Eighty-three year old “Donald” suffered from Parkinson’s Disease and Dementia. He had been in a slow decline for years to where he now was bedridden and dependent with all of his needs. He was confused and could not carry on any meaningful conversation.
Donald lived with “Loretta”, his wife of sixty-two years. Loretta, eighty-one years old, was in good health with lots of energy which enabled her to care for Donald. They had one son, “Devon”, who lived across the street. Devon had been laid off from his job and was available to help his parents on a daily basis.
Donald’s needs were increasing to where Loretta could no longer care for him at home alone. It broke her heart to place him in a Skilled Nursing Facility, but she knew she had no other choice. Loretta didn’t drive so Devon would drive his mom to the facility where she would spend the day. Devon would return to pick her up at dinner time.
Donald was in the facility for about a week when he went into a coma. The family knew he was dying and remained at his bedside. Devon’s son was away at college and was able to fly home to visit his grandfather before he died. When his grandson walked into the room, Donald woke up for a few minutes and smiled at his grandson. Donald died the next day never awakening again. It comforts the family knowing that he was able to acknowledge his grandson‘s presence.
As a hospice social worker I contact families twice after a death. The initial call is a condolence call when the patient first dies. I make another call two to four weeks later to check in and see how the family is coping. I called Loretta today and she shared that she had just picked up Donald’s ashes and how it gave her comfort.
She is coping appropriately with excellent support from her family and her many friends. She was able to talk about her grief quite easily. She was aware that she will have some difficult days ahead, but also knows that it is the normal process of grief. With her outgoing personality and her willingness to reach out to her family and friends, I know she will be okay. She also knows she can call me or hospice if ever needed. I wish her well.
HOME
She wanted him to remain at home.
She hoped she could care for him there.
But his needs became too much for her.
She could no longer manage him alone.
She had to place him in a facility.
She knew she had no other choice.
She saw the good care he was getting,
but still it wasn’t like he was at home.
He was confused and didn’t understand,
but he must have known when she was there.
He would calm down when she entered his room
with her soothing words and gentle touch.
He died quietly one evening
with his family at his side.
She said it was peaceful.
It was good for us all.
She brought his ashes home today.
She said that something had been missing.
She placed them gently on the mantle.
“It’s so good to have him back home.”
Saturday, December 24, 2011
Saturday, December 17, 2011
DEAR SANTA
Sixty-four year old “Gail” suffers from thymus cancer. She was diagnosed three years ago and has been through chemotherapy and radiation to no avail. She is divorced and is raising her two grandchildren; “Kelly”, thirteen, and “Arnie”, ten. Arnie’s developmental age is impaired due to being born with fetal alcohol syndrome.
Kelly and Arnie’s parents have not seen the children for years. Their father, Gail’s son, was in prison for seven years while their mother just left them on Gail’s doorstep one evening several years ago, knowing Gail would take them in. Gail lives in a very small two-bedroom home. The two children share a bedroom.
Gail has two other children who are devoted to her. Her son “Frank” is temporarily staying with her and sleeps on the couch to help out as she needs. He was recently laid off and is available to help out full time. Gail’s daughter, “Shelley” lives nearby and is with her mom on a daily basis. The plan is for Shelley and Frank to raise the two children after Gail dies.
Gail never complains and states, “I have had a good life.” She uses humor to cope and is realistic about her situation. She speaks openly about her dying which is a comfort to her children as Shelley recently stated, “It helps all of us to know how she is doing and what she is needing.”
I went out to do a visit today and Gail showed me the letter that Kelly wrote to Santa Claus. It made Gail cry tears of pride for her granddaughter. This is a family that doesn’t have much by society’s standards, but the love Gail has for her two children and her grandchildren is priceless.
DEAR SANTA
I wish for an I-pod
to hear my favorite songs.
I could download music so easily
and hear Justin Bieber sing.
Why does my Nana have to suffer?
Could you take away her pain?
She shouldn’t have to go through this.
It just is so unfair.
She’s been sick for quite a while.
I see her getting worse.
Santa, can’t you do something
to give her back her health?
It’s hard to see her suffer.
She’s been through way too much.
She’s raising me and my brother.
Why is she so sick?
Did I share my favorite music?
Did I tell you what I want?
The I-pod would be nice,
but then, my Nana is still sick.
Kelly and Arnie’s parents have not seen the children for years. Their father, Gail’s son, was in prison for seven years while their mother just left them on Gail’s doorstep one evening several years ago, knowing Gail would take them in. Gail lives in a very small two-bedroom home. The two children share a bedroom.
Gail has two other children who are devoted to her. Her son “Frank” is temporarily staying with her and sleeps on the couch to help out as she needs. He was recently laid off and is available to help out full time. Gail’s daughter, “Shelley” lives nearby and is with her mom on a daily basis. The plan is for Shelley and Frank to raise the two children after Gail dies.
Gail never complains and states, “I have had a good life.” She uses humor to cope and is realistic about her situation. She speaks openly about her dying which is a comfort to her children as Shelley recently stated, “It helps all of us to know how she is doing and what she is needing.”
I went out to do a visit today and Gail showed me the letter that Kelly wrote to Santa Claus. It made Gail cry tears of pride for her granddaughter. This is a family that doesn’t have much by society’s standards, but the love Gail has for her two children and her grandchildren is priceless.
DEAR SANTA
I wish for an I-pod
to hear my favorite songs.
I could download music so easily
and hear Justin Bieber sing.
Why does my Nana have to suffer?
Could you take away her pain?
She shouldn’t have to go through this.
It just is so unfair.
She’s been sick for quite a while.
I see her getting worse.
Santa, can’t you do something
to give her back her health?
It’s hard to see her suffer.
She’s been through way too much.
She’s raising me and my brother.
Why is she so sick?
Did I share my favorite music?
Did I tell you what I want?
The I-pod would be nice,
but then, my Nana is still sick.
Saturday, December 10, 2011
MAGIC WAND
Sixty year old “Laurie” suffers from pancreatic cancer. She is undergoing chemotherapy in an attempt to reduce the tumor to lessen her pain. Pain has been the biggest struggle for Laurie in the past. The chemotherapy is working and her pain is now at a tolerable level.
Laurie lives with “Walt”, her husband of nineteen years. They have no children. Walt was previously married, but his first wife died after a short illness. He was widowed ten years before he met Laurie.
Laurie is from a large family who are very involved, lively and exceptionally verbal with their thoughts and emotions. Laurie’s family is a sharp contrast to Walt and his family dynamics. Walt has a tendency to “stuff” his feelings and remain silent. Laurie wants Walt to talk to her and her family about his emotions and grieving process, but Walt has never learned how to do so.
I went out to do a routine visit today and was met at the door by Walt. Laurie was napping and not available during the visit. Walt said he wanted to ask me something. He told me about having a panic attack a week ago in the middle of the night. It woke him out of a sound sleep and scared him. He said he just wanted to scream. He felt so out of control.
The two of us talked for a while and it came out that Walt had many fears about facing his emotions. We talked about how it was for him when his first wife died after a one month illness. He said he just took a step and kept going. He added that he never has addressed any of those feelings. Walt said that as a child, he tried to talk about his feelings and was always stopped by his mother saying, “I have had it worse than you have it.”
Walt was receptive to meeting with our hospice bereavement interns to help him with his grief and emotions. He has stuffed his feelings for over six decades. Learning to undo how he processes his feelings will take some time. I was proud of him to have taken that first big step today.
MAGIC WAND
I wish I had a magic wand.
I wish I could ease his pain.
Emotions trapped so deep inside
struggling to come out.
The panic attack scared him.
It woke him from a deep sleep.
He knew it had to do with her dying.
He felt so out of control.
He learned years ago to stuff his feelings.
He was taught this as a young boy.
Do not ever complain.
Others have it worse than you.
Now he needs to talk about it,
but doesn’t know where to start.
He wants to address these deep feelings,
but is afraid of what will come.
He took a baby step today.
It was a healthy start.
It will take him years of hard work though,
to sift through all that pain.
But then,
I wish I had a magic wand.
Laurie lives with “Walt”, her husband of nineteen years. They have no children. Walt was previously married, but his first wife died after a short illness. He was widowed ten years before he met Laurie.
Laurie is from a large family who are very involved, lively and exceptionally verbal with their thoughts and emotions. Laurie’s family is a sharp contrast to Walt and his family dynamics. Walt has a tendency to “stuff” his feelings and remain silent. Laurie wants Walt to talk to her and her family about his emotions and grieving process, but Walt has never learned how to do so.
I went out to do a routine visit today and was met at the door by Walt. Laurie was napping and not available during the visit. Walt said he wanted to ask me something. He told me about having a panic attack a week ago in the middle of the night. It woke him out of a sound sleep and scared him. He said he just wanted to scream. He felt so out of control.
The two of us talked for a while and it came out that Walt had many fears about facing his emotions. We talked about how it was for him when his first wife died after a one month illness. He said he just took a step and kept going. He added that he never has addressed any of those feelings. Walt said that as a child, he tried to talk about his feelings and was always stopped by his mother saying, “I have had it worse than you have it.”
Walt was receptive to meeting with our hospice bereavement interns to help him with his grief and emotions. He has stuffed his feelings for over six decades. Learning to undo how he processes his feelings will take some time. I was proud of him to have taken that first big step today.
MAGIC WAND
I wish I had a magic wand.
I wish I could ease his pain.
Emotions trapped so deep inside
struggling to come out.
The panic attack scared him.
It woke him from a deep sleep.
He knew it had to do with her dying.
He felt so out of control.
He learned years ago to stuff his feelings.
He was taught this as a young boy.
Do not ever complain.
Others have it worse than you.
Now he needs to talk about it,
but doesn’t know where to start.
He wants to address these deep feelings,
but is afraid of what will come.
He took a baby step today.
It was a healthy start.
It will take him years of hard work though,
to sift through all that pain.
But then,
I wish I had a magic wand.
Saturday, December 3, 2011
SHE DRINKS
Sixty year old “John” suffers from brain cancer. He is confused and very forgetful. He was a systems analyst by trade and gets frustrated because he knows he can’t remember things. John lives with his wife, “Janet”. They both are admitted alcoholics. When we initially opened them to hospice two weeks ago, they both proudly proclaimed that they each had been sober for over one month.
Janet and John have a son who lives an hour away. He visits as often as he can. He is an accountant and can work from home, which makes his schedule flexible to be able to visit his parents when needed. Another son died four years ago from an accidental drug overdose while in jail. Janet easily tears up when talking about the loss of her son.
Six weeks ago, Janet fell, while drunk, and fractured her left shoulder. She has had several surgeries on her shoulder since then as she had not been keeping her arm immobile as directed by her physician. Due to the fracture, she is unable to care for John.
John has declined to where he is bed bound and not eating. He has stopped talking and it isn’t clear how much he understands. Likely he has just a short time to live. Fortunately, the couple have the funds to hire twenty-four hour attendant care. In addition, due to her own limitations, Janet has hired someone to help her with cooking, cleaning, household chores and transportation.
Yesterday, I went out to do a routine visit at 9:30 in the morning. I found Janet so drunk she could not even walk. She was stumbling and the caretaker was helping her to the kitchen table. Janet and I sat in the kitchen while she drank a half pint of tequila with a beer chaser. She said she started to drink again three days ago. She said she couldn’t be strong any longer. She admitted to drinking one pint of tequila and six beers daily. Her son called during the visit and she told him that she had started to drink again. Fortunately he is now aware.
I followed up with a call to her today and again found her drunk. She said she started to drink just today. She did not remember our visit yesterday and I reminded her that yesterday she said she had been drinking for three days. She then quickly said, “I will stop, I will stop.” I wanted to update her son, but she told me not to call him as he has enough stress.
I will follow this case closely to monitor safety for her and her husband. Fortunately hospice has a tremendous follow up bereavement program. She will need help for a long time to come and hopefully we can help her with the support she needs.
SHE DRINKS
She is crying.
She is laughing.
She is drinking.
He is dying.
She swallows her tequila
with a beer chaser
from the moment she awakens
until bedtime has come.
She slurs her words.
She stumbles and falls.
She can’t face his dying,
so she drinks.
She says she can’t remain strong.
She no longer has it in her.
Old habits die hard
so she takes another swig.
He’s in good hands
with the care she has hired.
They attend to her too
while she drinks.
She is crying.
She is laughing.
She is drinking.
He is dying.
Janet and John have a son who lives an hour away. He visits as often as he can. He is an accountant and can work from home, which makes his schedule flexible to be able to visit his parents when needed. Another son died four years ago from an accidental drug overdose while in jail. Janet easily tears up when talking about the loss of her son.
Six weeks ago, Janet fell, while drunk, and fractured her left shoulder. She has had several surgeries on her shoulder since then as she had not been keeping her arm immobile as directed by her physician. Due to the fracture, she is unable to care for John.
John has declined to where he is bed bound and not eating. He has stopped talking and it isn’t clear how much he understands. Likely he has just a short time to live. Fortunately, the couple have the funds to hire twenty-four hour attendant care. In addition, due to her own limitations, Janet has hired someone to help her with cooking, cleaning, household chores and transportation.
Yesterday, I went out to do a routine visit at 9:30 in the morning. I found Janet so drunk she could not even walk. She was stumbling and the caretaker was helping her to the kitchen table. Janet and I sat in the kitchen while she drank a half pint of tequila with a beer chaser. She said she started to drink again three days ago. She said she couldn’t be strong any longer. She admitted to drinking one pint of tequila and six beers daily. Her son called during the visit and she told him that she had started to drink again. Fortunately he is now aware.
I followed up with a call to her today and again found her drunk. She said she started to drink just today. She did not remember our visit yesterday and I reminded her that yesterday she said she had been drinking for three days. She then quickly said, “I will stop, I will stop.” I wanted to update her son, but she told me not to call him as he has enough stress.
I will follow this case closely to monitor safety for her and her husband. Fortunately hospice has a tremendous follow up bereavement program. She will need help for a long time to come and hopefully we can help her with the support she needs.
SHE DRINKS
She is crying.
She is laughing.
She is drinking.
He is dying.
She swallows her tequila
with a beer chaser
from the moment she awakens
until bedtime has come.
She slurs her words.
She stumbles and falls.
She can’t face his dying,
so she drinks.
She says she can’t remain strong.
She no longer has it in her.
Old habits die hard
so she takes another swig.
He’s in good hands
with the care she has hired.
They attend to her too
while she drinks.
She is crying.
She is laughing.
She is drinking.
He is dying.
Saturday, November 26, 2011
HORSES
"Paul”, ninety years old, suffers from lung cancer. He has been on hospice for about two months. He is declining rapidly to where he is now very weak and sleeps most of the day. Paul lives with his wife, “Joan”, who is eighty-six, but so full of life and energy.
Paul and Joan have three adult children and many grandchildren. The family is very close and all are devoted to Paul and Joan. Joan does not look or act her eighty-six years. She is very social and, in addition to her family, has many close friends and neighbors. She is very talented and has many interests. Joan paints water colors, plays the piano and currently is writing her second novel.
Joan has a strong interest in genealogy and has researched Paul’s family history as well as her own. Paul was a World War II hero as he was the pilot of the plane that first spotted the Japanese at Midway. Paul proudly showed me the one room in their home where he has displayed all the newspaper articles and medals he received while serving in the war.
During my visits, Joan will start sharing family history. She remembers all the details which make her stories so interesting and colorful. During my visit today, she started to share stories of the loss of members of her family. Seeing Paul’s decline in the recent weeks has brought up past memories that she has experienced.
During the visit, she shared the story of her father and how he died. She said his love for horses came from his father, her grandfather. Her grandfather was a cowboy and also rode horses throughout his life. She said he once raced against Jesse James in a horse race.
It gives her peace and comfort knowing that the moment her father died was the perfect moment for him.
HORSES
She has a colorful family history.
She’ll easily spin you a tale.
Anecdotes, adventures, olden times.
She’s a natural-born story teller.
She’ll proudly talk about her family.
So many people no longer around.
How she was there for many until the end.
Lasting memories she’ll never forget.
She shares stories about her father
and his lifelong love of horses.
Never without a cowboy hat
as he proudly rode throughout his life.
Late in life, a heart attack left him frail.
Her mother had to pick up the slack.
One day she wheeled him to the front porch
so he could watch her work in the yard.
Suddenly he saw children leading some ponies.
They were slowly walking past his home.
An unusual event never occurring before.
It was then he quietly slipped away.
It gives her peace and much comfort
knowing he died the moment he did.
One final image of the horses he so loved.
Further coloring of the already vibrant family tree.
Paul and Joan have three adult children and many grandchildren. The family is very close and all are devoted to Paul and Joan. Joan does not look or act her eighty-six years. She is very social and, in addition to her family, has many close friends and neighbors. She is very talented and has many interests. Joan paints water colors, plays the piano and currently is writing her second novel.
Joan has a strong interest in genealogy and has researched Paul’s family history as well as her own. Paul was a World War II hero as he was the pilot of the plane that first spotted the Japanese at Midway. Paul proudly showed me the one room in their home where he has displayed all the newspaper articles and medals he received while serving in the war.
During my visits, Joan will start sharing family history. She remembers all the details which make her stories so interesting and colorful. During my visit today, she started to share stories of the loss of members of her family. Seeing Paul’s decline in the recent weeks has brought up past memories that she has experienced.
During the visit, she shared the story of her father and how he died. She said his love for horses came from his father, her grandfather. Her grandfather was a cowboy and also rode horses throughout his life. She said he once raced against Jesse James in a horse race.
It gives her peace and comfort knowing that the moment her father died was the perfect moment for him.
HORSES
She has a colorful family history.
She’ll easily spin you a tale.
Anecdotes, adventures, olden times.
She’s a natural-born story teller.
She’ll proudly talk about her family.
So many people no longer around.
How she was there for many until the end.
Lasting memories she’ll never forget.
She shares stories about her father
and his lifelong love of horses.
Never without a cowboy hat
as he proudly rode throughout his life.
Late in life, a heart attack left him frail.
Her mother had to pick up the slack.
One day she wheeled him to the front porch
so he could watch her work in the yard.
Suddenly he saw children leading some ponies.
They were slowly walking past his home.
An unusual event never occurring before.
It was then he quietly slipped away.
It gives her peace and much comfort
knowing he died the moment he did.
One final image of the horses he so loved.
Further coloring of the already vibrant family tree.
Saturday, November 19, 2011
CARDS
Fifty-six year old “Sandra” suffers from ovarian cancer. She was referred to hospice several months ago because her cancer had spread to her stomach. Sandra has been divorced for years and raised her two children alone. Sandra‘s twenty-eight year old son lives with her. Her daughter lives nearby with her husband and young daughter.
Both children are devoted to their mother. Sandra is still able to manage many of her needs, although is slowly declining and becoming weaker. She stays home alone while her son is at work. She has many visitors throughout each day as well as phone calls from family and her large network of friends. Sandra is a very social person with such a positive outlook on life. She says she doesn’t miss working, but does miss the social interaction that goes along with it.
I went out today to do a routine visit and Sandra shared how she had been so sick the previous week. She had been weak, nauseas and couldn’t keep anything down. In addition, her eyes have started to become painful where she has stopped reading for a while wanting to give them a rest. Sandra loves to read, but in her typical positive way, says that she can always get someone to read to her. She is doing much better this week. Sandra’s experience of last week steered our conversation about her dying. She is a Christian with a strong belief in God and the afterlife.
Sandra picked up a book from her nightstand and shared some of the words of wisdom from a few of the pages. The book focused on recognizing the bright side of life. Sandra cannot control having cancer, but she has all the control in how she deals with her disease. Sandra stated that she prefers her days to be good days. The book wrote about the positive aspects of playing the cards that you have been dealt.
Sandra has no fears about dying or the afterlife. Her positive attitude has guided her throughout her life and I have no doubt that she will continue to play all the cards that she holds in her hand.
CARDS
She has such a positive attitude.
She always prefers the bright side.
No matter what cards have been dealt,
she’ll continue to seek out the aces.
She feels life is like a deck of cards.
One must always play the ones in their hand.
You can never rely on what card is coming next,
so it is best to accept the ones that you have.
She has been dealt some bad cards in her life.
Things have not always been easy or smooth,
but she’ll carry on, present a smile,
and do the best that she can.
She wants the end of her life to be happy.
She hopes to enjoy the days she has left.
She wants to always be remembered with a smile,
not with, sadness, sorrow or regret.
Her convictions about life may be simple,
although I know her legacy will be great.
“Success is when you find joy in your life
by playing the cards you have been dealt.”
Both children are devoted to their mother. Sandra is still able to manage many of her needs, although is slowly declining and becoming weaker. She stays home alone while her son is at work. She has many visitors throughout each day as well as phone calls from family and her large network of friends. Sandra is a very social person with such a positive outlook on life. She says she doesn’t miss working, but does miss the social interaction that goes along with it.
I went out today to do a routine visit and Sandra shared how she had been so sick the previous week. She had been weak, nauseas and couldn’t keep anything down. In addition, her eyes have started to become painful where she has stopped reading for a while wanting to give them a rest. Sandra loves to read, but in her typical positive way, says that she can always get someone to read to her. She is doing much better this week. Sandra’s experience of last week steered our conversation about her dying. She is a Christian with a strong belief in God and the afterlife.
Sandra picked up a book from her nightstand and shared some of the words of wisdom from a few of the pages. The book focused on recognizing the bright side of life. Sandra cannot control having cancer, but she has all the control in how she deals with her disease. Sandra stated that she prefers her days to be good days. The book wrote about the positive aspects of playing the cards that you have been dealt.
Sandra has no fears about dying or the afterlife. Her positive attitude has guided her throughout her life and I have no doubt that she will continue to play all the cards that she holds in her hand.
CARDS
She has such a positive attitude.
She always prefers the bright side.
No matter what cards have been dealt,
she’ll continue to seek out the aces.
She feels life is like a deck of cards.
One must always play the ones in their hand.
You can never rely on what card is coming next,
so it is best to accept the ones that you have.
She has been dealt some bad cards in her life.
Things have not always been easy or smooth,
but she’ll carry on, present a smile,
and do the best that she can.
She wants the end of her life to be happy.
She hopes to enjoy the days she has left.
She wants to always be remembered with a smile,
not with, sadness, sorrow or regret.
Her convictions about life may be simple,
although I know her legacy will be great.
“Success is when you find joy in your life
by playing the cards you have been dealt.”
Saturday, November 12, 2011
PAIN
Sixty-eight old “Catherine” suffers from lung cancer. She gets short of breath very easily although is able to manage well if she walks slowly. Catherine lives alone with plans on moving to a retirement community in two months where there are higher levels of care available as needed.
Catherine is divorced and has lived alone for years. She has two adult children who are very close to her. Her daughter, “Lisa”, moved in a few months ago to help out. Lisa works during the day, but is available weekends and nights. Catherine’s son, “Jay”, works nearby and can take off work whenever he needs to help his mother.
Catherine has a very independent personality and is very determined to live her life to the fullest. She pushes herself to keep going in order to live her life her way. She loves to eat out and lives near many restaurants within walking distance. Many days one will find her slowly walking up the street with her walker toward her restaurant of choice for that day.
Catherine has been on hospice for over six months. Whenever the nurse or I visit, we spend most of the time talking about food and the local restaurants. Catherine is a delight and so full of life.
Her one issue, though, is severe back pain. The hospice nurse offered morphine which Catherine quickly declined. She had the understanding that taking morphine would either mean you would become addicted or that you were dying. Roxanol is the same drug and, quite often, when presented that way, patients are more willing to accept the option.
Catherine’s son Jay was worried about his mom’s pain issues and offered to get her some marijuana. Catherine quickly said no as she felt she didn’t want to smoke it. When Jay offered getting it in a brownie, she again quickly declined as she didn‘t want to digest any marijuana. Jay discovered a lotion at a local marijuana dispensary that Catherine was willing to try. She is now happily using it as it is very effective in relieving her back pain.
Catherine said she is from the old school where values were such that one didn’t take certain drugs. She now is a big fan of her marijuana cream and will quickly praise its graces.
PAIN
She is from the old school
where beliefs were firmly set.
Certain values were acceptable
while many others were not.
She didn’t want to take morphine
even though her pain was often severe.
It would mean she’d become addicted.
It must mean the end of her life.
Roxanol is the official name for morphine
and she was willing to it a try.
She didn’t know it was the same as morphine.
She just liked how it helped with her pain.
Marijuana is sold legally in her state.
One just needs a special card.
Her son offered to get her some.
He hoped it would help her pain
She didn‘t want to smoke it.
She did not want to consume it.
She was willing though, to try the lotion
with the creative name of “Cannabliss”.
The lotion was instantly effective.
Her pain a steady decline.
She quickly amended her lifelong beliefs.
She only had to give it a try.
Catherine is divorced and has lived alone for years. She has two adult children who are very close to her. Her daughter, “Lisa”, moved in a few months ago to help out. Lisa works during the day, but is available weekends and nights. Catherine’s son, “Jay”, works nearby and can take off work whenever he needs to help his mother.
Catherine has a very independent personality and is very determined to live her life to the fullest. She pushes herself to keep going in order to live her life her way. She loves to eat out and lives near many restaurants within walking distance. Many days one will find her slowly walking up the street with her walker toward her restaurant of choice for that day.
Catherine has been on hospice for over six months. Whenever the nurse or I visit, we spend most of the time talking about food and the local restaurants. Catherine is a delight and so full of life.
Her one issue, though, is severe back pain. The hospice nurse offered morphine which Catherine quickly declined. She had the understanding that taking morphine would either mean you would become addicted or that you were dying. Roxanol is the same drug and, quite often, when presented that way, patients are more willing to accept the option.
Catherine’s son Jay was worried about his mom’s pain issues and offered to get her some marijuana. Catherine quickly said no as she felt she didn’t want to smoke it. When Jay offered getting it in a brownie, she again quickly declined as she didn‘t want to digest any marijuana. Jay discovered a lotion at a local marijuana dispensary that Catherine was willing to try. She is now happily using it as it is very effective in relieving her back pain.
Catherine said she is from the old school where values were such that one didn’t take certain drugs. She now is a big fan of her marijuana cream and will quickly praise its graces.
PAIN
She is from the old school
where beliefs were firmly set.
Certain values were acceptable
while many others were not.
She didn’t want to take morphine
even though her pain was often severe.
It would mean she’d become addicted.
It must mean the end of her life.
Roxanol is the official name for morphine
and she was willing to it a try.
She didn’t know it was the same as morphine.
She just liked how it helped with her pain.
Marijuana is sold legally in her state.
One just needs a special card.
Her son offered to get her some.
He hoped it would help her pain
She didn‘t want to smoke it.
She did not want to consume it.
She was willing though, to try the lotion
with the creative name of “Cannabliss”.
The lotion was instantly effective.
Her pain a steady decline.
She quickly amended her lifelong beliefs.
She only had to give it a try.
Saturday, November 5, 2011
THE RULES
Fifty-eight year old “Hank” suffers from brain cancer. Hank gets confused easily and has a difficult time processing any thoughts. Hank is very wobbly on his feet due to weakness. He has fallen multiple times when attempting to get out of bed. Fortunately, he has never been injured.
Hank lives with his wife, “Lana”. Lana is a flight attendant for a major airline. She is using her Family Leave to stay home and care for Hank. Hank and Lana have three children all living about two hours away. Recently, they have put their home up for sale and are planning on moving to be closer to where the children all live. Lana could use the additional support the children will be able to give once they move.
Lana intellectualizes her emotions. She has this idea that there are steadfast, obscure rules that she needs to follow. She has high expectations of herself to be perfect and to not do anything wrong. She is doing an amazing job caring for Hank. Hank is very demanding of attention as he gets agitated and restless quite often. He keeps wanting to get out of bed and does not understand that he would likely fall and possibly injure himself.
Lana has been so exhausted recently due to lack of sleep as Hank keeps her up at night trying to get out of bed. In addition, she has the responsibility of getting their home ready for sale. Lana hates to ask for help and feels that she should be able to do it all.
Recently, in the middle of the night, Hank tried to bite Lana as she was attempting to keep him from getting out of bed. Lana slapped Hank on the leg to try to protect herself. She immediately felt terrible as she left a small bruise on his leg. Lana felt that she was suppose to tell someone about what she had done so she shared it with the hospice nurse. By law, the nurse was mandated to call APS (Adult Protective Services). APS quickly made an unannounced visit and spoke with Lana about the incident.
I followed up with a visit the following day. Lana and I have a good relationship as she is like a sponge whenever I counsel her on her emotions and grief or discuss the strains of being a caregiver. I try to help her put into perspective what she is going through.
Lana feels that once they move, which may be in a few weeks, things will get better. She knows her children will be able to help out a lot more. Also, she plans on going back to work for a few flights each month. She said her work is what keeps her sane.
I hope in time, she can look back and know what an amazing job she did caring for her husband. This is such a difficult time for both of them and with encouragement and support, I have no doubt that they will make it through.
THE RULES
She always goes by the book.
She makes sure she understands the rules.
She wants to do everything just right.
It is the only way she knows.
The cancer has made him confused.
He’s weak and can no longer walk.
Agitation keeps him up at night.
Neither can get a good night’s sleep.
She has the patience of a saint with him.
She’s devoted and never complains.
She continues to expect a lot from herself,
even though she could use additional help.
He had her up all night long.
He kept trying to get out of bed.
She was so exhausted with nothing left.
She slapped his leg to make him stop.
She feels she did something terribly wrong,
although her intent was to keep him safe.
She feels others would not have broken the rule.
She has a hard time forgiving herself.
I pray someday she will look back
and see all the right things that she has done.
Maybe in time she’ll bend a few rules,
or better yet,
break a big one
without any regret.
Hank lives with his wife, “Lana”. Lana is a flight attendant for a major airline. She is using her Family Leave to stay home and care for Hank. Hank and Lana have three children all living about two hours away. Recently, they have put their home up for sale and are planning on moving to be closer to where the children all live. Lana could use the additional support the children will be able to give once they move.
Lana intellectualizes her emotions. She has this idea that there are steadfast, obscure rules that she needs to follow. She has high expectations of herself to be perfect and to not do anything wrong. She is doing an amazing job caring for Hank. Hank is very demanding of attention as he gets agitated and restless quite often. He keeps wanting to get out of bed and does not understand that he would likely fall and possibly injure himself.
Lana has been so exhausted recently due to lack of sleep as Hank keeps her up at night trying to get out of bed. In addition, she has the responsibility of getting their home ready for sale. Lana hates to ask for help and feels that she should be able to do it all.
Recently, in the middle of the night, Hank tried to bite Lana as she was attempting to keep him from getting out of bed. Lana slapped Hank on the leg to try to protect herself. She immediately felt terrible as she left a small bruise on his leg. Lana felt that she was suppose to tell someone about what she had done so she shared it with the hospice nurse. By law, the nurse was mandated to call APS (Adult Protective Services). APS quickly made an unannounced visit and spoke with Lana about the incident.
I followed up with a visit the following day. Lana and I have a good relationship as she is like a sponge whenever I counsel her on her emotions and grief or discuss the strains of being a caregiver. I try to help her put into perspective what she is going through.
Lana feels that once they move, which may be in a few weeks, things will get better. She knows her children will be able to help out a lot more. Also, she plans on going back to work for a few flights each month. She said her work is what keeps her sane.
I hope in time, she can look back and know what an amazing job she did caring for her husband. This is such a difficult time for both of them and with encouragement and support, I have no doubt that they will make it through.
THE RULES
She always goes by the book.
She makes sure she understands the rules.
She wants to do everything just right.
It is the only way she knows.
The cancer has made him confused.
He’s weak and can no longer walk.
Agitation keeps him up at night.
Neither can get a good night’s sleep.
She has the patience of a saint with him.
She’s devoted and never complains.
She continues to expect a lot from herself,
even though she could use additional help.
He had her up all night long.
He kept trying to get out of bed.
She was so exhausted with nothing left.
She slapped his leg to make him stop.
She feels she did something terribly wrong,
although her intent was to keep him safe.
She feels others would not have broken the rule.
She has a hard time forgiving herself.
I pray someday she will look back
and see all the right things that she has done.
Maybe in time she’ll bend a few rules,
or better yet,
break a big one
without any regret.
Saturday, October 29, 2011
IN THE GARDEN
Eighty-four year old “Mary” was diagnosed with cancer four months ago. After several failed attempts of chemotherapy and radiation, she chose to stop treatment. It was then she was referred to hospice.
Mary has six children who all live locally and visit often. She has a large, extended family with in-laws and multiple grandchildren. The family is very close and loving to her. She has been the matriarch to them all.
Since Mary has stopped treatment, she has been feeling better day by day. She says she is stronger and her appetite is improving. She has started to get out; her biggest pleasure being able to attend church again.
She is wobbly on her feet and needs supervision while up and about. The family are all eager to help her as her positive attitude is wonderful to be around. Three of her daughters rotate so that at least one of them is with Mary at all times. They help Mary with meals and household chores.
I met with Mary today and she told me about meeting Jesus in the garden when she was six. She shared how her strong faith in God has enabled her to appreciate her life and be thankful each day for the blessings she has had.
She has no fears about dying. She says she has had a good life. She will embrace the day she will meet Him again. It’s what her life has been all about.
IN THE GARDEN
She first met Him when she was six.
She was sitting on a bench in the garden.
She knew immediately who He was,
even though she never saw His face.
He sat down next to her on the bench.
He told her He would always be there.
No matter what troubles befall her in life,
she will never ever be alone.
Things had been rough in her short life.
There had been many troubling times.
But once she met Him, it quickly changed,
never again to be the same.
Her life did transform that day.
She was no longer afraid.
She knew He would always be around.
He was there to guide her way.
She saw Him again across the river.
He was motioning her to come.
She was afraid to go in the water.
She stood motionless while He walked away.
She wonders sometimes what would have been
if she chose to cross the river.
She feels she may have been a teacher;
instructing others about Him.
She talks about Him to whomever will listen.
Her strong faith leads the way.
She need not speculate about crossing the river,
as she’s been a teacher all along.
Saturday, October 22, 2011
A SMALL THING
Fifty-four year old, “Caroline” suffers from ALS (Lou Gehrig’s Disease). She was diagnosed eight months ago when she noticed her left thumb and fingers were becoming weak. She has declined rapidly to where now she is totally paralyzed. She spends her days in a hospital bed totally dependent upon others.
Caroline lives with her husband, “Sam”, who is devoted to her. They have no children, but have tremendous support from their families. Between Sam’s five siblings, Caroline’s parents and three brothers, there is always someone around to help out. In addition they have a tremendous network of close friends. There are always at least two people in the home to help out. Sam has a calendar where people sign up for times they are available.
When I went out to meet with the family, Sam answered the front door. He immediately started to vent out his frustrations about “the system”. Caroline’s decline has been so rapid, that by the time certain medical equipment gets delivered, she no longer is able to use what has been ordered.
A physical therapist was to come out this afternoon to instruct family on how to use a Hoyer lift. A Hoyer lift enables one person to transport Caroline from place to place with ease. Right before I arrived, Sam received a call from the physical therapist saying he had to cancel because he worked for home health and with hospice now following, he could not come out.
I told Sam that hospice doesn’t have their own physical therapists and we use home health therapists when needed all the time. I made several phone calls and with help from a hospice nurse, I was able to track down the proper person. Fortunately we were able to re-schedule for another therapist to come out this afternoon. Sam had taken off work and had arranged for several family members to be available so all could be instructed in how to use the Hoyer lift.
Sam was so appreciative of what I was able to accomplish. He couldn’t thank me enough. I told him that this was a perfect example of how hospice can help him. I encouraged him to keep hospice informed of any needs as the hospice team will always advocate for him and his family.
It made me think about how it is the small things that make the biggest difference in this world. Sam was so appreciative and I was so appreciative of the hospice nurse who stopped what she was doing to help me help this family. It does take a village.
A SMALL THING
We all can make a difference
at any moment of any day.
Some we are aware of,
most often we’re not.
He was so frustrated
by the system that let him down.
A system that is made up of people
as strong as the weakest link.
Their lives have dramatically changed
these past eight months.
So much has happened,
it’s been hard for them to keep up.
The moment I stepped into their home,
he immediately vented his frustrations.
Sharing what had just happened.
It was the final straw.
I made a couple of phone calls.
I tracked down the source of the problem.
The issue was resolved rather quickly.
It didn’t take much effort on my part at all.
He was so amazed.
He couldn’t thank me enough.
I really didn’t do that much,
but to him and his family,
this small thing was profound.
I am so blessed to work in a field
where each day I receive thanks.
Being told often that I made a difference
in such a huge way.
But to me, moreover than not,
it usually is such
a small thing.
Caroline lives with her husband, “Sam”, who is devoted to her. They have no children, but have tremendous support from their families. Between Sam’s five siblings, Caroline’s parents and three brothers, there is always someone around to help out. In addition they have a tremendous network of close friends. There are always at least two people in the home to help out. Sam has a calendar where people sign up for times they are available.
When I went out to meet with the family, Sam answered the front door. He immediately started to vent out his frustrations about “the system”. Caroline’s decline has been so rapid, that by the time certain medical equipment gets delivered, she no longer is able to use what has been ordered.
A physical therapist was to come out this afternoon to instruct family on how to use a Hoyer lift. A Hoyer lift enables one person to transport Caroline from place to place with ease. Right before I arrived, Sam received a call from the physical therapist saying he had to cancel because he worked for home health and with hospice now following, he could not come out.
I told Sam that hospice doesn’t have their own physical therapists and we use home health therapists when needed all the time. I made several phone calls and with help from a hospice nurse, I was able to track down the proper person. Fortunately we were able to re-schedule for another therapist to come out this afternoon. Sam had taken off work and had arranged for several family members to be available so all could be instructed in how to use the Hoyer lift.
Sam was so appreciative of what I was able to accomplish. He couldn’t thank me enough. I told him that this was a perfect example of how hospice can help him. I encouraged him to keep hospice informed of any needs as the hospice team will always advocate for him and his family.
It made me think about how it is the small things that make the biggest difference in this world. Sam was so appreciative and I was so appreciative of the hospice nurse who stopped what she was doing to help me help this family. It does take a village.
A SMALL THING
We all can make a difference
at any moment of any day.
Some we are aware of,
most often we’re not.
He was so frustrated
by the system that let him down.
A system that is made up of people
as strong as the weakest link.
Their lives have dramatically changed
these past eight months.
So much has happened,
it’s been hard for them to keep up.
The moment I stepped into their home,
he immediately vented his frustrations.
Sharing what had just happened.
It was the final straw.
I made a couple of phone calls.
I tracked down the source of the problem.
The issue was resolved rather quickly.
It didn’t take much effort on my part at all.
He was so amazed.
He couldn’t thank me enough.
I really didn’t do that much,
but to him and his family,
this small thing was profound.
I am so blessed to work in a field
where each day I receive thanks.
Being told often that I made a difference
in such a huge way.
But to me, moreover than not,
it usually is such
a small thing.
Saturday, October 15, 2011
DOUBT
“Maureen“, sixty, suffered from ovarian cancer. She recently moved into her son’s home to get the help she needed from her family. Her aunt was with her during the day while “Keith“, her son, worked. Keith and his sister then took over the care for their mother on evenings and the weekends.
When I went out to do my initial visit, it was apparent how much Keith loved his mom. He didn’t say much, but his behavior showed how much he cared. He was very attentive to any need she had. She didn’t have to ask him for anything as he had the instinct to know just how to help her.
Keith underwent brain surgery himself one year ago. He has recovered well and is doing great. I am sure that experience helped him understand his mother’s needs. Maureen was only on hospice for a few short weeks. She declined rapidly and died peacefully on a Sunday morning with her family at her bedside.
Part of my role as a social worker is to follow up and call families to offer condolences and support after a death. When I spoke with Keith he sounded so sad. He was able to talk about his feelings and how much he missed his mom. He shared that he had doubts about the afterlife. He was raised Catholic, but did not believe in a lot of the church’s doctrine.
His mother had a strong belief in the afterlife, but Keith feared that he would not see her again. He hoped that there was an afterlife. He said there is no proof of, if anything, what the afterlife is all about.
I stated that his mother may no longer be with him in the physical sense, but her spirit will remain forever. I shared that anytime he thought of his mother, he was embraced by her spirit. It was then that he shared the story about the blinds in her bedroom. That experience did not erase his doubt, but hopefully, in time, it will help him find his peace.
DOUBT
There was never any doubt
how much he loved his mother.
He was there until the end
caring for her; showing his love.
She raised him to believe in God.
She taught him all about heaven.
How loved ones are reunited
when their journeys have come to an end.
Now that she is gone,
he worries about being alone.
Will he be with her again?
Is what she said the truth?
He has doubts about the afterlife.
He has doubts he’ll see her again.
He questions the teachings he learned as a boy.
He doesn’t know what to believe.
He hoped to find some comfort
so he laid down in her room.
He thought if he slept in her bed,
he might feel her near.
As he laid down he said, “Goodnight Mom”.
He didn’t know if she would hear.
A moment later the shades waved.
He hoped that it was her.
He’ll continue to have some doubts
as he knows nothing can be proven.
Maybe one day when his life is done
all will become crystal clear.
He’ll know all the answers of life
and hopefully then
he’ll no longer have
any doubt.
When I went out to do my initial visit, it was apparent how much Keith loved his mom. He didn’t say much, but his behavior showed how much he cared. He was very attentive to any need she had. She didn’t have to ask him for anything as he had the instinct to know just how to help her.
Keith underwent brain surgery himself one year ago. He has recovered well and is doing great. I am sure that experience helped him understand his mother’s needs. Maureen was only on hospice for a few short weeks. She declined rapidly and died peacefully on a Sunday morning with her family at her bedside.
Part of my role as a social worker is to follow up and call families to offer condolences and support after a death. When I spoke with Keith he sounded so sad. He was able to talk about his feelings and how much he missed his mom. He shared that he had doubts about the afterlife. He was raised Catholic, but did not believe in a lot of the church’s doctrine.
His mother had a strong belief in the afterlife, but Keith feared that he would not see her again. He hoped that there was an afterlife. He said there is no proof of, if anything, what the afterlife is all about.
I stated that his mother may no longer be with him in the physical sense, but her spirit will remain forever. I shared that anytime he thought of his mother, he was embraced by her spirit. It was then that he shared the story about the blinds in her bedroom. That experience did not erase his doubt, but hopefully, in time, it will help him find his peace.
DOUBT
There was never any doubt
how much he loved his mother.
He was there until the end
caring for her; showing his love.
She raised him to believe in God.
She taught him all about heaven.
How loved ones are reunited
when their journeys have come to an end.
Now that she is gone,
he worries about being alone.
Will he be with her again?
Is what she said the truth?
He has doubts about the afterlife.
He has doubts he’ll see her again.
He questions the teachings he learned as a boy.
He doesn’t know what to believe.
He hoped to find some comfort
so he laid down in her room.
He thought if he slept in her bed,
he might feel her near.
As he laid down he said, “Goodnight Mom”.
He didn’t know if she would hear.
A moment later the shades waved.
He hoped that it was her.
He’ll continue to have some doubts
as he knows nothing can be proven.
Maybe one day when his life is done
all will become crystal clear.
He’ll know all the answers of life
and hopefully then
he’ll no longer have
any doubt.
Saturday, October 8, 2011
IN STRIDE
Sixty-five year old “Ken” suffers from lung cancer. His doctors referred him to hospice as his cancer has spread. Ken lives with his wife of fourteen years, “Missy”. He calls Missy his soul mate. They met years ago when Missy was friends with Ken’s younger sister.
Missy and Ken lost touch when Ken enlisted into the military and was shipped to Vietnam. Ken subsequently married twice with both marriages ending in divorce. Ken has three adult children who are estranged. He has had no contact with them for years. Ken takes all of this in stride as has no regrets about not having any contact with his children.
Ken and Missy met up again and were married 14 years ago. Missy, fifty years old, is devoted to Ken. They have a lot in common even with a fifteen year age difference.
Ken’s parents owned a local restaurant for years. Ken took over the business when his parents retired. They had three devoted employees who worked for the restaurant for years. Over the course of a four month period, all three employees left; one retired; one died and the third moved away. In the middle of all of this, Ken was diagnosed with lung cancer. Ken knew how hard it would be to find qualified replacement staff and, with his illness, decided it was time to close the restaurant.
Ken’s doctor offered him treatment for his cancer, which he quickly declined. He would rather have some good months ahead of him than extend his life with the side affects of chemotherapy.
Ken shares all of this without any regret or sense of loss. He sees each day as a new day. He would rather focus on what he has going in his life, than have regrets over some of his past decisions. His wife is in total agreement with his decision not to pursue treatment. They talk and laugh about the good times they have had and look forward to the day ahead of them.
IN STRIDE
He takes everything in stride.
He doesn’t worry about a thing.
He accepts what life throws at him
then continues on his way.
Even a cancer diagnosis
didn’t slow him down much at all.
He declined treatment options.
He wants to live his life to the fullest
as long as he can.
He doesn’t worry about his dying.
He’d rather focus on his living.
He sees full months ahead of him
not hampered by side affects of treatment.
He lost his family business.
Circumstances out of his control.
He has two failed marriages,
but now is with his soul mate.
He has no regrets, no remorse.
He appreciates what he has now.
Each morning is a brand new day
and no matter what this day shall bring
he’ll take it all in stride.
Missy and Ken lost touch when Ken enlisted into the military and was shipped to Vietnam. Ken subsequently married twice with both marriages ending in divorce. Ken has three adult children who are estranged. He has had no contact with them for years. Ken takes all of this in stride as has no regrets about not having any contact with his children.
Ken and Missy met up again and were married 14 years ago. Missy, fifty years old, is devoted to Ken. They have a lot in common even with a fifteen year age difference.
Ken’s parents owned a local restaurant for years. Ken took over the business when his parents retired. They had three devoted employees who worked for the restaurant for years. Over the course of a four month period, all three employees left; one retired; one died and the third moved away. In the middle of all of this, Ken was diagnosed with lung cancer. Ken knew how hard it would be to find qualified replacement staff and, with his illness, decided it was time to close the restaurant.
Ken’s doctor offered him treatment for his cancer, which he quickly declined. He would rather have some good months ahead of him than extend his life with the side affects of chemotherapy.
Ken shares all of this without any regret or sense of loss. He sees each day as a new day. He would rather focus on what he has going in his life, than have regrets over some of his past decisions. His wife is in total agreement with his decision not to pursue treatment. They talk and laugh about the good times they have had and look forward to the day ahead of them.
IN STRIDE
He takes everything in stride.
He doesn’t worry about a thing.
He accepts what life throws at him
then continues on his way.
Even a cancer diagnosis
didn’t slow him down much at all.
He declined treatment options.
He wants to live his life to the fullest
as long as he can.
He doesn’t worry about his dying.
He’d rather focus on his living.
He sees full months ahead of him
not hampered by side affects of treatment.
He lost his family business.
Circumstances out of his control.
He has two failed marriages,
but now is with his soul mate.
He has no regrets, no remorse.
He appreciates what he has now.
Each morning is a brand new day
and no matter what this day shall bring
he’ll take it all in stride.
Saturday, October 1, 2011
MAKING PLANS
Forty-five year old “Laurie” was diagnosed with breast cancer nine years ago when she was just thirty-six. She recently came onto hospice as her cancer has now spread to her bones, liver and lungs. Laurie is on continuous oxygen as gets short of breath with any activity.
Laurie has been married to “Jack” for thirteen years. They have an eleven year old daughter, “Julie.” Laurie’s sister, “Cindy” is visiting from the east coast with plans on staying as long as needed. Laurie has no other family, although Jack’s family lives nearby and are very involved and supportive.
Cindy answered the phone when I called to set up my first visit. Immediately the conversation turned to Julie and how best to talk with her about what is going on with her mother. The family’s focus is all on Julie and her needs.
When I went out to meet with the family, Laurie was sleeping in the bedroom. Jack, Cindy and I spoke in the living room. I gave them a lot of guidance and information about how best to help themselves and Julie through this difficult time.
During the course of our conversation, Jack started sharing the history of Laurie’s disease. How through it all, Laurie knew that one day she would lose her battle. She started talking with Julie’s school teachers, other parents and her friends about how best to help Julie after she is gone. She made arrangements for someone to pick up Julie after school as she knew her husband would not be able to do so because of his work schedule. Laurie also arranged for someone to help Julie with homework, drive her to sport practices etc.
While Jack was sharing Laurie’s stories, I was impressed how someone so young could be so mature. When we all went back to the bedroom to meet with Laurie, she was very sleepy and did not say much as she kept dozing on and off. Jack says that Laurie gets confused at times and has a hard time focusing on the conversation.
There is a lot of love and maturity in this family. I believe that Laurie’s time is close and hopefully she has some comfort knowing that her daughter will always have someone around to help her through some tough times ahead.
MAKING PLANS
She’s been planning this for years.
She knew the time would one day come
when her daughter would need some assistance;
she would need a helping hand.
She knew she likely wouldn’t be around
to see her daughter’s growing years,
so she started getting organized.
She started to make some plans.
She spoke with other parents.
She spoke with all her friends.
She arranged for after-school pickup.
She made sure someone would always be there.
She did this systematically,
never thinking of herself.
Her focus always on her daughter.
Making sure she would never be without.
Her husband proudly tells her story
of the diagnosis nine years ago.
How through years of difficult treatment,
she would always focus on others, never herself.
She is an amazing person.
Wise well beyond her years.
I hope one day her daughter will appreciate,
her daughter will know
that it was her mother’s love,
her mother’s planning,
that paved her way.
Laurie has been married to “Jack” for thirteen years. They have an eleven year old daughter, “Julie.” Laurie’s sister, “Cindy” is visiting from the east coast with plans on staying as long as needed. Laurie has no other family, although Jack’s family lives nearby and are very involved and supportive.
Cindy answered the phone when I called to set up my first visit. Immediately the conversation turned to Julie and how best to talk with her about what is going on with her mother. The family’s focus is all on Julie and her needs.
When I went out to meet with the family, Laurie was sleeping in the bedroom. Jack, Cindy and I spoke in the living room. I gave them a lot of guidance and information about how best to help themselves and Julie through this difficult time.
During the course of our conversation, Jack started sharing the history of Laurie’s disease. How through it all, Laurie knew that one day she would lose her battle. She started talking with Julie’s school teachers, other parents and her friends about how best to help Julie after she is gone. She made arrangements for someone to pick up Julie after school as she knew her husband would not be able to do so because of his work schedule. Laurie also arranged for someone to help Julie with homework, drive her to sport practices etc.
While Jack was sharing Laurie’s stories, I was impressed how someone so young could be so mature. When we all went back to the bedroom to meet with Laurie, she was very sleepy and did not say much as she kept dozing on and off. Jack says that Laurie gets confused at times and has a hard time focusing on the conversation.
There is a lot of love and maturity in this family. I believe that Laurie’s time is close and hopefully she has some comfort knowing that her daughter will always have someone around to help her through some tough times ahead.
MAKING PLANS
She’s been planning this for years.
She knew the time would one day come
when her daughter would need some assistance;
she would need a helping hand.
She knew she likely wouldn’t be around
to see her daughter’s growing years,
so she started getting organized.
She started to make some plans.
She spoke with other parents.
She spoke with all her friends.
She arranged for after-school pickup.
She made sure someone would always be there.
She did this systematically,
never thinking of herself.
Her focus always on her daughter.
Making sure she would never be without.
Her husband proudly tells her story
of the diagnosis nine years ago.
How through years of difficult treatment,
she would always focus on others, never herself.
She is an amazing person.
Wise well beyond her years.
I hope one day her daughter will appreciate,
her daughter will know
that it was her mother’s love,
her mother’s planning,
that paved her way.
Saturday, September 24, 2011
"CLINK"
Sixty year old “Valerie” suffered from multiple strokes, leaving her paralyzed and unable to speak. She spent her days lying in bed as she was totally dependent with all of her needs.
Valerie was married to “Joe”, who was her primary caregiver. Joe was a huge “teddy-bear” kind of guy with the biggest heart of anyone I have known. It was so apparent how much he loved Valerie. He was devoted to her and constantly told her how much he loved her. She was totally alert and aware and communicated by mouthing her words.
Valerie took a downward turn several weeks ago. It was then when she came onto hospice. Both Joe and Valerie had a strong Christian faith with a belief in God and the afterlife. Joe said that Valerie was at peace as she knew where she was going.
About two weeks ago, Joe was lying next to Valerie in their bed. Joe said that he was telling Valerie how much he loved her when they both noticed a shadow and then a sound of a “clink”. Joe said it sounded like a dinner plate. Valerie immediately mouthed to Joe that it was his father’s spirit. Joe said that they both believed that loved ones are always with us, but it is nice to get a reminder now and then.
When I heard that Valerie had died early this morning, I called Joe as I had a scheduled visit planned for this afternoon. Joe asked that I still come out as he needed the support.
Joe and I sat at the kitchen table and he, in his typical fashion, started sharing how much he loved Valerie and how blessed he was to have her in his life. He said the fourteen years they were together was a lifetime of living.
He shared the story about hearing the “clink” of his father’s spirit. He then added that, while he and other family members were sitting around the kitchen table earlier today, they heard a “clink” of a dinner plate a few feet away. Joe says it gives him peace to know that Valerie is, and will always be, around.
“CLINK”
He is an amazing guy.
He loved her so much and it showed.
He talked about how they met.
How she changed his life for the better.
He is forever grateful
God placed her in his life.
Each day with her a blessing.
Each day, a special gift.
These past few weeks have been tough
as he brought her home to die.
He intuitively knew what she needed,
even though she could no longer talk.
He laid down next to her in their bed,
telling her how much he loved her.
First a shadow, then a sound like a “clink”.
She mouthed that it was his dad’s spirit.
They both believed in the afterlife.
They both felt the spirit of his dad.
It gave them comfort to know
that loved ones are always around.
He woke up this morning and found her gone.
He called family who gathered around.
Sitting in the kitchen grieving the loss,
suddenly all heard a dinner plate go
“Clink”.
Valerie was married to “Joe”, who was her primary caregiver. Joe was a huge “teddy-bear” kind of guy with the biggest heart of anyone I have known. It was so apparent how much he loved Valerie. He was devoted to her and constantly told her how much he loved her. She was totally alert and aware and communicated by mouthing her words.
Valerie took a downward turn several weeks ago. It was then when she came onto hospice. Both Joe and Valerie had a strong Christian faith with a belief in God and the afterlife. Joe said that Valerie was at peace as she knew where she was going.
About two weeks ago, Joe was lying next to Valerie in their bed. Joe said that he was telling Valerie how much he loved her when they both noticed a shadow and then a sound of a “clink”. Joe said it sounded like a dinner plate. Valerie immediately mouthed to Joe that it was his father’s spirit. Joe said that they both believed that loved ones are always with us, but it is nice to get a reminder now and then.
When I heard that Valerie had died early this morning, I called Joe as I had a scheduled visit planned for this afternoon. Joe asked that I still come out as he needed the support.
Joe and I sat at the kitchen table and he, in his typical fashion, started sharing how much he loved Valerie and how blessed he was to have her in his life. He said the fourteen years they were together was a lifetime of living.
He shared the story about hearing the “clink” of his father’s spirit. He then added that, while he and other family members were sitting around the kitchen table earlier today, they heard a “clink” of a dinner plate a few feet away. Joe says it gives him peace to know that Valerie is, and will always be, around.
“CLINK”
He is an amazing guy.
He loved her so much and it showed.
He talked about how they met.
How she changed his life for the better.
He is forever grateful
God placed her in his life.
Each day with her a blessing.
Each day, a special gift.
These past few weeks have been tough
as he brought her home to die.
He intuitively knew what she needed,
even though she could no longer talk.
He laid down next to her in their bed,
telling her how much he loved her.
First a shadow, then a sound like a “clink”.
She mouthed that it was his dad’s spirit.
They both believed in the afterlife.
They both felt the spirit of his dad.
It gave them comfort to know
that loved ones are always around.
He woke up this morning and found her gone.
He called family who gathered around.
Sitting in the kitchen grieving the loss,
suddenly all heard a dinner plate go
“Clink”.
Saturday, September 17, 2011
CHARM
Eighty-eight year old “Bobby” has been on hospice for over six months. Bobby suffers from prostate cancer which has spread to his bones. He had been doing pretty well until the past few weeks where he has been in a slow, but steady decline. Each time I visit, he looks a little bit weaker.
Bobby loves to tell stories of his childhood, military years and his career as a beat cop. He has this charming way of spinning a tale which captivates those listening. Add to that, his great sense of humor which always makes a perfect combination. There is always a lot of laughter and storytelling in his home.
Bobby’s daughter, “Brenda”, moved in to help once Bobby could no longer live alone. She is a Catholic nun and has tremendous support from her church and sisterhood community. She inherited her father’s gift of telling stories. The two of them will get going with a story while constantly interrupting each other. It is a joy to witness.
Bobby always makes one feel so special. He acts like your visit is the light in his day. In reality, it is the hospice staff that are blessed with every visit. This past week has been hard on Bobby as he has been so nauseas and unable to keep anything down. When the nurse visited him yesterday, she had him admitted to the hospital for treatment.
The hospice nurse and I visited Bobby today in the hospital. When we first walked into his room, he looked so sick. I immediately became so sad with the reality that his disease was progressing. Bobby heard us walk in and slowly opened his eyes. When he saw who it was, he immediately produced this amazing smile.
The medication had him so drowsy that he would doze on and off during our visit. When Bobby was awake, he would try to talk to us. He was a bit hard to understand because he was pretty weak, but he still had his wit and charm about him. Brenda happened to share an amusing antidote that had happened earlier that morning. The hospice nurse then asked Bobby if he had gotten himself in trouble. Bobby sleepily replied, “Trouble has a way of following me.” His wit and charm continued to shine even in his drowsy state.
I sure would like to believe that he will take his wonderful personality with him wherever he goes. He has left a huge imprint in his life and will be missed by all who have had the honor to have met him.
CHARM
When we stopped in and saw him,
suddenly I became so sad.
He looked so sick.
He looked so vulnerable.
He was sleeping when we walked in,
but slowly he opened his eyes.
When he saw that it was us,
in his typical fashion,
he produced a wonderful smile.
He grabbed a large part of my heart
from the moment I first met him.
His humor, his smile, his charm.
He had me right from the start.
I knew he was in a slow decline.
I have known his time is short.
But with each visit, each change,
he could always snag me
with that captivating charm.
I know I will miss him when he is gone.
He is someone I will never forget.
But I also know that those on the other side
will be just as enthralled
with that huge smile
and his amazing charm.
Bobby loves to tell stories of his childhood, military years and his career as a beat cop. He has this charming way of spinning a tale which captivates those listening. Add to that, his great sense of humor which always makes a perfect combination. There is always a lot of laughter and storytelling in his home.
Bobby’s daughter, “Brenda”, moved in to help once Bobby could no longer live alone. She is a Catholic nun and has tremendous support from her church and sisterhood community. She inherited her father’s gift of telling stories. The two of them will get going with a story while constantly interrupting each other. It is a joy to witness.
Bobby always makes one feel so special. He acts like your visit is the light in his day. In reality, it is the hospice staff that are blessed with every visit. This past week has been hard on Bobby as he has been so nauseas and unable to keep anything down. When the nurse visited him yesterday, she had him admitted to the hospital for treatment.
The hospice nurse and I visited Bobby today in the hospital. When we first walked into his room, he looked so sick. I immediately became so sad with the reality that his disease was progressing. Bobby heard us walk in and slowly opened his eyes. When he saw who it was, he immediately produced this amazing smile.
The medication had him so drowsy that he would doze on and off during our visit. When Bobby was awake, he would try to talk to us. He was a bit hard to understand because he was pretty weak, but he still had his wit and charm about him. Brenda happened to share an amusing antidote that had happened earlier that morning. The hospice nurse then asked Bobby if he had gotten himself in trouble. Bobby sleepily replied, “Trouble has a way of following me.” His wit and charm continued to shine even in his drowsy state.
I sure would like to believe that he will take his wonderful personality with him wherever he goes. He has left a huge imprint in his life and will be missed by all who have had the honor to have met him.
CHARM
When we stopped in and saw him,
suddenly I became so sad.
He looked so sick.
He looked so vulnerable.
He was sleeping when we walked in,
but slowly he opened his eyes.
When he saw that it was us,
in his typical fashion,
he produced a wonderful smile.
He grabbed a large part of my heart
from the moment I first met him.
His humor, his smile, his charm.
He had me right from the start.
I knew he was in a slow decline.
I have known his time is short.
But with each visit, each change,
he could always snag me
with that captivating charm.
I know I will miss him when he is gone.
He is someone I will never forget.
But I also know that those on the other side
will be just as enthralled
with that huge smile
and his amazing charm.
Monday, September 12, 2011
REALITY
Eighty-eight year old “Bob” suffers from end stage lung disease. He is also bed bound due to suffering a multitude of additional health problems. He has had moments of confusion, although recently his confusion has increased along with some additional paranoia. He is unable to ambulate so spends his days in a hospital bed in the family room.
Bob’s wife, “Annie”, whom he calls “Mother”, has been in and out of the hospital recently due to her own health issues. Currently she is in a skilled nursing facility receiving physical therapy from two broken hips. Bob and Annie’s son, “Chris”, has moved in to help out. Chris was recently laid off from his job and is on unemployment. Chris says that it is a blessing to not be working in order for him to be available to help his parents.
Chris met me at the front door when I went out to do a visit today. He shared that dad is more confused and paranoid this afternoon. I walked into the family room and Bob seemed anxious to talk with me. He complained that they didn’t let him get up to walk. He was very frustrated and would whisper so Chris wouldn’t hear our conversation.
The hospice nurse had a visit scheduled right after my visit and Bob asked that I stay until the nurse showed up. He appeared afraid to be left alone with his son. Chris is doing a fabulous job caring for his dad and takes all of his dad’s comments in stride.
While we were waiting for the nurse, Bob asked to use my pen. He started writing on a piece of paper that was lying nearby. He was gesturing for me not to show Chris. I told him I would read it after I leave.
When the nurse showed up, I updated him on the situation so he would be aware. I opened the note while sitting in my car in front of Bob’s house. The note said “Dear Mother. I am prisoner here, prisoner here”. I felt sad reading it as I knew this was Bob’s truth. There is nothing anyone can do to help him understand that Chris is a loving, attentive son.
Somehow I wonder why some people have to suffer so much, especially at the end of their life. There just is no answer. It is what it is. Bob is teaching us all to appreciate our physical and emotional health. Both are a gift and never to be taken lightly. I suppose we all need reminders now and then.
REALITY
He’s been sick for quite a while.
His decline is steady but slow.
He’s in bed all day long now.
He still thinks he can get up and walk.
He feels like he is a prisoner
where they are the ones in charge.
He feels he has lost all control of his life,
They tell him what to do.
His confusion has made him paranoid.
His reality has dramatically changed.
Why has his family turned on him?
He keeps trying to solicit help.
He is reacting to his reality,
He’s responding to his truth.
His world consists of imagined beliefs.
His fears are all too real.
No matter what is false.
No matter what is true.
He believes what he believes.
It will be like this until the end.
Trapped by his own reality.
He’ll continue to remain unaware.
Sadly his family can only stand by
with a reality of their own.
Bob’s wife, “Annie”, whom he calls “Mother”, has been in and out of the hospital recently due to her own health issues. Currently she is in a skilled nursing facility receiving physical therapy from two broken hips. Bob and Annie’s son, “Chris”, has moved in to help out. Chris was recently laid off from his job and is on unemployment. Chris says that it is a blessing to not be working in order for him to be available to help his parents.
Chris met me at the front door when I went out to do a visit today. He shared that dad is more confused and paranoid this afternoon. I walked into the family room and Bob seemed anxious to talk with me. He complained that they didn’t let him get up to walk. He was very frustrated and would whisper so Chris wouldn’t hear our conversation.
The hospice nurse had a visit scheduled right after my visit and Bob asked that I stay until the nurse showed up. He appeared afraid to be left alone with his son. Chris is doing a fabulous job caring for his dad and takes all of his dad’s comments in stride.
While we were waiting for the nurse, Bob asked to use my pen. He started writing on a piece of paper that was lying nearby. He was gesturing for me not to show Chris. I told him I would read it after I leave.
When the nurse showed up, I updated him on the situation so he would be aware. I opened the note while sitting in my car in front of Bob’s house. The note said “Dear Mother. I am prisoner here, prisoner here”. I felt sad reading it as I knew this was Bob’s truth. There is nothing anyone can do to help him understand that Chris is a loving, attentive son.
Somehow I wonder why some people have to suffer so much, especially at the end of their life. There just is no answer. It is what it is. Bob is teaching us all to appreciate our physical and emotional health. Both are a gift and never to be taken lightly. I suppose we all need reminders now and then.
REALITY
He’s been sick for quite a while.
His decline is steady but slow.
He’s in bed all day long now.
He still thinks he can get up and walk.
He feels like he is a prisoner
where they are the ones in charge.
He feels he has lost all control of his life,
They tell him what to do.
His confusion has made him paranoid.
His reality has dramatically changed.
Why has his family turned on him?
He keeps trying to solicit help.
He is reacting to his reality,
He’s responding to his truth.
His world consists of imagined beliefs.
His fears are all too real.
No matter what is false.
No matter what is true.
He believes what he believes.
It will be like this until the end.
Trapped by his own reality.
He’ll continue to remain unaware.
Sadly his family can only stand by
with a reality of their own.
Saturday, September 3, 2011
ROSE'S STORY
Ninety-three year old “Tom” suffers from kidney cancer. He has been living in an Assisted Living Center for six months. He has declined the past few weeks where now he is in bed most of the time. Staff from the facility check on him every two hours and attend to any needs.
Tom was widowed one year ago after his wife of sixty-seven years, Rose, died of cancer. Tom is aware that he is declining and feels his time is running out. During my visit this week, Tom started talking about his wife’s childhood. He was so proud of her and of what she became in spite of all the struggles she endured growing up.
Poverty was a big part of that struggle. Also her parents traveled in the circus and she was sent to her aunt’s home in another state. She was loved like a daughter, but always had a sense of not quite belonging.
Tom met Rose while both were attending college and he was instantly smitten. This was during the years where women were expected to stay home and become wives and mothers; not attend college.
Recently Tom started writing Rose’s story on a yellow legal pad. He is slowly becoming weaker and is struggling with putting his words together. When I asked him if he would like a hospice volunteer to help him complete Rose’s story, his face just lit up. He feels it is so important that his children know their mother’s background and the family history.
Tom spoke about how his father was drafted into the Turkish army and subsequently escaped to France. He would love to know the story about his father’s daring adventure, but there is no one to ask. He doesn’t want his children to have the same unanswered questions. He is anxious to get her story down on paper because, at his death, there will be no one else to ask.
This is a strong reminder for each of us to ask and document our own family histories. Tom has taught me that each of us is a walking history book that needs to be shared in order for future generations to know about their own family history.
ROSE’S STORY
He wants to tell Rose’s story.
He wants their children to know
all about their mother’s childhood;
all about her life.
The poverty that existed;
the difficulties abound.
It may help them understand her
by the struggles she endured.
He’ll tell them about the circus.
How it kept her parents away.
Her mother a trick pony rider;
her father a cook.
How she was raised by relatives
miles away in another state.
How they loved her like a daughter,
but somehow she never fit in.
She was strong, she was determined,
a trailblazer in her time.
How she graduated college
while her peers tended home.
He wants to write it all down
so their grandchildren too will know
all about their grandmother;
all about their ancestry.
No faded memories.
No questions left unturned.
Her legacy handwritten on paper.
A family heirloom forevermore.
He knows the clock is ticking.
He knows his time is near.
One last wish before he dies
is all wrapped up in
Rose’s story.
Saturday, August 27, 2011
A ROLE MODEL
I went out to open “Nick”, seventy-five, to hospice. Nick suffers from brain cancer and is confused. He is not aware of his limitations and gets frustrated when family “fuss” on him. He feels he is able to manage many of his needs alone. Nick uses a walker to ambulate, but is very wobbly on his feet. He cannot get up from a sitting position alone and is dependent with all of his activities of daily living.
Nick lives with “Alice”, his wife of fifty-four years. Alice worries about Nick and knows she is unable to care for him alone. Their children all live out of the area and two daughters have been visiting for a week. They will leave in a few days when their brother will then arrive for a three week visit.
During the time their son is in town, the children will arrange for twenty-four hour care to help Alice care for Nick. Fortunately Nick and Alice have the funds to pay for the help. This is a very close and devoted family. Alice gets overwhelmed easily and the children have quickly stepped in to help.
When I went out to do my initial visit, Nick and Alice’s daughter, “Bonnie”, answered the door. She welcomed me into her parent’s home with a cute tease. Humor is a wonderful coping skill. I always enjoy families who use humor. It helps me relate to them so easily as my family is the same way.
Bonnie led me into the living room where her father was sitting on the couch. Another woman was sitting next to him and I assumed it was Alice as she appeared to be about Nick’s age. She said her name was “Katherine” and added that she was Nick’s mother and she was ninety-five years old. At first I thought she was joking. I could not imagine Nick’s mother looking so young.
Katherine was so full of life and spunk. She was vibrant and had so much energy. She was engaging and it was so obvious how much she loved life. Her handshake was firm and strong. She was amazing to me and someone whom I instantly admired. She loved and lived each day to the fullest. She is a teacher, a role model and an inspiration. I feel honored to have met her.
A ROLE MODEL
The moment I walked in,
I noticed how she lit up the room.
She smiled so brightly
with her endearing, infectious laugh.
A petite woman.
Not much over five feet.
But one instantly saw her big heart;
her big personality;
her engaging spirit.
She is so full of life.
She enjoys every minute.
She embraces every hour.
She loves every day.
She uses a walker nowadays,
but manages very well on her own.
She has had some rough times in her life,
but moves on with a chuckle and a positive spin.
Her solid, firm handshake reflects her spunk.
You can’t help but notice the twinkle in her eye.
She instantly became my role model
at her young age
of ninety-five.
Nick lives with “Alice”, his wife of fifty-four years. Alice worries about Nick and knows she is unable to care for him alone. Their children all live out of the area and two daughters have been visiting for a week. They will leave in a few days when their brother will then arrive for a three week visit.
During the time their son is in town, the children will arrange for twenty-four hour care to help Alice care for Nick. Fortunately Nick and Alice have the funds to pay for the help. This is a very close and devoted family. Alice gets overwhelmed easily and the children have quickly stepped in to help.
When I went out to do my initial visit, Nick and Alice’s daughter, “Bonnie”, answered the door. She welcomed me into her parent’s home with a cute tease. Humor is a wonderful coping skill. I always enjoy families who use humor. It helps me relate to them so easily as my family is the same way.
Bonnie led me into the living room where her father was sitting on the couch. Another woman was sitting next to him and I assumed it was Alice as she appeared to be about Nick’s age. She said her name was “Katherine” and added that she was Nick’s mother and she was ninety-five years old. At first I thought she was joking. I could not imagine Nick’s mother looking so young.
Katherine was so full of life and spunk. She was vibrant and had so much energy. She was engaging and it was so obvious how much she loved life. Her handshake was firm and strong. She was amazing to me and someone whom I instantly admired. She loved and lived each day to the fullest. She is a teacher, a role model and an inspiration. I feel honored to have met her.
A ROLE MODEL
The moment I walked in,
I noticed how she lit up the room.
She smiled so brightly
with her endearing, infectious laugh.
A petite woman.
Not much over five feet.
But one instantly saw her big heart;
her big personality;
her engaging spirit.
She is so full of life.
She enjoys every minute.
She embraces every hour.
She loves every day.
She uses a walker nowadays,
but manages very well on her own.
She has had some rough times in her life,
but moves on with a chuckle and a positive spin.
Her solid, firm handshake reflects her spunk.
You can’t help but notice the twinkle in her eye.
She instantly became my role model
at her young age
of ninety-five.
Saturday, August 20, 2011
STOP THE WORLD
Seventy-eight year old “Keith” suffers from colon cancer. One month ago, Keith was up and walking around. Today he is bed bound and dependent with all of his activities. Keith says that he is becoming weaker as each day passes.
Keith lives with “Melanie”, his wife of fifty-four years. Two weeks ago when I first met them, Melanie was complaining about back pain. She is a very strong, independent woman and was “toughing” it out. She was diagnosed with breast cancer eight months ago and thought she was doing well. Her doctor ordered more tests to see if her previous treatment was successful.
During my visit yesterday, Melanie’s doctor called to tell her that the cancer has now spread to her spine. He said the chemotherapy had not worked, but he did have a new treatment in mind which would require injections into her spine in an attempt to stop the tumor’s growth.
While Melanie was talking with her doctor on the phone, one could see the concern on Keith’s face. The moment she hung up the phone, he quickly asked about what was said. Melanie remained stoic while telling Keith about the conversation with her doctor, which is her way of dealing with things concerning herself. However with all others, she is very open and loving with her concern and feelings.
Melanie shared that she wished she could stop the world for just a moment to gather her thoughts and formulate a plan. Melanie is very organized and practical and she will deal with this the same way. The couple have two children who are very involved and loving. They also have multiple friends who are a tremendous support.
I know Melanie will call in her support system and she and Keith will get through this with many loving people by their side. They will never be alone.
STOP THE WORLD
His decline has been swift.
They are seeing continual changes.
He is becoming weaker
with each day that passes.
He’s in bed now and can’t get up.
She worries so much about him.
She also has her own health issues,
so he worries as much about her.
She was just told her cancer has spread.
Her doctor has a treatment plan in mind.
She knows it is something she must do soon,
but who will take care of him?
She wishes she could stop the world
if only for a little while.
Just long enough to finish her treatment.
To give her the needed time.
She is overwhelmed right now
as the news is still fresh.
She wants to be able to stop the world
to tackle one thing at a time.
She’ll reach out to her family.
She’ll reach out to her friends.
Even though her world can’t stop,
either will those who rally around.
Keith lives with “Melanie”, his wife of fifty-four years. Two weeks ago when I first met them, Melanie was complaining about back pain. She is a very strong, independent woman and was “toughing” it out. She was diagnosed with breast cancer eight months ago and thought she was doing well. Her doctor ordered more tests to see if her previous treatment was successful.
During my visit yesterday, Melanie’s doctor called to tell her that the cancer has now spread to her spine. He said the chemotherapy had not worked, but he did have a new treatment in mind which would require injections into her spine in an attempt to stop the tumor’s growth.
While Melanie was talking with her doctor on the phone, one could see the concern on Keith’s face. The moment she hung up the phone, he quickly asked about what was said. Melanie remained stoic while telling Keith about the conversation with her doctor, which is her way of dealing with things concerning herself. However with all others, she is very open and loving with her concern and feelings.
Melanie shared that she wished she could stop the world for just a moment to gather her thoughts and formulate a plan. Melanie is very organized and practical and she will deal with this the same way. The couple have two children who are very involved and loving. They also have multiple friends who are a tremendous support.
I know Melanie will call in her support system and she and Keith will get through this with many loving people by their side. They will never be alone.
STOP THE WORLD
His decline has been swift.
They are seeing continual changes.
He is becoming weaker
with each day that passes.
He’s in bed now and can’t get up.
She worries so much about him.
She also has her own health issues,
so he worries as much about her.
She was just told her cancer has spread.
Her doctor has a treatment plan in mind.
She knows it is something she must do soon,
but who will take care of him?
She wishes she could stop the world
if only for a little while.
Just long enough to finish her treatment.
To give her the needed time.
She is overwhelmed right now
as the news is still fresh.
She wants to be able to stop the world
to tackle one thing at a time.
She’ll reach out to her family.
She’ll reach out to her friends.
Even though her world can’t stop,
either will those who rally around.
Sunday, August 14, 2011
NO WORRIES
Ninety-three year old “Karl” suffers from Parkinson’s Disease and dementia. Communication is difficult as he is mildly confused and has garbled speech. Karl has trouble hearing even with the use of hearing aids. Karl lives with his wife of fifty-nine years, “Sue”. Sue is nine years younger and does not act or look her age. She is in excellent health and has lots of energy.
The couple live in a very tiny, one-bedroom apartment. Every inch of space is taken up with their possessions. In a strange way, it is organized clutter. Filled plastic bins are piled high to the ceiling. Books, papers, and miscellaneous items are all around.
Karl and Sue have no children. There is very little family except for a brother, who suffers from dementia. Sue is very content the way her life is. She knows her husband is dying and soon she will be alone, but takes it all in stride without any worry. If you ask her how she is coping, she’ll reply with a lighthearted joke.
Safety is an important issue with hospice. Karl is wobbly on his feet and at risk for falling. He can no longer be safely left alone. Sue does leave him to run short errands even though hospice has informed her of the risks. Hospice has a volunteer program and I have offered to assign a volunteer to them. Sue then would be able to run errands while a volunteer could stay with Karl.
It is very difficult to maneuver around in their apartment so Sue is agreeable to moving some of the bins into storage, but declined hospice’s offer to assist her with the task. She states that she can do it herself. I do not think she has grasped the seriousness of leaving Karl alone, even for short periods. I am hoping that she will utilize the hospice volunteer as needed.
Sue has such an upbeat personality. Her positive attitude is likely what has gotten her through many of life’s struggles. She has a tendency not to worry about things, although is aware that her husband is declining and needing help. My one concern is that she will continue to leave him alone to run short errands. I will visit frequently to reinforce safety issues as well as to give them the continued support they need.
NO WORRIES
They live in cramped quarters.
Not much space to move around.
Four storage units are completely full.
They could easily fill a few more.
Rubbermaid bins are stacked ten feet high.
Each one full of who knows what.
Surprisingly she knows where everything is.
She doesn’t seem to mind.
He spends his days sitting on the sofa.
There is no place else to rest.
Behind him are countless piles of books,
stacked neatly side by side.
He’s declining and getting confused.
Garbled speech makes it difficult to talk.
He’s not the man he once was.
She jokes as she attends to his needs.
They have no family or close friends.
There only is just them.
Before too long, she’ll be alone.
She takes it all in stride.
She is content the way things are.
She has no worries at all.
The couple live in a very tiny, one-bedroom apartment. Every inch of space is taken up with their possessions. In a strange way, it is organized clutter. Filled plastic bins are piled high to the ceiling. Books, papers, and miscellaneous items are all around.
Karl and Sue have no children. There is very little family except for a brother, who suffers from dementia. Sue is very content the way her life is. She knows her husband is dying and soon she will be alone, but takes it all in stride without any worry. If you ask her how she is coping, she’ll reply with a lighthearted joke.
Safety is an important issue with hospice. Karl is wobbly on his feet and at risk for falling. He can no longer be safely left alone. Sue does leave him to run short errands even though hospice has informed her of the risks. Hospice has a volunteer program and I have offered to assign a volunteer to them. Sue then would be able to run errands while a volunteer could stay with Karl.
It is very difficult to maneuver around in their apartment so Sue is agreeable to moving some of the bins into storage, but declined hospice’s offer to assist her with the task. She states that she can do it herself. I do not think she has grasped the seriousness of leaving Karl alone, even for short periods. I am hoping that she will utilize the hospice volunteer as needed.
Sue has such an upbeat personality. Her positive attitude is likely what has gotten her through many of life’s struggles. She has a tendency not to worry about things, although is aware that her husband is declining and needing help. My one concern is that she will continue to leave him alone to run short errands. I will visit frequently to reinforce safety issues as well as to give them the continued support they need.
NO WORRIES
They live in cramped quarters.
Not much space to move around.
Four storage units are completely full.
They could easily fill a few more.
Rubbermaid bins are stacked ten feet high.
Each one full of who knows what.
Surprisingly she knows where everything is.
She doesn’t seem to mind.
He spends his days sitting on the sofa.
There is no place else to rest.
Behind him are countless piles of books,
stacked neatly side by side.
He’s declining and getting confused.
Garbled speech makes it difficult to talk.
He’s not the man he once was.
She jokes as she attends to his needs.
They have no family or close friends.
There only is just them.
Before too long, she’ll be alone.
She takes it all in stride.
She is content the way things are.
She has no worries at all.
Saturday, August 6, 2011
NO OTHER WAY
Eighty-four year old “Leo” suffers from lung cancer. He is blind in one eye from glaucoma and uses hearing aids to hear. His cancer has spread causing him great weakness. He is still able to ambulate slowly using a cane, but is very wobbly and needs supervision.
Leo lives with his wife, “Margo”. They have been married fifty-nine years. Margo also uses a cane to walk due to bad knees and a bad back. Leo needs assistance with most of his needs and feels guilty asking Margo for help as he knows it is hard for her.
Leo and Margo have three adult children who all live out of the area. One son died seven years ago from an accidental overdose. He had been in recovery from drug addiction when he had an accident and was put on pain medication. Leo and Margo look at their son’s death as God taking him at the time he was at his best. They feared he was possibly at the start of another relapse. The timing of his death relieved him of any further pain with his addiction.
Leo lost his right arm when he was nine years old after a fall and fracture. At the time, two doctors disagreed on the appropriate treatment and, unfortunately, a poor decision was made resulting in an infection which ultimately resulted in the loss of his right arm. He does not blame the doctors as feels it taught him to be more independent. He said his mother told him that he would have to learn to do things on his own. He is so thankful she gave him the courage to do so as that is what defines his life today.
He feels that one gains something with every loss. He has such a positive attitude no matter what comes his way. When asked how he copes with his illness, he quickly responds, “I am blessed”. “Why not me?” He is amazing and I feel honored to have met him. He laughs so easily, and with his wicked sense of humor, he is a lot of fun to be around.
NO OTHER WAY
He lost his right arm when he was nine.
Medical treatment gone bad.
He quickly learned how to manage alone.
There was no other way.
Life has not always been easy for him,
but he doesn’t see things that way.
Even when difficulties come around,
with each loss, he sees a gain.
He sees each day as a blessing
no matter what unfolds.
Not much can get him down,
not even the death of a son.
His health is declining swiftly.
He’s getting weaker with each passing day.
He hates asking for help,
but knows he can’t manage alone.
He will continue to smile.
He will continue to count his blessings.
He will always find the bright side,
“You always gain something with every loss.”
He knows of no other way.
Leo lives with his wife, “Margo”. They have been married fifty-nine years. Margo also uses a cane to walk due to bad knees and a bad back. Leo needs assistance with most of his needs and feels guilty asking Margo for help as he knows it is hard for her.
Leo and Margo have three adult children who all live out of the area. One son died seven years ago from an accidental overdose. He had been in recovery from drug addiction when he had an accident and was put on pain medication. Leo and Margo look at their son’s death as God taking him at the time he was at his best. They feared he was possibly at the start of another relapse. The timing of his death relieved him of any further pain with his addiction.
Leo lost his right arm when he was nine years old after a fall and fracture. At the time, two doctors disagreed on the appropriate treatment and, unfortunately, a poor decision was made resulting in an infection which ultimately resulted in the loss of his right arm. He does not blame the doctors as feels it taught him to be more independent. He said his mother told him that he would have to learn to do things on his own. He is so thankful she gave him the courage to do so as that is what defines his life today.
He feels that one gains something with every loss. He has such a positive attitude no matter what comes his way. When asked how he copes with his illness, he quickly responds, “I am blessed”. “Why not me?” He is amazing and I feel honored to have met him. He laughs so easily, and with his wicked sense of humor, he is a lot of fun to be around.
NO OTHER WAY
He lost his right arm when he was nine.
Medical treatment gone bad.
He quickly learned how to manage alone.
There was no other way.
Life has not always been easy for him,
but he doesn’t see things that way.
Even when difficulties come around,
with each loss, he sees a gain.
He sees each day as a blessing
no matter what unfolds.
Not much can get him down,
not even the death of a son.
His health is declining swiftly.
He’s getting weaker with each passing day.
He hates asking for help,
but knows he can’t manage alone.
He will continue to smile.
He will continue to count his blessings.
He will always find the bright side,
“You always gain something with every loss.”
He knows of no other way.
Sunday, July 31, 2011
EVOLUTION OF A CAREGIVER
“Ed” was diagnosed with pancreatic cancer seven months ago. At the time of the diagnosis, the doctors gave him four months to live. Ed lives with his wife, “Iris”. They have been married forty-two years. They have two children who are both supportive. Their son flies up routinely from his home 500 miles away. Their daughter lives an hour away and visits weekly.
When I first met Ed and Iris, Ed was still able to manage many of his needs. Iris has a history of anxiety and easily frets over things. She likes to have things certain ways and gets fretful when they are not.
Before Ed’s needs increased, Iris would get anxious as she worried about how she was going to be able to manage him in the future as the disease progressed. She works in the medical field and knows that pancreatic cancer is deadly, which increased her fears about being able to care for him.
As the months have gone on, and with Ed’s decline, Iris’s confidence as a caregiver has grown. In the beginning, she needed continual reassurance that she was doing things right. She is a fantastic caregiver, and with each visit, I reassured her that she was doing a great job.
Ed and Iris have frequent visits from friends and their church community. In the beginning, the visits were so welcomed, but now Iris loves to have a day all to herself. Ed has not eaten for over a month, but still takes chips of ice. She has given him permission to go as, is now aware, that he has suffered way too long. He is now totally dependent upon Iris for every need. She no longer needs reassurance in her role as Ed’s caregiver.
EVOLUTION OF A CAREGIVER
She started out overwhelmed.
She was anxious, doubtful and afraid.
How will she be able to manage him?
How will she know what to do?
She questioned her every move.
She feared she was doing things wrong.
She was on guard, she hovered.
She watched his every move.
She hoped for a miracle, but prepared for the worst.
His decline was slow, but continued downhill.
Her faith gave comfort knowing he would be okay,
but how would she go on without him?
Friends call and often stop by.
She is thankful for the support.
I praised her skills as a caregiver
as she needed reassurance she was doing things right.
She now sees this as blessed times,
although will be relieved when it is over.
He has suffered way too long.
She’s ready for him to let go.
Her confidence has grown with each new task.
She easily attends to his needs.
She no longer questions her every move.
She’s now knows she is,
and has always been,
a caregiver extraordinaire.
When I first met Ed and Iris, Ed was still able to manage many of his needs. Iris has a history of anxiety and easily frets over things. She likes to have things certain ways and gets fretful when they are not.
Before Ed’s needs increased, Iris would get anxious as she worried about how she was going to be able to manage him in the future as the disease progressed. She works in the medical field and knows that pancreatic cancer is deadly, which increased her fears about being able to care for him.
As the months have gone on, and with Ed’s decline, Iris’s confidence as a caregiver has grown. In the beginning, she needed continual reassurance that she was doing things right. She is a fantastic caregiver, and with each visit, I reassured her that she was doing a great job.
Ed and Iris have frequent visits from friends and their church community. In the beginning, the visits were so welcomed, but now Iris loves to have a day all to herself. Ed has not eaten for over a month, but still takes chips of ice. She has given him permission to go as, is now aware, that he has suffered way too long. He is now totally dependent upon Iris for every need. She no longer needs reassurance in her role as Ed’s caregiver.
EVOLUTION OF A CAREGIVER
She started out overwhelmed.
She was anxious, doubtful and afraid.
How will she be able to manage him?
How will she know what to do?
She questioned her every move.
She feared she was doing things wrong.
She was on guard, she hovered.
She watched his every move.
She hoped for a miracle, but prepared for the worst.
His decline was slow, but continued downhill.
Her faith gave comfort knowing he would be okay,
but how would she go on without him?
Friends call and often stop by.
She is thankful for the support.
I praised her skills as a caregiver
as she needed reassurance she was doing things right.
She now sees this as blessed times,
although will be relieved when it is over.
He has suffered way too long.
She’s ready for him to let go.
Her confidence has grown with each new task.
She easily attends to his needs.
She no longer questions her every move.
She’s now knows she is,
and has always been,
a caregiver extraordinaire.
Saturday, July 23, 2011
SMILE
Fifty-nine year old, “Stu” suffers from liver cancer. Stu suffered a stroke three years ago which left him paralyzed on his left side. He uses a can to ambulate, although it is a struggle and he needs help to do so. Stu’s primary support is his ex-wife, “Carol”. They were married for fifteen years until their divorce several years ago.
Carol lives nearby, although stays with Stu overnight and on weekends. While she is at work, Stu has a caregiver with him as he cannot be left alone. Carol is Stu’s biggest supporter and he so appreciates her friendship.
The first thing one notices is how easily Stu smiles. He has a very positive attitude toward life. He was addicted to drugs and alcohol for years. He became clean and sober fifteen years ago. Since then he has been a counselor for other addicts. With his passion for life and his strong faith, he is a joy to be around.
I visited Stu today and witnessed him struggling to get up off his bed in order to walk the short distance to his recliner in the living room. It took a lot of patience and time for him to maneuver into the other room. Carol was by his side holding on in order that he wouldn’t take a fall. Throughout the ordeal, Stu continued to have a positive attitude using humor to keep the situation light.
Even at the end of his life, no matter what the outcome, I have no doubt he will do it all with a smile.
SMILE
The first thing one notices
is his amazing, contagious smile.
His eyes light up when he sees you.
It’s like you have made his day.
He struggles with his cane.
He’s wobbly and needs help.
The stroke has paralyzed his left side.
The cancer is taking a toll.
Through it all he continues to smile.
You will never hear him complain.
He has a strong faith in God.
His faith guides him through each day.
He reads the bible daily.
It’s what gives him strength.
He has many life regrets,
but forgives himself as he
easily forgives others.
When asked what keeps him going;
what helps him through each day?
He easily replies that with each step he takes,
the Lord will always take two.
He patiently faces each new day
knowing the Lord won’t let him down;
aware that he is never alone
and til the end, I have no doubt
he will do it all
with his amazing, contagious smile.
Carol lives nearby, although stays with Stu overnight and on weekends. While she is at work, Stu has a caregiver with him as he cannot be left alone. Carol is Stu’s biggest supporter and he so appreciates her friendship.
The first thing one notices is how easily Stu smiles. He has a very positive attitude toward life. He was addicted to drugs and alcohol for years. He became clean and sober fifteen years ago. Since then he has been a counselor for other addicts. With his passion for life and his strong faith, he is a joy to be around.
I visited Stu today and witnessed him struggling to get up off his bed in order to walk the short distance to his recliner in the living room. It took a lot of patience and time for him to maneuver into the other room. Carol was by his side holding on in order that he wouldn’t take a fall. Throughout the ordeal, Stu continued to have a positive attitude using humor to keep the situation light.
Even at the end of his life, no matter what the outcome, I have no doubt he will do it all with a smile.
SMILE
The first thing one notices
is his amazing, contagious smile.
His eyes light up when he sees you.
It’s like you have made his day.
He struggles with his cane.
He’s wobbly and needs help.
The stroke has paralyzed his left side.
The cancer is taking a toll.
Through it all he continues to smile.
You will never hear him complain.
He has a strong faith in God.
His faith guides him through each day.
He reads the bible daily.
It’s what gives him strength.
He has many life regrets,
but forgives himself as he
easily forgives others.
When asked what keeps him going;
what helps him through each day?
He easily replies that with each step he takes,
the Lord will always take two.
He patiently faces each new day
knowing the Lord won’t let him down;
aware that he is never alone
and til the end, I have no doubt
he will do it all
with his amazing, contagious smile.
Saturday, July 16, 2011
I'D LIKE TO THINK
During the course of my years in hospice, I have heard many stories about copper pennies. Many feel that finding a copper penny is a message from a loved one who has died letting folks know they are doing okay and just saying “Hi”.
A new patient was opened to hospice just a few days ago. “Myra” was a fifty-one year old African-American woman who suffered from leukemia. Myra lived with her devoted daughter, “Sandra” and Sandra’s seven month old son. Sandra told me that her mother always wanted a grandchild, which I thought was cute.
Myra died suddenly and the family asked me to come out for support. I had not met any of the family yet and walked into a house full of grieving family members. I started counseling them on grief and loss while offering condolences. It was apparent that they were still numb and in shock from Myra’s sudden death.
Myra’s mother stood next to me and didn’t say much, although admitted that losing a daughter is out of order. She said her strong faith in God will help her through. During the course of my visit, I shared that Myra will show them, in a way they will understand, that she is okay. I then told a story about a another family who found solace in finding six copper pennies in front of their home and how they believed it was their loved one.
I truly believe that loved ones continue to communicate with us, although it is only my perception and trust. None of this can be proven, but with my strong belief in the afterlife, it somehow makes a lot of sense to me. Myra’s family, being of a strong Christian faith, did believe in the afterlife. They spoke of relief knowing that she is no longer suffering. I believe they will be okay due to the family support and their strong ties to their church community.
Myra lived in a large apartment building with limited parking for guests. I had to park across a thoroughfare in a shopping center parking lot. Sandra walked me out halfway to my car. When we parted, I walked a few more steps and looked down and spotted two coins partially buried in mud near a flower bush. I was wondering if the coins were a message from Myra. When I cleaned off the mud, I noticed one of the coins was from Zambia, a country in South Africa. It made me wonder if Myra’s family ancestry is from South Africa. Maybe I will just have to ask Sandra, but somehow I wouldn’t be surprised.
ADDENDUM: Today, one week later, I spoke with Sandra. During the course of our conversation, I shared the story of the two coins. She said she was going to call me to thank me for bringing up copper pennies with the family. She shared that family were finding pennies all over the place. Her aunt found a penny in the shower and had some doubts about it being from Myra. She then turned around and found another one. Sandra didn't know if their family history included Zambia, but she will definitely try to find out.
I'D LIKE TO THINK
I’d like to think she heard me share
the copper penny story with her family.
I’d like to think she left the coins
letting me know it was her.
Her family were still numb.
Her death only hours before.
They were holding on to some hope
that she was safely on the other side.
Their faith is strong.
They truly believe.
But a child dying before the mother,
is so out of order somehow.
Mom listened intently to my story.
She didn’t say a word.
But later when I was ready to leave,
she softly whispered, “Copper Pennies”.
On the sidewalk not far away,
I noticed a penny at my feet.
To my surprise; not one but two
held together by caked on dirt.
One coin from Zambia, the other from here.
Both copper and about the same size.
What was its meaning if any at all?
Family ancestors from a forgotten past?
I’d like to think she was letting them know
so they would clearly understand,
that she is still around; she’s doing okay
and made it safety to the other side.
I’d like to think….
A new patient was opened to hospice just a few days ago. “Myra” was a fifty-one year old African-American woman who suffered from leukemia. Myra lived with her devoted daughter, “Sandra” and Sandra’s seven month old son. Sandra told me that her mother always wanted a grandchild, which I thought was cute.
Myra died suddenly and the family asked me to come out for support. I had not met any of the family yet and walked into a house full of grieving family members. I started counseling them on grief and loss while offering condolences. It was apparent that they were still numb and in shock from Myra’s sudden death.
Myra’s mother stood next to me and didn’t say much, although admitted that losing a daughter is out of order. She said her strong faith in God will help her through. During the course of my visit, I shared that Myra will show them, in a way they will understand, that she is okay. I then told a story about a another family who found solace in finding six copper pennies in front of their home and how they believed it was their loved one.
I truly believe that loved ones continue to communicate with us, although it is only my perception and trust. None of this can be proven, but with my strong belief in the afterlife, it somehow makes a lot of sense to me. Myra’s family, being of a strong Christian faith, did believe in the afterlife. They spoke of relief knowing that she is no longer suffering. I believe they will be okay due to the family support and their strong ties to their church community.
Myra lived in a large apartment building with limited parking for guests. I had to park across a thoroughfare in a shopping center parking lot. Sandra walked me out halfway to my car. When we parted, I walked a few more steps and looked down and spotted two coins partially buried in mud near a flower bush. I was wondering if the coins were a message from Myra. When I cleaned off the mud, I noticed one of the coins was from Zambia, a country in South Africa. It made me wonder if Myra’s family ancestry is from South Africa. Maybe I will just have to ask Sandra, but somehow I wouldn’t be surprised.
ADDENDUM: Today, one week later, I spoke with Sandra. During the course of our conversation, I shared the story of the two coins. She said she was going to call me to thank me for bringing up copper pennies with the family. She shared that family were finding pennies all over the place. Her aunt found a penny in the shower and had some doubts about it being from Myra. She then turned around and found another one. Sandra didn't know if their family history included Zambia, but she will definitely try to find out.
I'D LIKE TO THINK
I’d like to think she heard me share
the copper penny story with her family.
I’d like to think she left the coins
letting me know it was her.
Her family were still numb.
Her death only hours before.
They were holding on to some hope
that she was safely on the other side.
Their faith is strong.
They truly believe.
But a child dying before the mother,
is so out of order somehow.
Mom listened intently to my story.
She didn’t say a word.
But later when I was ready to leave,
she softly whispered, “Copper Pennies”.
On the sidewalk not far away,
I noticed a penny at my feet.
To my surprise; not one but two
held together by caked on dirt.
One coin from Zambia, the other from here.
Both copper and about the same size.
What was its meaning if any at all?
Family ancestors from a forgotten past?
I’d like to think she was letting them know
so they would clearly understand,
that she is still around; she’s doing okay
and made it safety to the other side.
I’d like to think….
Saturday, July 9, 2011
DISPLACED ANGER
Seventy-one year old "Walt" suffered from end stage lung disease. He was on constant oxygen and got short of breath with any activity. Needless to say, his life was very sedentary. Walt had been married to "Val" for eleven years. Val was thirty-four years old and a mail-order bride from overseas. Val and Walt were devoted to each other.
Walt had two children from a previous marriage, although they both lived out of state and did not have a close relationship with their father. All of Val's family lived overseas. She kept in touch with them frequently over the internet. Val had several co-workers with whom she felt close.
Walt was opened to hospice about a month ago. Immediately one could see how much he protected his wife from the reality of his disease. He did not want hospice to talk about his dying with his wife. Walt had no fears about dying, although he spoke about the difficulty in leaving his wife. His estate was in place so that Val would not have to worry about losing her home or having unpaid bills.
Two weeks ago, Walt asked me about the end of life process. He wanted to know what he might experience. I was honest with him, but stressed that we are all individuals and each one of us travels our journey our own way. I offered to bring in a booklet that explains the physical changes one might expect during the last months, weeks, days of one's life. He said he would like a copy.
Walt died two days ago. I called Val yesterday to offer condolences. She said she was doing okay and just felt like being alone. She had called both of their families, but was content just to sit in his recliner.
She called me this morning and was angry that I had given Walt the booklet about the end of life. She said she read it last night and that the book took away his hope. She said that hospice should not give out the book to people as she wouldn't want to know the day she is going to die. There wasn't much I could say as her anger was her focus.
In the end, she hung up on me. I thought about the situation thinking what can I learn from this and what should I have done differently. In the end, I realized it wasn't the book or me that was at fault. Her anger was the only safe place for her to go with her grief at this time.
Hospice does have a huge bereavement department and follows up for thirteen months. Hopefully she will avail herself to the support that is offered. It makes me sad though, that she is having such a difficult time. I hope in time she will find her peace.
DISPLACED ANGER
Grief is complicated.
Emotions galore.
Anger is huge,
but who do you blame?
Sorrow is overwhelming.
Victimized by intense sadness.
Denial no longer works.
He won't be back tomorrow.
Anger gives you action.
It gives you something to do.
It delays facing reality.
It postpones what lies ahead.
I understood her anger.
I understood her blame.
She directed her anger at me.
It was the easiest way to turn.
He wanted to know his outcome.
He wanted to know how much time.
She said we took his hope away
when we answered what he needed to know.
In time she'll come to accept things.
Her pain will be a memory of the past.
She'll learn to move on without him.
But for now,
anger remains.
Walt had two children from a previous marriage, although they both lived out of state and did not have a close relationship with their father. All of Val's family lived overseas. She kept in touch with them frequently over the internet. Val had several co-workers with whom she felt close.
Walt was opened to hospice about a month ago. Immediately one could see how much he protected his wife from the reality of his disease. He did not want hospice to talk about his dying with his wife. Walt had no fears about dying, although he spoke about the difficulty in leaving his wife. His estate was in place so that Val would not have to worry about losing her home or having unpaid bills.
Two weeks ago, Walt asked me about the end of life process. He wanted to know what he might experience. I was honest with him, but stressed that we are all individuals and each one of us travels our journey our own way. I offered to bring in a booklet that explains the physical changes one might expect during the last months, weeks, days of one's life. He said he would like a copy.
Walt died two days ago. I called Val yesterday to offer condolences. She said she was doing okay and just felt like being alone. She had called both of their families, but was content just to sit in his recliner.
She called me this morning and was angry that I had given Walt the booklet about the end of life. She said she read it last night and that the book took away his hope. She said that hospice should not give out the book to people as she wouldn't want to know the day she is going to die. There wasn't much I could say as her anger was her focus.
In the end, she hung up on me. I thought about the situation thinking what can I learn from this and what should I have done differently. In the end, I realized it wasn't the book or me that was at fault. Her anger was the only safe place for her to go with her grief at this time.
Hospice does have a huge bereavement department and follows up for thirteen months. Hopefully she will avail herself to the support that is offered. It makes me sad though, that she is having such a difficult time. I hope in time she will find her peace.
DISPLACED ANGER
Grief is complicated.
Emotions galore.
Anger is huge,
but who do you blame?
Sorrow is overwhelming.
Victimized by intense sadness.
Denial no longer works.
He won't be back tomorrow.
Anger gives you action.
It gives you something to do.
It delays facing reality.
It postpones what lies ahead.
I understood her anger.
I understood her blame.
She directed her anger at me.
It was the easiest way to turn.
He wanted to know his outcome.
He wanted to know how much time.
She said we took his hope away
when we answered what he needed to know.
In time she'll come to accept things.
Her pain will be a memory of the past.
She'll learn to move on without him.
But for now,
anger remains.
Saturday, July 2, 2011
A BLANKET
"Marie", eighty-eight, suffered from bone marrow cancer. From the minute I met her, I saw a very independent woman. She had lived alone for years and liked it that way. Marie was widowed and had three adult children. All of her children lived nearby and were wanting to help, but Marie would tell them that she was doing fine.
In the end, her daughter, "Trish", moved in to care for her. Marie resigned herself to having her daughter around all of the time as I think deep down she knew she needed the help. During this time, Marie was focused on a blanket that she was crocheting for her grandson, Trish's son. She was so pleased at how it was turning out.
In the recent weeks, Marie was becoming weaker and it was apparent that she likely would not finish the blanket. Marie was so determined, that every day she willed herself to sit on the couch and crochet a row or two.
Marie fell four days ago and fractured her shoulder. Returning home from the Emergency Department, she went straight to bed. It was then, that she stopped eating, drinking or talking and started into her dying process.
I went out to do a visit this morning and it was apparent that Marie was close to death. Trish and I went out and sat on the couch. Trish started to talk about her mother while she picked up the blanket and started to crochet. Tears flowed as she shared stories about her mother. Marie died four hours later. Trish plans on finishing the blanket to present it to her son.
This story brought up a beautiful memory of my own blanket. I was one of nineteen grandchildren. My grandmother knitted and was working on knitting an afghan for each of her grandchildren. When I was eighteen, she was working on my afghan when she suddenly passed away. My aunt then picked up the afghan and finished it for me. Today it is still one of my most cherished possessions.
A BLANKET
She was crocheting him a blanket.
She hoped to be able to finish it soon.
She felt time had become her enemy
as she became weaker with each passing day.
She was stubborn and independent.
She had always stood her ground.
Even when she could hardly sit up,
she would crochet him one more row.
She picked yarn she knew he would like.
She stitched each row with love.
Now it sits idle on her living room couch
unfinished and waiting to be done.
Her daughter gently picked up the blanket.
She knew it needed a few more rows.
Tears flowed as she started to crochet.
Each stitch a reminder of what she has lost.
When she is done, she'll present it to him.
A treasured gift linking three generations.
The blanket has become all the more precious
as it was now stitched by two women that love him.
Two women that, he too, has always loved.
In the end, her daughter, "Trish", moved in to care for her. Marie resigned herself to having her daughter around all of the time as I think deep down she knew she needed the help. During this time, Marie was focused on a blanket that she was crocheting for her grandson, Trish's son. She was so pleased at how it was turning out.
In the recent weeks, Marie was becoming weaker and it was apparent that she likely would not finish the blanket. Marie was so determined, that every day she willed herself to sit on the couch and crochet a row or two.
Marie fell four days ago and fractured her shoulder. Returning home from the Emergency Department, she went straight to bed. It was then, that she stopped eating, drinking or talking and started into her dying process.
I went out to do a visit this morning and it was apparent that Marie was close to death. Trish and I went out and sat on the couch. Trish started to talk about her mother while she picked up the blanket and started to crochet. Tears flowed as she shared stories about her mother. Marie died four hours later. Trish plans on finishing the blanket to present it to her son.
This story brought up a beautiful memory of my own blanket. I was one of nineteen grandchildren. My grandmother knitted and was working on knitting an afghan for each of her grandchildren. When I was eighteen, she was working on my afghan when she suddenly passed away. My aunt then picked up the afghan and finished it for me. Today it is still one of my most cherished possessions.
A BLANKET
She was crocheting him a blanket.
She hoped to be able to finish it soon.
She felt time had become her enemy
as she became weaker with each passing day.
She was stubborn and independent.
She had always stood her ground.
Even when she could hardly sit up,
she would crochet him one more row.
She picked yarn she knew he would like.
She stitched each row with love.
Now it sits idle on her living room couch
unfinished and waiting to be done.
Her daughter gently picked up the blanket.
She knew it needed a few more rows.
Tears flowed as she started to crochet.
Each stitch a reminder of what she has lost.
When she is done, she'll present it to him.
A treasured gift linking three generations.
The blanket has become all the more precious
as it was now stitched by two women that love him.
Two women that, he too, has always loved.
Saturday, June 25, 2011
TO LIVE
Forty year old "Jennie" was opened to hospice today. Jennie suffers from ovarian cancer which has spread to her spine. Her pain is excruciating and has left her bed bound this past week as it is difficult for her to walk. She feels if the pain could get under control, she would be able to get up and about and live her life.
Jennie lives with her husband, "Jimmy" and her sixteen year old son, "Shawn". Jimmy and Jennie have been married three years. The three of them are a very close family. Jennie is also very close to her sister, "Laura". Laura is Jennie's biggest advocate. Laura lives four blocks away, and the plan is to move Jennie to her sister's home because it is larger and can accommodate their mother, "Susan", more comfortably. Susan is from out of town, and the plan is for her to stay and care for Jennie for as long as needed because of everyone's work schedule. It is a perfect plan for all.
Shortly after the nurse and I walked in and introduced ourselves, Jennie proclaimed, "I want to live!" She is full of life with such a positive attitude. Some of it may be her own denial, but deep inside, I know she is aware that her disease is critical. She was diagnosed with cancer over ten years ago and, during that time, she has followed a holistic regiment, supported by her physician.
I was so impressed by her spunk and spirit because it was a strong reminder that each of us must live each day to the fullest as we never know when it will be our last.
TO LIVE
She thought hospice was about giving up.
She thought we would just let her die.
But after meeting and hearing about us,
she then knew we were all about life.
"I just want to live."
"I am not going to die."
"I've had this disease for ten years."
"I'm going to get on with my life."
The cancer has spread to her spine.
The pain makes it difficult to walk.
Her medication is vast and a constant need.
Sixty pills with marijuana; a daily regime.
I told her hospice is all about comfort care.
Hospice is about quality of life.
She will guide us through this journey.
Only she knows what is best for her.
I told her we are all living, until we die.
She is living just as much as the rest of us.
It isn't over until it is over,
when we have taken our final breath.
She is spiritual with strong beliefs,
so it's not the afterlife she fears.
She just wants to get on with her life.
"I want to live!"
Jennie lives with her husband, "Jimmy" and her sixteen year old son, "Shawn". Jimmy and Jennie have been married three years. The three of them are a very close family. Jennie is also very close to her sister, "Laura". Laura is Jennie's biggest advocate. Laura lives four blocks away, and the plan is to move Jennie to her sister's home because it is larger and can accommodate their mother, "Susan", more comfortably. Susan is from out of town, and the plan is for her to stay and care for Jennie for as long as needed because of everyone's work schedule. It is a perfect plan for all.
Shortly after the nurse and I walked in and introduced ourselves, Jennie proclaimed, "I want to live!" She is full of life with such a positive attitude. Some of it may be her own denial, but deep inside, I know she is aware that her disease is critical. She was diagnosed with cancer over ten years ago and, during that time, she has followed a holistic regiment, supported by her physician.
I was so impressed by her spunk and spirit because it was a strong reminder that each of us must live each day to the fullest as we never know when it will be our last.
TO LIVE
She thought hospice was about giving up.
She thought we would just let her die.
But after meeting and hearing about us,
she then knew we were all about life.
"I just want to live."
"I am not going to die."
"I've had this disease for ten years."
"I'm going to get on with my life."
The cancer has spread to her spine.
The pain makes it difficult to walk.
Her medication is vast and a constant need.
Sixty pills with marijuana; a daily regime.
I told her hospice is all about comfort care.
Hospice is about quality of life.
She will guide us through this journey.
Only she knows what is best for her.
I told her we are all living, until we die.
She is living just as much as the rest of us.
It isn't over until it is over,
when we have taken our final breath.
She is spiritual with strong beliefs,
so it's not the afterlife she fears.
She just wants to get on with her life.
"I want to live!"
Monday, June 20, 2011
ROLE REVERSAL
Sixty-three year old "Eugene" suffers from pancreatic cancer. He was diagnosed over eighteen months ago and, until recently, had been managing quite well. Eugene lives with his wife of forty-two years, "Ingrid". Ingrid and Eugene have two children who are supportive and visit often.
Until two weeks ago, Eugene was able to manage many of his needs. Recently, though, he has been in a rapid decline. Eugene stopped eating yesterday and it is likely he will die within a week. He is still alert, oriented and understands what is happening. He spends his days in his recliner in the family room. He has the recliner's head way back so he can easily stretch out.
When Eugene and Ingrid married, he went to work while she stayed home and cared for the home and family. Once the children were grown, Ingrid went to work as a medical transcriber, but continued to care for the home while Eugene took care of the finances, yard work and her. Ingrid gets anxious easily, so Eugene thought it would be best if he took responsibility for the things that caused her stress.
These past two weeks have been hard on Ingrid. She is doing a marvelous job caring for Eugene, but constantly questions if she is doing the right thing. I went out to do a visit today and reassured her that she was doing a marvelous job. She frets about and anxiously keeps asking Eugene what he needs. He wants to ease her stress and so will do what he thinks she wants him to do.
Both of them know his time is close and that there is nothing else that can be done for him. Toward the end of my visit today, Ingrid sat down in a chair next to Eugene's recliner. He put his hand on her hand and looked at her so lovingly. All he needs is to have his wife at his side. He started to softly cry and it was so apparent how difficult it will be for him to leave her. One could see and feel the love between the two.
She is doing a beautiful job.
ROLE REVERSAL
He has always taken care of her
while she took care of the family.
Their roles were clear and defined.
They both knew what they had to do.
He was always in charge.
It worked well for them that way.
But now that he is sick,
their roles have dramatically changed.
She's doing a great job caring for him,
but her anxiety tells her different.
She fusses, she frets, she hovers.
She worries she is doing things wrong.
He sleeps most of his days
in his recliner tilted back far.
With his decline and increasing needs,
she is doing a fantastic job.
She knows there is nothing more to be done.
The doctors have told her so.
He likely has less than a week to live.
She wants to know what she can do.
He looks at her so lovingly as he is well aware
that she has shifted beautifully into her new role.
She just wants to do the right thing.
He knows she has always
done just that.
Until two weeks ago, Eugene was able to manage many of his needs. Recently, though, he has been in a rapid decline. Eugene stopped eating yesterday and it is likely he will die within a week. He is still alert, oriented and understands what is happening. He spends his days in his recliner in the family room. He has the recliner's head way back so he can easily stretch out.
When Eugene and Ingrid married, he went to work while she stayed home and cared for the home and family. Once the children were grown, Ingrid went to work as a medical transcriber, but continued to care for the home while Eugene took care of the finances, yard work and her. Ingrid gets anxious easily, so Eugene thought it would be best if he took responsibility for the things that caused her stress.
These past two weeks have been hard on Ingrid. She is doing a marvelous job caring for Eugene, but constantly questions if she is doing the right thing. I went out to do a visit today and reassured her that she was doing a marvelous job. She frets about and anxiously keeps asking Eugene what he needs. He wants to ease her stress and so will do what he thinks she wants him to do.
Both of them know his time is close and that there is nothing else that can be done for him. Toward the end of my visit today, Ingrid sat down in a chair next to Eugene's recliner. He put his hand on her hand and looked at her so lovingly. All he needs is to have his wife at his side. He started to softly cry and it was so apparent how difficult it will be for him to leave her. One could see and feel the love between the two.
She is doing a beautiful job.
ROLE REVERSAL
He has always taken care of her
while she took care of the family.
Their roles were clear and defined.
They both knew what they had to do.
He was always in charge.
It worked well for them that way.
But now that he is sick,
their roles have dramatically changed.
She's doing a great job caring for him,
but her anxiety tells her different.
She fusses, she frets, she hovers.
She worries she is doing things wrong.
He sleeps most of his days
in his recliner tilted back far.
With his decline and increasing needs,
she is doing a fantastic job.
She knows there is nothing more to be done.
The doctors have told her so.
He likely has less than a week to live.
She wants to know what she can do.
He looks at her so lovingly as he is well aware
that she has shifted beautifully into her new role.
She just wants to do the right thing.
He knows she has always
done just that.
Saturday, June 11, 2011
KINDNESS
Sixty-six year old "Valerie" suffers from ovarian cancer. Valerie lives with her husband "Carl." They have been married twenty-three years. They have no children, but Valerie is close to her siblings and has amazing friends. Carl suffers from diabetes and cardiac disease, although is able to manage his own needs without much difficulty. Valerie has been declining in the recent weeks whereas she is needing more assistance. Instead of stepping up to the plate to assist his wife, Carl continues to ask Valerie, for example, to make him lunch. Valerie will then fix Carl a sandwich.
Carl says that he is aware that Valerie is dying, but, on the other hand, he focuses on the difficulty he is having with his own health problems. Fortunately, Valerie's brother, "Chad" and her good friend, "Linda" are very involved and attentive to Valerie's changing needs and decline.
Valerie and Carl live in a very tiny one bedroom apartment. She quit her job as a waitress because of her declining health. Carl is retired and on Social Security. Funds are limited, although Linda is able to hire attendant care for the weekends to assist. Either she or Chad are with Valerie daily for support. Even though he knows his wife is declining and needs more help, Carl will sit on the couch and not offer any assistance.
Through it all, Valerie will continue to smile and ask about others. If you ask her how she is doing, she will always reply, "I'm doing fine." She is amazing and a teacher to us all. She has taught me to stop for a moment when I have an urge to complain about something and to concentrate on the positive. Valerie is able to focus on what she has and not what she doesn't have. All in all, it is all about her amazing kindness to others. What a beautiful person she is and what an amazing legacy she will leave behind.
KINDNESS
Her kindness comes from within.
From the deepest part of her soul.
She doesn't have a mean bone in her body.
She sees the good in everyone.
Her focus is always on others.
I have never heard her complain;
even though her own life
is slowly slipping away.
She can barely walk now.
Fluid has invaded her legs.
The tumor is growing so rapidly,
her clothes no longer comfortably fit.
But still she continues to smile.
She continues to ask, "How are you?"
Never a thought to her own sufferings.
She takes it all in stride.
She has amazing family and friends
who are right there by her side.
She has a husband who doesn't help much,
but she loves him all the more.
She will die the way she lived;
with kindness and consideration all around.
She will leave amazing footsteps.
It's the only way she knows how.
Kindness
Carl says that he is aware that Valerie is dying, but, on the other hand, he focuses on the difficulty he is having with his own health problems. Fortunately, Valerie's brother, "Chad" and her good friend, "Linda" are very involved and attentive to Valerie's changing needs and decline.
Valerie and Carl live in a very tiny one bedroom apartment. She quit her job as a waitress because of her declining health. Carl is retired and on Social Security. Funds are limited, although Linda is able to hire attendant care for the weekends to assist. Either she or Chad are with Valerie daily for support. Even though he knows his wife is declining and needs more help, Carl will sit on the couch and not offer any assistance.
Through it all, Valerie will continue to smile and ask about others. If you ask her how she is doing, she will always reply, "I'm doing fine." She is amazing and a teacher to us all. She has taught me to stop for a moment when I have an urge to complain about something and to concentrate on the positive. Valerie is able to focus on what she has and not what she doesn't have. All in all, it is all about her amazing kindness to others. What a beautiful person she is and what an amazing legacy she will leave behind.
KINDNESS
Her kindness comes from within.
From the deepest part of her soul.
She doesn't have a mean bone in her body.
She sees the good in everyone.
Her focus is always on others.
I have never heard her complain;
even though her own life
is slowly slipping away.
She can barely walk now.
Fluid has invaded her legs.
The tumor is growing so rapidly,
her clothes no longer comfortably fit.
But still she continues to smile.
She continues to ask, "How are you?"
Never a thought to her own sufferings.
She takes it all in stride.
She has amazing family and friends
who are right there by her side.
She has a husband who doesn't help much,
but she loves him all the more.
She will die the way she lived;
with kindness and consideration all around.
She will leave amazing footsteps.
It's the only way she knows how.
Kindness
Saturday, June 4, 2011
I'M OKAY
Eighty-four year old "Nora" suffers from colon cancer. She lives with her husband, "Jack" who is her primary caregiver. Jack is eighty-eight years old and is in good health, although hard of hearing. He is able to effectively care for his wife and their home.
Jack and Nora have been married for over fifty-seven years. They have two sons who are devoted to their parents. Both sons live close by and visit often. Nora and Jack had a daughter, who, at age nineteen, died of leukemia. They are both able to talk about their daughter and share wonderful stories about her short life.
Nora had been on hospice before, but was discharged six months ago because she was so stable. She was readmitted into hospice two months ago due to a decline. During my visit today, I was shocked at how weak she looked. I also was surprised to see her still in her pajamas as, with prior visits, she has always been dressed.
Nora is able to walk slowly using her walker, although is a bit wobbly on her feet and Jack needs to be nearby to help her if needed. Nora shared that yesterday she could not even get up out of the chair. Jack spoke about his worries when Nora can no longer get out of bed. He worries that he will not be able to help her.
I shared that, quite often, when the patient is bed bound, it is easier as one does not have to do much lifting. Knowing that they had the funds, I spoke about the option of hiring attendant care. Jack and Nora both think that right now they are okay, but will likely hire help in the future.
It is so sweet as both of them are worrying about the other. Jack's eyes lit up when he spoke about his concern for Nora. He softly rubbed her foot while he spoke. After fifty-seven years, their love is forever strong.
I'M OKAY
He is eighty-eight years old.
He is still able to get around.
He is the primary caregiver for his wife;
attentive to her every need.
His days are full caring for her,
cooking, gardening, managing the home.
He worries about their future
when she is bed bound and needs more help.
His eyes light up when he looks at her.
He wants to help her the best he can.
If you ask him how he is doing,
he replies, "I'm okay, but I worry about her."
She looks at him so gently.
She wishes she could do more.
These last few days have been hard on them.
She's getting weaker and slowing down.
She has no fears about dying.
Her strong faith gives her peace.
He is her biggest concern,
I'm okay, but I worry about him."
They've been relying on each other
for more than fifty-seven years.
It has always worked so beautifully,
so there's never been any doubt,
that both of them will continue to be,
perfectly okay.
Jack and Nora have been married for over fifty-seven years. They have two sons who are devoted to their parents. Both sons live close by and visit often. Nora and Jack had a daughter, who, at age nineteen, died of leukemia. They are both able to talk about their daughter and share wonderful stories about her short life.
Nora had been on hospice before, but was discharged six months ago because she was so stable. She was readmitted into hospice two months ago due to a decline. During my visit today, I was shocked at how weak she looked. I also was surprised to see her still in her pajamas as, with prior visits, she has always been dressed.
Nora is able to walk slowly using her walker, although is a bit wobbly on her feet and Jack needs to be nearby to help her if needed. Nora shared that yesterday she could not even get up out of the chair. Jack spoke about his worries when Nora can no longer get out of bed. He worries that he will not be able to help her.
I shared that, quite often, when the patient is bed bound, it is easier as one does not have to do much lifting. Knowing that they had the funds, I spoke about the option of hiring attendant care. Jack and Nora both think that right now they are okay, but will likely hire help in the future.
It is so sweet as both of them are worrying about the other. Jack's eyes lit up when he spoke about his concern for Nora. He softly rubbed her foot while he spoke. After fifty-seven years, their love is forever strong.
I'M OKAY
He is eighty-eight years old.
He is still able to get around.
He is the primary caregiver for his wife;
attentive to her every need.
His days are full caring for her,
cooking, gardening, managing the home.
He worries about their future
when she is bed bound and needs more help.
His eyes light up when he looks at her.
He wants to help her the best he can.
If you ask him how he is doing,
he replies, "I'm okay, but I worry about her."
She looks at him so gently.
She wishes she could do more.
These last few days have been hard on them.
She's getting weaker and slowing down.
She has no fears about dying.
Her strong faith gives her peace.
He is her biggest concern,
I'm okay, but I worry about him."
They've been relying on each other
for more than fifty-seven years.
It has always worked so beautifully,
so there's never been any doubt,
that both of them will continue to be,
perfectly okay.
Monday, May 30, 2011
ADDICTION
Fifty-eight year old "Ronald" was referred to hospice because of prostate cancer. Ronald recently moved back in with his wife, "Inga". They have been married for over thirty years, but have been separated for eighteen months due to his addiction to methamphetamines. Because of Ronald's recent diagnosis of cancer, Inga allowed him to move back home so that she could help care for him.
Inga says that Ronald has been using drugs for over thirty years. He is on disability because of his addiction. Inga has her own house cleaning business and works three days a week. She feels that she can care for Ronald with assistance from their two adult children, who have agreed to help as needed. She also plans on hiring an attendant to supplement the hours the two children are not able to cover.
Ronald looks twenty years older than his stated fifty-eight years. He has lost all of his teeth because of his drug use. He is on a soft diet because he cannot wear his ill-fitting dentures.
Inga feels obligated to help Ronald. The two children are willing to help their father in order to support their mother. Ronald has lost the respect and love of his family. Ronald has lost so much more, but still continues to use drugs. His addiction is that strong.
Using drugs is the life that Ronald knows. About once a week, he disappears with his drug buddies and will be gone for three days. He returns home dirty and disheveled with no explanation to where he has been. Likely the only way he will stop his drug use is when the cancer gets to a point where he can no longer walk and is unable to leave the home.
Hospice may discharge him as he is not following the plan of care. That is one criteria that patients agree to when they are admitted to our program. It is difficult to help someone when they won't help themselves. Sadly, addiction is a family disease.
ADDICTION
He's been using for years.
It's apparent he still is.
He says he's been clean for months,
but his behavior exposes the truth.
He disappears for days at a time.
No one knows where he's gone.
He returns home disheveled and dirty.
It's easy to figure out why.
He has tubes that need to be sterile;
bandages that need to be changed.
He's been on hospice for less than a month.
He's missing for much of that time.
One says you have to hit bottom.
He's definitely on his way down.
There's not much else for him to lose.
He's already lost
his job; his health; his family.
He's miserable when he's home.
Withdrawal leaves him nauseous and weak.
He's risking it all for some feigned pleasure.
Sadly, methamphetamines are in control.
Addiction.
Inga says that Ronald has been using drugs for over thirty years. He is on disability because of his addiction. Inga has her own house cleaning business and works three days a week. She feels that she can care for Ronald with assistance from their two adult children, who have agreed to help as needed. She also plans on hiring an attendant to supplement the hours the two children are not able to cover.
Ronald looks twenty years older than his stated fifty-eight years. He has lost all of his teeth because of his drug use. He is on a soft diet because he cannot wear his ill-fitting dentures.
Inga feels obligated to help Ronald. The two children are willing to help their father in order to support their mother. Ronald has lost the respect and love of his family. Ronald has lost so much more, but still continues to use drugs. His addiction is that strong.
Using drugs is the life that Ronald knows. About once a week, he disappears with his drug buddies and will be gone for three days. He returns home dirty and disheveled with no explanation to where he has been. Likely the only way he will stop his drug use is when the cancer gets to a point where he can no longer walk and is unable to leave the home.
Hospice may discharge him as he is not following the plan of care. That is one criteria that patients agree to when they are admitted to our program. It is difficult to help someone when they won't help themselves. Sadly, addiction is a family disease.
ADDICTION
He's been using for years.
It's apparent he still is.
He says he's been clean for months,
but his behavior exposes the truth.
He disappears for days at a time.
No one knows where he's gone.
He returns home disheveled and dirty.
It's easy to figure out why.
He has tubes that need to be sterile;
bandages that need to be changed.
He's been on hospice for less than a month.
He's missing for much of that time.
One says you have to hit bottom.
He's definitely on his way down.
There's not much else for him to lose.
He's already lost
his job; his health; his family.
He's miserable when he's home.
Withdrawal leaves him nauseous and weak.
He's risking it all for some feigned pleasure.
Sadly, methamphetamines are in control.
Addiction.
Friday, May 20, 2011
ASLEEP
"Al", thirty-five, suffers from lymphoma that has spread throughout his body. Al lives with his wife and two young daughters in a two story townhouse. There are no bedrooms downstairs and Al spends his days sitting on the living room couch. He can no longer manage the stairs and is using the couch as his bed. He has refused a hospital bed and is content to stay on the couch.
Al has rapidly declined this past week. I made a visit today to see him and he looked jaundiced, pale and weak. He was sitting up so straight on the couch. When speaking with him, his eyes would glaze over and his eyelids would start to droop. He had difficulty focusing because he was so tired.
Several times Al fell asleep sitting up. He would jolt himself awake and open his eyes wide to prevent himself from falling back to sleep. He would slap his cheek to keep himself awake. Al's parents were present and caring for him while his wife was out running errands. Al's parents speak only Cantonese, but one could see from their body language; anguish and grief.
I encouraged Al to lie down and take a nap. He said he wanted to stay awake as his parents and wife feared that if he fell asleep, he would not wake up. I encouraged Al to tell his parents that sleep does not cause death. Sleep is the natural progression of the disease as his body needs rest to fight the cancer.
Al could not focus enough to translate the information to his parents. Whereas in the past, it worked well to have him translate. In hospice we always offer to have an interpreter, and at each offer, Al stated that he could translate.
I asked Al if I could return in two days with an interpreter in order to speak with his wife and parents about disease progression and expectations. Al was receptive to that idea.
I have arranged for an interpreter to accompany me for my next visit in two days. Hopefully I will be able to offer support and clarify disease progression with the family. Also I hope to learn and understand their cultural beliefs and support that as well.
ASLEEP
He fights to stay awake.
He does not want to fall asleep.
His eyes shroud over and slowly droop.
He needs to get some rest.
His family fears he won't wake up
if he closes his eyes or lays down his head.
They believe sleep will cause his death.
They just don't want him to die.
He slaps his cheek to keep awake
when he feels the pressure to doze.
He won't lay down, but sits up straight.
He strives to not disappointment them.
He speaks some English; his family does not.
Communicatiopn has been slow.
But now he can no longer translate for us.
The disease has robbed him of precious strength.
He told me that he wants it over.
He's tired of the fight.
But he'll continue to honor his family,
until he falls asleep.
Al has rapidly declined this past week. I made a visit today to see him and he looked jaundiced, pale and weak. He was sitting up so straight on the couch. When speaking with him, his eyes would glaze over and his eyelids would start to droop. He had difficulty focusing because he was so tired.
Several times Al fell asleep sitting up. He would jolt himself awake and open his eyes wide to prevent himself from falling back to sleep. He would slap his cheek to keep himself awake. Al's parents were present and caring for him while his wife was out running errands. Al's parents speak only Cantonese, but one could see from their body language; anguish and grief.
I encouraged Al to lie down and take a nap. He said he wanted to stay awake as his parents and wife feared that if he fell asleep, he would not wake up. I encouraged Al to tell his parents that sleep does not cause death. Sleep is the natural progression of the disease as his body needs rest to fight the cancer.
Al could not focus enough to translate the information to his parents. Whereas in the past, it worked well to have him translate. In hospice we always offer to have an interpreter, and at each offer, Al stated that he could translate.
I asked Al if I could return in two days with an interpreter in order to speak with his wife and parents about disease progression and expectations. Al was receptive to that idea.
I have arranged for an interpreter to accompany me for my next visit in two days. Hopefully I will be able to offer support and clarify disease progression with the family. Also I hope to learn and understand their cultural beliefs and support that as well.
ASLEEP
He fights to stay awake.
He does not want to fall asleep.
His eyes shroud over and slowly droop.
He needs to get some rest.
His family fears he won't wake up
if he closes his eyes or lays down his head.
They believe sleep will cause his death.
They just don't want him to die.
He slaps his cheek to keep awake
when he feels the pressure to doze.
He won't lay down, but sits up straight.
He strives to not disappointment them.
He speaks some English; his family does not.
Communicatiopn has been slow.
But now he can no longer translate for us.
The disease has robbed him of precious strength.
He told me that he wants it over.
He's tired of the fight.
But he'll continue to honor his family,
until he falls asleep.
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