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.