I'm sitting in a writing class, trying to concentrate on my writing assignment when the text pops up from my mother's care manager on my phone: "Your mother is down to 79.2 pounds this morning." Suddenly I'm back in Cleveland in mind and body, picturing her—or trying to—this skeletal version of the woman I'd last seen in August. Back then, she was at a new low of 87. Now, in the space of just two weeks, the bottom had dropped out, and she had lost another 8 pounds, ten percent of her body weight.

I text the care manager and my brother in Florida, call my mother in assisted living and beg her to eat, hear her say she has no appetite, "I'm just not hungry." As adrenaline surges through my body, I call her care manager, tell her we have to do something, but we are running out of options.

We will try medical marijuana, a last desperate step, while I sign her up for hospice. Sitting in that class, and trying to form words on the page,

I write:
I am pushing her uphill like Sisyphus
Keep her breathing, eating, body in motion
But gravity takes its toll
And soon she will be weightless
Lighter than air

Two days later I'm in Cleveland, steeling myself for this new version of my Mom. Though my mother has a touch of dementia and almost no short-term memory, we discussed the idea of hospice on the phone before I came in, and now, this weekend we're due to meet the intake nurse and the care team—nurse, social worker, and chaplain—who will be taking care of her.

The meetings are less depressing, more hopeful than I expected. Their focus is on quality of life rather than quantity; my mother can avoid trips to the hospital emergency room, where the assisted living nurses sent her in the past, where she would wait in purgatory for the hospital doctors to admit her or send her back home after six or eight hours.

My mother is lucid, and follows the gist of the conversations, if not the details. The intake nurse asks about funeral arrangements, "Will she be buried or cremated?"

Later, when I ask my mother if she understood the conversations and the process of signing up for hospice, she replies, "Sort of."

"These are difficult questions, it's hard to talk about this," I say.

"She was just being practical, it's going to happen," and I know in that moment, that my mother got it, that she knows what's coming next.

I've been my mother's long-distance caregiver for 15 years, have watched the slow, steady decline: a broken femur and months of rehab, the ruptured appendix along with the anesthesia that took her memory, the weight loss and gradual wasting along with the isolation of the Covid pandemic.

Ten years ago, when my mother grudgingly moved from her townhouse to assisted living, she bounced back, going to book clubs, attending musical programs, and eating with her tablemates in the dining room. She gained 20 pounds, and six months after moving in, told me that living at Wiggins Place was so much better than living alone.

My mother bounced back from her broken femur, from pneumonia, from a series of medical events, but even she, all five-feet and iron-willed, could only bounce for so long.

Today, my life centers around my phone, around texts, emails, crises that come on a daily basis. I manage moment to moment, getting her the best care that I can.

And yet I can't change the outcome, and can't rewrite what's coming next.

Judah Leblang is a writer, teacher, and storyteller in Boston. Find out more at judahleblang.com