My mother died in April after a years-long battle with vascular dementia. I buried her last Friday.

It hurts worse now than then.

I knew my mother was going to die. When she was first diagnosed two years and change ago, I looked up the medical literature. It said that life expectancy was six to nine years post-diagnosis.

I knew my mother was going to die, but I thought I had four to seven more years with her.

When she was diagnosed, it was terrifying. She had packed her things and wanted to "go back home" from the home she had been living in for decades. I called 911, got her to the ER. She spent a week and change in the hospital while they assessed her. They asked me then if I wanted to place her. I did not. I wanted to give her a chance to spend her last years in "familiar" surroundings, although she recognised the place, and me, less and less.

Things were going until last November. She had a fall. I called 911. ER passed her to orthopedics (she had metal prostheses in her left arm from the car accident that took her better son decades ago.) Orthopedists saw the prostheses were out of place but did not want to operate. They released her back to the ER. ER doctor asked me if I was comfortable with discharge back home.

My mother had had her fall "while getting ready to go to work." She had not worked in several decades. I told that to the ER doc, who kept her for observation. My mother was upset.

I visited her in the hospital over the next month and change. Initially, the plan was temporary discharge home, eventual placement. Then, the physio pulled me aside one day and told me that my mother could not or would not use her walker safely and that discharge home would inevitably lead to another fall, while placement reduced the chance of a fall. I immediately responded that they should place her.

She was placed in early January. But, by then, she had lost even more of her faculties, and she was refusing to eat anything but Ensure. When she was transferred to a care home, she hardly made the distinction between the care home and the hospital.

I visited her every day I could at the care home, until visits were shut off in March because of the pandemic. After that, I called the care home every day. A week before she died, they got her to talk on the phone to me. Same combative spirit. They were even making plans to modify her diet.

Then, one night last April, a nurse called. My mother died. The nurse was as kind and understanding as she could be, but she told me that, due to the pandemic, they could not keep my mother's remains longer than a day. She asked me if there were pre-arrangements. There were not, but I knew there was a funeral home nearby. I got in contact with them, then called the care home to give them the funeral home's number. They picked up my mother's remains that night. Because of the pandemic, I could not even see her. I called most of her family. Most handled it well.

I called the home the next day. The agent told me there was only one option. I already knew. I authorised the cremation of my mother's remains, but I could not see her one last time. I had her ashes a week later.

In the first month or so after my mother died, I accepted the line that, with the pandemic, my mother was suffering no more, that my mother was no longer in the mental agony of vascular dementia.

Then, another nurse from the care home called me to tell me I could pick up my mother's belongings. This nurse had been on duty when my mother died. She broke down crying over the phone. I tried to be as professional as I could, I tried to tell the nurse it was not her fault, that it was OK for her to cry since crying is better than vicarious traumatisation, a major risk among health care professionals.

It was not that nurse's fault. It was entirely my fault that my mother died. I did not pick up on the early warning signs of her vascular dementia. Three years later, when it became inescapable, the only thing I could think of doing was what I was trained to do, preserve her life. I hardly thought about her quality of life.

My mother was an intelligent person. She knew there was something wrong, but she just could not say it out loud. She did not have to. The horror in her eyes when she could not understand said it all. Because I fell back on my training (preserve life about all else), I tried to divert her attention, I tried to keep her fed and clean and out of harm's way. I never thought about the horror she felt.

In my useless attempts to preserve her life, I completely ruined whatever quality of life she may have had in her last two years of life.

I see the horror in my mother's eyes whenever I am between deep sleep and waking up, just like I see my brother's face at that time. It is a horrible feeling, but it is karma, it is justice.

I have had multiple surgeries, I have had gallstones and kidney stones, I have been hit on the head and I have fallen on my head. But I never knew what pain was until my mother died.

I buried my mother Friday, months after she died. I could not even get her funeral right. I am in pain, but that pain is justice and karma. I will be in pain for the rest of my conscious life, but that is what I deserve for failing my mother.