“Pete, sixty-seven years old, suffers from Non-Hodgkin’s lymphoma. Pete was diagnosed four years ago. Three months ago, he started to become weaker and having increased pain. Pete’s biggest complaint is his itching. Tumors just randomly pop up under his skin causing him pain and itching.
Pete lives with his wife of fourteen years, “Laurie”. Laurie is the caregiver of the family. She is the one that family members call when needing support. Laurie is so focused on Pete’s needs, she is getting overwhelmed. She is fearful of making a mistake regarding his medications and care.
Laurie had wanted Pete to come onto hospice several weeks ago so she could have the twenty-four hour support. Pete agreed to meet with us, although was not ready to stop any treatment. He was still hoping for a cure. Hospice is not a curative program, but patients always have the right to choose whatever treatment option that fits them best.
Pete still wants blood transfusions and IVs to prevent dehydration. In addition, there is a new chemotherapy treatment that he wants to pursue. We encouraged Pete to make decisions based on his needs. Education is powerful and we were glad that we were able to inform Pete and Laurie about our program.
During the visit, Laurie started to share all of the losses she has suffered. Pete’s brother, her sister, her best friend, her son, two aunts and her dog have all died within the past three years. Many of the deaths were just weeks apart not giving Laurie or Pete time to grieve. Laurie says she is “stuffing” her feelings down as, for now, she needs to focus on Pete’s needs.
Laurie says her friends want to comfort her and that is what makes her cry the most. Her friends want to hug her and she always says, “Don’t hug me.” She added that she cannot let her tears show as she is afraid she will totally lose control. Laurie likely will grieve the loss of so many, once Pete has died. It will be then that she will need the support of those she won’t allow in now.
As the nurse and I were leaving the home, I teased Laurie and we gave each other an “air hug”. She laughed as knows that in time, the true and genuine hugs her friends will give her, will be the best medicine of all.
“DON’T HUG ME”
She doesn’t want to be hugged.
She doesn’t want to break down.
She’s been holding so much in.
It is much too scary to let it out now.
She has suffered from so many losses.
More than most could ever imagine.
Her son. her sister, her best friend and more;
all within these past three years.
Her close friends want to hug her.
They want to give her support,
but she keeps them arm’s length away.
She’s afraid she’ll break down and cry.
She can’t cry now.
She has way too much to do.
She needs focus; she needs control.
But most of all, she needs to help him.
When all is over and done,
she says she’ll let her support in.
But for now in order to cope,
all she can say is,
“Don’t hug me.”
Saturday, January 31, 2015
Saturday, January 24, 2015
A QUIET GUY
“John”, seventy-one, was on hospice for only one day. John suffered from esophageal cancer. John lived with “Denise”, his wife of forty-eight years. They have one son, “Seth”, who lives about two hours away. On Monday when the hospice nurse and I went out to admit John to hospice, we knew he was into his dying process. John had stopped eating several days ago. He slept through most of the visit. When he did awaken, he only said a few words and then fell back asleep.
Denise and Seth both were aware that John’s time was close. Seth was staying with his parents for a few days before he was to return home. Denise was very open, honest and direct with her emotions. She would talk very factual about John’s dying. Her strong spiritual support helped her cope. Seth would not sit with us at the kitchen table even though his mother asked him to. Seth would keep saying that he had one more thing to do first. During the entire visit, Seth kept himself busy doing laundry, checking on his dad or some other task.
Denise shared how she wished John and Seth were not so stoic with their emotions. I talked about how often men want to fix things and can feel so helpless because they can’t fix cancer. Many men will do tasks to show their grief. I added that Seth was a perfect example of how some men, or even women, may grieve. He was showing his emotions by tasks, not words.
Seth’s birthday was one week away. Seth and his father shared a joy of hunting. John had ordered a classic gun for his son for his upcoming birthday. The gun was delivered on Tuesday evening, the day after we admitted John to hospice. John died quietly hours later.
Denise shared that she knew that John waited until the gun was delivered before he left. She added that he also waited for she and Seth to leave his room. She said that John was protecting his family. She added. “John’s last gift to us was passing as peacefully as he did.” The way he died, gave her and Seth peace. Over the years, John had been showing his emotions with actions; never words.
We all speak constantly as body language is very revealing. What a gift they gave each other. She and Seth giving John permission to go and John dying the way he did. The only thing Denise and Seth wanted was for John to do things his way. John did; quietly.
A QUIET GUY
He was a quiet guy;
an unassuming, stoic man.
Silently doing what needed to be done.
His family foremost on his mind.
Even in his dying,
his wife and son came first.
Making sure all tasks were complete,
before he chose to let go.
She always hoped he would open up one day;
share his feelings so she would understand.
But she loved and accepted him as he was,
showing emotions with his actions; not his words.
“The two of us will be okay.
If you need to go home, go home.”
They knew he worried so much about them,
so they gave him permission to be on his way.
She said his final gift to them was serenity.
“He passed so peacefully, so gently.”
He died the way he always lived.
Until the end of time,
a quiet guy.
Denise and Seth both were aware that John’s time was close. Seth was staying with his parents for a few days before he was to return home. Denise was very open, honest and direct with her emotions. She would talk very factual about John’s dying. Her strong spiritual support helped her cope. Seth would not sit with us at the kitchen table even though his mother asked him to. Seth would keep saying that he had one more thing to do first. During the entire visit, Seth kept himself busy doing laundry, checking on his dad or some other task.
Denise shared how she wished John and Seth were not so stoic with their emotions. I talked about how often men want to fix things and can feel so helpless because they can’t fix cancer. Many men will do tasks to show their grief. I added that Seth was a perfect example of how some men, or even women, may grieve. He was showing his emotions by tasks, not words.
Seth’s birthday was one week away. Seth and his father shared a joy of hunting. John had ordered a classic gun for his son for his upcoming birthday. The gun was delivered on Tuesday evening, the day after we admitted John to hospice. John died quietly hours later.
Denise shared that she knew that John waited until the gun was delivered before he left. She added that he also waited for she and Seth to leave his room. She said that John was protecting his family. She added. “John’s last gift to us was passing as peacefully as he did.” The way he died, gave her and Seth peace. Over the years, John had been showing his emotions with actions; never words.
We all speak constantly as body language is very revealing. What a gift they gave each other. She and Seth giving John permission to go and John dying the way he did. The only thing Denise and Seth wanted was for John to do things his way. John did; quietly.
A QUIET GUY
He was a quiet guy;
an unassuming, stoic man.
Silently doing what needed to be done.
His family foremost on his mind.
Even in his dying,
his wife and son came first.
Making sure all tasks were complete,
before he chose to let go.
She always hoped he would open up one day;
share his feelings so she would understand.
But she loved and accepted him as he was,
showing emotions with his actions; not his words.
“The two of us will be okay.
If you need to go home, go home.”
They knew he worried so much about them,
so they gave him permission to be on his way.
She said his final gift to them was serenity.
“He passed so peacefully, so gently.”
He died the way he always lived.
Until the end of time,
a quiet guy.
Saturday, January 17, 2015
A LONG LIFE
“Alan”, ninety-four, has been active most of his life. Alan lives with “Dorothy”, his wife of seventy three years. They have three adult sons who all live nearby. Years ago, Alan inherited an eighty acre farm from his father. The business has grown over the years, to where Alan and his three sons now work hundreds of acres in the area.
Alan and Dorothy have a twenty-four hour attendant as Dorothy suffers from Dementia. Alan recently had a heart attack and was hospitalized for care. His heart is failing and he is on continuous oxygen. His body has taken a large hit. Alan is very weak and will need constant care himself now.
The hospice nurse and I went out to the hospital to meet with Alan and his three sons. Alan’s doctor had made the hospice referral earlier, and the family was ready to have our services. Alan didn’t talk much as is hard of hearing. His sons were very involved and signed all the paperwork required.
The family farm has been a successful business for years. Alan’s hard work has paid off in so many ways. He taught his sons well as they, too, are very hard workers. Alan has accepted what was happened to him without complaint. He will smile so easily. Where once his father handed the business over to him, Alan now had completely handed over the farm to his three sons.
Alan has lived his life to the fullest and is not yet ready to stop living. He was anxious to get home to be with his wife. He feels confident about his business as knows his sons will keep it going like he has had for so many years. Alan will brag about growing acres of tomatoes, almonds and sunflowers. His spunk and spirit were inspiring. Whatever the day brings, he will cherish the joy in it. What a teacher Alan is for all of us.
A LONG LIFE
He’s lived a long life.
He’s accomplished quite a bit.
Endless hours harvesting the earth;
raising three hard-working sons.
He inherited the farm from his father.
Raising tomatoes, sunflowers and almonds.
Knowing when to hand the business over
to his three grown sons.
After ninety-four years of hard living,
his body can take no more.
His heart and lungs are weakening.
It’s time for him to slow down.
He has an easy smile.
Not much will get him down.
He appreciates his life; his sons.
He’s happy just to know he’s going home.
I asked him about his longevity.
What is his secret to such a long life?
With a sheepish smile, he turned and said,
“I don’t know. I haven’t gotten there yet.”
Alan and Dorothy have a twenty-four hour attendant as Dorothy suffers from Dementia. Alan recently had a heart attack and was hospitalized for care. His heart is failing and he is on continuous oxygen. His body has taken a large hit. Alan is very weak and will need constant care himself now.
The hospice nurse and I went out to the hospital to meet with Alan and his three sons. Alan’s doctor had made the hospice referral earlier, and the family was ready to have our services. Alan didn’t talk much as is hard of hearing. His sons were very involved and signed all the paperwork required.
The family farm has been a successful business for years. Alan’s hard work has paid off in so many ways. He taught his sons well as they, too, are very hard workers. Alan has accepted what was happened to him without complaint. He will smile so easily. Where once his father handed the business over to him, Alan now had completely handed over the farm to his three sons.
Alan has lived his life to the fullest and is not yet ready to stop living. He was anxious to get home to be with his wife. He feels confident about his business as knows his sons will keep it going like he has had for so many years. Alan will brag about growing acres of tomatoes, almonds and sunflowers. His spunk and spirit were inspiring. Whatever the day brings, he will cherish the joy in it. What a teacher Alan is for all of us.
A LONG LIFE
He’s lived a long life.
He’s accomplished quite a bit.
Endless hours harvesting the earth;
raising three hard-working sons.
He inherited the farm from his father.
Raising tomatoes, sunflowers and almonds.
Knowing when to hand the business over
to his three grown sons.
After ninety-four years of hard living,
his body can take no more.
His heart and lungs are weakening.
It’s time for him to slow down.
He has an easy smile.
Not much will get him down.
He appreciates his life; his sons.
He’s happy just to know he’s going home.
I asked him about his longevity.
What is his secret to such a long life?
With a sheepish smile, he turned and said,
“I don’t know. I haven’t gotten there yet.”
Saturday, January 10, 2015
INVISIBLE BARS
“Albert”, eighty-six, has suffered from Alzheimer’s Disease for over ten years. He is widowed and lives in a Residential Care Facility where someone is available twenty-four hours a day to attend to his needs. Albert is able to walk slowly with some assistance. He has cataracts and can barely see. He is very hard of hearing and one must speak into his one good ear in order to communicate with him. Albert understands simple instructions.
Albert has been in a recent decline to where he is weaker, sleeping more and eating less. He is getting more confused and has started to resist staff when they are trying to assist him. Albert has four daughters, although only his youngest, “Betsy” ever routinely visits.
The hospice nurse and I went out to meet with Albert and Betsy this morning to admit him to our hospice program. Albert was sitting about fifty feet away from us in a recliner chair. Every so often, he would start a conversation with no one there. Betsy said her dad talks to John F. Kennedy quite often. Albert would laugh, then sit back in his chair with a contented look on his face.
Betsy lives about thirty minutes away and visits weekly. She said her other sisters rarely visit. Betsy’s eldest sister lives two states away and suffers from Multiple Sclerosis which limits her activity level. She does fly down occasionally to visit her dad and help her sister as much as she can.
Betsy said another sister lives nearby but only visits every three to four months. Betsy said her sister is in strong denial and wants things done to keep her dad alive. Fortunately, Albert assigned Betsy as his agent on his Advanced Directive so only she, legally, can express his medical wishes.
Betsy’s third sister, who had been a big help to Betsy, was recently incarcerated. Betsy added that they don’t know how long she will be in prison. It is a huge loss for Betsy as she was the only sibling who helped out.
It made me think that bars can be visible and invisible. Prison bars are strong and impassable. In addition, one can feel just as trapped with limitations due to poor health. Also, the invisible bars we place ourselves, are just as powerful and impenetrable.
INVISIBLE BARS
He seems happy and pretty content,
although his memory is all but gone.
He talks when no one is about.
His vision and hearing have faded away.
He’s trapped inside his body
by invisible bars hidden from view.
There is no way out for him;
no magical key.
He has four grown daughters,
but only one ever comes around.
The eldest lives in another state.
Multiple Sclerosis keeps her away.
Another is in strong denial.
Her visits are many months between.
She cannot face her father’s prognosis.
Staying away makes everything okay.
A third daughter was recently arrested.
She will be incarcerated for a long time.
Her bars are real and holding her inside,
leaving her one sister to carry the burden alone.
Invisible or not, both bars are equally strong.
Even though few ever escape from a prison cell,
the invisible bars of poor health; of denial
are the most compelling bars of all.
Albert has been in a recent decline to where he is weaker, sleeping more and eating less. He is getting more confused and has started to resist staff when they are trying to assist him. Albert has four daughters, although only his youngest, “Betsy” ever routinely visits.
The hospice nurse and I went out to meet with Albert and Betsy this morning to admit him to our hospice program. Albert was sitting about fifty feet away from us in a recliner chair. Every so often, he would start a conversation with no one there. Betsy said her dad talks to John F. Kennedy quite often. Albert would laugh, then sit back in his chair with a contented look on his face.
Betsy lives about thirty minutes away and visits weekly. She said her other sisters rarely visit. Betsy’s eldest sister lives two states away and suffers from Multiple Sclerosis which limits her activity level. She does fly down occasionally to visit her dad and help her sister as much as she can.
Betsy said another sister lives nearby but only visits every three to four months. Betsy said her sister is in strong denial and wants things done to keep her dad alive. Fortunately, Albert assigned Betsy as his agent on his Advanced Directive so only she, legally, can express his medical wishes.
Betsy’s third sister, who had been a big help to Betsy, was recently incarcerated. Betsy added that they don’t know how long she will be in prison. It is a huge loss for Betsy as she was the only sibling who helped out.
It made me think that bars can be visible and invisible. Prison bars are strong and impassable. In addition, one can feel just as trapped with limitations due to poor health. Also, the invisible bars we place ourselves, are just as powerful and impenetrable.
INVISIBLE BARS
He seems happy and pretty content,
although his memory is all but gone.
He talks when no one is about.
His vision and hearing have faded away.
He’s trapped inside his body
by invisible bars hidden from view.
There is no way out for him;
no magical key.
He has four grown daughters,
but only one ever comes around.
The eldest lives in another state.
Multiple Sclerosis keeps her away.
Another is in strong denial.
Her visits are many months between.
She cannot face her father’s prognosis.
Staying away makes everything okay.
A third daughter was recently arrested.
She will be incarcerated for a long time.
Her bars are real and holding her inside,
leaving her one sister to carry the burden alone.
Invisible or not, both bars are equally strong.
Even though few ever escape from a prison cell,
the invisible bars of poor health; of denial
are the most compelling bars of all.
Sunday, January 4, 2015
HOVER
“Bonnie”, sixty-four, was diagnosed two years ago with leukemia. Bonnie lives with her husband, “Brad” and her two adult sons. She took a fall eleven days ago and was hospitalized for internal bleeding. She had numerous blood transfusions and platelets to no avail. The doctors told the family that there is nothing more to be done.
The hospice nurse and I went out to meet with Bonnie and her family shortly after she arrived home from the hospital. Bonnie is very weak which made communication difficult. It appears she likely has just days to live. Bonnie was sleeping nearby while the nurse and I sat at the kitchen table with Brad to talk about hospice support.
Bonnie’s two sons were standing by their mother asking her if she needed this or needed that. They were trying hard to help her, but not really knowing what to do. With any laugh or loud talk from his sons, Brad would jump up and rush over to Bonnie’s side. The whole family was so anxious and could not stop hovering over Bonnie.
Quite often men will grieve by doing tasks. Men are good at fixing things and that is what they want to do. They want to make Bonnie better. Many of us feel like we are accomplishing things by doing tasks, but just being there is huge for folks. If the boys and Brad just sat quietly next to Bonnie, they wouldn’t feel like they were doing anything, but Bonnie would know that, in a heartbeat, they would do anything to help her.
I heard a quote that I now have hanging in my workstation saying, “Don’t just do something, sit there.” Doing something often makes us feel better, but sitting there, is wonderful support for the patient.
Bonnie was the anchor in the family and will be sorely missed. I hope that Brad and his sons avail themselves to hospice’s bereavement support. I think it will help them through these tough times that lie ahead.
HOVER
All three are hovering around.
They don’t want to leave her side.
They’re helpless to what she needs,
but feel the urge to just do something.
The doctors said there is no treatment.
Her disease has run its course.
They were anxious to get her home.
Now they don’t quite know what to do.
Inside they want to fix things.
They want to make her well.
She was the strong one; the anchor
who held them all together.
“Are you cold; a blanket?
Are you thirsty; a small sip?
Let’s move the bed over here
so you can see the TV easier”.
They are doing tasks
for a need to do just something.
Their hearts are in the right place,
but all she needs is for them to just be.
It is obvious how much she is loved by them.
I know she feels it too.
So they will continue to hover nearby,
as that is all that they know how to do.
The hospice nurse and I went out to meet with Bonnie and her family shortly after she arrived home from the hospital. Bonnie is very weak which made communication difficult. It appears she likely has just days to live. Bonnie was sleeping nearby while the nurse and I sat at the kitchen table with Brad to talk about hospice support.
Bonnie’s two sons were standing by their mother asking her if she needed this or needed that. They were trying hard to help her, but not really knowing what to do. With any laugh or loud talk from his sons, Brad would jump up and rush over to Bonnie’s side. The whole family was so anxious and could not stop hovering over Bonnie.
Quite often men will grieve by doing tasks. Men are good at fixing things and that is what they want to do. They want to make Bonnie better. Many of us feel like we are accomplishing things by doing tasks, but just being there is huge for folks. If the boys and Brad just sat quietly next to Bonnie, they wouldn’t feel like they were doing anything, but Bonnie would know that, in a heartbeat, they would do anything to help her.
I heard a quote that I now have hanging in my workstation saying, “Don’t just do something, sit there.” Doing something often makes us feel better, but sitting there, is wonderful support for the patient.
Bonnie was the anchor in the family and will be sorely missed. I hope that Brad and his sons avail themselves to hospice’s bereavement support. I think it will help them through these tough times that lie ahead.
HOVER
All three are hovering around.
They don’t want to leave her side.
They’re helpless to what she needs,
but feel the urge to just do something.
The doctors said there is no treatment.
Her disease has run its course.
They were anxious to get her home.
Now they don’t quite know what to do.
Inside they want to fix things.
They want to make her well.
She was the strong one; the anchor
who held them all together.
“Are you cold; a blanket?
Are you thirsty; a small sip?
Let’s move the bed over here
so you can see the TV easier”.
They are doing tasks
for a need to do just something.
Their hearts are in the right place,
but all she needs is for them to just be.
It is obvious how much she is loved by them.
I know she feels it too.
So they will continue to hover nearby,
as that is all that they know how to do.
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