Wilma Boles Died: June 24, 2024 3:51 AM CDT
My mother passed this morning in the Bryan Hospital West Emergency Room in Lincoln, Nebraska. Last night, at 6:00pm CDT, I received a call from her rehab nurse informing me my mother’s vital signs had crashed – she was unresponsive with glassy eyes, she had been complaining about abdominal pain all day, and she did not eat, or take her medication. Wilma was delivered by ambulance to the ER where, after a thorough evaluation of her condition, I, along with her medical care team, and even Wilma herself – who forced herself to be lucid for a few moments – agreed the right path forward was comfort care. Fewer than 10 hours later, in her 85th year, Wilma J. Boles died of sepsis at 3:51 AM CDT.
For the past three weeks, my mother wanted to die, and begged me to help her, but there was nothing I could do to give her a quick, and merciful, death. She did not qualify for hospice, there is no right to assisted suicide in Nebraska; so, she was left to herself to struggle alone with the end her life in what feels like the most horrible, and cruel, way to endure what was once begun: Not wanting to eat, not trying to move, not accepting medication.
My mother was always of strong will, and in her last moments, she fought to get what she wanted, and did. I cannot beg from her the right to her own life; but I also cannot comprehend the pain of her unnecessary suffering. Perhaps it’s better I not think about that right now, but I do know there must be a gentler, wiser, way to complete a life than the end she was forced to finish.
I will write more about my mother, and her death, in detail soon, but for now, thank you for reading this, and take care of yourself.
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Wilma Boles Health Update: June 15, 2024
This message is an update concerning my mother, Wilma Boles, and her end stages of life. She is 85-years-old. I am sharing this to inform as many people as possible with the facts of her situation without any filters or telephone tag. I will post new updates as necessary.
On May 23, my mother was admitted to Bryan Hospital in Lincoln, Nebraska for elective hernia surgery. Her diaphragm was torn and half her stomach and half her colon were lodged in her chest cavity. Her surgeon believes she was in that critical state for at least 25 years. The surgery was successful, however, some of her stomach has since pressed back into her chest cavity where fluid has pooled, placing pressure on her left lung. She is uncomfortable. She had a feeding tube. Despite all that, her surgeon told me there “was no good reason she cannot get better.” He also made it clear that, while Wilma may have to change some things, her quality of life could be fine for many years.
For some reason nobody yet understands, my mother decided not to get better. The surgeon said after her surgery, “something snapped in her mind.” She refused to eat. She fought the feeding tube. She refused to get out of bed or move. She demanded a darkened room with no light and no sunshine. She refused her medications – which is a certain irony because her father was a small town pharmacist, and selling medication is what got her family through the Great Depression – she would not even sit up in her hospital bed for the doctor to more easily examine her.
Wilma expected her hospital stay to last two days; she was hospitalized for more than three weeks. I believe her expectation against reality was too much for her to take, and she then made the decision to die.
Because of her long list of refusals, and because of her worsening condition, hospital psychiatry intervened and, after a long evaluation, Wilma was diagnosed as “non-decisional” and that meant the hospital was immediately forced to invoke her durable Power of Attorney. That meant I was required to take over all healthcare and financial decisions concerning her care and wellbeing. I received that POA invocation from the hospital in the early morning of June 11.
A few days later, after the POA was invoked, I was able to briefly speak to Wilma on the phone. She “wanted a suicide pill” and she demanded that I “sign the paper for her to be sent to Hospice” because she wanted to die. In discussion with the medical staff, I was told Nebraska is not a “right to die” state – there are no suicide pills anyway, and because of her mental condition she would not quality for that even if it were allowed. As well, Wilma was not, and is not, terminal and that means she does not medically qualify for end-of-life hospice. When I relayed that information to Wilma – telling her neither the hospital or I would kill her – she repeatedly shouted “no, no, no, no, now!” and ended the call. We have not spoken since.
For those family members who are concerned about Wilma, please know no decision is being made for her without the expert advice and consent of trained medical, and legal, professionals. Please also know it does not help when local family members try to “support Wilma” by promoting her death wish because “she lived a good life.” It also does not help when local family members approach hospital staff demanding to see Wilma when a “no contact” order has been set in place.
The decision was made to not allow Wilma visitors at this time because of the wrong type of support being offered: “you have the right to die, Wilma!” (sorry, not in Nebraska!), as well as other good-intentioned visitors who bring gifts, and who want to visit with her, but right now that only angers her and, according to her direct medical team, causes her to spiral down.
My mother has always been a proper, public-facing, individual, and I’m certain her current state of incapacitation is somewhat embarrassing to her, and she gets angry, and combative with medical staff later after visitors see her in her current state. She angrily sent home the latest visitor attempt and did not accept their gift. She was rebellious against medical staff the rest of the afternoon.
I'm sure she would object to this post, but we are here because of her behavior – behavior that has already caused a lot of confusion, hard feelings, and pain. Share this post with her at your own risk.
To avoid unnecessary stress, and the unhelpful local and remote support for Wilma, I, along with the medical staff, decided to not allow Wilma any visitors right now that may trigger her decline and adverse state of mind. That visitation policy may change in the future; but that decision will be determined alone by Wilma’s behavior with her care team.
Because of Wilma’s refusal to do any physical therapy in the hospital, she placed her life, and future, at risk. She is not trying to get better. The hospital decided to discharge her because she was being non-cooperative in her care and, I have been told, that cooperation is a requirement to keep your insurance and Medicare – they will not pay for you to give up and not move from your bed.
Bryan Hospital was wary in discharging her because they feared no local rehab facility would take her, even though she has excellent insurance, because of her non-cooperation in physical therapy. For the rehab center to get paid, Wilma must actively participate in her plan of care. So far, she has not. We got lucky when two rehab centers in Lincoln accepted her even though she refused hospitalized physical therapy.
Those rehab centers are the lowest rated in the city and I know that will upset Wilma, but the higher rated facilities would not accept her because of her non-cooperation. I understand some of that non-cooperation may be due to cognitive decline; but insurance doesn’t care, they only want documented medical evidence of her moving. Her feeding tube has been removed. She began to eat a bit, but, at last report, she was still refusing to take her medication.
Wilma is currently in transition into rehab. The name of that place, and its location, is not important right now because the “no visitors” policy is being continued.
Wilma’s stay in rehab may last a few days, or a few weeks, or even months. We do not know if she will return to assisted living, or modified cognitive care, or the hospital, or, eventually, hospice. It all depends if Wilma decides to get out of bed and walk again. Her feet have not touched the floor for three weeks.
We want Wilma to get better. We want Wilma to take back her life. We want Wilma, if she is able, to realize the reason she had the hernia operation in the first place was because she wanted to live and feel better.
At this time, Janna and I ask for no comments. No DMs. No thoughts and prayers. No phone calls. There is nothing for us to do now but wait and see if Wilma decides to live or not. That decision is in her hands.
Here is the most recent photo of Wilma we have, taken on the day of her admission into Bryan East Hospital on May 23, 2024.
In case this post is removed, here is the public document link to this update:
https://Boles.co/wilma-j-boles