“Ellen”, ninety years old, was admitted to hospice today because of a recent decline in her health. Ellen suffers from Alzheimer’s Disease. These past several weeks, Ellen has become more confused, weaker and needing more help.
Ellen lives with “George”, her husband of fifty-eight years. When the hospice nurse and I first walked into their apartment at the Assisted Living Center to admit Ellen to hospice, George immediately started to ask questions about the hospice program. After explaining what hospice can offer the family, George was happy that Ellen could stay at home. That was his biggest concern.
George comes across brusque and abrupt when one asks him about how he is coping. Grief support is a large part of what hospice can offer families and patients. When explaining the hospice program to families, I like to be thorough regarding the benefit. I want to make sure hospice is a good match for the family. Often doctors make a referral to hospice without patient’s and families truly understanding what it is all about.
Any time I even broached the subject of the grieving process, our bereavement program or coping skills, George immediately said, “Those things can come later”. George tried so hard to hide his big heart without success. It was so obvious how much he adored his wife. Ellen’s death will be a huge loss for George, but he just can’t go there yet. He spoke about Ellen needing to be by his side when they were sleeping. I have a feeling, George was speaking also about himself.
George and Ellen’s daughter, “Beverly”, was also present during the visit. Beverly shared that she is worried about her father after her mother is gone. I told her that the assigned social worker can meet George where he is at by using baby steps to sneak in some grief counseling with him. Hopefully George will get the help he needs, in his terms and at his time. Even if it is later.
LATER
He comes across abrupt.
Trying hard to hide any emotion.
“Let’s get on with things.
Let’s get this paperwork done.”
She’s declined these past few weeks.
She is much more confused than before.
She needs more care as has no strength.
He’s hired attendants to help her out.
When asked about how he is coping,
he will immediately reply,
“I will worry about things later.
Now is not the time.”
He said no to a hospital bed.
“It gives her comfort,
when she reaches out at night,
knowing I am lying by her side.”
He likes that hospice comes to them.
His biggest concern is her comfort.
He wants her to be able to stay at home.
“It calms her to see me here.”
It is so obvious how much he loves her;
how much he is going to miss her.
He’ll continue to hide his heart,
until, hopefully,
he will reach out.
later.
Saturday, November 29, 2014
Saturday, November 22, 2014
HOSPICE
I went out to admit “Greg”, sixty-three to hospice today. Greg was diagnosed four months ago with lung cancer that has spread to his brain. Greg has had a rapid decline this past week to where he is wobbly on his feet, weak and states, “I just feel crummy”. Greg lives with his wife, “Ilsa”. They have been married thirty-one years.
Greg has two children from a previous marriage while Ilsa has three. Greg states that he has five children all together. This is a very supportive, loving, blended family. Greg has no fears about dying saying, “I have had a wonderful life.” I had met Greg and Ilsa a month ago when a hospice nurse and I went out to educate Greg and Ilsa about the Hospice program. Greg only wanted information at the time. He wasn’t quite ready to come onto hospice.
Greg was now ready to be admitted to hospice. Greg’s daughter, “Heather” was visiting during today’s visit. Before I start to explain the hospice program, I always ask patients and families if they have any questions. Heather asked if hospice rushes the death along. I am never surprised when I hear a question like Heather’s. It is something the hospice staff hears all the time.
Doctors make a referral with an estimation of a life span of six months or less. I tell patients that the doctor is basing his decision on their health history and diagnosis. What doctors cannot put in that equation is the patient’s heart, drive, soul, independence, stubbornness, miracles etc. We all have our own individual journey. Hospice is totally about comfort care and quality of life as defined by the patient.
Once patients and families have an understanding that the patient is in charge in how things proceed, one can see relief in their faces. Patients lose so much independence with a terminal diagnosis. In addition to the loss of their health, they also lose so much control of not being able to do what they enjoy etc. The whole family is grieving and trying to regain some balance.
Hospice is guided by the patient and family in how things will work. We are all living, giving and receiving until we breathe our last breath. No more no less.
HOSPICE
She asked me about hospice.
She didn’t quite understand.
“Are you going to help him die?
Do you rush things along?”
Doctors make a referral.
Families don’t know what to expect.
“Does this mean I die in ten days?”
“Will I have pain until the end?”
Valid questions we hear every day.
Fear, uncertainty, feeling overwhelmed.
Not sure where their road is turning.
Trying to regain some control.
Hospice is all about comfort and quality of life.
We tell the patient that they are in charge.
Let us know how you want to do things.
We‘re right next to you, to help you along.
Relief comes with the knowledge of hospice;
knowing that they are never alone.
You see it in their faces,
you hear it in their words.
Living, loving, embracing life.
Saying what needs to be said;
doing what needs to be done
until the end.
Hospice.
Greg has two children from a previous marriage while Ilsa has three. Greg states that he has five children all together. This is a very supportive, loving, blended family. Greg has no fears about dying saying, “I have had a wonderful life.” I had met Greg and Ilsa a month ago when a hospice nurse and I went out to educate Greg and Ilsa about the Hospice program. Greg only wanted information at the time. He wasn’t quite ready to come onto hospice.
Greg was now ready to be admitted to hospice. Greg’s daughter, “Heather” was visiting during today’s visit. Before I start to explain the hospice program, I always ask patients and families if they have any questions. Heather asked if hospice rushes the death along. I am never surprised when I hear a question like Heather’s. It is something the hospice staff hears all the time.
Doctors make a referral with an estimation of a life span of six months or less. I tell patients that the doctor is basing his decision on their health history and diagnosis. What doctors cannot put in that equation is the patient’s heart, drive, soul, independence, stubbornness, miracles etc. We all have our own individual journey. Hospice is totally about comfort care and quality of life as defined by the patient.
Once patients and families have an understanding that the patient is in charge in how things proceed, one can see relief in their faces. Patients lose so much independence with a terminal diagnosis. In addition to the loss of their health, they also lose so much control of not being able to do what they enjoy etc. The whole family is grieving and trying to regain some balance.
Hospice is guided by the patient and family in how things will work. We are all living, giving and receiving until we breathe our last breath. No more no less.
HOSPICE
She asked me about hospice.
She didn’t quite understand.
“Are you going to help him die?
Do you rush things along?”
Doctors make a referral.
Families don’t know what to expect.
“Does this mean I die in ten days?”
“Will I have pain until the end?”
Valid questions we hear every day.
Fear, uncertainty, feeling overwhelmed.
Not sure where their road is turning.
Trying to regain some control.
Hospice is all about comfort and quality of life.
We tell the patient that they are in charge.
Let us know how you want to do things.
We‘re right next to you, to help you along.
Relief comes with the knowledge of hospice;
knowing that they are never alone.
You see it in their faces,
you hear it in their words.
Living, loving, embracing life.
Saying what needs to be said;
doing what needs to be done
until the end.
Hospice.
Sunday, November 16, 2014
PRACTICAL
“Daniel”, aged 70, was admitted to hospice today with a recent diagnosis of lung cancer that has spread to his brain. Daniel lives with his second wife, “Laurie”. Both Laurie and Daniel have two children from previous marriages. Since Daniel’s cancer diagnosis two months ago, he has become weaker to where he uses a walker when walking outside. He can still manage to maneuver in his home by holding onto furniture etc.
Daniel is very practical and matter of fact. When speaking about his cancer, he stated, “I did this to myself,” adding that he smoked and drank for years. Daniel continued on, saying that he only stopped drinking and smoking when he received the cancer diagnosis two months ago. He is straightforward and shows no emotion regarding his terminal diagnosis and decline.
Laurie, on the other hand, will get tearful when speaking about what has been happening to her husband. Fortunately, she has great support from several girlfriends. Daniel shared a lot of stories about being a motorcycle cop. He was straightforward when speaking about the rough side of life, but his face did light up when sharing how he delivered three babies during his career. He stated, “I think there is a little Daniel out there somewhere.”
Daniel is very practical regarding stress in his life. He also is very composed when speaking about the love for his wife. Life is just very practical and simple to him. It has worked for Daniel for seventy years and it will continue to work for him until the end. I wish he and his family well.
PRACTICAL
He is a very pragmatic man.
Straightforward in every respect.
No matter what, he will react
in a direct and practical way.
He was a cop for thirty years.
Stories about criminals and drug addicts.
He treated each with the same respect.
No judgment, no blame.
He’s sees life as black or white;
not even a hint of seeing anything grey.
He’ll tell you about his family problems
in a humorous and matter-of-fact way.
He’ll tell you all about his daughter.
How she has struggled with drugs for years.
To no surprise, he is candid and frank,
“She and her two children
all have the same probation officer.”
He does worry about his family though.
It’s harder for the ones left behind.
He has no fears or unfinished business;
only wanting to know the exact date he will die.
No one will be surprised
as he will die the way he has lived;
steadfast, practical, humorous.
His family wouldn’t have it any other way.
Daniel is very practical and matter of fact. When speaking about his cancer, he stated, “I did this to myself,” adding that he smoked and drank for years. Daniel continued on, saying that he only stopped drinking and smoking when he received the cancer diagnosis two months ago. He is straightforward and shows no emotion regarding his terminal diagnosis and decline.
Laurie, on the other hand, will get tearful when speaking about what has been happening to her husband. Fortunately, she has great support from several girlfriends. Daniel shared a lot of stories about being a motorcycle cop. He was straightforward when speaking about the rough side of life, but his face did light up when sharing how he delivered three babies during his career. He stated, “I think there is a little Daniel out there somewhere.”
Daniel is very practical regarding stress in his life. He also is very composed when speaking about the love for his wife. Life is just very practical and simple to him. It has worked for Daniel for seventy years and it will continue to work for him until the end. I wish he and his family well.
PRACTICAL
He is a very pragmatic man.
Straightforward in every respect.
No matter what, he will react
in a direct and practical way.
He was a cop for thirty years.
Stories about criminals and drug addicts.
He treated each with the same respect.
No judgment, no blame.
He’s sees life as black or white;
not even a hint of seeing anything grey.
He’ll tell you about his family problems
in a humorous and matter-of-fact way.
He’ll tell you all about his daughter.
How she has struggled with drugs for years.
To no surprise, he is candid and frank,
“She and her two children
all have the same probation officer.”
He does worry about his family though.
It’s harder for the ones left behind.
He has no fears or unfinished business;
only wanting to know the exact date he will die.
No one will be surprised
as he will die the way he has lived;
steadfast, practical, humorous.
His family wouldn’t have it any other way.
Saturday, November 8, 2014
DEPRESSION
I went out to open “Penelope”, who is eighty-seven, to hospice today. Penelope suffers from esophageal cancer. Penelope also has dementia and is pleasantly confused. Penelope was sitting in her recliner when we walked into her living room. She easily smiles as she loves the company.
Penelope has never married and has no children. Her family consists of many nieces and nephews. Her niece, “Diana”, is the contact person and is responsible for Penelope‘s care. Diana lives about thirty minutes away and visits often. Diana recently hired twenty-four hour attendant care to manage Penelope’s needs.
Diana was sitting on the couch when the nurse and I walked into the home. Diana is devoted to her aunt and is diligent in making sure all of her needs are met. Penelope struggles with keeping up with any conversation. She deals with it by smiling and then pointing to her niece to answer any question that comes up.
Diana, like her aunt, was very pleasant and social. At one point, I asked Diana how she is coping with all of this. It was then when she shared how she attempted suicide years ago by shooting herself in her head. The bullet lodged near her eye. Diana has some slurred speech, likely from that injury.
Diana talked at length about her depression and her life. Fortunately, she has one close friend/spiritual guide, that gives her support. Diana is on anti-depressants, but does not see a therapist. I encouraged her to think about seeing a therapist as well as reaching out to her spiritual friend for support.
Depression is such a powerful emotion. It makes me sad when hearing about suicide as one feels that is the only option they have. How blessed most of us are to be able to recognize the joy, laughter and love in our lives. I wish Penelope and Diana all the best.
DEPRESSION
She has been depressed for years,
never finding joy in her world.
She was unsuccessful in one suicide attempt.
She still thinks about suicide every day.
She owns a dog grooming business.
She cares for the pets in her home.
She feels responsible to her clients;
giving her purpose to continue to hold on.
She is now the primary caretaker for her aunt.
Her aunt is confused and needs constant care.
Having attendants around the clock helps a lot.
One less thing to worry about.
Her aunt’s quality of life is diminishing.
She is confused and forgets a lot.
She cannot keep up with any conversation,
but will smile and just go along.
With sad eyes, she watched her aunt sitting in the recliner.
She wishes she could trade places with her.
“Not that I want her to continue to live this way,
but I would prefer to die”.
Despair, melancholy, sadness, grief;
overshadowing any joy or happiness inside.
Others easily see her thoughtful, caring heart.
Hopefully, one day, she too, will believe.
Depression.
Penelope has never married and has no children. Her family consists of many nieces and nephews. Her niece, “Diana”, is the contact person and is responsible for Penelope‘s care. Diana lives about thirty minutes away and visits often. Diana recently hired twenty-four hour attendant care to manage Penelope’s needs.
Diana was sitting on the couch when the nurse and I walked into the home. Diana is devoted to her aunt and is diligent in making sure all of her needs are met. Penelope struggles with keeping up with any conversation. She deals with it by smiling and then pointing to her niece to answer any question that comes up.
Diana, like her aunt, was very pleasant and social. At one point, I asked Diana how she is coping with all of this. It was then when she shared how she attempted suicide years ago by shooting herself in her head. The bullet lodged near her eye. Diana has some slurred speech, likely from that injury.
Diana talked at length about her depression and her life. Fortunately, she has one close friend/spiritual guide, that gives her support. Diana is on anti-depressants, but does not see a therapist. I encouraged her to think about seeing a therapist as well as reaching out to her spiritual friend for support.
Depression is such a powerful emotion. It makes me sad when hearing about suicide as one feels that is the only option they have. How blessed most of us are to be able to recognize the joy, laughter and love in our lives. I wish Penelope and Diana all the best.
DEPRESSION
She has been depressed for years,
never finding joy in her world.
She was unsuccessful in one suicide attempt.
She still thinks about suicide every day.
She owns a dog grooming business.
She cares for the pets in her home.
She feels responsible to her clients;
giving her purpose to continue to hold on.
She is now the primary caretaker for her aunt.
Her aunt is confused and needs constant care.
Having attendants around the clock helps a lot.
One less thing to worry about.
Her aunt’s quality of life is diminishing.
She is confused and forgets a lot.
She cannot keep up with any conversation,
but will smile and just go along.
With sad eyes, she watched her aunt sitting in the recliner.
She wishes she could trade places with her.
“Not that I want her to continue to live this way,
but I would prefer to die”.
Despair, melancholy, sadness, grief;
overshadowing any joy or happiness inside.
Others easily see her thoughtful, caring heart.
Hopefully, one day, she too, will believe.
Depression.
Saturday, November 1, 2014
HEART
“Barb”, seventy-eight, suffers from end stage cardiac disease. Barb lives with, “Jim“, her husband of forty years. Barb was discharged home today after a month hospital stay. The doctors were treating her heart disease to no avail. Barb finally told her doctors that she’s had enough and wanted to go home.
The nurse and I went out today to admit Barb to hospice. Barb was lying in her hospital bed in the living room. Jim answered the door and then quickly returned to Barb’s side. He was fussing around adjusting her pillows and blankets. He was so concerned that she wasn’t comfortable.
Jim was so worried about Barb. The minute we walked in, Jim wanted the nurse to check Barb out to make sure she was okay. I went and sat in the kitchen with Barb’s two daughters from a previous marriage. I discussed hospice and the support we can offer to families. Both daughters live nearby and visit daily. Barb’s sister is also visiting from out of town and will be staying for several more days. There is a lot of family support.
After about thirty minutes, Jim did come to the kitchen table and sit down with us. I was then able to quickly explain our program and have him sign paperwork. He said he only wanted the short version as he didn’t want to spend much time not being with Barb.
Men like to fix things because they are good at it. Often men will grieve by doing tasks like tinkering with the car, gardening, jogging etc. Jim may be afraid to show any emotion as he fears he will lose total control. All Jim can think to do is to fix things for Barb. That is what he knows.
Jim is so devoted to Barb. He would give up his life for her. He will do whatever he has to do to help her. His love is that strong. It appears Barb likely has only weeks to live. Hopefully, with his family and hospice’s help, he can have the support he needs to get through this difficult time.
HEART
His heart is breaking.
He doesn’t know what to do.
Any wish she wants is not too big.
He’ll do whatever it takes for her.
She mentioned some food.
He quickly ran to the store.
She seemed uncomfortable;
he rearranged her covers.
He has to keep busy; to keep moving.
He can’t seem to quite slow down.
He’s like an anxious hummingbird;
fluttering all around.
She is just home from a long hospital stay.
Her heart disease is now end stage.
She had all the tests and treatments.
There is nothing more to be done.
He is so angry at the doctors
as they didn’t listen to him.
He has a solution he knows would work.
“Take my heart and give it to her.”
His heart is breaking.
He doesn’t know what to do.
Any wish she wants is not too big.
He’ll do whatever it takes
for her.
The nurse and I went out today to admit Barb to hospice. Barb was lying in her hospital bed in the living room. Jim answered the door and then quickly returned to Barb’s side. He was fussing around adjusting her pillows and blankets. He was so concerned that she wasn’t comfortable.
Jim was so worried about Barb. The minute we walked in, Jim wanted the nurse to check Barb out to make sure she was okay. I went and sat in the kitchen with Barb’s two daughters from a previous marriage. I discussed hospice and the support we can offer to families. Both daughters live nearby and visit daily. Barb’s sister is also visiting from out of town and will be staying for several more days. There is a lot of family support.
After about thirty minutes, Jim did come to the kitchen table and sit down with us. I was then able to quickly explain our program and have him sign paperwork. He said he only wanted the short version as he didn’t want to spend much time not being with Barb.
Men like to fix things because they are good at it. Often men will grieve by doing tasks like tinkering with the car, gardening, jogging etc. Jim may be afraid to show any emotion as he fears he will lose total control. All Jim can think to do is to fix things for Barb. That is what he knows.
Jim is so devoted to Barb. He would give up his life for her. He will do whatever he has to do to help her. His love is that strong. It appears Barb likely has only weeks to live. Hopefully, with his family and hospice’s help, he can have the support he needs to get through this difficult time.
HEART
His heart is breaking.
He doesn’t know what to do.
Any wish she wants is not too big.
He’ll do whatever it takes for her.
She mentioned some food.
He quickly ran to the store.
She seemed uncomfortable;
he rearranged her covers.
He has to keep busy; to keep moving.
He can’t seem to quite slow down.
He’s like an anxious hummingbird;
fluttering all around.
She is just home from a long hospital stay.
Her heart disease is now end stage.
She had all the tests and treatments.
There is nothing more to be done.
He is so angry at the doctors
as they didn’t listen to him.
He has a solution he knows would work.
“Take my heart and give it to her.”
His heart is breaking.
He doesn’t know what to do.
Any wish she wants is not too big.
He’ll do whatever it takes
for her.
Subscribe to:
Posts (Atom)