LAUGH

My dear friend, Ray, died on Thanksgiving morning, after a four month battle with bile duct cancer. Throughout the entire ordeal, Ray was upbeat with a positive outlook on his situation.

Judy, Ray's wife, and I have been friends for over twenty years. Every Wednesday night we talk on the phone. I call Wednesdays "Judy Night" and she calls them "Marilou Night". Humor is a huge part of our friendship. Judy laughs so easily at almost everything and anything. She finds humor in the simplest things, which is wonderful.

Judy's humor is in her stories. She can go to the grocery store and return home with a crazy experience that she can spin into a funny story. I go to the grocery store and come home with milk and bread.

I visited Judy and Ray a few weeks ago. I said my goodbye to Ray as I knew his time was near. We talked about his life and legacy. His biggest concern was Judy and I promised him that I would take care of her forever. He also was worried about having their financial paperwork completed.

During the course of his disease, Judy kept herself busy managing their home, caring for Ray and all the other numerous tasks that needed to be done. Through it all, she was still herself and able to laugh. The morning of Thanksgiving when she called to tell me that Ray had died, she was in shock and numb. Living so far away, I felt so helpless as I wanted immediately to be there to comfort her.

Later, I gave her a call to let her know that I am always here for her. I hoped to be able to cheer her up. But it was her, in the end, who cheered me up as she, so typically, made me laugh. I am so blessed to have her in my life.

LAUGH

You can always make me laugh.
You laugh so easily; so often.
Even when things are rough,
you find something to chuckle about.

We have been through a lot;
you and me.
Lots of great times, with some a bit tough.
But through it all, you eased the pain
because you can always make me laugh.

Now we are facing a tough time.
Your heart is breaking, the pain is deep.
I promised him I would take care of you forever,
but I feel so helpless, so powerless.

There is nothing I can say.
There is not much I can do,
but to let you know I am always here
to help share the burden, to ease the pain.

I gave you a call to cheer you up.
To let you know you are not alone.
But it was you, who instead, cheered me up,
because then again,
you, so amazingly,
made me laugh.

INDEPENDENT

One of several criteria for opening to hospice is that the patient needs to have either twenty-four hour care or a plan for that care in the future when the need arises. The care can consist of family members, friends, hired help or a combination of any of these. Another option is to move into an environment that offers the appropriate care; such as a Board and Care home or a nursing home.

Many families don't have long term care plans and that is okay as long as they are willing to work with the hospice staff toward that end. Part of my job as a social worker, is to assist patients with the options that are available in order for them to have a workable and safe plan. Safety is an important component of hospice.

Quite often, people have a difficult time letting go of their independence as it is a struggle to have hired care or family members being around. Most of us are independent souls and want to run our own lives. I always relate to patients that struggle with letting go of their independence as I know that I will have a difficult time as well if I am faced with a similar situation.

"Leslie" was sixty years old and lived alone. She suffered from colon cancer that had spread to her lungs and bones. She was bed bound and spent her time in the bedroom of her small apartment. She had no family or children, but had many friends with whom she considered her family. Unfortunately, the majority of her friends lived a few hours away and were not available to the extent that she needed.

Leslie relied on her neighbor, "Sandy", to assist her with meals, household chores, errands, etc. Sandy came over three times a day for a few hours at a time. Leslie needed someone twenty-four hours a day due to her limitations, but she would have none of that. She wanted to stay right where she was and was resistant to any changes in the way things were right now.

Leslie was very gregarious and upbeat. I admired her independence as I could understand and relate to what she was saying. But, on the other hand, she was putting herself at risk. One of her dearest friends is driving up in a few days to try to convince her to move in with her. I hope Leslie agrees. If not, she will be at risk for any multitude of things that could arise.

Because I am a mandated reporter, I did call Adult Protective Services to report the situation. Hopefully Leslie will listen to them and find a plan that is safe as well as workable for her. But then, she has a right to make poor decisions. She also has a right to live her life in a way that works for her. I wish her the best.


INDEPENDENT

You couldn't help but like her.
She immediately drew you in.
She was optimistic, upbeat
and independent as hell.

I went in to try to assist her.
She was bed bound and needed some help.
She was resistant to anything I offered.
She was doing just fine living alone.

She had no family, but a few cherished friends
who lived a few hours away.
She relied on a neighbor who stopped by a lot.
To her that was sufficient enough.

I spoke of the risk of living alone.
How safety is a big concern.
Hospice can't open unless she was safe.
Our biggest worry is that she would get hurt.

She would have nothing to do with hiring help
or moving to a Board and Care home.
She wanted to stay right where she was.
She was just fine being alone.

I hope in time she'll change her mind,
although I respect that she stands firm in her beliefs.
Independence is one of her strongest personality traits,
but it also may be her weakest link.

TIME

Seventy-six year old "Bill" suffers from lung cancer. He has been married to his wife, "Vicky" for almost fifty years. When I first walked into their tiny mobile home, he was lying back in a recliner in the small living room. There was a bookcase next to him full of pill bottles, water glasses, paperback books and lots of clutter.

Bill was quick to smile and shared that he spent his days and nights lying in his recliner. It was the only place where he was comfortable and could breathe easily. He was on continuous oxygen and felt safe as everything he needed was within arm's reach. Bill spends his day watching television and listening to chamber music.

Each time I visited Bill's home, I would find him in good spirits with an easy smile. I am always amazed how someone, who has had every pleasure taken away, can still find joy. He was one of those folks. Bill spoke of God and the afterlife and felt that Earth was Hell. He felt that the more one suffered on Earth, the better it will be in Heaven. His belief is what sustains him and what gets him through each of his days.


TIME

He lies in his recliner.
That's all that he can do.
His needs are within arm's reach;
the remote,
his pills,
his oxygen.

His days are long.
The nights even longer.
Not sure if it's Monday or Tuesday.
Each day repeating just like the last.

He is a spiritual man.
He believes in God and the afterlife.
He feels the more we suffer on Earth,
the better our Heaven will have to be.

He takes things all in stride.
He says there's not much else one can do.
When asked how things are going,
he's quick to reply
"I'm puttin my time in."

HUGS

I just flew home from spending three days with my friends Judy and Ray. Ray was diagnosed with cancer four months ago and has been declining rapidly since then. He is so weak and eating very little. His color is ashen and he sleeps most of the day.

This was the first time I saw them since his diagnosis. I couldn't wait to get there to give Judy a big hug. When Judy met me at the baggage claim to pick me up at the airport, I hugged her for so long. I didn't want to let her go. I wanted to ease her pain and let her know that I am and will always be there for her and Ray.

Over the course of the three day trip, I probably hugged Judy every hour on the hour. I needed to have that connection with her. I felt that it was the only thing I could do for her.

I spent some time alone with Ray and I promised him that I would take care of Judy and make sure she will be okay. Judy had asked me to write his obituary and I wanted to ask Ray about what he would want his legacy to be. I started out by saying that Judy had asked me to write.....I paused for a moment and immediately Ray added, "my obituary?"

Ray has accepted his situation from the moment of his diagnosis. He is in good spirits with a quick smile. I am in awe of how he is coping with such a horrific disease.

As Judy dropped me off at the airport, I gave her one final, long hug. It was hard to walk into the terminal and leave her. I know before too long, though, I will return.


HUGS

I have always loved to give hugs.
It's a great way to say hello.
A hug is one of the few things in life
that comes back the moment it's given away.

This time the hugs were so different.
They weren't for goodbye or hello.
I needed to wrap my arms around her.
To protect her from the pain.

I cannot stop him from dying.
I cannot freeze him in time.
He probably has only a few more weeks.
She knows he's slipping away.

All I could do was hug her.
Then hug her again and again.
It's the only way I knew how to comfort her.
The rest is out of our hands.

I wanted her to know I'll always be there
no matter what day or what time.
Her hugs were soothing.
Her embraces so warm.
I guess I needed some hugging too.

HER BROTHER

Eighty year old "Ben" suffered from end stage lung disease. Ben and his wife, "Milly" have been married for fifty-four years. They have two sons who reside locally and a daughter who lives about six hours away. Ben and Milly raised their children with love and lots of humor.

Ben was only on hospice for a few weeks when he took a sudden turn for the worse. He died three days later. I went out hours before he died and found him unconscious. Ben's breathing was very shallow and it appeared that his death was imminent.

The family said that Ben's sister, "Paula", was driving up and would be there later that day around dinner time. They had told Ben about his sister's visit and believed that he was holding on until she arrived.

Ben's only sibling, Paula, was twelve years old when he was born. She clearly remembers the day her little brother was born. She was out in the waiting room and couldn't wait to see him. The two of them have remained close their entire lives. Paula now lives about 500 miles away, but had been calling several times each week to check in on her brother.

The moment Paula heard that Ben's death was near, she and her husband got into their RV to drive the six hour trip to her brother's home. It was ironic that Paula was there when Ben was born and likewise there when he peacefully died.

Patients hold on for specific reasons. I have experienced patients waiting until an anniversary date, a certain telephone call, some unfinished business to be completed or, like the story above, until a special person visits. It happens too often to be a coincidence. I believe patients have control over when they let go. This story is a perfect example of such a phenomenon.


HER BROTHER


She sat patiently in the hospital room
waiting for him to come.
She wanted to meet her new brother.
To welcome him into her world.

She'll always remember that special day
even though eight decades have passed.
She and her brother have always been close.
It never mattered that she lived hours away.

It broke her heart to hear of his illness
for he had always been strong.
When they were small, she took care of him.
Now there was nothing she could do.

She called weekly to keep in touch.
She needed to hear his voice.
When they told her his time was close,
she knew she had to come.

He was unconscious and barely breathing.
The family had gathered around.
He knew the moment she walked in
as ninety minutes later he was gone.

He had been lying calmly
waiting for her to come.
He wanted one final goodbye
before moving onto his next world.