Today’s article is the third in an occasional series, called the “The Dying Project,” about the dying process of Daniel Morii, who, along with his spouse, Shari, invited the Hawaii Tribune-Herald to follow their experiences and share them with the community.
Daniel Morii is preparing to transition to hospice care.
He has been using Kupu Care through Hospice of Hilo, which helps patients with cancer or congestive heart failure try to maintain a positive quality of life despite health concerns.
But he’s ready for hospice, which offers more services for people who are terminally ill, such as the availability of nursing assistants, more-frequent nurse visits, and the ability to use the hospice facility, if needed.
Hospice of Hilo offers “support, guidance and compassionate care of body, mind and spirit” from staff who focus on patient comfort, symptom moderation and pain management.
Morii, who has cancer, held a “death cafe” earlier this summer to start a conversation about death and dying. At that time, he actively interacted with attendees and was involved in planning and execution of the event.
On Thanksgiving Day, though, Morii had planned a large gathering of loved ones to celebrate the holiday, to reconnect and give the people who have known him a chance to spend quality time by his side.
But Morii bowed out of the event because the pain of his disease became overwhelming. Instead, his loved ones cooked and chatted and reminisced, even though Morii wasn’t able to be there.
They wrote notes about having an “attitude of gratitude” to fulfill a wish he has to focus on the good parts of life.
On Wednesday, his doctor sent him to the ER to make sure the cancer was the root of his pain — not some other, as-yet-unrecognized problem.
Medicine from the ER helped him ease into a slumber the likes of which he’d been missing for several days.
Friends and family at the Thanksgiving gathering held at a retreat near Morii’s home, shared conversation about every topic under the sun, but returned often to what they can do to help Morii’s spouse, Shari. They’re organizing a schedule for close friends of the couple to take shifts so she can get sleep without worrying that he might fall during the night.
It is already impossible for her to be the solitary family caregiver for Morii, who will need pain medicine in the middle of the night, early in the morning, at lunchtime, dinnertime and bedtime. He’ll need a steadying hand to get from bed to the bathroom. He’ll need someone to help get him oriented when he first awakes.
He and his wife have gotten a whirlwind education about the intricacies of the health-care system, which has new protections to prevent people from getting addicted to narcotics. Morii was averse to taking pain pills at all. But he has slowly accepted that he has a significant medical need to take the medicine.
He and his spouse recognize that terminal illness has its own timetable and that each person’s end-of-life experiences are unique.
“Everyone’s journey is so different, for many reasons,” Rebekah Bernard, Kupu Care spiritual counselor, said Friday morning as she shared with loved ones about Morii’s current status — something he had asked her to do.
Morii had hoped to reach a sort of transcendental state of readiness for death.
That, Bernard and Kupu Care Nurse Janelle Todd told his loved ones Friday morning, does indeed happen for some hospice patients.
But pain can interfere with attaining that stage. Morii’s cancer is unforgiving and has caused bone pain.
“He told me in the ER, ‘This is what it feels like to die,’” Todd said.
Bernard told the gathered loved ones Friday that it’s important for them to understand how important their love and support has been for Morii while he tolerates pain and health providers work to blunt it.
“Not everybody has this,” she said. “In fact, few people do. So your support is monumental.”
Morii is giving up independence, in tiny increments at a time, allowing the dying process to nudge him along — not without resistance on his part. He’s driving less (though he hopped on a lawn tractor several days ago and mowed) and is allowing others to handle his medication schedule.
He is sleepier, getting out less often and working hard to live a quality life, regardless of what the cancer does.
Todd compared terminal cancer to a patch of weeds that doubles in size. At the start of growth, the weed patch doubles from one plant to two. But when weeds get to 64 in number, they rapidly balloon to 128 plants, 256, 512 and then 1024. Likewise, Todd said, Morii’s cancer, early on, was similar to that first plant. But now it continues to reach more of his body.
“I think we might have turned a corner,” Todd said.
Even so, Morii hopes to attend a Monday doctor’s appointment, not allowing the cancer to take away control of what he decides to do.
Email Jeff Hansel at jhansel@hawaiitribune-herald.com.