Monday, December 23, 2013

THANK YOU

It has been almost two months since I suffered a ruptured appendix. While in the Emergency Room, I realized that the Emergency Room Doctor and the surgeon were working to save my life. I was later told by my surgeon that “You were going down, and we pulled you back up.” Also, my primary physician, whom I saw about ten days after my hospital discharge, shared, “You were as close to death as anyone can go, and you came back.”

My recovery is slow but steady. My endurance is low, but also, I am getting stronger by the week. It is now that I have the energy to really process and think about what happened during those 19 days in the hospital. In the past week, I have been able to participate in family activities that one could call “normal” times. And boy do I appreciate my normal.

This past weekend, we attended a Christmas party at my cousin’s home. It was being with those who love you and whom you love, doing normal activities. I, now, appreciate all the love on a much deeper level. I know how quickly it can all be taken away and how very special it all truly is. My cousin lives about two hours away, which has limited our time being together. We both are determined to meet up much more often.

We were able to stay overnight in a hotel near her home, which I hadn’t been able to do until now. During the drive, I was noticing the scenery and the other drivers, and was taking in how wonderful it all was. I felt blessed to be able to see the deep blue sky, along with the normalcy of the other drivers. It all is so wonderful and so good.

This experience has brought up so many questions for me. Why was I allowed to live, when so many others have not? Why did I have to experience this at all? Is this one of my life’s lessons? I know that I have learned a lot from this experience. I hope to never forget and to be forever thankful. For which I truly am.


THANK YOU

It was a life changing experience,
although I didn’t realize it at the time.
Now weeks later and much stronger,
the reality of it all is sinking in.

The gift of life is powerful.
Thoughts of what might have been.
Thank you God for letting me live.
So much I could have missed.

Knowing each day is a sacred gift,
love feels so much stronger.
Birds soar higher; the sky a deeper blue.
The magnificence of a normal routine.

Thank you God for all your blessings.
You grace me with tremendous love.
Aware of how fragile life really is.
Hoping to never forget.

Help me embrace my blessings.
Let others feel the love.
Never to take things for granted again.
Let me forever know.

Some lessons do come hard,
but thank you for teaching me so.
Appreciating the gift of life and love,
and to never forget
       to thank you God,
              again and again.

Monday, December 16, 2013

GRAND REOPENING

Look for the grand reopening of my blog in February, 2014.  I thank you all for  your patience and support.  My blog and I will both be back as good as new.  Blessings to all. 

THE PATIENT

On October 30, 2013, after several days of stomach pain and weakness, my husband called for an ambulance and I was taken to the Emergency Room where my blood pressure was 80/50. After eleven bags of fluid, my pressure continued to stay low. Due to fluid overload, my lungs started to fill with water and I had trouble breathing.

It was then I had my first thought that I could die if my blood pressure wasn’t corrected. I was so weak, this thought had no emotion. It didn’t seem real. My surgeon said my appendix had ruptured and I was septic with an infection throughout my stomach cavity. He said I would be on life supports in the ICU with a likely hospitalization from two to three weeks.

It was about this time that I felt my body leaving. I saw my spirit floating around me. Suddenly, I was near a stucco fence that I knew was heaven. Again, with no emotion, I said, “It is not my time. I am not ready. I am going back.” I also had a sense that I was thirty years too early. Again this was an unemotional moment. The feeling felt so natural.

The next thing I remember is waking up in the ICU on life supports. Fortunately, I was off the life supports within twenty-four hours. The ICU doctor and my surgeon both assured me that ,”You are now in recovery”. I spent a total of 19 days in the hospital. I had no energy and was so helpless. My intestines were not working and I had a partial bowel obstruction. Because of that, I could not eat or drink anything for two weeks. My nutrition came in the form of IV bags.

What kept me going was the love and support I have in my life. I have always felt blessed by having so many in my life that I care about and so many that care about me. This is what it is all about. In addition, the hospital staff were so caring and loving toward me and my needs.

My recovery is slow as I have limited endurance, but every day I am getting better and doing a little bit more. Another blessing is that I will have no after effects from this experience. My surgeon said I will be as good as new. I look forward to having normal back, but know that my normal now will involve feelings of being blessed by good health and being able to do those “normal” things that we all, at times, take for granted. 

 
This has been a difficult time, yes, but overall, there have been so many amazing, priceless moments. I have learned so much by having this experience. With difficult times, I realize, that if one has a good support system, one will get through. The difficulty will pass, but the support will always remain. As one friend said to me, “This is a tough situation, but you are tougher.”



THE PATIENT


She had never been through anything like this before.
It seemed so sudden and came on strong.
No energy to process what was happening.
She didn’t realize how sick she really was.

Emergency room, surgery, ICU, life supports.
Dependent upon all who came along.
Being so helpless was somehow humbling.
Surprised by all who were there.

She felt her spirit leaving.
She was up near heaven’s wall.
She knew it wasn’t her time today.
“I’m not ready; I’m going back.”

She knows now why nurses are called angels.
Not by seeing any wings or halos,
but the love she felt from their hearts
was confirmation for it all to be so.

A humbling, awe-inspiring experience.
Feeling blessed by all the support.
I know all of this to be true,
as for the first time,
this particular patient
          was me.

 

Saturday, October 26, 2013

LIVING THEIR FAITH

“John”, sixty years old, suffers from brain cancer. John lives with “Nina, his wife of thirty-one years. They have two adult children and many extended family members living nearby. John’s family is very devout in their faith. Their daughter, “Shawna”, twenty-five, lives on the third level of their home, while their son, “John, Jr”, thirty, lives close by. John’s elderly parents and ninety-nine year old Grandmother live about two miles away.

John’s cancer was discovered two years ago after he suffered a seizure. It was then that John had an “out-of-body” experience. That event squashed any fear that John had about dying. John and his family’s strong Christian belief give them comfort, support and peace. This family not only talks their faith, but it is so obvious by their kindness to others, that they also live their faith.

John came onto hospice eight days ago due to a sudden decline over a two week period. All thought that John would die within days. He is hanging on as has had a few short awake and alert moments, although mostly spends his days sleeping. He is minimally responsive to his family and eating very little. John’s family has rallied to give their love and support. The family’s minister calls daily to check in. It is this family’s deep devotion that carries them through.

The moment one walks into the family’s home, you feel the love. Last week when I went out for the first time to visit, I stepped into John’s bedroom to check on him. Shawna was caressing her father’s face in such a loving, endearing way, while whispering soft words to him. I felt I was witnessing a miracle as what I saw was pure, unconditional love from a daughter to her father. John has taught his children well. Their kindness and love reaches out to all.

The family is an inspiration to all who meet them. I have visited twice, and each time, there is extended family visiting for support. They all pitch in and do what they have to do to help each other. John and Nina are role models for love, faith and kindness. It is such a reminder of what is so right, and, in addition, it serves us all so well.


LIVING THEIR FAITH

 

He has been the patriarch of the family.
He’s the one they’ve turned to for guidance.
He has always been there for everyone.
His leadership; his faith; a testimony to all.

Soon, family dynamics are about to change.
They all will have to find their own way.
He no longer will be around like before.
His courageous battle is nearing the end.

Getting such a diagnosis
had to have been quite a shock.
But an “out-of-body” experience
increased his faith while diminishing any fear.

He is leaving behind an elderly grandmother.
His parents thought they would go first.
The family’s strong, devout faith keeps them going.
They know it is all in God’s hands.

His grandmother visited him the other day.
Still spry and young at ninety-nine.
She questioned, “Why him and not me?”
Suddenly the answer was loud and clear.

“I am here so that I can pray for him”.
Acceptance.
          Devotion.
                    Faith.
 

Saturday, October 19, 2013

GRAIN OF SAND

Eleven year old, “Hailey” lives with her father, “Danny” and step-mother “Sheri”. Hailey has never known her own mother. Her father raised her as a single dad until Sheri moved in three years ago.

Hailey has a very large, extended family. The family all live nearby and are very close and loving. Hailey has tremendous support from grandparents, aunts, uncles and cousins. The entire family was gathered together to celebrate the life of her grandfather, who had died three days before after a long illness.

During the celebration, Hailey and Sheri had an argument. Sheri was upset so went outside to cool off. She went to sit in her van that was parked in front of the house. A little while later, Danny went to check on Sheri and found her unconscious. Danny, with the help of his brother, tried CPR to no avail.

Sheri had a lifelong heart problem, but still it was quite a shock to everyone. Hailey’s grandmother called me and asked if I could come out to talk with Hailey. She added that Hailey blamed herself for her step-mother’s death because of the argument.

When I walked into the living room, Hailey was sitting on the couch. She looked so sad. Hailey had met me before as I was her grandfather’s hospice social worker. I told her why I was there and asked her if it was true that she blamed herself for her step-mother’s death. She stared at me with saddened eyes and slowly nodded yes.

I asked her about the number of conversations she thought she had with her step-mother. She admitted to thousands. I told her that each conversation is like a grain of sand. Over time, the pile will slowly grow larger. I cupped my hands and told her to imagine that sand pile and to throw as hard as she could, the grain of sand that represented the last conversation she had with Sheri. I then said, “Not much changes, does it?” Her eyes widened, her face lit up and she showed me the most amazing smile. She got it. She said she understood. She looked so relieved.

Children will always amaze me. They want to learn and will listen intently. They are like a sponge and will soak up what they need in order to carry on. It seems at times, that we, as adults, learn more from children, than visa-versa.


GRAIN OF SAND
 

They had argued shortly before.
It doesn’t really matter what about.
Their last conversation before she died.
She felt it was all her fault.

She had just lost her grandfather.
It had only been three days.
Now her step-mother so suddenly.
She must be the one to blame.

She didn’t have to say anything.
Her body language was shouting out loud.
Her face was drawn; she looked so sad.
A huge burden for one so young.

I told her about a pile of sand.
Each grain; one conversation with her step-mom.
Good or bad, adding one grain with each discussion;
there is never any notable change.

Her eyes widened; her face lit up.
A huge smile spread across her youthful face.
She got it; she understood.
A heavy weight lifted
by one tiny grain of sand.
 

Saturday, October 12, 2013

MAN CAVE

Fifty-four year old, “Duane”, suffered from colon cancer. Duane lived with “Trudy”, his wife of thirty-two years. They have three adult sons who are devoted to their parents. Growing up, the boys always brought their friends over and Trudy would dote on all of them. Trudy said she had about eight additional “adopted” sons.

Duane converted his two car garage into his “Man Cave”. He loved being out there surrounded by his large screen television, a comfy sofa with two recliners and a refrigerator holding his favorite food and drink. Duane made toys, lamps and picture frames out of wooden match sticks. Duane had many of his creations displayed in the garage. It was where he did his work.

Duane came onto hospice about six weeks ago when it became apparent that he was declining. My weekly visits were spent in the Man Cave with Duane and his family. He would proudly show me many of his match stick creations.

Duane took a rapid decline two weeks ago. He stopped eating and became very weak. The hospice nurse wanted to order a hospital bed so that he would be more comfortable, but Duane refused to leave his Man Cave. Even though he was so weak, he would will himself to sit up on the couch. This past week, Duane no longer was able to sit up. He spent his final days lying where he was most comfortable; his couch.

Hours after he died, family discovered two pennies near his couch side by side. They knew it was a sign from Duane letting them know that he was okay. His son, “Dennis” noticed the coins first. He turned and called out to his family to come to the Man Cave to see. When Dennis turned his attention back to the two pennies, he realized that one penny had moved and was now lying about six feet away from the other coin.

No one had touched the coins and Dennis only looked away for a moment. It was then that the family were truly convinced that it was Duane and he was doing just fine enjoying his new Heavenly Man Cave.

Later that night, Duane’s six year old granddaughter, “Shiloh”, saw her grandpa in the clouds. She says she felt love. The family experienced many other moments convincing them all that Duane was still checking in with them.

Duane loved his coffee, but wasn’t able to drink any for several months because it upset his stomach. At 3am the following morning after his death, his daughter-in-law woke up to the smell of coffee. She checked throughout the home to find that there was no coffee brewing. In addition, the family are finding copper pennies everywhere. It gives them great peace knowing that Duane is doing well and is still around.


MAN CAVE

 
He loved his Man Cave.
His favorite place to hang out.
One would typically find him there on the sofa
watching his large, flat-screen TV.

His sons were often with him,
reminiscing about fish stories of the past.
Freezing by the river;
          holding tight to their poles;
                    the big one that got away.

His illness took a sudden turn.
He declined rather quickly.
He refused to come inside.
Not budging from his couch.

He died yesterday in his Man Cave.
Peacefully they say, with his eldest son by his side.
Dying where he always lived;
his favorite spot to be.

They weren’t surprised at all
when he showed them he was fine.
Leaving a message for all of them
so that they would,
          without a doubt,
                    know that it was him.

Again, saying hello
from the Man Cave.


 






 

Saturday, October 5, 2013

TASKS

Sixty-five year old, “Barb”, suffers from peritoneal cancer. Barb lives with, “Ray”, her husband of thirty-eight years. They have two adult sons who live nearby with their families. After their workday, both boys will drop by to check in on their parents. Barb’s sister, “Celeste”, has come from the Midwest to stay for the duration to help Ray in caring for Barb.

Barb spends most of her days in bed now. She has a poor appetite and is eating very little. Barb still manages to get to the bathroom using her walker. Due to weakness though, Ray or Celeste will walk next to her in case she starts to fall.

During my visit today, Ray, Celeste and I sat down and spoke in the living room. Barb was asleep nearby in the family room. Ray was sharing stories about Barb. He says she has always been very organized. He added that Barb is always several steps ahead of him as she is constantly thinking about future tasks that are needing to be done. Barb always wants to be in control of her life and their activities. He said she is very good at it.

Ray added that the system has always worked well for them as he had the luxury of focusing only on the current task at hand. Ray shared that, over this past weekend, Barb was telling them how she wants her memorial. She was informing them where to have it; what music she wants etc.

Ray showed sadness while sharing Barb’s final request of him. Fortunately, Ray and the family want what Barb wants, and will follow her wishes. Letting go is never easy, but when the patient is so dependent, oftentimes it is a blessing. I believe any of us, when our quality of life is diminished, could find ourselves also saying, “I am done. Let me go.”


TASKS
 

She has always been the one in charge.
She stays organized by making her lists.
She often has had trouble sleeping through the night,
as her brain works overtime filtering tasks.

She makes it easy for him.
He only has to focus on the task at hand.
He doesn’t worry about what’s next.
It has always worked well for them.

Even now when she is dying,
she doesn’t want to lose any control.
She is arranging her future memorial;
telling them what to do; what she wants.

Her quality of life has diminished.
She is sleeping more and eating less.
They have increased her pain medication.
She has told her family she is ready to go.

She had one last item on her list;
one final task to complete.
She knows it wasn’t easy for him to hear;
but this morning she did ask;

“The best way to show your love for me
           is to let me go.
                    Just let me go.”
 

Saturday, September 28, 2013

HE'LL LAUGH

“Ray”, fifty-seven years old, suffers from bladder cancer that has spread to his lungs and lymph nodes. He has had health problems his entire life. When he was six years old, he was run over by a truck which resulted in a lifelong back problem. Ray went on disability ten years ago due to that back injury.

Ray has been married to “Toni” for thirty years. They have three adult children, who all live nearby. Toni works part time as an attendant for an elderly woman. She gets minimum wage for her effort. The couple struggle with finances due to their limited monthly income.

Ray was admitted to hospice as his treatments were no longer working. His cancer had metastasized to where there was an obvious tumor on his face and hand. Ray is always in a good mood and laughs so easily. He will talk honestly about the pain of the two tumors. The next thing you know, he is telling you a silly joke or story and then he’ll laugh.

Ray does worry about Toni as he feels she is the one carrying the burden. Ray is unable to handle many of the tasks he used to be able to manage around the house. Toni will openly talk about her stress and, as she terms it, “the weight on my shoulders.” Initially, Toni worried that once Ray was on hospice, he was going to drop dead at any moment. I talked with her about the end of life process and typically what happens. She was relieved when she understood that Ray likely will be around a little while longer.

Our hospice receives donated funds from families. The donations all go back to our patients and families. We use the funds to purchase appropriate booklets and handouts which we routinely hand out. In addition, when a family’s income is low and they are not able to pay a basic expense, we are able to utilize those donated funds.

When we admitted Ray to hospice, two weeks ago, I was able to get hospice team’s approval to pay for his cremation expense. Ray and Toni were so grateful, they could not believe it. I discovered from my visit yesterday with the couple, that their electricity will be turned off in four days if they don’t pay the balance. Again, I was able to get team approval to pay the bill.

I called Toni to say I would need to come out today to pick up the bill in order to present a copy of it to the proper manager for payment. An hour later, as I walked into their home, Toni said that Ray cried when he heard what we had done. Ray emotionally shared that, "No one has every done anything like that for them before." They were so moved and thankful, it melted my heart.



HE’LL LAUGH
 

Life has been hard for them.
They have struggled for years.
They work so hard to stay ahead,
but somehow are always one step behind.

They talk about the hard times.
They’ll share the worries and the pain.
He’ll tell you a funny story about his best friend;
          and then he’ll laugh.

They don’t have fancy furniture.
They don’t wear designer clothes.
He’ll smile at you and share a corny joke,
          and then he’ll laugh.

They count their blessings every day;
of which they feel abundant.
Not one possession do they consider.
It’s all about family and their many friends.

We covered the cost of his funeral plans.
We paid their late electric bill.
“No one has ever done
anything like this for us before.”
          And then he cried.

Saturday, September 21, 2013

HER JOURNEY

Fifty-one year old “Sam” suffers from lung cancer. She was diagnosed about a year ago and has had a slow decline. Sam was admitted to hospice three months ago as she was bedridden, eating very little and weakening. The family and hospice all believed that Sam had only a few weeks to live.

Sam’s sister, “Vicky”, moved in with Sam to help out. Vicky took a leave from her job in order to be available to her sister. Sam’s only other family is her son, “Brian”, who lives in the home with his wife, “Abby” and their two daughters. Brian works and is available on the weekends.

About a month ago, Sam started to slowly get stronger. With her increased energy, she was able to sit up more in the living room, initially using her wheelchair as a walker. During this time, she has improved enough to get out of the home and enjoy her life. She no longer needs a wheelchair or walker, but does say she still gets tired easily. She says she has gained weight because she is eating a lot more.

Sam has hope for her future. It appears that she may be in remission from her cancer. Her doctor ordered a scan in order to see the status of her disease. Today, I heard that her cancer has spread to her liver and glands. The doctor now predicts a sudden decline prior to Sam’s death.

The news saddens all of us, but Sam has had so many joyful days believing that her cancer was receding. I see her experience as a powerful lesson to us all. Embrace today as that is all that any of us ever have. Each day is a precious gift. This is a strong reminder at how precious that gift is. Life is so fragile and none of us know where the journey will lead us.



HER JOURNEY
 

Each of our journeys have twists and turns.
Some corners we choose to go around;
others we don’t see coming.
In the end, we all are surprised more often than not.

Her journey had been fairly calm and routine
until cancer came to call a year ago.
She revised a new course; picked up the speed;
altered her route around the obstacle on the road.

There was a slow decline like predicted.
To no surprise, she became weak and bedridden.
Family rallied around to give support.
Everyone thought it wouldn’t be long.

Then suddenly, things began to change.
She is now getting stronger day by day.
She’s eating more and gaining needed weight.
She is enjoying her life once again.

Hope is now a word in her vocabulary.
There is a small light at the end of the tunnel.
She is making plans and getting out more.
A long, healthy journey is now in her prayers.

A routine scan surprised everyone.
The cancer is still growing and spreading its wrath.
The doctors say her decline will be quick.
Her journey has taken another surprising turn.

She is teaching us all a valuable lesson.
Enjoy today as that is all that we ever have.
There are no guarantees for a tomorrow.
Embrace your journey,
          no matter where it leads you.
 
     
    

Saturday, September 14, 2013

COMFORTING WORDS

“Dave”, sixty-six, was diagnosed with prostate cancer two years ago. He was admitted to hospice yesterday because of a recent, dramatic decline. Dave lives with his wife of two years, “Joyce.” I went out today to meet with the family. When I walked into the home, Dave’s two best friends were there helping out.

Joyce stated that three weeks ago, Dave was riding his motorcycle. Today, Dave is confused, weak and has not eaten for two days. It appears that he is into his dying process. I called the hospice nurse because the family was struggling to keep Dave from falling. He was restless and kept trying to get up off the hospital bed. Dave is very weak and is wobbly on his feet. The family said that Dave was up all night and Joyce did not get any sleep.

The nurse came out within the hour and informed the family that Dave likely has hours to days to live. The family was aware prior to our visit today, but hearing it out loud can be shocking. The nurse explained things so clearly in the kindest way possible. Her words are like gentle hugs.

The family started asking appropriate questions and it was apparent that they did hear what the nurse was telling them. The nurse opened up the conversation to where it was easy for me to introduce tough topics regarding funeral planning, giving Dave permission to go etc.

A favorite phrase of mine is when she first admits a patient to our program, she will say, “Hospice will follow you for the duration of your illness.” What a gentle way of saying we will be with you until your journey is over. She always amazes me and it always is a joy to see her in action.


COMFORTING WORDS

 
Hospice conversations can be emotional.
Families, quite often, are overwhelmed.
Comprehending what is being said is difficult
in addition to being an overload of information.

Our goal is to relay important facts,
knowing the subject matter is stressful.
We want them to utilize our support
with perpetual comfort wherever we can.

This is often a challenging goal.
One must meet the family where they currently are.
We must find the subtle line so they softly can hear.
Being direct is often hurtful where listening stops.

I worked with one of our special nurses today.
Over the years, she has taught me well.
She has a way of relaying information from her heart,
in the kindest, most gentlest way I know.

I have stolen many amazing expressions from her.
Somehow she knows perfectly how to coin a phrase.
She will let families know she truly hears them,
in words that soothe and always console.

The family today was no different.
He has hours to a few days at most.
The family is appropriately sad, but wish him peace,
by truly hearing her amazing,
          thoughtful,
                     comforting words.

 

Saturday, September 7, 2013

TROUBLES

Fifty-seven year old “Doug” was diagnosed with bladder cancer two years ago. Unfortunately, chemotherapy did not work for him. His doctor told him that there was no more treatment available, as radiation was not a viable option for him. Unfortunately, his cancer has spread to his bone and lymph nodes.

Doug has been married to “Tanya” for thirty-six years. They have four adult sons; of which three live in the home, along with Doug’s handicapped brother. All four of their sons have some emotional and physical needs ranging from alcoholism, bi-polar disorder, post traumatic stress disorder; just to name a few. In addition, their one son, who doesn’t reside in the home, cannot raise his six year old daughter, due to his own emotional challenges. Doug and Tanya have guardianship over “Kaley”, their granddaughter. Fortunately, throughout the hard times, this is a very devoted, close-knit family.

Through all of these struggles, Tanya has been the anchor that has held this family together. Doug has been on disability for over ten years due to back problems prior to being diagnosed with cancer. Tanya works part time as a hired caretaker for an elderly woman. Tanya says she has done it for seven years and feels supportive by her patient as it is someone with whom she can talk with.

Even though Doug has been ill for over two years, Tanya has been able to manage and cope, praying that someday he will be cured. Since Doug was admitted to hospice two days ago, the reality of his situation has come to a head. She has switched from hoping for a cure, to feeling that he may die at any moment. The strain has her easily in tears to where she cannot stop thinking about it.

Tanya has always found a way to respond to her troubles. Her electricity may be turned off within four days unless she pays the $400 overdue bill. She declines any help, as feels she will find a solution. Her philosophy is “Things always have a way of working out.”

Tanya was receptive to meeting with a bereavement counselor weekly. In addition, I will visit weekly to give her the additional support. Hopefully between hospice’s and her family’s support, she will be able to get through this difficult time.


TROUBLES

Her road has been rough.
It’s been one thing or another.
Each time, she’s been able to keep on going,
          until now.

She is raising her young granddaughter,
as her son can’t handle the task.
Her other sons can’t make it on their own,
so all three have recently moved back home.

No one is working but her.
Part time; minimum wage.
She loves her job caring for another.
It’s where she gets her needed support.

It’s been a struggle to pay the bills.
There just isn’t enough money coming in.
It has always worked out somehow,
          until now.

Her husband is dying; she sees the decline.
There is nothing she can do.
Her tears flow so easily, she can’t stop crying.
Now, for the first time, she’s the one needing help.

She has always been the one they all turned to.
Now it is their turn to support her.
She has never asked them for help before,
          until now.

Troubles.

Monday, September 2, 2013

SAVINGS

Sixty-six year old “Yvonne”, suffered from lung cancer that had spread to her bones. She was on hospice for only a few weeks as her decline was rather swift. Yvonne lived with her husband, “Joseph”. They had one son, “Jason”, who was twenty-five. Jason was studying medicine at Ohio State University. One could instantly see how proud she was of him, as her face would light up when speaking about him.

Yvonne was also so proud of being married to Joseph. She would always say how lucky she was to have such an attentive husband. Joseph was a high school math instructor and was off for the summer so he was available to care for Yvonne during her rapid decline. The two were devoted to each other. Joseph was so aware of Yvonne’s needs before she even was aware herself.

Jason flew home to say goodbye to his mother. He knew this would be the last time he likely would see her. I made a visit and was able to meet Jason and give support to the entire family. We talked about how difficult it is to say goodbye. How can one condense twenty-five years of having such a wonderful mother in one five day visit?

During Jason’s visit, Yvonne didn’t speak much as she slept most of the time. Due to weakness, her voice was very soft. Jason, like most college students, didn’t have much money to spend on extras. Over the course of twenty years, Yvonne would hide any extra cash she had all over the home. She would put it in pockets of clothes or in the back of drawers and closets. It was amazing that she was able to remember all her secret hiding spots.

The day before Jason had to return to school, Yvonne directed Joseph and Jason all around the home. The money was for Jason so he would have extra cash while in school. With every dollar hidden, Yvonne was giving love back to her family in a way she knew would make a difference. She never saw what a beautiful person she was, but always appreciated her husband and son. She was the most amazing one of all. Yvonne died three days later and I know she was at peace knowing her son would be okay. A mother’s final gift to her family.



SAVINGS

 
Her family was her primary focus.
Proud and lucky were words that she used.
Her husband so attentive;
          her son studying hard.

She never put herself first.
Her focus, always on them.
Keeping the house up for her husband;
enlightening her son the value of school.

She secretly hoarded money away.
For years, she hid cash all over their home.
Extra dollars hidden deep in the closet;
an old coat pocket stuffed with spare change.

Her son took a break from his studies.
He flew home to tell his mother goodbye.
He knew this was the last time he’d see her
as her disease was nearing the end.

She could hardly speak any longer,
but she had something important to share.
She directed them all over the house
to look in old boxes; to search dresser drawers.

They were dumbfounded; amazed
as money was stuffed everywhere they looked.
Her one final gift to her family so proud;
more than twenty thousand dollars
          no one ever knew that was there.

Saturday, August 24, 2013

FINAL WORDS

Eighty-eight year old, “Rhonda”, suffered from lung cancer. Rhonda had been widowed for over twenty-five years and had always been very independent. Rhonda had three adult children, who all lived nearby. All three were actively involved in their mother’s care and increasing needs.

Rhonda was on hospice for less than two months. I only made a few visits, but each time I walked into her bedroom, her face would light up and she would smile. She was pretty weak the entire time she was on our program. Much of her day was spent lying in her hospital bed. The family hired a twenty-four hour caregiver to assist mom. It worked out well for the family, as then they could focus on being Rhonda’s children and not her caretaker.

This was a very devoted family and it was so clear how much Rhonda loved her children and grandchildren; of which there were many. Rhonda died two days ago and I called her daughter, “Denise” to offer condolences. Denise shared stories about her mom; the most wonderful being Rhonda’s last words to her daughter.

In addition, Denise shared that last week her mother wanted everyone in the family to come for a visit. Denise assumed Mom wanted to give everyone one last goodbye. The gathering was planned for this evening. She said “I guess my mom won’t be there, after all.” I assured her that her mom will be there in spirit. The family just has to feel her presence.

The family is at peace about their mother’s death as Denise said it was very peaceful and very quiet. It is what most of us hope for.



FINAL WORDS
 

I called her to check in.
I wanted to offer support.
The family had suffered another earlier loss,
so I hoped they were doing alright. 

She said she was doing just fine.
“I have my moments of missing her,
but her passing was quiet and peaceful.
We knew she was ready to go.”

Her family was always her priority.
There was never any doubt.
She loved it when all were together.
They were that important to her.

Her maternal instinct rang true.
She was still taking care of them,
for she waited for all to leave;
then, quietly slipped away.

Her final words to her daughter
have given the family great strength.
Words they won’t soon forget;
letting them know she is fine.

With her daughter at the bedside,
she softly said, “I’m happy.”
Two simple words so profound.
Then, hours later she was gone;
          peacefully.

Saturday, August 17, 2013

FIGHT!

Sixty-two year old, “Laura, suffers from colon cancer that has spread to her lungs. Laura was diagnosed two years old and had been doing quite well, until three months ago, when she started a slow decline. It was then we admitted her to our hospice program.

Laura has been married to “Dennis” for forty-three years. They have three adult children and eight grandchildren. Family all live nearby and visit frequently. This is a very close, religious and devoted family.

Laura has always been strong-willed with an independent personality. She is used to being in charge. Even with her limitations, she works at least one day a week as an office manager. Laura is fortunate as she can go in as often or as little as able. The past few days, though, Laura has been weakening. She is starting to have more bad days than good days.

During my routine visit today, Laura spoke a bit about her nineteen year old grandson who left today for a two year mission for the church. While he is away, family can only e-mail. She shared how hard it was to say goodbye to him knowing that she likely will never see or speak to him again.

She then started to cry saying that she was waiting for me to come as she had a question she needed to ask me. She asked if it was okay for her to continue to fight her disease. She spoke of feeling guilty as this has been going on for over two years. She added that she feels like a burden to her family.

I shared with her that her family is with her out of love, not burden. They need to be there for her as she has always been there for them. I said that there is no right or wrong way to do things, but Laura’s way. I said we all do ourselves best. I shared a quote I recently read that seemed so fitting, “Be yourself, everyone else is taken.” I added that it doesn’t matter what others think. The important thing is what you think. I told her to follow her heart and she won’t go wrong.

I asked her to share her feelings with her family, if she could. I know they will validate all what I said to Laura. I told her that what she was feeling was called, “normal”. The important thing is to do it her way. Even if she did stop fighting, her journey will be what it will be. As it is for all of us.


FIGHT!
 

She was waiting for my arrival.
There was something she needed to know.
Tears flowed as she asked,
“Is it okay for me to keep fighting?”

She’s been sick for over two years.
There’s been good days as well as bad.
She feels guilty as thinks she’s a burden to them,
but wants to continue to fight.

I told her, family is there as much for themselves.
They are with you out of love, not obligation.
Their need to be there comes from within.
You raised them all to care that way.

They want you to do this your way.
Follow your heart to what is right for you.
You guide the direction of your journey.
Keep up the fight for as long as you need.

Let them know how you are feeling.
They will tell you their truth.
Without a doubt, all would agree,
“Mom, you just continue to fight,
          until you’re done.”
 

Saturday, August 10, 2013

A MIRACLE

Eighty-one year old “Shelley” was diagnosed with pancreatic cancer nine months ago. Pancreatic cancer is one of the most deadliest forms of cancer. Many patients only survive a few months after diagnosis. Shelley was hospitalized three months after diagnosis and, at that time, was close to death. It was then, when she was discharged home to hospice.

Shelley has been married to Jack for thirty-five years. Jack and Shelley had been active bicyclists. A thirty mile bike ride was routine for them. They belonged to a bike club and traveled all over the world riding their bikes. They both were in excellent health and it came as quite a shock when Shelley was diagnosed with her cancer.

Shelley has such a positive attitude about life. She feels blessed by the tremendous support she has from all of their friends and family. She and Jack are very social and, if they weren’t entertaining, they were off bicycling with friends.

When Shelley came onto hospice, she was quite weak and spent a lot of time home as did not have energy for much more. To her doctors and the hospice team, it appeared she had only weeks to live. Then, suddenly, she slowly started to get stronger. She was eating more and sleeping less. She started to entertain. At first, Jack would cook for friends, but then Shelley started to take over the food preparation as well.

Jack and Shelley had just finished a thirty mile bike ride when I made a visit three weeks ago. Her doctor had ordered tests to determine the status of her cancer. Her blood work showed normal readings. Shelley's doctor told her last week that she was not only in remission, but she was cured.

The hospice nurse and I went out today to do one final visit with Shelley. Shelley is an atheist and I was surprised to hear her call being cured a miracle. Shelley also shared that a friend, who is very spiritual, told her about a dream that he had. He said an angel came to him and told him that Shelley will be okay.

Whether it is a miracle or not, something fantastic happened no matter how anyone defines it. Shelley is a great example for others to never give up. No one knows where their journey will take them. I will likely share Shelley’s amazing story to many others as I travel along my own journey.


A MIRACLE

 
She had a deadly cancer.
Most never do survive.
She declined like the prediction.
We all thought weeks at most.

She went through all of the treatments.
The side effects left her weak.
She had no fears about dying.
Her atheist belief made sense to her.

She cherished each of her days,
preferring to focus on the positive.
She was realistic, although determined
to make it through another day.

Then, she started to slowly get better.
All thought a temporary high.
Her doctor was amazed and overjoyed
when test results were totally clean.

Her doctor said she was one in a million.
“You will likely die from something else.
You are not in remission, but cured.”
He was as surprised as all of us.

Even though a non-believer,
she is the first to admit,
somehow the stars have all aligned,
as all she can say is,
          “It’s a miracle!”
 

Saturday, August 3, 2013

HER SCRIPT

Eighty-one year old “Bonnie” suffered from end-stage heart disease. She was a devoted Catholic and received comfort from its doctrine and teachings. She had a strong belief in heaven and the afterlife. She knew her loved ones, who had passed before, were there waiting for her.

Bonnie had no fear of dying. Her one fear though, was that she would be alone when it happened. Bonnie was widowed and lived alone. She had one son, “Gary”, who lived nearby. When Bonnie got to the point that she could no longer be alone, she hired an attendant. The attendant would be with Bonnie five days each week, while Gary stayed with his mom the other two remaining days.

Bonnie died at 9:45 last night. The hospice nurse had just walked in when Bonnie took her final breath. Two hours earlier, Bonnie’s breathing changed and the family called hospice to inform them of the change. The nurse said that she could be there in a few hours. It was then that Gary called Bonnie’s sister to come over.

When Bonnie took her final breath, Gary was holding one of her hands, while her sister was holding the other. Other family members were standing nearby. It was comforting to the family knowing that Bonnie did not die alone and that they all were able to be there for her.

I called Gary today to offer condolences and my sympathy. It was then when Gary told me about his mom’s script. He is at peace with her dying as he knew she was ready and she did not die alone. He said she set the stage to have the hospice nurse and the family there when she took her final breath.

Bonnie’s brother, “Bob”, had died a few years ago. When Gary called his cousin, Bob’s daughter, to inform her of his mother’s death, his cousin told him something amazing. His cousin knew how much Bonnie was ready to go and so she spoke silently to her father and said, “Help Aunt Bonnie cross over.” Gary’s cousin said that she relayed these thoughts to her father at 9:35 last night; ten minutes before Bonnie died. It gives Gary peace to hear what she had to say, as he knows his mom was not alone when she transitioned to the other side. He truly believes, that as they were releasing her, other family members were receiving her.

Gary says that he knows he will have some tough days ahead, but is at peace at how everything turned out. I have no doubt, that in time, he will be fine.


HER SCRIPT
 

She never had a fear of dying.
She has been ready for a while.
She hates living this way.
She can’t wait to let go.

She knows she will be with family
when she crosses to the other side.
Her parents; her brother; so many others.
This is taking way too long.

Her son says she wrote a script.
She wished to never die alone.
She wants her relatives with her
when it is her time to go.

She took her final breath last night,
with her family by the bedside.
Her son; her sister; each holding a hand.
Her final wish did come true.

She got the lead role in her screenplay.
She played her part so well.
No rehearsals ever needed,
for her “once in a lifetime”
          script.


 

Saturday, July 27, 2013

WHAT HE KNOWS

“Leon”, eighty-two, was just diagnosed eight days ago with inoperable brain cancer. Leon is widowed and lives alone. Leon’s wife died of cancer seven years ago. Her slow decline left an impact on Leon as to how she suffered through her ordeal. Leon was at his wife’s bedside as she was dying in the hospital. It was then he told his three sons, “I want to die quickly in my sleep”.

Leon’s three sons knew something was wrong about two months ago, when their father seemed to be getting forgetful and confused. Since the diagnosis, Leon’s middle son, “Mike” has moved in to be with his father. Mike and his two brothers rotate and take turns staying with their father. All three are devoted to him.

I went out today to open Leon to hospice. All three sons were present. While Leon was sleeping, we all sat and talked in the kitchen. The boys shared how their father was a safety engineer for the state and wrote policy about how to block off the highway when road work was needing to be done. Previously, there had been no policy and each crew manager was left to figure out things for themselves. They said their dad can simplify any complex situation. It was so obvious how proud the three boys were of their father.

Toward the end of my visit, Leon woke up and I was able to speak with him. He conveyed stories about his wife. He told the stories of their families by describing the various photos that were hanging on the living room wall. As I was leaving, I told Leon that I would be back in two weeks to check in on him. He told me, in an unemotional voice, “I won’t be here then”. I attempted to have him say more about that, but with his confusion, he drifted off into another topic.

After learning about Leon from his three sons, somehow I wouldn’t be surprised if Leon did die before these next two weeks are up. For Leon, it is just the way it is.

Addendum: Although unexpected, Leon’s forecast did come true. Leon died this morning, seven days after sharing his prediction. Somehow I am not surprised. Way to go, Leon!


WHAT HE KNOWS

 
He just found out a week ago,
there is nothing to be done.
An explanation for all those symptoms.
He just wants things to move fast.

He saw his wife suffer with her cancer.
How it slowly took away her life.
He knows the heartbreak she went through.
He hopes to die in his sleep.

He has always been a meticulous thinker.
He knows how to maneuver around details.
He is honest and always tells his truth.
He shares what’s on his mind.

He can simplify any complex situation.
He will clarify with a few, intelligible words.
His sons are at peace about his wishes.
They know he’ll have his way.

I told him I would see him again in two weeks.
He said he won’t be here.
I believe and his sons believe,
it is just something
          that he knows.
 

Saturday, July 20, 2013

JUST ASK HER

Seventy-one year old “Julie” suffers from lung cancer. Julie lives with her partner, “Maury”. They have been together for twenty years. Maury is a musician and is out of the home during the day working on his music. Julie spends most of her days home alone. She is on oxygen, but is able to maneuver around her home safely and take care of her needs.

Julie has a very large network of close friends. She is very devoted to them, although recently it has been getting more difficult with all the visits and phone calls. She has been slowly getting weaker and has hired part time attendant care to fix her meals and do some light housekeeping for her.

Julie has two children, both of whom live out of state. Her son, “Josh” lives in Washington State while her daughter, “Kathy” lives in Switzerland. Kathy flew over to be with her mother a few weeks ago with plans on staying for the duration. Kathy has her own health problems which leaves her exhausted at times.

The family asked me to make a visit as Josh will be in town. Kathy said they had a lot of questions about taking care of their mom. Julie is very strong willed and, I wasn’t at all surprised, that Josh and Kathy are the same. They all speak their truth no matter what the consequence. They respect each others opinions, even though they know they are at odds on many topics.

Josh and Kathy are very specific and wanted detailed answers on how best to care for their mom. Both speak very meticulous and wanted answers back the same. They asked me about what other families do. I said everyone has individual needs and every family handles things in ways that work for them.  I told them that it really isn’t all that complicated. When in doubt on how to help mom, “Just ask her”.

They both were surprised by my answer as they had never thought to do that before. Julie was then able to share her perception of her needs and concerns. This family will continue to struggle with the small details, but I hope that, with any uncertainty, they just remember to ask mom about what she needs and thinks.


JUST ASK HER

 
She raised them to be strong.
She taught them to speak their truth.
They both have distinct opinions,
although unsure about what to do.

He is decisive and to the point.
She needs to openly process her thoughts.
Both want what’s best for their mom,
even though they do not think alike.

The talk to each other about what to do.
They talk about their different ideas of a perfect plan.
They need specific direction on how to start.
They want to know what other families do.

They want easy answers to their complex questions.
No two family’s needs are alike.
To find out what your mother needs,
“Just ask her”.

They both seemed surprised by my answer.
They never thought to do that before.
Your mother will design her perfect plan.
She knows what she needs.

It is not that complicated or involved.
No need to think so exhaustive.
Mom will know what to do.
When in doubt, all you have to do is,
          “Just ask her.”
 

Saturday, July 13, 2013

HALF FULL

“Barbara”, eighty-one years old, suffers from end-stage cardiac disease. Due to his drinking, Barbara had been separated from her, now deceased, husband for many years. Barbara has three adult sons. Two live out of the area, while her youngest son, “Gavin”, lives about thirty minutes away.

Gavin’s two brothers have limited involvement with their mother. Gavin shared that on Mother‘s Day or their mom‘s birthday, the two eldest brothers do not even call her. The estrangement is a result of theft, anger and entitlement from the two sons. Gavin has come to terms with his brothers’ personalities and has accepted the situation as it is. Barbara still dreams that her three sons will all come together one day and get along.

Barbara was admitted to hospice three months ago. Initially, she was doing quite well. Recently, she has declined quite suddenly to where she is bedridden, weak and sleeping most of her days. If one could guess, it looks like she has less than a few weeks left to live.

When I first met Gavin and Barbara, I was impressed at how open both of them were with their emotions toward each other and their feelings of grief. When I discovered that Gavin was a retired policeman, I was surprised. One can only imagine the horrors and heartbreak he witnessed throughout his career. He sees the positive in everyone and everything. He speaks about how thankful he is for his life and always counts his blessings.

Gavin spends half the week with Barbara and the other half with his own wife and two young sons thirty minutes away. He and a hired caretaker share Barbara’s care. It works out well for all.

I made a visit today and, for the first time, Barbara slept through it all. She typically is such a sweet hostess and the two of us get into our, “girl talks”, as she calls them. Today I was able to spend time alone with Gavin. It was then when I heard some remarkable stories about his family and his career. He told me about how his one brother stabbed their father to death and spent eight years in prison. He also shared that his other brother has stolen money from mom over the years.

It is amazing to me, that Gavin is able to focus on the positive with everything. He has had some rough times in his life, but he will pull out the best that there is in any situation. He is a realist, but refuses to be drawn into any negativity. He accepts others as they are without needing to change them. Gavin is straight with others and hopes that they understand that we all have choices in life to turn anything around. I admire his courage, his strength and his honesty.


HALF FULL
 

He was a career policeman.
He witnessed a lot of hate and heartbreak.
Such a challenging and dangerous job
would leave some cynical and hardened.

He always saw the good in others,
no matter what the deed.
He attempted to educate, not penalize.
It kept him fulfilled and rewarded.

He always sees the positive side.
His cup is always half full.
Even now with his mother dying,
he will smile and be thankful for each day.

He is with her more days than not.
No other family is willing to help out.
He gets tired and run down,
but he wouldn’t change a thing.

He shared some family history today.
Alcoholism, anger, murder, theft.
Surrounded by chaos and hatred,
he became a stronger, realistic man.

He loves his mother with all of his heart.
She taught and influenced him well.
He is a better man because of her.
No matter what struggle each day brings, 
       his cup will always be
              half full.


 



 

 

 

 

Saturday, July 6, 2013

JUST LIKE ME

Eighty-two year old Mary suffers from lung cancer. She is widowed and lives alone. She has two adult sons; one living about two hours away who visits frequently. She came onto hospice three months ago after receiving all available treatment without success.

Mary accepts what life brings her; counting her blessing along the way. She will find the positive in any situation knowing that there are so many in her life that care. Mary had been doing quite well since on hospice until last week. She had been driving and managing all of her personal and household needs. Occasionally, she had a few bad days where she tired easily.

I went out to do a routine visit today and found Mary weak and nauseas. She said she had not eaten much for a week except for a nutritional supplement. She added that today she could not keep anything down. She then said, “I am ready for this to be over.” She says she still finds joy in her life with her huge network of friends, but does not like living this way.

Mary has Long Term Care insurance that will pay for twenty-four hour care. She is resistant to initiate the care saying, “What do I need them for?” I explained that they could do the laundry, make her bed, household chores etc., so she could have the energy for things she enjoys.

Her stubbornness and independence reminded me of me. I could see myself in her behavior. We both are very stubborn and independent which often makes it difficult to accept any needed help. I have already told my two adult sons, “I am not going down easy.”

I respect Mary and understand how difficult it is to ask for help. I encouraged her to take into account her safety and what could happen while weak and living alone. She agreed to call the Attendant Care Agency tomorrow to let them know that she may need them sooner rather than later.

Through all of this, she keeps her positive attitude about life. In her, I see myself as likely managing things the same way if I ever were in her situation; stubborn, positive and accepting. We all are who we are. I will end with a favorite quote, “Be yourself. Everyone else is taken.”


JUST LIKE ME
 

We share more than our first names.
We share more than bearing two sons.
She is stubborn, determined and optimistic.
          Just like me.

She’s been sick for a short while.
She had been doing quite well.
Last week there was a sharp decline.
Not quite knowing where to turn.

She is resistant to let go of some control.
She is accepting her weakness; her changes,
saying “I am doing alright.”
Just like I probably would.

She has always been there for others,
but finds it hard to reach out.
Family and friends are available to help.
She knows how much she is loved.

She’ll die the way she has always lived.
Seeing her cup continually half full.
Realistic and accepting of what life brings.
          Just like me.
 

Saturday, June 29, 2013

"I LOVE YOU"

Seventy year old “Larry” was admitted to hospice after a one week diagnosis of lung cancer. Once the cancer was discovered, it had advanced to the point that there was no treatment for him. Larry took things in stride and accepted his fate without complaint or fears.

Larry and his wife, “Christine” were retired from the medical field and both had a good understanding of Larry’s diagnosis. Larry and Christine were married sixteen years. Christine had been divorced and had raised her three children alone. Christine’s children loved Larry as they all knew how happy he made their mother.

Larry struggled with speaking as for over eighteen months he had constant hiccups. The doctors tried so many treatments; all without success. When Larry spoke, he was direct and to the point. Larry’s biggest worry was how Christine would manage after he was gone. Each night the two of them would talk about tasks that he wanted to make sure she knew how to do. For example; the backyard sprinkler system or how to get the cars serviced etc.

Christine would constantly talk about how special Larry was to her. She would brag how he exposed her to museums, Native American Art, small town Americana. Many of their vacations were car trips all over the United States. She shared that Larry was, “The love of my life.” She was always telling him how much she loved him. One could feel the love between the two of them when you walked into their home.

Larry died suddenly yesterday after being on hospice for four months. Two days before Larry died, he turned to Christine and said, “I love you” for the first time. She was moved by his tender words, even though she never doubted she was loved by him. Her final words to Larry as he lay dying was, “I love you.” He weakly replied, “Me too.” And then he was gone. The last moment together so tender, so loving. It doesn’t get any better than that.



“I LOVE YOU”

 
They met later in life.
It was an instant connection.
After sixteen years together,
she knows how special he was.

She was demonstrative;
he, a practical man.
She would fuss all over him.
His priority was to take care of her.

She told him constantly, “I love you”.
His typical response always, “Me too.”
He showed his love by his actions;
she; by her tender words.

Two days before he died,
for the first time she heard,
“I love you,” coming from his lips.
Affectionate words from his gentle heart.

She sat by the bedside as he lay dying.
One final “I love you” to send him off.
His reply was what she has cherished all along;
what always made her heart flutter.

Two final words driven
by his deep love for her,
        “Me too.”

Sunday, June 23, 2013

REGRETS

Sixty-two year old “Jackie” suffers from lung cancer. Jackie had been living alone in her trailer, abusing cocaine. About two weeks ago, Jackie went to the Emergency Room for help. The hospital knew she could no longer live alone and, after a short hospital stay, she was transferred to a Skilled Nursing Facility for care.

Jackie was referred to hospice because of her declining health. She has been in the facility for eleven days, and for eleven days she has been clean and sober. I met with Jackie, her two daughters, “Grace” and “Victoria” and her nineteen year old granddaughter, “Allison.” Even though both of Jackie‘s daughters live nearby, Jackie had not seen Allison for years.

When I met with Jackie and her family today at the nursing home, it was obvious that Jackie’s two daughters loved her. They would hug her and caress her with loving words. Jackie was very open and honest with her emotions. She has so many regrets in her life. Even though Jackie believes in a forgiving God, she fears God may not forgive her.

Jackie and I spoke at length about her regrets and angst. I told her that each of us have regrets over our past. One has to experience hate to know what love is; illness to know about health; turmoil to know about peace etc. Her past has made her who she is today. With the drugs out of her system, I have a feeling her daughters are seeing the mom they know from the past.

Right now Jackie has to come to terms, in her own way, about her life choices. She is worthy of change and deserves any chance that comes her way. Jackie only has to reach out. I wish only the best for her and her painful journey. I will do whatever I can do, to give her the support she so deserves in order to help her on her way.


REGRETS
 

She has so many regrets,
she doesn’t know where to start.
Neglecting her family for years
as crack/cocaine always came first.

She’s been in a facility for eleven days.
No longer able to live at home.
She’s been clean and sober since then,
facing her demons for the very first time.

She believes in an unconditional loving God,
but fears her past may not be forgivable.
She speaks openly about her angst.
Her awareness so painful; her remorse genuine.

Her daughters listen intently.
It is obvious they love her so.
They hug her; they console her.
You know she did some things right.

She will continue to process her emotions.
She will continue to mull over her regrets.
You and I know, God has forgiven her.
Let’s hope there is time
for her to forgive herself.

Regrets.

Monday, June 17, 2013

A HAPPY HOME

“Sue”, sixty years old, suffers from cervical cancer that has spread to her bones. Sue was admitted to hospice as there is no more treatment available to help her. She had been doing quite well until recently. I first visited Sue two weeks ago when she was able to walk independently using a walker. Today, she is wheelchair bound and needs assistance in transferring to the hospital bed. Sue accepts her situation without fears or concerns.

Sue lives with her husband, “Steve”, their twenty year old son, “Albert”, Albert’s girlfriend, “Rhea” and their eight month old baby, “Allison”. This very tiny, one bedroom home is in complete disarray. There is very little space to walk around because of all their belongings. There are boxes, knick-knacks, books and baby paraphernalia piled high throughout the home.

During my visit today, I was able to meet Steve and Albert as they both were not available during my initial visit two weeks ago. Steve is a big teaser and no one is immune to his playful antics. Sue was sitting in her wheelchair, dozing on and off during my visit. Steve would tease Sue and everyone, including Sue, would laugh.

The baby started to fuss during my visit. Rhea said that the baby was due for a nap. She took him into the bedroom and before long, the baby was sound asleep. Several times Steve went into the bedroom to fetch some paperwork. Rhea said that Allison can sleep anywhere to which Albert added, “We all can sleep anywhere. We sleep right where we happen to be when we fall asleep.”

This family is amazing as to how they approach life. They have accepted their lifestyle, without complaint or excuses. They are a perfect example of what we all should strive for. Happiness is not what we have in our lives, but who we have in our lives. It takes a strong family, in any circumstances, to trust and have faith in each other. They are a perfect example of what is really important in life. Kudos to all of them.


A HAPPY HOME
 

Five people in a tiny, one bedroom house.
Not enough beds for all to sleep.
Belongings, furniture, knick-knacks,
all begging for more space.

The house could use some paint;
the lawn, a little weed killer.
Furniture stained and worn out,
but I would definitely call this
       a happy home.

She’s been sick for a while
and had been doing quite well.
Recently though, she is in a decline;
weaker, sleeping more, no appetite.

The hospital bed looms large in the living room.
Less space now to move around.
No one seems bothered that the room has shrunk.
They, like usual, keep pressing on.

This family will giggle; this family will joke.
No one is spared any light-hearted tease.
Humor and laughter is what helps them through.
There isn’t a lot that can get them down.

I’m sure there is not much that this family desires.
They appreciate life and what they do have;
love, humor, loyalty, each other.
A perfect example of what we all strive for;
       a happy home.
 

Saturday, June 8, 2013

BEAUTIFUL SMILE

Ninety year old “Hank” has been on hospice for about two months. He came onto hospice as he suffers from Alzheimer’s Disease and has been in a sharp decline.

Hank is single and has never married. He has no family left to call his own. His long time next door neighbor, “George” manages his finances, while George’s daughter, “Anna” is responsible for any health care decisions. Hank has twenty-four hired caregivers in the home to assist him.

Five years ago, George noticed Hank out in his front yard looking emaciated and confused. George figured out that Hank hadn’t eaten much for a while as his refrigerator and kitchen cabinets were empty. It was then that George and Anna got involved. They are the only people that Hank can call “family”.

George says that Hank has always been a loner and never has had many visitors to his home. George added, Hank was an intellect and kept to himself. It surprises me as Hank is such a charmer with his engaging giggle and smile. Even though Hank is confused, he has insight to his dilemma. During my first visit two months ago, Hank shared with me and his hired caregiver, “I remember things a long time ago, but can’t remember what I ate for breakfast.” The hired caregiver sweetly told Hank, “If you ever want to know what you had for breakfast, you can just ask me.”

With each visit, I am greeted with Hanks’ beautiful smile. He laughs and giggles so easily. You just have to look at him and he will smile back. He is a cutie and, with each visit, I am captivated by his charm.


BEAUTIFUL SMILE
 

The first thing one notices
when you walk into his home,
is his big, beautiful smile
as he greets you by the door.

He is confused and forgetful,
but aware he doesn’t know.
He will giggle and laugh at himself
for not remembering much at all.

He said, “Nice to see you again”,
although had forgotten who I am.
I replied back, “Good cover up” ,
which made him giggle all the more.

I am surprised he’s never married
with no children to call his own.
With his charm, his personality,
you’d never guess he’d be alone.

They say he’s always been a loner.
Not many visitors at his door.
He was intellectual, he studied.
Activities better done on one’s own.

All that has changed since
hired help is in the home.
He’s smiles, he giggles.
He charms us off our toes.
 

Saturday, June 1, 2013

ACCEPTANCE

Patty, my cousin by marriage, has been suffering from colon cancer for a year and a half. Eighteen months ago, the doctors sent her home to die. That wasn’t the way Patty wanted to do things and so chose to have chemotherapy. The side affects were crippling, but Patty continued on living each day with a smile.

One of the hardest things Patty had to do was step down from her job. Even though all of the family knew that she likely would never be able to go back to work, Patty held out hope that one day she would be able to do so. She has such a positive outlook on life. Even when the chips are down, she will continue to smile and accept life’s challenges.

Ten days ago, Patty was admitted to the hospital. She was so weak that we thought she would die within a few days. Patty rallied and was discharged home three days ago with hospice. Patty needs twenty-four hour care as is bedridden and on a liquid diet due to tumor growth.

A schedule has been set up for family members to be available to stay with Patty. I am off on Mondays and able to sit with Patty each week. I call myself “The Monday Gal” for Patty. It is so different then working with my own patients. This is personal and a whole different ball game. I share with families the power of just being there for someone. Even though I know that, one feels so helpless as I want to make things better for her.

Today Patty was talking about her spiritual beliefs. She has a strong belief in God and the afterlife. I asked her if she had any fears. She smiled and said none at all. She is amazing to me. This recent change has been dramatic and, through it all, she will laugh, smile and appreciate what she has. I am in awe of her. She is teaching me humility, acceptance and grace. I hope I learn well.


ACCEPTANCE
 

As long as I have known her,
she has always been quick to smile.
No matter what cards life has dealt her,
she will unconditionally accept her hand.

She will voluntarily give away her good cards;
all that one has to do, is ask.
She will move on with what cards are left
making the best of her hand that remains.

She got sick eighteen months ago.
She has fought with all that she has.
Smiling with full acceptance.
Obviously handling things her way.

She can no longer eat solid foods.
Everything has to be pureed.
She is bedridden and needs help.
I can’t imagine living this way.

She continues to smile and enjoy her days.
You will hear no complaints from her.
She’ll die the way she has always lived;
with full acceptance of what is to come.
 

Saturday, May 25, 2013

HIS WAY

Fifty-seven year old “Ronald” suffers from soft tissue cancer. The cancer is throughout his stomach and is slowly spreading. Ronald is either in his bed or wheelchair. He needs assistance transferring to his wheelchair.

Ron lives with his wife, “Angela” and one of their adult sons, “Jesse”. Jesse works at night in an ice cream parlor and is available during the day to care for his dad. Angela works during the weekdays and is available nights and weekends. The couple have another son, “Jon”, who lives nearby and comes a few days each week to help. He is able to do computer work at his parent’s home and is available to help his dad as needed.

Ronald is very open about his cancer and prognosis. Ronald lives his life like he is living, not dying. He spends most of his days in a hospital bed in the master bedroom. He is surrounded by his laptop, telephone, books, papers and all that he needs to fill up his days.

Ronald is very spiritual and spends several days each week, giving bible studies to several extended family members and friends. In addition, he spends time researching topics on his laptop. Recently, Ronald has been able to utilize a Senior Transportation Service which has allowed him to attend church and other outings. Ronald is a perfect example of someone living their life to the fullest.

I visit Ronald every two weeks or so to check in with him. The visits end up being long as the two of us get into amazing conversations about life and death. He is not only a brilliant speaker, but an excellent listener. Ronald and I get into all sorts of topics that are thought-provoking.

During our conversation today, he was sharing the doctors’ bleak prediction last summer. He added that he wants to live each of his days to the fullest as he never knows when it will all end. I don’t deny that he will, and told him that I thought his death would come fast as he grabs life from each day that he has. He agreed with my prediction. In the end, things will be what they will be, but I won’t be surprised if it happens the way we both believe. He is truly inspirational and his footsteps will be long remembered after he has left us.


HIS WAY

 

He sees the good in everyone.
He’s open to what they offer.
He lives his life to the fullest,
by celebrating each day, his way.

The doctors’ prediction was bleak.
Forty-eight hours was all that he had.
Nine months later, he is living his life.
Finding joy and pleasure in each of his days.

He is a fascinating conversationalist.
He listens with all of his heart.
He’s inspirational, insightful, spiritual;
igniting discussions between him and me.

Each morning, he awakes with a smile.
Another bonus day to celebrate life.
Embracing each moment as if it’s the last,
knowing one day, it will truly be.

He spoke today about his dying.
He believes his end will be fast.
Until then, he’ll fill up his days,
savoring each hour the only way he knows;
          his way.
 

Friday, May 17, 2013

GET ANGRY

Forty-one year old “Lena” was diagnosed with breast cancer two years ago. She underwent chemotherapy and treatment. The cancer continued to grow and spread to her lung and brain. Four days ago, her doctor told her that the treatment wasn’t working and there was nothing else to be done. It was then she was referred to hospice for comfort care.

The hospice nurse and I went out today to admit Lena to hospice. Lena’s husband, “Nat”, left his work to be there as well. Lena and Nat have been married twenty-one years. They have two children; a twenty year old son who attends a local college and a seventeen year old daughter in high school.

Lena informed us that she was told four days ago that her cancer was growing and no further treatment was available. She accepted her fate and denied any fears or concerns about what was happening. She did shed a few tears when we talked about her legacy, her children and her wishes.

She was handling things so calmly, that I was wondering if she still was in shock from the devastating news four days ago, had already processed her emotions or if it was a cultural belief system. I realize that we all have to process and cope our own individual ways. What works for one, doesn’t work for another. Lena is only five months older than my own son. It was hard not to think about how it would be if my son got such horrid news. My first impulse was to get angry. I didn’t realize it while in Lena’s home, but after the visit and driving away, I was thinking about how I, as a parent, would feel. I got angry.

Lena’s parents live in Russia and had just left a few weeks ago after visiting for three months. My heart goes out to Lena and her family. Lena will never know about my anger, as I will respect her and encourage her to continue to cope her way. After all, this is her journey and she is the only one who can do it Lena’s way.


GET ANGRY!
 

I want you to get angry!
I want you to yell and scream!
Fight back with all that you‘ve got!
But then, maybe you already have.

You were just told four days ago
that there was nothing else to be done.
No more treatment; no more chemo.
Comfort care now, until the end.

You sit there calmly accepting your fate.
No concerns or fears pulling you down,
“It is what it is.
There is nothing more I can do”.

I want you to get angry.
I want you to get mad.
I want something to be done.
It’s so unfair; you are way too young.

I’ll continue to support you.
I’ll assist you where you need.
You will never know my anger,
because it surely isn’t about me.

You are the age of my own son.
These emotions have hit close to home.
So now and then in the quiet;
when I think of you,
       every so often,
              I may,
                   get angry!

 

Saturday, May 11, 2013

SAYING GOODBYE

Sixty-nine year old, “Lani” has been on hospice for almost three months. Lani was diagnosed six months ago with pancreatic cancer. Lani lives with “Jim”, her husband of twenty-five years. Jim is a few years younger than Lani and still works. Jim has taken leave from his job to care for Lani.

When I first met the couple three months ago, one immediately saw the strong love and devotion they had for each other. They married late in life and have no children. The only family is Lani’s sister, who lives about five hours away. She has made several trips to help out and has been able to stay at least two weeks during each of her visits.

Lani has had a rapid decline these past few weeks. Jim is now off work full time to care for her. Fortunately, Lani had a Long Term Care Insurance Policy so that Jim has been able to hire full time attendant care. Lani has not had any fluids or food for over a week. Her time is close. She is in a deep sleep most of the time now.

Jim had asked Lani forgiveness for all that he has done wrong. Lani easily forgave Jim, but he needs to forgive himself. He is very hard on himself, but doesn’t see a fault in anyone else. He has such a huge heart for others.

Jim gets overwhelmed easily now and I am helping him out with his leave and disability paperwork. In addition, I am also helping with his Long Term Care Insurance. I am able to take some of that burden off his shoulders. With each visit, once the paperwork is done, Jim and I sit in the family room and have a good discussion. He is so insightful to what he is feeling and easily is able to process those emotions.

I validate a lot of Jim‘s grief. He questions and doubts himself so much. I am able to tell him that what he is feeling is normal. I also give him a lot of reassurance that he is caring for Lani so beautifully. He hears what I tell him and feels validated.

He shared today that he has said goodbye to Lani. He told her that when she is ready to let go, he will be okay. I also told Lani goodbye today. I always speak from my heart. I reassured Lani that I would visit Jim to make sure he is coping okay. I also shared that hospice has a huge bereavement department that follows up for a year.

Jim and Lani have a wonderful and supportive network of friends who reach out and give the needed support to this family. Because of that support, I know that, in time, Jim will be okay.


SAYING GOODBYE
 

His heart is breaking.
He knows her time is soon.
He doesn’t want her to suffer,
but it is so hard to say goodbye.

He told her that he would miss her.
He thanked her for all she has done for him.
He said he will be sad for quite a while,
but it is okay for her to go.

I visit often to give him support.
I see the love and pain in his eyes.
I reassure him that he is doing things perfect.
“Keep following your heart; you will be fine.”

I turned and promised her that I would make sure
that he would have the needed support.
He won’t be alone as so many do care.
I reassured her from the depths of my heart.

Her eyes were closed and she didn’t speak.
She appeared to be in a deep sleep.
I know she heard me as her response
was a single tear on the edge of one eye.

She too
       was saying,
                 Goodbye.

 

Saturday, May 4, 2013

"I DON'T KNOW"

Sixty-nine year old “Laurie” was diagnosed with pancreatic cancer about six months ago. She stopped working two months ago when she became too weak to keep up that pace. Laurie lives with her husband of seventeen years, “Kyle”. Kyle is fifteen years younger than Laurie, but their love is true. Kyle is devoted to Laurie. They have no children and their extended family is few in numbers. Kyle and Laurie belong to a car club with whom they consider family. They have a vintage 1936 Ford parked in their garage in mint condition.

Kyle has been working full time and using his Family Leave time on an intermittent basis. Last week, Laurie took a dramatic change to where she is getting confused and weaker. She can no longer be left alone. Laurie’s sister, “Glenda” has come for a week from out of town to help.

Laurie is restless and not sleeping much. She keeps Kyle up all night with her tossing and turning. She has fallen several times as she keeps trying to get out of bed. Laurie needs to be watched constantly. Kyle is not getting sleep and has decided to stay home full time. He worries about how much leave he has, even though he knows he has about four weeks in his balance.

Laurie has long term care insurance from her employer, but the family had not initiated the application process as Laurie was doing fine. The quick decline has made these details urgent.

I knew Laurie was declining and I called Kyle to see what he needed. He sounded so exhausted and tired, he could not even think. When I asked him what he needed he just didn’t know. He could not even think to answer my offer to make those calls. He needed someone to take charge and to take care of him as well as Laurie. He had no energy left to give.

My heart aches for him as he is drained and grieving so deeply. I will keep in close contact with Kyle with phone calls and visits. Kyle has tremendous support from his car club buddies and, along with his strong Christian faith, I am convinced he will get through the tough times ahead.


“I DON’T KNOW”
 

She’s been sick for a short while.
Her decline has been swift.
She is restless and getting confused.
He just doesn’t know what to do.

He is taking time off work,
but worries about not being paid.
He needs to hire some help
as she can no longer be left alone.

She keeps him up at night;
tossing, turning, getting out of bed.
She is so weak and has had several falls.
He cannot keep this up.

I called and asked what I could do.
I knew he needed some help.
In a weary and exhausted voice, he replied,
“I don’t know”.

I asked if he wanted me to make some calls
to get some help in the home.
In the same fatigued voice, he answered,
“I don’t know”.

I said I would help to get things rolling.
I would gladly make those calls.
In no time at all, things were started.
In an exhausted voice, I softly heard
       an appreciative and lovely
              “Thank you.”

Saturday, April 27, 2013

TECH SUPPORT

Eighty-two year old “Earl” came onto hospice a few days ago with a diagnosis of Debility and Decline. That is a diagnosis that does not have a specific illness related to it, but when someone is becoming frail and needing help to assist them with their daily activities and care. Typically, it is someone elderly whose body is just tiring out.

Earl has lost forty pounds in the past few months as he can no longer swallow. He agreed to a feeding tube, but still cannot take in much nutrition. Earl was widowed three years ago and lives alone. He has two adult children who live locally and are very involved with his care and needs.

I called up Earl’s daughter, “Karen”, to set up my first appointment. After we set a time and date, she shared how she and her brother, “Dan”, each, in their own way, help their father. She said that her brother handles all the detailed needs and finances. He pays their dad’s bills and arranged for twenty-four hour attendant care. Dan handles all the paperwork; legal and financial. Karen says she is the nurturer and gives hugs and holds her dad’s hand whenever he needs. She then added the technical term she uses to describe her and her brother’s individual role in caring for dad.

It works well for this family. I will be meeting with them tomorrow for the first time, and know ahead, that it will be a pleasure working with such a loving, supportive family.


TECH SUPPORT
 
 

He had been independent for over 80 years
until his body started to slow him down.
He is becoming frail and needing more help;
no longer able to do the things he once enjoyed.

He has difficulty swallowing anything with ease.
The doctors cannot find a cause.
He’s lost over forty pounds these past few months,
succumbing to a feeding tube to meet basic needs.

He’s been widowed a while and adores his two kids.
Their love is mutual as they are always around.
Each have their distinct roles in helping him out.
Specific tasks fitting perfectly to their personality type.

He’s the engineering one tackling tasks that need to be done.
He’s comfortable with numbers and specific details.
She’s a good balance with her nurturing heart.
At ease with emotions and tears that may flow.

They both are aware of each other’s role.
Both available with their unique love.
He is the hardware; she is the software;
Tech support mixed with love,
       available
              whenever he needs.

 

Saturday, April 20, 2013

ROUGH DAY

“Shirley”, seventy years old, suffered from chronic lung and heart problems. Shirley was divorced for many years and raised her two children alone. She lived in a duplex that she owned with her son, “Mitch”. Mitch lives in the other half of the duplex with his wife, “Annie” and their three month old son. Shirley also had a daughter, “Jessie”, who, with her fiancée, lived nearby. A few weeks ago, Jessie set her wedding date for this Spring, hoping that mom would be able to attend.

Seeing their mother’s recent decline, Jessie and her fiancee spent time this week moving in with Shirley. It was a win-win situation for all. As recent as two weeks ago, Shirley was doing well enough to be left alone for hours at a time. She was able to walk around using her walker quite independently. With Jessie and her fiancee living with Shirley, there was a guarantee that Shirley would have the help available as her needs increased.

Shirley’s decline started about two weeks ago. In these past few days, she is so weak that she is unable to get out of bed. Shirley stopped eating and was only taking sips of water. She started to get confused, although knew exactly what was happening. Her children took leave from their jobs to be with Shirley full time.

Shirley died early this afternoon with her family at the bedside. Later, I spoke with Jessie to offer my condolences. I know they will be okay and will get through the hard times ahead. The strong love they all share for each other, and for their mother, will definitely ease their way.


ROUGH DAY
 

She dealt with health issues for years.
Chronic problems that never slowed her down.
Her independent spirit kept her on track,
helping her to live her life the only way she knew.

She was always in charge of things,
more so after her health betrayed her.
She fought fervently until the end;
not surprising anyone at all.

She stopped eating two days ago.
She was asleep more than she was awake.
The family knew her time was near.
They bravely gave her permission to let go.

She died peacefully this afternoon
with her loving family by the bedside.
Along with deep sadness for a while,
there is also some relief that her suffering is over.

The family will come through this stronger
because of the steadfast love they all share.
“This has been a rough day,
but we are hugging it out.”