Sixty-two year old "Donna" suffers from end stage lung disease. Even while on continuous oxygen, she struggles with each breath. Donna came onto hospice four months ago when, at that time, the doctors told her that she would likely die within six months.
During my first visit to Donna's home, we talked in her office. She did computer work for a small construction company and was able to work from home. Donna has many friends and, during that time, was able to go out frequently and enjoy their company.
Over the course of these past few months though, Donna is spending more and more time in bed. She is becoming weaker and struggling more with her breathing. During my visit this week she shared that she lost air while attempting to use the commode next to her bed. Likely it is disease progression, but she wants it to be panic attacks. "Mark", Donna's husband, then said that Donna is sleeping a lot more. Quickly Donna said it is because she is depressed. She then added, "Craziness can be fixed."
Donna and I talked about panic attacks, depression and disease progression. I gently clarified the significance of each. She was hoping for an easy fix, but with her eyes tearing up, she then understood it was the disease driving the symptoms.
FIX IT
She gets short of breath so easily
so she spends her days in bed.
She struggles to breathe just lying there
using energy she does not have.
Her disease is winning the battle.
Her lungs are shutting down.
She is weaker, she is sleeping more.
She grieves the life she used to have.
She wants me to say she is depressed.
That's why she is sleeping more.
She wants me to say it's panic attacks
when she is gasping for precious air.
There must be something she can do.
There must be something that can be done.
With the right medication, the right dosage;
"Craziness can be fixed."
We talked about disease progression.
We talked about her grief.
A single tear rolled down her cheek
as the reality of the situation became clear,
"I was hoping you could fix it."
Saturday, January 29, 2011
Sunday, January 23, 2011
UPBEAT
Fifty-eight year old "Vic" was diagnosed with liver cancer three months ago. Last week, the doctors told him that the cancer has now spread to his lungs. There is no more treatment available for him.
Vic has accepted his fate without fears or concerns. He has always had an upbeat attitude about life and, not surprisingly, even a terminal diagnosis does not get him down. Vic and his wife, "Kay", have had many trials during their thirty-eight year marriage.
Vic and Kay have two daughters, both in their twenties. One of their daughters, "Sandy", still lives in the home. She is in remission from cancer herself. Sandy undergoes daily dialysis treatments in the home due to a chronic inherited genetic disease. Her sister, "Debbie", also suffers from the same disease to a lesser degree.
Through all of this, Vic continues to smile and laugh. His upbeat personality is contagious and within minutes of being with him, one can't help but have a smile too.
UPBEAT
He is always in a good mood
with each days eventful ups and downs.
Life has dealt him some serious cards,
but he always plays his hands his way.
His daughters have been chronically ill
from an inherited gene gone seriously wrong.
Difficult challenges set a daily mood,
but he continues on with an upbeat tone.
Not much has ever gotten him down.
He easily accepts what comes along.
He'll tease, he'll smile, he'll make a joke,
blending laughter into each of his days.
He just found out that he is dying.
There is nothing else that can be done.
This too, doesn't drag him down
as his upbeat personality continues to shine.
He's accepted his dying without regrets.
He believes in a glorious afterlife.
If you ask him if he has any fears,
he'll quickly respond with a wide grin,
"Hey, we all got to go sometime."
Vic has accepted his fate without fears or concerns. He has always had an upbeat attitude about life and, not surprisingly, even a terminal diagnosis does not get him down. Vic and his wife, "Kay", have had many trials during their thirty-eight year marriage.
Vic and Kay have two daughters, both in their twenties. One of their daughters, "Sandy", still lives in the home. She is in remission from cancer herself. Sandy undergoes daily dialysis treatments in the home due to a chronic inherited genetic disease. Her sister, "Debbie", also suffers from the same disease to a lesser degree.
Through all of this, Vic continues to smile and laugh. His upbeat personality is contagious and within minutes of being with him, one can't help but have a smile too.
UPBEAT
He is always in a good mood
with each days eventful ups and downs.
Life has dealt him some serious cards,
but he always plays his hands his way.
His daughters have been chronically ill
from an inherited gene gone seriously wrong.
Difficult challenges set a daily mood,
but he continues on with an upbeat tone.
Not much has ever gotten him down.
He easily accepts what comes along.
He'll tease, he'll smile, he'll make a joke,
blending laughter into each of his days.
He just found out that he is dying.
There is nothing else that can be done.
This too, doesn't drag him down
as his upbeat personality continues to shine.
He's accepted his dying without regrets.
He believes in a glorious afterlife.
If you ask him if he has any fears,
he'll quickly respond with a wide grin,
"Hey, we all got to go sometime."
Sunday, January 16, 2011
I'LL MISS YOU
Eighty-four year old "Shelley" came onto hospice with a diagnosis of end stage dementia. Shelley and her husband, "Frank", were married for sixty-five years. Frank and Shelley moved into a retirement community in order to be near their children. Frank knew that he would be needing his children's assistance to help in the care of his wife.
Once Shelley became bed bound, her needs became too much for Frank. "Janet" their daughter, lived nearby and offered to care for her mother. Shelley then moved into her daughter's home. Janet and her partner, "Cathy", were excellent caregivers. They were both nurses and knew the demands of caring for a terminal patient.
Janet was able to care for her mother during the day while Cathy was at work. On the weekends, their roles reversed as Janet worked the weekends leaving Cathy in charge of Shelley. Frank would spend a large part of each day at Janet's home. With the demands of physically caring for his wife no longer on his shoulders, he was able to sit by his wife and just love her. It was a perfect solution for the family.
Shelley came onto hospice soon after moving into Janet's home. She was bed bound and eating very little. Her prognosis was a few weeks based on her increasing weakness and confusion. Shelley had good days and bad days. During my weekly visits, there were times when she was lucid and had energy, while other times she was very weak and appeared more confused than usual.
During my visits, I spent most of my time sitting at the kitchen table talking with Janet. Janet had tremendous insight regarding her "roller-coaster" emotions during this time. She was forthright and honest regarding her feelings. She was very open about any positive and negative emotions. We had many lively conversations at the kitchen table while sipping an espresso.
Janet and Cathy welcomed hospice staff into their home with embracing arms. They constantly expressed their appreciation for any support. One felt like an honored guest. Janet and Cathy were easy to get to know as they were so open with their joy for each visit. The topics of conversation could get lively and off track, but their primary focus was the care and comfort of their mother.
I went to Shelley's funeral today. It was a beautiful ceremony befitting such a gracious lady. I hugged Janet, Cathy and Frank goodbye knowing, as I sadly walked away, that it was likely the last time I will see them. It is awkward for hospice staff to stay connected with families as it can never be a regular relationship between friends. The memory of the loss will always accompany hospice.
I'LL MISS YOU
It was hard to walk away today.
It was hard to say goodbye.
Knowing it was likely the last time
we would see each other again.
I will miss going to your home.
I will miss our spirited talks.
Our time together is now over.
We always knew that it would end.
I am glad that I have met you.
I am glad our paths did cross.
But now I'm a reminder of a sad time.
A memory you will never forget.
It's time for us to move along.
We must go our separate ways.
But you will always be a part of me.
You are someone I'll never forget.
Meeting another way
it's likely we would be friends.
I am really going to miss you
knowing what could have been.
Once Shelley became bed bound, her needs became too much for Frank. "Janet" their daughter, lived nearby and offered to care for her mother. Shelley then moved into her daughter's home. Janet and her partner, "Cathy", were excellent caregivers. They were both nurses and knew the demands of caring for a terminal patient.
Janet was able to care for her mother during the day while Cathy was at work. On the weekends, their roles reversed as Janet worked the weekends leaving Cathy in charge of Shelley. Frank would spend a large part of each day at Janet's home. With the demands of physically caring for his wife no longer on his shoulders, he was able to sit by his wife and just love her. It was a perfect solution for the family.
Shelley came onto hospice soon after moving into Janet's home. She was bed bound and eating very little. Her prognosis was a few weeks based on her increasing weakness and confusion. Shelley had good days and bad days. During my weekly visits, there were times when she was lucid and had energy, while other times she was very weak and appeared more confused than usual.
During my visits, I spent most of my time sitting at the kitchen table talking with Janet. Janet had tremendous insight regarding her "roller-coaster" emotions during this time. She was forthright and honest regarding her feelings. She was very open about any positive and negative emotions. We had many lively conversations at the kitchen table while sipping an espresso.
Janet and Cathy welcomed hospice staff into their home with embracing arms. They constantly expressed their appreciation for any support. One felt like an honored guest. Janet and Cathy were easy to get to know as they were so open with their joy for each visit. The topics of conversation could get lively and off track, but their primary focus was the care and comfort of their mother.
I went to Shelley's funeral today. It was a beautiful ceremony befitting such a gracious lady. I hugged Janet, Cathy and Frank goodbye knowing, as I sadly walked away, that it was likely the last time I will see them. It is awkward for hospice staff to stay connected with families as it can never be a regular relationship between friends. The memory of the loss will always accompany hospice.
I'LL MISS YOU
It was hard to walk away today.
It was hard to say goodbye.
Knowing it was likely the last time
we would see each other again.
I will miss going to your home.
I will miss our spirited talks.
Our time together is now over.
We always knew that it would end.
I am glad that I have met you.
I am glad our paths did cross.
But now I'm a reminder of a sad time.
A memory you will never forget.
It's time for us to move along.
We must go our separate ways.
But you will always be a part of me.
You are someone I'll never forget.
Meeting another way
it's likely we would be friends.
I am really going to miss you
knowing what could have been.
Monday, January 10, 2011
BLESSINGS
Eighty-nine year old "Carl" suffers from end-stage cardiac disease. His heart is weakening fast. Carl spends most of his days in bed. He is dependent with all of his needs. The doctors feel that he may survive for only a few more weeks.
Carl lives with his wife, "Eloise". They have been happily married for fifty-seven years. Eloise suffers from dementia and gets easily confused. She wanders at night and needs to be watched very closely. The couple's son, "John", manages their financial and personal affairs. John has hired twenty-four hour attendant care for his parents.
Eloise tries to assist the hired attendant when transfering Carl from the wheelchair to the bed. She is not strong enough to help much, but Carl will just smile with her struggle saying how beautiful she is. Then he'll softly kiss her so tenderly.
Carl counts his blessings and Eloise is number one on his list. Eloise will tell those around how much she loves him. She often will tear up as she knows he is dying. Carl has always had a strong, positive attitude about life and, not surprisingly, deals with his dying the same way.
BLESSINGS
They've been married for decades.
It was love at first sight.
He says he's blessed to have her.
She says he's the love of her life.
She gets confused and can't remember.
His heart is failing, making him weak.
These past few years have been rough on them,
but he still feels blessed to have her.
He prefers to focus on the positive.
He is easy going with a quick wit.
He has become dependent upon others,
but uses humor to lighten the load.
She tries to help him without success.
He responds by saying she's beautiful.
Then they'll kiss each other so gently.
Their love continues to grow.
He thanks God for his many blessings
even though his time is now short.
He speaks of a long and wonderful life.
Even in dying, he focuses on the positive.
"I'll just float along with it."
Blessings.
Carl lives with his wife, "Eloise". They have been happily married for fifty-seven years. Eloise suffers from dementia and gets easily confused. She wanders at night and needs to be watched very closely. The couple's son, "John", manages their financial and personal affairs. John has hired twenty-four hour attendant care for his parents.
Eloise tries to assist the hired attendant when transfering Carl from the wheelchair to the bed. She is not strong enough to help much, but Carl will just smile with her struggle saying how beautiful she is. Then he'll softly kiss her so tenderly.
Carl counts his blessings and Eloise is number one on his list. Eloise will tell those around how much she loves him. She often will tear up as she knows he is dying. Carl has always had a strong, positive attitude about life and, not surprisingly, deals with his dying the same way.
BLESSINGS
They've been married for decades.
It was love at first sight.
He says he's blessed to have her.
She says he's the love of her life.
She gets confused and can't remember.
His heart is failing, making him weak.
These past few years have been rough on them,
but he still feels blessed to have her.
He prefers to focus on the positive.
He is easy going with a quick wit.
He has become dependent upon others,
but uses humor to lighten the load.
She tries to help him without success.
He responds by saying she's beautiful.
Then they'll kiss each other so gently.
Their love continues to grow.
He thanks God for his many blessings
even though his time is now short.
He speaks of a long and wonderful life.
Even in dying, he focuses on the positive.
"I'll just float along with it."
Blessings.
Monday, January 3, 2011
TO SAY GOODBYE
Seventy-six year old "Millie" suffered from lung cancer. She had been on hospice for over a year when I first met her. My partner social worker, "Melanie" had been the social worker for Millie and spoke so highly of her after each visit that she made. Melanie found out that her own cancer had returned and was going to have to be off work for many months due to the treatment she would require herself.
During Melanie's time off, a part-time/on-call social worker would cover for her, although would not be able to manage Melanie's entire caseload. I would manage what the on-call couldn't cover. When we were dividing up the cases, Melanie told me to keep Millie on my caseload as she would brighten up my day. She said that Millie was good for my mental health.
It was a very difficult time for our hospice department having one of our own so seriously ill. We all feared that Melanie herself would be a hospice patient before too long.
Millie had been widowed five years and missed her husband tremendously. She spoke about her death openly and was disappointed that the decline was so slow. She had two wonderful daughters who lived nearby. Both were extremely devoted to their mother.
On each visit I made to Millie's home, she would continually ask about my life. My goal was to get to know her and help her, but she was not as interested in doing that. She was always so interested in others and had such an upbeat personality. She was tiny and petite, but had so much energy. I would visit weekly when able. Millie didn't need weekly visits, but she so enjoyed the company and was such a delight to be around.
Her decline came quickly. I hadn't seen her for about a month as she had been visiting a relative in another state and returned home while I was on my own two week vacation. I was able to do one final visit to say goodbye. She was unconscious, but looked so beautiful. I struggled with letting go. It helped knowing that she was so ready. Some patients I do grieve and Millie is one of those.
TO SAY GOODBYE
I had to come by on Friday.
I had to come to say goodbye.
You looked so beautiful, so peaceful.
You were ready to be on your way.
I wasn't ready to say goodbye to you.
I wasn't ready for you to go.
You came into my life because of my own loss.
You brightened up those troubled days.
I know it shouldn't be about me,
and usually it never is.
But somehow you are different.
It is not the same at all.
I heard about your death yesterday.
I'm so glad I came to say goodbye,
but I can't get you off my mind.
You have touched my heart and soul.
You were ready to say goodbye.
You were ready to let go.
That alone, gives me peace and comfort.
So I now say to you;
Goodbye.
During Melanie's time off, a part-time/on-call social worker would cover for her, although would not be able to manage Melanie's entire caseload. I would manage what the on-call couldn't cover. When we were dividing up the cases, Melanie told me to keep Millie on my caseload as she would brighten up my day. She said that Millie was good for my mental health.
It was a very difficult time for our hospice department having one of our own so seriously ill. We all feared that Melanie herself would be a hospice patient before too long.
Millie had been widowed five years and missed her husband tremendously. She spoke about her death openly and was disappointed that the decline was so slow. She had two wonderful daughters who lived nearby. Both were extremely devoted to their mother.
On each visit I made to Millie's home, she would continually ask about my life. My goal was to get to know her and help her, but she was not as interested in doing that. She was always so interested in others and had such an upbeat personality. She was tiny and petite, but had so much energy. I would visit weekly when able. Millie didn't need weekly visits, but she so enjoyed the company and was such a delight to be around.
Her decline came quickly. I hadn't seen her for about a month as she had been visiting a relative in another state and returned home while I was on my own two week vacation. I was able to do one final visit to say goodbye. She was unconscious, but looked so beautiful. I struggled with letting go. It helped knowing that she was so ready. Some patients I do grieve and Millie is one of those.
TO SAY GOODBYE
I had to come by on Friday.
I had to come to say goodbye.
You looked so beautiful, so peaceful.
You were ready to be on your way.
I wasn't ready to say goodbye to you.
I wasn't ready for you to go.
You came into my life because of my own loss.
You brightened up those troubled days.
I know it shouldn't be about me,
and usually it never is.
But somehow you are different.
It is not the same at all.
I heard about your death yesterday.
I'm so glad I came to say goodbye,
but I can't get you off my mind.
You have touched my heart and soul.
You were ready to say goodbye.
You were ready to let go.
That alone, gives me peace and comfort.
So I now say to you;
Goodbye.
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