Don't be surprised if you find yourself going through a tunnel, Mom.  Look for the light.  Go towards the light.  

     You'll be travelling from our shore to the next shore.  You're being sent off by our love, and you'll be received by 

     love.  No matter where you find yourself, you'll be surrounded by love.  Here or there, you'll be embraced by 

     love.  It doesn't matter where you land, Mom.


I now look directly into her closed eyes, my head hovering just above hers.  Nelson stands by the side of the bed.  He offers some words of assurance as well.  The clock continues its tick towards midnight.


What happens next is utterly shocking, stunning, without explanation, and grips both Nelson and me (even to this day).  Mom gives me a final gift...


Mom hasn't had a morsel of food in nearly two weeks and only a bite here or there in the week-and-a-half prior to that.  She's had nothing to drink for I don't know how long now.  How she hangs on is astounding.  She has long since lost the energy to even raise her eyelids--even if her consciousness were sufficiently present, which it hasn't been since last week.


Emerging from the deepest depths of her soul surges a pool of mother-love that manages to infuse her near-lifeless physicality for one last moment.  With closed eyes she raises her head and lands a kiss dead on my lips.  Nelson is blown away.  I am stunned.  Nelson quikly and softly utters, "ohhhh, she have you a smooch!"  There was nothing more either of us could say.

SUE E. FABIAN, J.D., M.Ed.

ElderWISE Advisor/Advocate

Elder Law Attorney

​Certified in Gerontology


March 24, 2014

Birthing Death - 3rd Excerpt from Chapter 4: A Chaplain On Each Side of the Dam

More days pass in this impossibility--Mom continuing to cling to life, despite no food for more than a week and barely any fluids.  As this incredibly intense and nerve-wracking journey continues, more rumbling manifests as Nelson tries to come to terms with the enormity of this "mother" of all life events.  As if sniffing out any subtle strands of faintly lingering doubt, Nelson asks me the most agonizing question of all..."Should we try to turn this train around?"  In other words, should we pull her out of hospice and initiate an all-out medical assault to bring her back?  Another shockwave.  How much more can any of us take?  Such a heavy question despite us being on the heels of The Debate.  I cannot take anymore.  It's late at night.  I go home.


It's just before midnight, October 28th.  Being beyond exhaustion, I decide to write to both of my brothers.  Sometimes e-mail fits the bill--it's quick yet has some distance...


Nelson asked me a terribly difficult question tonight--whether we should try to turn things around medically.  I couldn't help but have a fleeting thought that I was killing Mom.  It's a question I knowyou had to ask.  And as hard as it was to hear, it merely mimics a lingering thought of mine, so just as well to get it out in the open.  Here's what I know down to my bones.  Mom would be furious at me for trying to bring her back.  Further, even assuming she could--and I don't think it would be possible, she'd be relegated to nursinghome life, likely bedridden, and subject to yet another infection, another hospitalization for aggressive medical treatment, more piking, more prodding, more testing.  She could hardly stomach all that just a few months ago when she was on the medical floors.


her heart is also giving out.  Once one is on oxygen for Congestive Heart Failure, from my experience, it isn't long before one passes.


I also know her soul is wearier than weary.  Even upon themention of this wearniess of the soul to her, it would bring tears to her eyes.  As horrible as it is to watch Mom go through this process--one I never guessed would have occurred (I always figured that I'd get The Call from assisted living facility manager), she had a wonderful quality of life right up to being walloped with this virus.


​I'm saying what I know to be true, not as a defense.  I know you had to ask this question, and I just as much have to say this, being pained as I am at this arduous process.

SUE E. FABIAN, J.D., M.Ed.

ElderWISE Advisor/Advocate

Elder Law Attorney

​Certified in Gerontology

March 19, 2014

Birthing Death - 2nd Excerpt from Chapter 4: A Chaplain On Each Side of the Dam

A hospital chaplain shares what she saw in working with me and my Mom:


I saw Sue keeping alert to even themost subtle of shifts in her mother's state of consciousness.  In my long years of ministry, I had never before heard a loved one so sensitively and courageously describe, in detail, the way her mother's spirit would momentarily depart from her body to visit her loved ones on the other side and then re-surface to be back in the room, with us.  More and more, Sue noticed that her mother spent increasing time "away" in preparation to cross over.  It was remarkable.  I was moved.  I was in the presence of courageous love, between a mother and a daughter.  Clearly, they were communicating with one another in ways intangible to most witnessing what was happening; however, with an open heart and with prayerful intention, I was permitted to sense and to see these holy moments.


[Sue held Violet closely, laying beside her and talking with her.  Then, Sue would gently peel herself away and leave the room to offer space for Violet to transition.  After a while, Sue would return, hold her mom and continue to speak words of reassurance and comfort.]  Though Violet could no longer consciously react, understanding was nonetheless transferred between them  I witnessed this "holy dance."  It was excruciatingly beautiful.

SUE E. FABIAN, J.D., M.Ed.

ElderWISE Advisor/Advocate

Elder Law Attorney

​Certified in Gerontology

March 19, 2014

Birthing Death - ANOTHER ENDORSEMENT

A hospital chaplain from New York has reviewed Birthing Death and offers the following endorsement: Having the unique perspective of four vantage points--former Emergency Medical Technician, pastor, witness to the dying of my own parents and sibling, and longtime chaplain rendering comfort to people of all ages and from all walks of life who were impacted by an either sudden, catastrophic or long drawn out death process of their loved ones, I was affirmed and informed as I read Birthing Death.  Ms. Fabian skillfully weaves her own story into a book written for anyone dealing with end-of-life issues.  


Birthing Death opens the window wide to the physical, mental, emotional, spiritual, legal and practical needs of the dying, their loved ones and family members.  Communication in its depth, simplicity, clarity and courage is stressed as a vital element in engaging health providers, family and the dying.  This will be an eye-opening read for caregivers, clergy, professional healthcare systems and workers, and educators and students in geriatrics, gerontology, hospice, palliative care, nursing, social work and chaplaincy.


sue Fabian has written a book that truly is a gift to all who read it only once or refer to it year after year for consolation and as an outstanding resource guide and teaching tool.  Readers of Birthing Death will quickly discover that one does not have to be alone in this journey of life into death and beyond.  


Rev. Patricia A. Bancroft, M. Div. Chaplain St. James Mercy Hospital and McAuley Manor - ​Mercycare, Hornell, NY.


Finally, I share an excerpt from Chapter Four: A Chaplain On Each Side of the Dam...

Final Gifts: Understanding the Special Awareness, Needs, and Communications of the

Dying[1] invites you to such considerations.  They are both hospice nurses with long experience in helping those dying and their families.  Questions they have found most useful to ask (and I’m sure hospital chaplains would agree) are:  1.  How do you usually respond to stress? 2.  How will those responses work with someone who is dying? 3.  Are you afraid of dealing with the unknown? 4. What do you expect to accomplish through your involvement with your dying loved-one? 5.  Do you want to come away from this death with the sense of completion that accompanies the knowledge that you’ve done everything you could for the dying person? 6.  Are you intent on using whatever time remains to savor this relationship? 7.  Do you wish to convey important messages of love, gratitude, and farewell? 8.  Do you want to learn something that will help you face your own mortality? 9.  Are you confident in the medical professionals involved? 10. What impact will each person surrounding your loved-one have on the sense of teamwork so necessary in caring for him or her?  I never thought to ask myself such questions.  I did, however, carry their essence in my bones.  I’ve already engaged the hospital chaplain and found Rev. Renee’s help with similar issues simply indispensable.  [1] Maggie Callanan and Patriia Kelley, Final Gifts: Understanding the Special Awareness, Needs, and Communications of the Dying (New York: Bantam Books, 1992), 223-225. Shared with permission.

SUE E. FABIAN, J.D., M.Ed.

ElderWISE Advisor/Advocate

Elder Law Attorney

​Certified in Gerontology


March 10, 2014

Birthing Death - ENDORSEMENTS

I want to share some endorsements on my about-to-be published book, Birthing Death:


Throughout the past 19 years as a parish minister and police and hospital chaplain, I have never before encountered such a courageous journey into the realm of living and dying.  I was privileged to be a part of this voyage and the imprint that it has left in me gives light and life to my faith.  The author shares her experience as a long-time caregiver, elder care lawyer, patient advocate and grieving daughter so that others might find comfort, hope and needed resources during one of life's most challenging times...the death of a loved one.  She invites the reader to understand many of the feelings and faith issues that surfaced during her mother's death, the family conflicts that can complicate and bless this time of loss, and to consider some of the questions and answers relevant for hospital, hospice and griever care when facing illness, hospitalization and death.  This book offers hones first-hand experience with practical advice.  This book can be of great comfort and a useful tool while passing through the arduous and sacred process of loving, losing and living again in new and creative ways that honor the memory of loved ones now dwelling on the other side of life.  Rev. Renee Machiniak, Hospital Chaplain who worked with Sue, her mother Violet, and her brothers. 


This is a book that captures the journey at end-of-life with passion, purpose and practicality.  Sue Fabian--elder law attorney, health care advocate and daughter--vividly brings to life the heartfelt journey with her mother, Violet, during the last few weeks of her life.  Their walk together is filled with love, pain, uncertainty, frustration, profound connection and ultimately surrender into the great mystery of 'birthing death'.  If you are a companion to someone at end-of-life (and most of us will be at some point), Birthing Death is a wonderful resource--a powerful true story combined with useful and practical suggestions to help navigate the challenging landscape that is end-of-life.  Rev. BIRGIT LANGWISCH, President, Hospice Prince Edward, Ontario Canada. 


Death is something that everyone knows is coming and for which few are prepared.  Sue Fabian's book is a helpful guide for those who find themselves in the midst of uncharted waters as the end of life approaches for a loved one, is helpful to read before the hard times come and you begin to wonder if you are all alone and will help you advocate for better care, even when death is inevitable.  Perhaps most importantly, it will help you know how to BE with your dying loved one while maintaining your sanity.  PASTOR DAVID NICHOLS, Violet's pastor for over a decade who also worked with Sue and Violet during Violet's dying.


SUE E. FABIAN, J.D., M.Ed.

ElderWISE Advisor/Advocate

Elder Law Attorney

​Certified in Gerontology

February 26, 2014

Birthing Death - Chapter Three: The Roller Coaster of Birthing Death

Huh?  Birthing death?  


Having shared events up to the time of the bursting dam in this saga, deeper reflection on this maelstrom reveals something beyond the roller coaster of caregiving--if it is indeed even possible to sufficiently set aside one's internal upheaval at bearing witness to your loved one's dying.  There is something profound underlying this ride--experiencing the fraying bond of life and trying to stay present in the midst of a life unraveling.  Being present to our loved ones as their flame of life flickers ever more faintly is instrumental in helping them on their way to life beyond the veil.  We are indeed helping to birth them into the next life as their body falls away.  Miss this, and you miss your most important, sacred moment in caregiving, and the most trying.  Try remaining present, open and loving to your beloved when your insides are flipping cartwheels--who needs white water rafting!  


...Two weeks ago life was "normal."  A week ago, a sore throat.  A few days ago, near death in the ER.  Yesterday, a blessed upswing.  Today, another plummet.  No more antibiotics.  Is this the last stretch on the roller coaster--the final fling?  Even in the sacred Waiting Room we cannot shed these breathless ups and downs.


This is the birthing of death.  Tremendous labor pains groan in each of our souls as we try to be present to our beloved, and try even more to release them from our emotional grip.  I've heard a saying, Everything I ever let go of had claw marks all over it.  How apropos as I try to let go of her and hang onto her in the same breath.


Each of these days, each of these endless hours, we pace the floors wondering so much, "Am I doing what s/he wants?"  "Am I doing what I can to let go?"  "Am I helping h/er move towards the next life?"  "What am I deciding about my life as h/er life wanes?"  


I know her cognition is now deeply overcast.  With all my focus, concentration and powers of observation, I strain to catch her clues emanating from a subterranean world in which she now seems to have permanently settled.  Her precious-few clues are further compromised by her sapping strength.


What can I do to be present to her and yet hang onto my own rocking and rolling innerds?


SUE E. FABIAN, J.D., M.Ed.

ElderWISE Advisor/Advocate

Elder Law Attorney

​Certified in Gerontology

May 1, 2014

People are being impacted by reading Birthing Death 

A woman whose mother passed years ago was moved to tears after reading Birthing Death in one evening.  A man got through part of it and was "crying my eyes out."  Beyond its true, emotional impact, the reader is being informed of patient advocacy tools to employ even when their loved one is imminently dying, and emotional survival tips.  Birthing Death​ is now available of AMAZON.


SUE E. FABIAN, J.D., M.Ed.

ElderWISE Advisor/Advocate

Elder Law Attorney

​Certified in Gerontology

April 30, 2014

Hospitals Incorporating Author's Suggestions

Rev Renee Machiniak and I have visited with the director of William Beaumont Hospital's inpatient hospice director, who is incorporating suggestions made in Birthing Death to improve the waiting room experience of those walking the gauntlet of watching their loved-one dying.  Next stop, Oakwood Hospital in Dearborn.

SUE E. FABIAN, J.D., M.Ed.

ElderWISE Advisor/Advocate

Elder Law Attorney

​Certified in Gerontology


May 17, 2014

People Finding Help in BIRTHING DEATH 

Two Amazon reviews and growing reader feedback is showing that people are finding help in the pages of BIRTHING DEATH.  That's the great hope and prayer.  


I will be submitting the book to the State of Michigan Library, hoping to be designated in the top 20 books for 2015.  That would launch a 52-library tour in Michigan, enabling me to further spread the word about this work that in reaching hands and hearts in need as they either are observing their loved ones dying, or are experiencing the deadening grief tidal waving in them upon their loved ones' recent death.  


I've also made significant connections in increasing awareness of this new work, including: Wayne State of Gerontology, University of Michigan, Cleary University, U of D Mercy, Cleveland Clinic, St James Mercy Hospital and McAuley Manor in New York, Hospice Prince Edward County in Ontario Canada, and a growing list of new contacts.

SUE E. FABIAN, J.D., M.Ed.

ElderWISE Advisor/Advocate

Elder Law Attorney

​Certified in Gerontology

May 22, 2014

ANOTHER GREAT REVIEW FROM SINGER/SONGWRITER!  

This morning I received another great review.  Singer/Songwriter Jan Garrett sent me this...


All I can say is WOW!  What a beautiful and important work you have birthed.  I am humbly grateful that you included the words to "Let Her Go."  It is so poignantly and artfully framed by your compelling story.  Thanks for referring readers to our website so they can become acquainted with more of my music.


I am sure your courageous book will make a soulful impact for so many people on so many levels as they walk through this process themselves.  THANKS from all of us for diving in and getting it done with such heart and clarity.

​​

I know your beautiful work is already gaining momentum, and can only get bigger & better as time goes by.

Blessings

JG


SUE E. FABIAN, J.D., M.Ed.

ElderWISE Advisor/Advocate

Elder Law Attorney

​Certified in Gerontology

August 1, 2014

The 50th Anniversary

My family and me are approaching the 50th anniversary (actually on August 7th) of a life-altering, family smashing event--my father's death hastened by cancer at the tender age of 48.  How my then 42 y.o. mother kept it together enough to continue to rear 3 kids and keep a roof over our heads is beyond me.  Of course, being so young, she had the undying help of Gram and Gramp (her parents), and her life-long gaggle of high-school buds, "the Club."  Yet, can you imagine going through this?  She knew for many months what the outcome would be.  She told my oldest brother, a mere 16 at the time, a month or so before his death what the deal was.  She told my other brother, only 13, about 2 weeks beforehand.  I, being 9, was not told until...


I was allowed to sleep with my neighbor friend all that week.  I couldn't understand it.  Having that opportunity was great fun!  I was never before allowed to do this.  Of course, I had no idea what was really going on.  I knew Dad was sick, but I always assumed he'd get better.  From my 9 y.o. eyes and heart, what I knew was that something was wrong, Dad was always laying on the couch and getting skinnier and skinnier, but he never told me he didn't feel good, and nobody ever talked about the obvious, or that anything at all was wrong.  I continued to believe that we were just going through a big bad time but all would be well in the end.


It wasn't.  When I returned home that day from across the street, my Mom sat me on her lap.  Dad was gone.  Gram and Gramp and my brothers were there.  I can't recall if my 2 aunts and uncles were there.  My neighbor-friend Pam and I suppose her mother Eleanor were also there.  Then Mom told me the impossible...


"Daddy's gone to Heaven."  She said some more, but I can't remember what it was.  Emotionally, I suppose I didn't hear anything after learning he died.  I ran to my room.  Pam followed.  We just both sat there and cried.  I don't remember any of the day's events beyond that moment.  Then came the funeral.  We all just sat their like emotional stones.  I don't recall anyone saying anything.  We just sat in a circle in the room during family hour.  At the funeral, I recall my Mom bending down and kissing Dad on the forehead before the coffin was closed, and totally losing it.  


I've always had problems being blindsided in life.  It's taken me nearly 50 years to understand why.  What happened oh so long ago was the ultimate blindside.  Decades later, I learned that my Mom had talked to Gram and Gramp, the family doctor, my neighbor friend's mother and I'm sure all her "club girls" (those life-long high school buddies).  Her actions reflected the best wisdom of the era.


Fifty years later, I'm working with scores of families where their loved ones are dying.  I encourage them to SHARE with each other (unless cultural or intense family dynamics dictate otherwise).  I shared everything with Mom when she was dying in 2012--a 27-day ordeal in hospital-based hospice, after a 22 year saga of caregiving (she had a massive stroke in 1990).  As she loved her Detroit Tigers, I did the play-by-play of 2012's World Series as she lay comatose.  I held her as I lay by her side on the hospital bed.  I gently stroked her face and hair.  I whispered in her ear how I loved her, and that she needed to look for the Light.  


I write about much of this in my new book, BIRTHING DEATH.  The entire Chapter One and Two are shared in the Blog category above, "Birthing Death Book."  You may also preview it on Amazon.  I consider it absolutely vital to learn how to LIVE with the DYING.  


SUE E. FABIAN, J.D., M.Ed.

ElderWISE Advisor/Advocate

Elder Law Attorney

​Certified in Gerontology

June 18, 2014

ANOTHER GREAT REVIEW on ​BIRTHING DEATH!

Hi Sue,

After speaking to you at Gilda's Coffee House this month I purchased your book, "Birthing Death." I could not put it down and read it in one day. Many a tear was shed during this reading and I could not help but feel the love you and your mother had for each other. I wish I could have read this before my mother died 20 years ago. Very informative and certainly written by a very compassionate and caring person. YOU. It was good to see that you mentioned Gilda's Club as a cancer support organization. Nothing wrong with free advertisement for a good cause.

Hope to see you at a Gilda's event soon. Marlene

SUE E. FABIAN, J.D., M.Ed.

ElderWISE Advisor/Advocate

Elder Law Attorney

​Certified in Gerontology

February 14, 2014

Chapter Two - Beginning of the End (Excerpts-Part 2 of 2)

The story gets worse, however.  I backtracked to the assisted living facility's nurse to ask what her sugar levels had been throughout the day.  After all, I know the hospice nurse and the facility nurse had talked to each other--I saw them.  She said to myutter astonishment, no one was checking her sugars!...bad enough.


"Well, what medications has she been given today?," I asked.


To my incredulity, I learned that my mother's diabetic medication was still being administered, despite not having eaten in over two days--that alone drives down blood sugar.  To continue this sugar-lowering drug in addition?!  No wonder her sugar dropped like a lead ball.


Once again, but for my intervention, she wouldhave died that night already being as sick as she was.  Even worse, but for my brother deciding on a whim to stay thirty more minutes, he would not have witnessed her nose dive that prompted his call to me.  Her beloved Detroit Tigers unwittingly saved her life....


The straw had broken.  I couldn't take it anymore.  I could not shoulder both watching my mother suffer and also babysitting the medical personnel.  I immediately decided to pull her out of the facility and take her to the emergency room, where I knew she would hate to be...


What difference did it make that I saved her life twice within a few days if she was nearing death anyway?  The two weeks of her extended life allowed my Denver brother, Nelson, to fly in, come to terms with her dying and say goodbye to his beloved mother.

SUE E. FABIAN, J.D., M.Ed.

ElderWISE Advisor/Advocate

Elder Law Attorney

​Certified in Gerontology

February 13, 2014

Chapter Two - Beginning of the End (Excerpts-Part 1)

By Thursday morning, the facility called--"She doesn't look like herself at all, you'd better come."  Off again I ran and arrived to find a very sick woman.  I amped up hospice care and called my brother, Alan.  Alarmed at her condition, Alan stayed with her all night in her assisted living apartment.


I arrived the next morning and her condition was not improving.  Alan came again after work and had planned on leaving at 7:00p. However, the Detroit Tigers were in the playoffs and Mom wanted to see the first inning.  So he stayed while she slumbered, to awaken her at the appointed hour.  By 7:20p, he called me, "Mom is unresponsive."


I raced back, took one look at her, and immediately pulled out the glucometer.  Her sugar had again plummeted.  Now came an awful internal debate.  "Do I hope she is conscious enough to understand my command to swallow sugar, or call the ambulance (against her known wishes) to take her to the hospital (which she detests even more)."  She no longer wanted any treatment to prolong her life.  She was ready.  She was soul-weary.  She was complete.  My sole responsbility as her patient advocate was to carry out HER wishes.


There I stood, her limp head in hand, hoping against hope she'd be able to swallow the sugar.  I dropped the packet of sugar in her mouth and commanded her to swallow.  Thank God she was able to comply.  Her revival was immediate.


The story gets worse, however...


STAYED TUNED!


SUE E. FABIAN, J.D., M.Ed.

ElderWISE Advisor/Advocate

Elder Law Attorney

​Certified in Gerontology

February 12, 2014

Chapter One - The Aching Dam Bursts (Excerpts)

But for exhaustion, illness, or brief times away, I have been with her every day in those long-suffering twenty-two years as a sole caregiver.  I know what Mom wants!  I now sit here, in ah hospital conference room, and wonder how my two engineering-background brothers could debate so matter-of-factly whether Mom, who I know wants no extraordinary measures, should get a blood transfusion as her life hangs by a thread.


How can I say anything?  They have to find their own way.  How can I not?  I, after all, have the FINAL WORD.  I am her Medical Power of ATtorney.  This is my legal duty to carry out HER wishes.  More than that, I have THE KNOWING.  Deep down in my bones, borne through the arduous and harrowing daily path of walking with her through the health care maze for over eight-thousand days, talking with her, listening to her aphasic utterings that consistently confirm and harken back to her fluent pre-stroke expressions decades ago...


A torrent of frustration and gnarled, raw emotion bursts the aching dam.  I convulse.  No longer can I tamp it down.  Out rushes a howling knowing..."Do NOT ask Mom to go through one more night!  She WANTS TO GO HOME!  She wants to be with Dad so much more than seeing her Beloved Tigers play one more game."


I pause, catching my breath, trying however feebly to gather myself.


"I don't hate you...I don't hate you..." I repeat through tears to my dissenting and distressed brother.


SUE E. FABIAN, J.D., M.Ed.

ElderWISE Advisor/Advocate

Elder Law Attorney

​Certified in Gerontology


February 11, 2014

Introduction to Birthing Death (Part 2 of 2)

​I begin the book in the context of emotions  We are beset with bombshells of emotions and are continually buffeted by them until they are heard.  The chapters proceed along the thread of the roller coaster of the emotional experience, and what I did along the way to keep my feet on the ground.  I have found that only when I addressed my emotions did my mind clear enough to constructively walk this gauntlet and make more effective treatment decisions that confronted me along the way.


Such decisions become based on getting good information from the health care team, and that depends on good patient advocacy.  Being both a Geriatric Care Manager and Elder Law Attorney, Ihad to clear my head and gut enough to engage my professional knowledge.  Such "Advocacy Tips" are offered towards the end, in Chapter 10, to aid you in effectuating the best care possible foryour loved one.


Most fundamentally, while the heart-rending journey of family members is critical to acknowledge and validate, and advocacy tips are critical in helping to facilitate good care, awareness of a deeper reality is emphasized--the birthing of our beloved's soul into a greater world through their bodily death.


Finally, I want to introduce you to my family.  First in my mother Violet--a remarkable woman who bore so much, from the early death of her beloved (my father) to cancer where she watched the horror of her six-foot tall, one-hundred-and -eighty-pound loved one whither away to less than one-hundred pounds; being left to raise a young family; then suffering a massive strove in 1990 form which doctors gave her less than a twenty-percent chance of even surviving.  Survive she did, even learning to drive again when I was initially told she'd spend the rest of her days in a nursing home!  But the stroke left severe disability including a paralyzed dominant arm and extensive speech impairment.  Adding to her disability in 2003, she fell and endured hip replacement surgery and rehabilitation.  Try rehabilitating with one functional arm.  The wheelchair became her means of mobility thereafter.


After fifteen years of helping her remain in Mom home, I made the most difficult decision: to ask her to leave her home of over fifty years and live in assisted living where she spent the next seven years of her life.  They were good years.  After the initial shock of the move, she really came to enjoy life there.  Although this time was interrupted by periodic hospitalizations, she had a relatively stable and good-quality life for all those seven years...until the last few weeks, in early October of 2012, as this book re-tells.  Even to her last conscious moments, Mom continued to reflect her life's lessons learned in unconditional love and acceptance of the enormity of her disabilities and circumstances.  She was amazing to behold.


Then there are my siblings, Nelson, my oldest brother, and Alan, my second brother.  (I am the third and last child).  Nelson lives in Colorado and is director of a national association.  Alan lives north of Detroit and is a General Manager of a manufacturing plant.  They both have undergraduate degrees in engineering and graduate degrees in business administration.  They are both married and have grown children, some of whom have families of their own.  Nelson's point of view is brought into light as his thoughts on end-of-life care and mine clashed.


Then there's me.  I am a late bloomer, having entered law school at the age of forty, being catapulted into it soon after my mother suffered her stroke, to better advocate for her and others like her.  Of Mom's three kids, I have been closest to her, both emotionally and geographically.  Hence, I was her natural choice as her Patient Advocate.  It became my job to not only insure her good care, but to know her end-of-life treatmet wishes and advocate effectuating them.


My point of iew is primarily represented in the following pages.  You may or may not agree with my point of view in end-of-life medical care decisions, or Nelson's.  I merely re-tell events as they occurred for you to learn from and consider.  As Bette Davis so poignantly expressed, "Fasten your seat belts, it's going to be a bumpy night..."  Indeed, she voiced my favorite adage about aging: "Aging ain't no place for sissies."  Growing old, or courageously walking beside our dying loved one and then walking on after their departure is indeed one of life's bumpiest rides, and is surely is no place for sissies.

SUE E. FABIAN, J.D., M.Ed.

ElderWISE Advisor/Advocate

Elder Law Attorney

​Certified in Gerontology

February 10, 2014

Introduction to Birthing Death  (Part 1 of 2)

The Waiting Room; it's a sacred room.  We family members come here to grab a nervous cup of coffee or tea.  We come here to take a break from the intensity of it all  We come here to catch our breath, grab a magazine in which to lose ourselves to mindlessness, to gain brief reprieve from the heaviness of experiencing our loved one's dying.


Perhaps we just want to be alone.  Or we want to find a not-so-strange stranger walking the same painful path; make much-needed phone calls or get caught up on some work; pay those backlogged bills; or simply to close our eyes to futilely attempt to get some rest.


We pace the halls.  we walk in and out of their room, to and from the cafeteria or vending machines, or out the front door just to get some fresh air...


Some of us respond with silence--we don't want the rest of our family to know how much we are breaking inside; others throw heaving tears.  For the rest of us, we're somewhere in between.  Yet we all seek the Waiting Room for a break


After twenty-two long years of sole caregiving, I ran the gamut of emotions and waiting room respites as I kept vigil over Mom at the end of the trail for a breathtaking twenty-seven days in a hospital's inpatient hospice ward.  I paced those halls.  I meandered to the cafeteria--not that I really wanted to eat but that my spring-tight energy had to somehow gain its expression, if only in walking and pacing.


As I've reflected on my journey for the better part of a year since Mom's passing, my inner guidance system draws me to pen these pages for all those now walking "The Walk"--perhaps your life's most difficult walk, hence, its capitalization.  In this part of your journey, hospice or the hospice ward, there must be something more than a sport or homemaker magazine, a TV, a box of tissues, and a cup of coffee in the sacred space of "The Waiting Room"--again, a waiting room like not other ever encountered.  There must be a lifeline you can take along your way, wherever you may find a break from it all.  And it might be helpful to know that you are not alone, as I share with you what happened under my skin as the one most closely bonded with my mother, what happened in my advocacy role, what happened in my family as divergence emerged in medical treatment decisions, and what happened as my loved one inched closer and cloer to the horizon's point of no return.


Earnestly, I hope you find a lifeline in these pages to seize upon, to help you if only in small measure on your current daunting journey.  You may continue to find solace in the days, weeks and months ahead, after your loved one's eventual passing over, as you read on where I share with you my first year's journey.


But there is more byond the emotional journey.  While your loved one is still with you, you must continue to advocate for good care, and critical to grasp is the inherent spiritual undertow of this moment.  I know of nithing in the grief literature that combines this book's three-fold content; sharing: (1) the internal experience of a caregiver/adult child of a dying elder/parent and how to survive and productively process family conflicts that erupt over end-of-life care; (2) advocacy tips, even in hospice; and most importantly, (3) how to reframe feeling helpless in watching your loved one dying and seeing it as your most sacred of moments--helping the dying person birth into a new life through the death of the body.  I hope this unique offering assists you on your way through one of your life's most difficult times.

SUE E. FABIAN, J.D., M.Ed.

ElderWISE Advisor/Advocate

Elder Law Attorney

​Certified in Gerontology