ALL ALONE

Ninety-four year old “Judith” suffers from end stage cardiac disease and dementia. She has been confused for many years and has been living in a locked memory center for the past seven years. Judith is widowed and has no children. Her husband died eighteen years ago. Her only family are several nieces and nephews.

One niece, “Sheila”, is her conservator and manages all of Judith’s affairs. Sheila never visits Judith and prefers to handle everything over the telephone or e-mail. When admitting patients to hospice, there are several pages of paperwork that need a signature. Judith asked that hospice fax the paperwork to her for completion.

I went out to visit Judith at the Memory Care Unit. The unit it small as there are only ten residents. There is a dining room and a sitting room for activities. Each resident has their own room. I found Judith in the sitting room listening to a musician entertaining the residents.

The attendant told Judith she had a visitor and wheeled her to her room. Judith didn’t seem to mind being interrupted. Judith is very forgetful, but was very forthcoming when asked about her earlier life. I was not sure how much was accurate, but Judith was willing to share a lot. At the end of my visit, I asked her if she wanted to go back to listen to the musician. Without much emotion, Judith answered yes.

It made me sad to learn that Judith never had any visitors. Her family never comes and Judith really is all alone. Her affairs are handled as a sense of duty only. The staff are very kind and gentle with her and the other residents, but there is turnover and often there are new faces helping out.

The one advantage of Judith’s dementia, is that she is not aware that she has no visitors. She didn’t appear happy or particularly sad. With her flat affect, it is hard to really know how much she understands. I only hope she knows that she is in good hands and that the staff at the Memory Care Unit do care about their residents.

ALL ALONE

　
Her eyes have that far away look
of acceptance without being aware.
She doesn’t seem necessarily happy,
nor particularly distressed about much of anything.

She goes along as they guide her.
She doesn’t resist at all.
All her needs are taken care of,
but so much she just does not know.

She’s lived there over seven years,
with nine others needing help like her.
Doors are locked to keep them safe.
They would never make it alone on their own.

Her only family are nieces and nephews,
but they never come around.
One niece handles all her decisions,
by e-mail, texting or the telephone.

She doesn’t grasp that family never visits.
She knows the staff, but they come and go.
Confusion may have some advantage,
as there is no awareness ever of being
         all alone. 

BABY STEPS

Fifty-six year old “Lisa” suffers from liver cancer. Lisa is single and has never married. Lisa was told, upon her diagnosis one month ago, that there was no treatment available for her. Lisa is the youngest daughter of seven. Lisa’s sister, “Shelley” says that their father spoiled Lisa. If Lisa didn’t want to do something, she would get angry. Her father always gave in to her.

Lisa has used that anger throughout her life, although has a heart of gold inside. One can see through her rough exterior. Lisa gets attention with her anger, but then she has this gentle side of her that also shines through. She will thank you for coming and always ends the visit with a big, long hug. She is genuinely happy you were there.

During my visit today, Lisa and her sister were in the backyard sitting on the patio. During the course of our conversation, I asked Lisa if she had any fears. She responded in anger not wanting to talk about it. I assured her that hospice’s role is to allow Lisa to do things her way. We will support her throughout this ordeal.

A few moments later, Lisa’s sister went inside. Lisa started talking about another subject, then suddenly asked, “How long do I have”. I answered her as gently as I could. Then, just as suddenly, she changed the subject to something safer. I believe Lisa is coming to terms with what is happening to her. She still uses her anger, but is also processing in the only way she knows how.

Lisa’s sister had previously told me that Lisa is mending bridges as is calling several people with whom she had an angry parting of the ways years ago. Lisa is calling up some selective friends with whom she has been estranged and inviting them over. Lisa is doing what she needs to do. She has some unfinished business that she wants resolved.

I will continue to meet with Lisa weekly. My goal is to help her process her emotions as she needs; one baby step at a time.


BABY STEPS
　

She was spoiled as a child.
She always got what she wanted.
She learned how to use anger
to make things go her way.

They told her she had cancer.
There was nothing to be done.
She is trying to process; to regain control.
It has only been one month.

She cried when I first met her,
“I don’t want to die!”
Then lashes out to her family;
something she can still control.

I asked her if she had any fears.
She snapped, “I don’t want to talk about it”.
I assured her she was in charge of things.
We will support her to do this her way.

Moments later when we were alone,
she suddenly asked, “How much longer do I have?”
I gently shared my thoughts with her.
Then just as quickly, we moved on.

She continues to do things her way.
Showing her heart more than her anger.
I’ll walk along side her cautious pace. 
Doing it her way;
       baby steps;
              slowly,
                     one step at a time.   

HIS WISH

“Walter”, aged eighty-six, had been healthy and active most of his life. Walter was diagnosed with prostate cancer several years ago. He had been doing well, until recently, when he was told by his doctors that his cancer has spread. Walter tried chemotherapy, but the side affects were intense. He chose to stop the chemo in hopes to having some quality days.

Walter lives with his wife, “Frances”. They have been married twenty-eight years. Frances is fifteen years younger than Walter. They both were married once before. Frances has two daughters, who live nearby, and are very supportive and devoted. Walter and France’s two daughters have a wonderful relationship. Walter proudly says that they are like his own daughters.

I first met Walter last week when I went out to do my open and meet with him and Frances. Walter was sitting on the couch and said that he felt miserable. He looked very uncomfortable, to which he admitted being. In addition, he added that he was also very nauseas. Walter denied being in pain, just feeling “crummy“.

Walter hated feeling this way and was determined when he said, “I just want this to be over.” Walter had no fears about dying as has a strong Christian faith and says he knows where he is going. Walter slipped away in the middle of the night. He was in a hospital bed in the dining room. Frances was sleeping nearby on the couch. She noticed that Walter’s breathing was very slow and deep right before she fell asleep. Several hours later, she woke up and went to check on Walter. It was then that she noticed that he was no longer breathing.

I called Frances the next day to offer my condolences. She felt at peace about it all as he was no longer suffering. She will grieve, but hopefully she will get comfort knowing Walter got his wish.


HIS WISH
　

He has been sick for a while,
but his decline came quickly.
Not able to walk or enjoy a meal;
he hated being this way.

When asked how he was doing
or how he was holding up,
his response was always determined,
“I just wish this were all over.”

Feelings were sympathetic
with a blending of bittersweet.
They didn’t want him to suffer,
but also did not want him to leave.

He slipped away in the middle of the night.
She awoke to find him gone.
She felt sadness along with relief.
His suffering was finally over.

She will tell those who will listen;
“He wanted to go; he got his wish.
         He wanted to sleep away.
                  He got his wish”. 

GIRLFRIENDS

“Kimmy” and “Mari” have been best friends since they met forty years ago in sixth grade. The two have remained close over the years, even though their individual lives have developed in dramatically different directions.

Mari, fifty-two years old, is divorced and has three adult children. Her son, “Mickey” lives with her. Mickey looks to Kimmy as his second mother. Mari worked for the state for enough years to be able to retire at age fifty. Kimmy, on the other hand, got hooked on illegal drugs. Kimmy’s income has been limited as she works at a local gas station for minimum wage with no benefits. Kimmy never married and has no children, although looks at Mari’s children as her own.

Kimmy suffers from lung cancer which has spread to her bones. She was diagnosed just a month ago. Her doctors told her that there is no treatment. She was referred to hospice for care. Two days ago Kimmy moved into Mari’s home. Mari is her primary caretaker. Mari shared that Kimmy has been off drugs ever since she was hospitalized three weeks ago.

I first met the two friends today. The moment I walked into Mari’s living room, Kimmy asked me, “Why do I have to die?” She started to cry and Mari went over and the two friends hugged so tightly. Mari wants to take care of Kimmy. She will do what she has to do to keep her safe and comfortable.

Kimmy wanted to smoke, so the three of us went out to sit in the backyard away from the oxygen. My focus on this first visit was to assess Kimmy and Mari’s needs while educating them on our hospice program and the support that is available. Kimmy kept interrupting, commenting on my shoes or name tag. Kimmy suddenly stopped, interrupting herself saying, “I want to go inside to take a nap.”

Mari and I continued to talk outside. Fifteen minutes after Kimmy went inside, Mari got a phone call from a friend saying that Kimmy is texting a lot of her buddies trying to get some cocaine. Mari is adamant about keeping illegal drugs out of the home. After that phone call, Mari told me, “I will kick the %^&* out of anyone who tries to bring illegal drugs here.” Mari knows Kimmy may get mad at her, but she is determined to keep her friend clean, safe and sober.

I was touched by the closeness of these two best friends. Although, their lives are much different from each other, their devotion and love for each is strong. They truly are kindred spirits.


GIRLFRIENDS
　

They have known each other forty years.
They were best friends from the start.
Trials, struggles, good times and bad.
Both have been through quite a lot.

Their loyalty has often been tested.
Divorces, drug addiction, illnesses, now death.
She’s abused her body for too many years.
“Why do I have to die?”

She cries about losing her girlfriend.
She tells herself she will be alright.
Now she just wants to care for her.
To keep her safe; free from pain.

This past month has been a roller coaster.
Her friend’s life has dramatically changed.
Her girlfriend wants things back to normal;
she wants her crack cocaine.

Two lives traveling different paths.
Why not go their separate ways?
Soul mates, kindred spirits.
Unbreakable bond.
         Girlfriends.