The aides had just come in, as they did every two hours, to turn Dad over to his other boney haunch. The plan was to keep him off his bottom and the bedsores.

“One, two, three,” Tammy said and she and Katie hoisted his panting body up off the bed and onto the right side. With the motion, his open mouth closed slightly and his milky vacant eyes opened wider.

“There you go, Mr. Douglas,” Tammy said, as she smoothed the cotton blanket over him, her blue-gloved hands gentle.

“So he wasn’t wet?” my sister Nancy asked, her voice steady, but her eyes puffy, tearful.

“No,” Tammy said, “Not wet.”

Dad had not been wet for two days. Not surprising since he’d had nothing to eat or drink since an incident several nights earlier.

When the phone rang on that evening, Nancy had just come home from a busy day at the office and prepared herself a modest supper: homemade soup and salad. She had just sat down, cloth napkin in her lap. It was Dan on the phone, the nurse in charge of Dad that evening.

He explained that Dad had had a choking episode; the staff had struggled to get him breathing again.

“Can I eat my dinner or should I come right out?” Nancy asked.

“Better come right out,” Dan said.

And that was the beginning of the final vigil with our father.

Fortunately, since it was my Dad’s 95th birthday, my other sister Susan and I were already due to arrive in Philadelphia the next day, and my older daughter was coming from New York City to join us. Not that Dad was aware of the upcoming milestone. Despite Nancy’s having reminded him every time she visited, which was often since she lived only five miles away, he had left birthdays behind.

Dad barely spoke anymore. Sometimes Nancy would put the receiver up to his ear when she called me from his room, and I would tell him things. Maybe he would whisper something back, breathless and unintelligible. I had learned to stop saying “What, Dad?” and just go on with my story about our latest attempt to keep squirrels off the bird feeders or the kitchen sink from leaking. Dad had always been Mr. Handy Man, measuring and heading to the lumberyard for wood, grouting bathrooms, digging in the garden. He used to like to hear about projects. Now, it seemed, he just wanted to sleep.

We all planned to stay only one night. We’d have a birthday lunch the next day and head home.

Nancy had told us that he had not eaten well lately – probably only 15 percent of one of his three daily meals. This was unusual. At my last visit in December, Dad had allowed the aide to feed him every pureed morsel on his plate. It seemed to me that as long as there was appetite, there was life force, desire.

Now he had no desire that we could measure. And my sisters and I were entering that same treacherous terrain we had bumped across when our mother lay dying: What constitutes “comfort?” Or “intervention?” What would our parent want now? What did we need?

Trust me. These are difficult questions but necessary to discuss. It’s never too soon, often too late. Even with explicit living wills there can be gray areas, differences of interpretation among family members. This was certainly true with my sisters and me, but in the end we were able to find agreement on the comfort issue.

I knew my dad did not want to go on indefinitely, getting turned side to side, with oxygen tubes up his nose, and his heart racing.

His desires, if he had any, were to not linger and to die comfortably. He had always said so in earlier, healthier years. He was no longer able to make his own decisions, but he knew what he wanted, and, finally, just days after his birthday, he got it.