Let the birthday girl decide on celebration

Q. My mother lives in an assisted-living facility and soon will be 90 years old. Our family wants to celebrate her milestone birthday, but traditional gifts seem silly and she gets weary easily so taking her out for a big celebration seems challenging. Ideas?

A. Ask your mother. While you may have some ideas that include traditional celebrations, your mother may be able to tell you exactly what she would like. Start with her wishes and honor them.

Many families take this time to create photo albums or memory books that trace a person’s life events and significant relationships. Keep the book simple and lightweight so your mom can hold it easily. Write the captions or use a font large enough for her to read the words. You may ask her children and grandchildren to write one paragraph about their favorite memory or story. Or include a picture instead.

“Hand-written notes and paintings or drawings from grandchildren are wonderful. Children are so innocent and forthcoming,” said Annie Clay, a hospice chaplain in Olympia.

Be careful about a person’s energy level as well as your own expectations. A big party may seem grand, but your mom may feel overwhelmed and quickly become exhausted, Clay said.

You may want to host a small family party at the assisted-living facility where your mom can rest awhile, if she gets tired. She may enjoy simply being with her family and listening to you celebrate in her honor.

“We had my niece’s wedding shower at mom’s assisted-living facility,” Clay said. “While mom could not attend the wedding, she was included in the shower and enjoyed herself.”

Gathering our loved ones, sharing stories and eating favorite foods make for our best parties – at any age.

Clay advised: “It doesn’t have to be fantastic. Do whatever fills your heart.”

Q. Most of our older family members live out of town. We have been summoned to their “death beds” on a few occasions. Some died when we were there or shortly after. Some are still living several years later. These trips can get expensive. Is there a way to know when to go?

A. Congratulations on making the effort to say goodbye. We know it’s expensive. We know it’s disruptive of routine. But being present with a dying family member is “the greatest gift you can ever offer a loved one,” said Stephanie Godinez, nurse and administrator with Crest Home Health and Hospice in Coeur d’Alene.

It’s impossible to know exactly when a person will die, but hospice workers, as well as doctors and nurses who have been with a lot of dying people, can “read” some of the telltale signs indicating that death will likely occur within a few days.

Godinez said that your loved one may sleep more and be less and less responsive. The color of the skin may change in places such as the feet and knees, turning purplish and blotchy in an end-of-life phenomenon known as “mottling.”

Experts may give you their best guess, but it’s always a guess. And as Godinez and other death and dying experts well know, some dying people, even when in comas, seem to hang on until certain loved ones gather.

Godinez also pointed out you can say your goodbyes on the phone, even if the dying person is unresponsive. Ask someone to place the phone to your loved one’s ear and speak the words you would if you were there in person.

“It may be something as simple as saying ‘I love you’ or ‘thank you,’ ” Godinez said.