David Butters saw a lot of suffering and death during a long military career.
He served with the U.S. Army as an infantryman in the Korean and Vietnam wars and retired as a sergeant major after 28 years. During the Gulf War in 1991, he was called back into service to escort dead soldiers to their burial sites at home.
David says his toughest job wasn’t in the military, but as his wife Fran’s primary caregiver while she received hospice at home. Their story is one of love and devotion that began in high school, survived a 60-year break, and saw them through Fran’s illness and death in April 2023 at the age of 86.
David Butters and Frances Kraft grew up in Chelsea, Mass., and were high school sweethearts. David was a year older and of a different faith than Fran. He recalls Fran’s mother did not want her daughter to marry him. David enlisted in the Army right after finishing high school. He married and started a family. Fran earned two master’s degrees and became a teacher. She married, took her husband’s last name (Pearlman), and gave birth to two sons.
David and Fran’s paths didn’t cross for six decades until they reconnected at a grand reunion for alumni of Chelsea High School in 2013. They both were widowed. Sparks flew and on December 7, 2014, they married (he was 78 and she was 77). David, who had been living in Delaware, moved into Fran’s Swampscott condo. They enjoyed spending time with each other and with friends. They looked forward to growing older together.
Fran and David were hospitalized with COVID-19 for about a week in January 2021. X-rays found nodules on both of their chests. Radiation worked well on David’s cancer but not Fran’s. A follow-up visit determined that the cancer had migrated into Fran’s bones and had damaged vertebrae in her lower back. She had spinal fusion surgery but became too frail to withstand chemotherapy. She decided to go on hospice and was admitted onto Care Dimensions’ service Feb. 2, 2023.
At first, Fran could get around their apartment well with a walker. Hospice aide Esther Fouche visited several mornings each week to help Fran with bathing, dressing, and moving to the couch. Massage therapist Charlene Dacey-Sullivan helped Fran relax with a massage, which was well received.
David helped Fran with the walker, but as the disease progressed, Fran had trouble just getting out of bed. Hospice Nurse Annie O’Connor arranged to have a portable toilet delivered and she instructed David on how to move Fran from the bed to the toilet in between visits from the hospice team.
“I had difficulty picking her up and dealing with the whole process,” recalled David, who is 87. “I was totally physically exhausted and not sleeping well. I wasn’t that exhausted when I was an infantryman in Vietnam.”
Nurse Annie knew that caring for Fran was taking a toll on David, so she gave him several caregiving tips and helped him set up a system for safely giving Fran her medications. On a spreadsheet, David noted details about each medication he gave to Fran, including the date, time, and amount, plus her symptoms.
Like many patients nearing end of life, Fran had difficulty swallowing pills. Annie got orders from the hospice doctor to change some medications to liquid concentrate, but there were still two small pills used to treat nausea and anxiety. Annie taught David how to fill small syringes and to dissolve the pills in the liquid concentrate. “This way, David was able give Fran her medications all at once in a tiny amount of liquid under her tongue,” explained Annie. “We didn’t need more complex solutions like infusion pumps that would have made Fran more uncomfortable and been difficult for David to manage.”
As Fran spent more time in bed, Annie and David wanted to ensure that she did not develop bedsores. Annie had an air mattress delivered and gave David a tip that Esther and other hospice aides used – how to place a rolled-up towel under Fran’s torso and pull it so Fran could be easily repositioned.
“David used all his life experiences to care for his beloved Fran,” said Annie. “He watched over her day and night, learned how to physically care for her, and learned how to assess and treat her symptoms so she experienced no discomfort.”
“I couldn’t have kept Fran at home without Annie teaching me the caregiving tips that she did,” said David. “She may have assumed that I knew a lot of these things because of my military background, but I didn’t. I couldn’t have done it without her.”
Social Worker Jenne Robertson provided emotional support and reassured David that he was doing a great job caring for Fran. “He was a wonderful, loving caregiver and very diligent attending to his wife’s needs,” said Jenne. She met with him monthly, then more frequently as Fran’s health declined. During their meetings, David often would reminisce about his and Fran’s lives together and his time in the Army.
Early one evening, David was getting ready to give Fran her medication and noticed she stopped breathing. He listened closely. Suddenly, Fran gasped and started breathing again. David called Care Dimensions’ 24-hour nursing support line, and a nurse soon arrived. She explained that patients in the late stage of hospice often stop breathing and Fran could do it again.
Later that night, David called the nursing support line a second time. He could no longer lift Fran. Annie arrived and inserted a catheter so Fran could be kept clean and dry, which ensured Fran’s dignity was maintained and that David would not get hurt moving her.
Fran’s condition declined further. She was mostly unresponsive. During previous visits, Annie had not mentioned how much longer Fran may have to live, but during her visit on April 12, she felt it necessary to tell David that Fran could pass that night.
Coincidentally, Fran’s two sons called David to say they were in the area and were thinking of stopping in to see their mother. David told them yes, they should come.
About 30 minutes after her sons arrived, Fran took her final breath.
“Fran had no fear of death. She had no pain, was totally relaxed, and died peacefully,” recalled David.
When Care Dimensions Chaplain Hilary Davis made a condolence call to David, he told her, “I served in three wars, and being the sole caregiver for a loved one at end of life was the hardest thing I ever did. I couldn’t have done it without your team.”
A couple months after Fran died, David made a gift to Care Dimensions in her memory. He included the following note:
“God bless my Irish lass, Annie. She guided me, supported me, taught me, and most of all was there for me 24/7. I could not have survived physically without her comfort and support. When it’s my time to go, my family knows that I want Care Dimensions to help me through my final days.”
About the author
Lisa Conti is Senior Marketing Communications Specialist for Care Dimensions and manages its Voices of Care blog.
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Since 1978, Care Dimensions has provided comprehensive and compassionate care for individuals and families dealing with life-threatening illnesses. As the non-profit leader in advanced illness care, we offer services in over 100 communities in Massachusetts.