Saturday, December 31, 2016

LOVE

My work involves a lot of stressful times that families need to share. I see tears and anguish, but most of all, there is laughter and a lot of love. Cream rises to the top as does love. Love is what gets folks through those tough times as it lets them know they are never alone.

2016 has given a lot of folks I know a lot of medical challenges. I myself, was not immune as I too had a medical challenge during this year. What helped me cope was all of those in my life who care and whom I care about. In the end, that is what I was able to embrace to help me through some tough moments.

I was talking with a co-worker today, who herself has struggled with a serious illness. We were talking about why both of us were presented with these critical diagnoses. I continued to process our conversation for the rest of today. The best any of us can do is to show kindness and love towards another. What one gives out, always returns a thousand-fold. Maybe life isn't all that complicated. One day, I believe, all of us will learn what it is all about.


LOVE

I have done hospice work for years
and I still don't understand why
some people have to suffer so.
What is it
          all about?

One thing is in abundance though.
It is consistent to those who care.
Love comforts these families.
It helps them to laugh and also to cry.

Each day I hear so many stories,
but I also see unconditional love.
They need to share their life with you
along with tears and lots of laughter.

Maybe it is not that complicated.
Maybe life is just a simple thing.
Love and be loved
and take notice of it
                   all around.


 

Saturday, December 24, 2016

MY SMALL TOWN

I grew up in a small town south of San Francisco. I attended grammar school and high school there. When I was twenty-three, I moved to another town a few miles south.

I now live about ninety miles north and seldom run into anyone from my small town. I am always so surprised when I do. It always feels like I have met a kindred spirit. I meet so many people doing my work, but seldom ask someone where they grew up. Quite often, patients and families tell their family stories and will share where they grew up. More often than not, it is another state.

I had two admissions today; one in the morning and one early afternoon. Both women lived in the same facility, although in totally separate areas from each other. Both of these women were quite elderly and did not sit in on the Admission Visit. In the morning visit, I met with the patient's son, "Will", and his mother-in-law, "Sylvia". The two of them started to share the patient's history and did some life review.

Sylvia was near the patient's age and started to share some of her life history. She started to talk about places that I knew so well from growing up. It was them that I asked her where did she grow up. The moment we found out we grew up in the same town, we started sharing places we knew and loved. We both agreed that it felt like we were kindred spirits from having a similar background.

During the afternoon visit, I met with the patient's daughter, "Diana", in a sitting room. Diana's mom has dementia so it was best for us to meet in a conference room. Diana, too, started to share her family's history and life. She, like Sylvia, started to share stories about areas that I was so familiar with. So once again, I had to ask where did she grow up. Surprisingly, she also answered my small town.

With Sylvia and Diana, we could not connect any dots, as both were older than I and we all went to different schools. I still wouldn't have been surprised, if we had more time, that we would have found a connection. All I can say is, what an amazing coincidence!!


MY SMALL TOWN

I grew up in a small town
about ninety miles south of here.
I seldom run into anyone from there
and am always surprised when I do.

I admitted two patients to hospice today.
Both reside in the same facility,
although one in Assisted Living;
while the other in Memory Care.

Seldom do I ask anyone where they grew up,
but in both of these visits the question came up.
The adult children were talking about the early years.
Sharing their mother's life events and experiences.

Each child shared places that I knew about.
Places that were close to where I grew up.
So I just had to ask each of them,
"Where did you grow up?"

To my shock and surprise,
both answered the same.
They were raised the same place I was,
living about one mile from me.

We are different ages
and went to different schools,
but had one major thing in common;
             My small town.
 

Saturday, December 17, 2016

A GIRLFRIEND

Each person we meet along our life's journey, impacts us in a small or big way. I have always been blessed with a wonderful family and supportive friends. Of those, one of my most amazing gifts is having kindred spirits around. Hence; a girlfriend.

A woman can talk to another woman with ease and comfort knowing that their girlfriend understands, knows and cares. There is no judgment, just compassion and love.

"Janice", who is grieving the recent decline of her elderly father, is a perfect example of the importance of a supportive girlfriend. Janice and I were discussing her grief and what helps her cope, when she stated, "My life is full of stressors." Janice shared some examples of her stresses. Most were associated with how she didn't do something in a perfect way as had to do with the tasks needed to reach a certain goal. She was particularly hard on herself.

Janice appeared anxious and stressed throughout most of our visit. Toward the end of our time together though, Janice started talking about her girlfriend whom she met in high school. Her entire persona changed to comfort while she shared how her friend supported her. Janice stated, "It feels so good just to talk with her." It is Janice's friend who will who will be there for her throughout her father's disease process and decline.

I have a magnet on my refrigerator that says, "There is nothing better than a girlfriend, except a girlfriend with chocolate." That magnet was given to me by a dear friend who also understands the importance of a good girlfriend.


A GIRLFRIEND

I meet a lot of women in my work.
Exceptional souls with distinctive personalities.
But one thing, I do believe, most do agree,
"There is nothing better than a girlfriend."

Our girlfriends listen to us because they care.
They understand what we are feeling.
Good or bad, we can speak our true minds.
Their unconditional love is forever more.

Her elderly dad is weak and getting more confused.
She knows he gets good care from the staff,
but it still is hard to see his decline.
Who he was has been gone for a long time.

She has a nervous personality,
but I was still a bit surprised,
when I asked her how she copes,
she knowingly replied,
             "I cope by being anxious."

There is one thing though that is working well.
A high school buddy she has known for years.
"Talking with her helps me so much.
She understands where I am coming from."

Another perfect example
of what we ladies do all agree;
"There is nothing better
             than a girlfriend!"
 

Sunday, December 11, 2016

THE LIGHT

During this month of December, our hospice chaplains are presenting to staff different beliefs, customs and religions that are celebrated throughout the world. One of the chaplains came to me to write a poem about the importance of one of these rituals; the Winter Solstice, and Yalda Night. Part of the Yalda Night includes the reading of poetry. December 21st, being the shortest day of the year, and Yalda Night are celebrated concurrently. Both cultures celebrate the importance of light.

Per his request to write a poem, I came home tonight and wrote a poem about Light. I will give him a copy tomorrow and will be honored to read it to the staff on December 21st. What an honor.


THE LIGHT

Cultures worldwide honor the light
on Winter Solstice, Yalda Night and Yule.
Celebrating hues of dawn and the glow of life
on the longest, darkest night of the year.

The symbolic rituals are alive in December,
but we all acknowledge that light year round.
It is subtle and we may not quickly notice,
but the presence of light is powerful and strong.

We notice the light in another's eyes.
The light that shines in one's heart.
Filling one's cup with positive thoughts.
Energy of goodness, peace and pure love.

At the end of one's life we say, "Go to the light.
They are waiting for you with open arms.
We will miss you, but it is your time.
The light will guide your way."

So keep celebrating as long as you can.
The light is everything good.
Centuries of rituals have kept the light strong.
The darkness will always crumble
as nothing is as powerful as
                                   "The Light."


Saturday, November 26, 2016

HIS BIRTHDAY

Sixty-seven year old, "Shirley", has been in poor health for many years. Shirley lives with her husband, "Jake", who is twelve years older than she. The couple have four adult children and multiple family members who all live nearby in their small town. This is a very large, extended family who are all very devoted to each other.

The patient had been in the hospital multiple times this previous month. She has been through a lot of treatment for her cancer, but when the doctors offered kidney dialysis, Shirley declined. She became confused and unresponsive while in the hospital. The family wanted to follow Shirley’s wishes to be able to go home. That is when they contacted our hospice for help.

The hospice nurse and I met the family late this afternoon at the patient’s home. Her husband, their four children and numerous other extended family were all holding vigil. One could feel the strong love in this home. We observed each family member caring for each other. Humor was a huge coping mechanism for this family. They were sharing how Shirley would always be laughing so loudly. She never complained about anything, but would rather look on the positive side of what life gives out.

Jake got serious and shared how he wanted Shirley home today as it was his birthday. He told Shirley a few days ago to hang on until his birthday; and she did. Jake said he will be ok after she dies because of his strong faith and his amazing family. Jake and his family are such a strong example of being able to give love to another. What a remarkable family.


HIS BIRTHDAY

Being twelve years older than she,
he always thought she'd outlive him.
But recently things have dramatically changed.
He knows her time is now near.

She's been in the hospital almost a week.
There is nothing more to be done.
He hopes to get her home today.
This special day; his birthday.

She is unresponsive, imminent, hardly aware,
but she did make it home by four.
He stroked her face to say welcome home.
His loving heart so sincere.

Such a large family all gathered around.
Telling her stories; laughing out loud.
Teasing each other in such a positive way.
Obviously, humor, helping them cope.

In the end, he truly knows and strongly believes
it is not what is in your life, but whom.
He felt so blessed that she made it home
on this special day;
                   his birthday.
 

Saturday, November 19, 2016

A PERFECT PLAN

An urgent referral was made to hospice for "James", eighty-four, who had a sudden decline since he suffered a stroke several weeks past. James has ultimately been in a skilled nursing facility following that stroke.

The hospice nurse and I met James's son, "Dan", and his daughter-in-law, "Julie" in the lobby of the nursing facility. The staff directed us to a conference room down the hall from James room for us to inform the family about hospice supports and to complete the admission paperwork.

Dan immediately started telling us stories about he and his dad and how close they were. While sharing these stories, Dan face would redden and his tears would flow. He would hold onto his wife's hand and continue to share his memories.

Ten minutes into the visit, the admission nurse, out of character, suddenly stood up and said she was going to check on James. She came back a moment later informing us that the patient was near death. Dan and Julie quickly left the room to sit with James. Ten minutes later, James took his last breath.

I have always believed that patient's let go when the time is right for them. It makes me wonder, did James know hospice was there to give comfort to his son? Did James know it was okay to go while his son sat by his bedside? I truly believe we all did witness James's perfect plan.


A PERFECT PLAN

We met them there at ten;
like we had previously scheduled.
We sat in a conference room
not far from where his father slept.

He spoke about his life
and what his father meant to him.
His grief so strong that tears would flow.
They were so sad by his recent decline.

We started to talk about hospice support.
Twenty-four hour care by a dedicated team.
Help us to follow your father's wishes.
Guide us to do things his way.

The hospice nurse hastily left
to check on how his father was doing.
She came back quickly saying,
"He is dying right now; you better come."

Ten minutes later, he was gone.
Letting go with his son by his side.
Did he choose this perfect time to leave?
Did he know there was support for his son?

A gift from a son; he didn't die alone.
A gift from a father; peacefully leaving this life.
Each giving the other a token of love.
All in all;
          indeed it was;
                   a perfect plan.


Saturday, November 12, 2016

HE HAS

Sixty-three year old, "Bill", was diagnosed with throat cancer three years ago. He has since been on a feeding tube as can no longer swallow any food or liquid. Bill was referred to hospice as there is no further treatment for him.

Bill lives in the small town where he was born and raised. Three of his children live close by. Bill has a tremendous number of family and friends who are so involved and supportive. He lives in a very tiny apartment in the rough part of town. The strongest impression is all that he doesn't have.

The minute one walks into his tiny apartment, that first impression is immediately gone. Bill has so much love for others and a strong acceptance of personal challenges. We spoke about the loss of not being able to eat or taste food. Food is such a part of every culture in the world. It is a large part of what we do when family is visiting or we are on vacation.

Bill spoke about his losses in such a positive way. He totally has accepted his cancer and limitations. He has a lot of humor and laughs so easily. He knows that he cannot fight his cancer. He has chosen to accept it and continue to enjoy his life to the fullest. He sees death as "an adventure." Bill is such an amazing teacher to us all.


HE HAS

First impressions are powerful.
Conclusions come flying pretty fast.
He lives in such a small apartment.
Hardly any place to sit yourself down.

He's fought his cancer for several years.
A feeding tube keeps him alive.
He has no teeth, his clothes are frayed,
He has so little to get by.

But he astounds you with his attitude.
He smiles, he laughs, he is an amazing guy.
His positive thinking; his corny humor.
His philosophy is, "One step at a time."

He has no fears about dying.
He's not sure about heaven or hell.
"I am at peace with my God.
Death will take us where we need to go."

Initially one notices what he has not,
but once meeting him, you observe so much more.
He has peace, acceptance, love in his life,
while embracing his challenges with open arms.

One can't help noticing
           all that
                     he has.


Sunday, November 6, 2016

"I AM SORRY"



"Joseph", sixty-two, was diagnosed with cancer four years ago. He had been doing fine, until four days ago, when he rapidly declined. Joseph lives with his wife, "Barb". They have a daughter, "Annie", living nearby. Joseph stopped eating several days ago and stopped drinking water yesterday. He is bedridden, unresponsive and actively dying.

The hospice nurse and I walked into Joseph's home to do our hospice admission. Barb led us into the kitchen to sit down at the kitchen table. Moments later, Annie walked in. She immediately cried and hugged me so tightly, while saying several times, "I am sorry." So many folks, myself included, say "I am sorry" when we ever cry. One need not ever express regret, but somehow we do feel apologetic.

This family is such a strong example of why hospice workers do what we do. It is so rewarding. This family kept thanking us while crying, but it is us who need to say thank you to them. Barb and Annie’s words were telling us we made a difference to them today. It doesn’t get much better than that.


"I AM SORRY"

Four days ago he was walking.
They thought he had some time.
Now he is bedridden, unresponsive.
Likely hours to days is all.

We walked into their home to support them.
She immediately cried and fell into my arms,
saying, "I am sorry" at least three times.
I held her tight, knowing she needed the embrace.

I praised her for showing her emotions.
It's good not keeping things inside.
It releases your pain, your strong grief.
It's not easy having someone you love die.

They asked about having a priest come out
to bless her father before he dies.
I made a phone call to our chaplain.
A priest was coming in one hour's time.

She was so appreciative. she hugged me
while strongly crying one more time.
Saying again, "I am sorry", but so thankful.
"You were meant to be here today".

She didn't have to apologize to us at all.
We are the blessed ones to be able to come.
It is humbling and an honor to do our work.
We thanked them for all they gave to us.
The gifts do run
               both ways.
 

Saturday, October 29, 2016

HOW CAN YOU?

I have worked in hospice for over fifteen years. The rewards are so amazing as each day we get told that we made a difference today. Often we get asked, “How can you do this work?” I believe that most ask as they remember their grief when a loved one of theirs died. When someone you love is on hospice, your emotions are so strong while you feel such pain. It is hard to function as oftentimes one can feel overwhelmed. I have had family and a few friends on hospice and my first reaction is always, “What can I do?” I didn’t know what the first step was, even though I work in this field. Emotions are so powerful.

It does take a lot of heart to do this work, but the rewards are so amazing. The look of relief on faces or those special thank you words make it all worthwhile. We all can see and feel what is coming in, but do not see what we give out. In hospice, we get told frequently how much we helped just by being there and listening to their words.

We had “Tom” scheduled to open to hospice today. Tom’s wife, “Valerie”, called hospice early this morning to say that Tom had died last night. I gave Valerie a call to offer condolences and support. I listened to her story about Tom and their family. There are several young grandchildren who are also grieving their grandpa. I educated her on children’s grief and shared some ways to give them support.

At the end of our conversation was when I knew I made a difference to her by what she said. Our phone conversation is a perfect example of why I can do hospice. It is my life’s mission as I often think, “How can I not continue to do this work?” I am so honored and blessed.


HOW CAN YOU?

We get asked frequently,
"How can you do what you do?
Don't you get depressed?
It must be so hard on you."

We meet the most amazing people
who welcome us into their homes
to share such intimate moments
while gratefully thanking us.

The rewards are a thousand-fold,
hearing you made a difference today.
“Thank you for listening to us.
Thank you for your care.”

We were scheduled to open him to hospice today.
I called her knowing he died last night.
She spoke about her experience; her grief.
“As sad as it is, we were gifted at the opportunity
to share our feelings with him.”

I validated her emotions; I normalized her grief.
It was humbling as I know I made a difference when she said,
“You are an amazing person.
Your words are magical.”

The rewards are a thousand-fold,
knowing they too made a difference today.
As we can also say to them,
“Thank you for listening to us.
Thank you for your care.”
 

Saturday, October 22, 2016

TWO SOULS

I first met "Marian", 95, three weeks ago. I did a visit for another Social Worker to help out. The moment Marian answered the door, there was a sudden connection between us. We were instantly talking before we even sat down in her living room. She is such a sweetheart. She has such a positive attitude about life and laughs so easily.

Marian shared many life stories about her life and family. During it all, she would always have a broad smile showing. I so understood how she thought about life experiences as I process thoughts the same way. The two of us shared that connection. It is always such a gift to meet someone so much like you.

I did a second visit this afternoon. The sudden bonding was still there and wonderful. I hope I will be able to see her again in order to spend time with such a special lady. I have to look at life as, "If it is meant to be, it will be." But, on the other hand, I would love to hear more of her life stories. She is a wonderful story teller. Gifts from above.


TWO SOULS

We know instantly when we meet them.
Easily understanding spoken thoughts.
A spiritual link bringing us together.
A sudden connection between two souls.

She's twenty-five years my senior.
She speaks about life experiences;
Pearl Harbor; the depression;
events way before my time.

But age does not matter at all.
It is not the events or the times.
It is the processing of those experiences
that we both clearly understand.

She's had some hard times during her life,
but she will share life stories with a broad smile.
She'll laugh so easily when talking about her sons;
the good, the bad, the funny, the memories.

I sure wish we met earlier in our lives.
I wish she lived next door.
But life brings us those things when we need them.
I will always cherish and always remember
          the connection of
                       our two souls.
 

Saturday, October 15, 2016

DEMENTIA

Dementia is such an unpleasant disease. I can only imagine the emotions that sprout forth when told of the diagnosis; when you understand what will be happening to your brain. “John”, ninety-three, was diagnosed with Alzheimer’s eight years ago. He has been in a recent decline and it was then, that his doctor made a hospice referral.

We met John and his daughter in a visiting room at the facility where John has lived for four years. John did not understand who we were or why we were there. The first thing I noticed was how happy he appeared. His daughter, “Amanda”, was so attentive to her father. John would ask Amanda about the athletic pants she was wearing and then would laugh. She would respond, “Do you want a pair?” Both of them would laugh so hard. It was wonderful to see.

This family was a joy to be with as John and Amanda had us all laughing throughout the visit. It was a blessing that John did not understand what was happening. That is the one gift that Alzheimer’s can give folks; no memory of how much they have lost. I know John will continue to laugh, and keep others laughing, as long as he can. God bless you John.


DEMENTIA

He's lost a lot of his memory,
but his wide smile still remains.
No matter what topic of conversation,
his laugh will permeate the room.

Dementia slowly robs one's memory.
Day by day, bit by bit.
One's reality may become distorted;
their truth known only to them.

You could tell he had a great sense of humor.
He was witty in his own way.
His laugh was so contagious;
with humorous sarcasm shining through.

I asked his daughter about his faith.
Would he like a chaplain to stop in?
She said he was a lifelong Mormon.
For ninety years he lived his faith.

Recently though, things have changed.
His faith has taken a dramatic turn;
as three years ago he adamantly proclaimed,
          “Enough of that!”

He made us all laugh,
like he's been doing all of his life.
Dementia may have robbed him blind,
but it kindly left him one wondrous gift;
          his humor.
 

Saturday, October 1, 2016

BOOKENDS

"Russ", sixty, was diagnosed with cancer five months ago. He found out last week that his cancer has now spread to his bones. In the past few weeks, he has become much weaker and needing more help. Russ spends a lot of time in bed because of his weakness. He has had a poor appetite and is focused on eating better and getting stronger in order to be able to sit outside in the sun.

Russ has been a successful painter and singer throughout his career. His art gives him much joy. His face lights up when talking about his art or sharing photos of his paintings.

Russ's life has changed dramatically since this recent diagnosis, but nothing gets him down. He has a very positive outlook on his life. He spoke of many past achievements and future goals. His goals are simple, but important to him. He has no regrets or unfinished business. He left us all smiling as we walked out to the car after the visit. What an honor to have met such an amazing individual.


BOOKENDS
 
His gift is his creativity.
Watercolors, opera, paint and song.
He's made a long career doing what he loves;
living a life, joyfully, his way.

He just found out his cancer is terminal.
The doctors told him just three months.
He wants to get strong to sit outside.
His goals are small; but important to him.

He has no fears about dying.
His spirituality is his art.
Egyptian beliefs, centuries old.
Death is energy; nothing more.

He sang in an opera at age ten.
A highlight in his young life.
Three months ago singing again
in a much larger operatic production.

His last hurrah.
Going out with a bang.
"My life has been opera bookends
          at the beginning
                   and at the end."
 

Saturday, September 24, 2016

DENIAL IS

Three years ago, the doctors discovered a benign tumor by a fluke. The tumor is threatening my optic nerve. I have been watched closely since that time with annual appointments, MRIs and visual field tests. All was well, until four months ago, I was told by my surgeon that the tumor has been slowly growing. He wanted to wait five months to watch it.

I agreed, but pretty quickly I discovered I could not live knowing that at any time my peripheral vision may diminish. Any visual deficits is irreversible. My doctor consulted his colleagues and they all agreed that it was a valid surgery and waiting would be riskier. I have come to terms with needing this surgery as the alternative would be blindness.

My surgery is less than two weeks away and I am having great days, but stressful moments. Yesterday, I spoke with a Nurse Practitioner at the surgery clinic, who informed me of the surgery and what to expect during recovery. It made it all so real, which is a bit scary. It was a stressful day for me.

Today, I am doing great and realize I am in some denial, which is so helpful. I know what is ahead, but when talking about it, it is like it is someone else. So often folks want another to be realistic and know the truth, but, for me, denial can also be one’s best friend.

ADDENDUM: I wrote this poem six months ago. It was a long recovery, but I am now back to normal. This experience has changed me so much for the better. I appreciate each day knowing that the result could not have gone as well as it has. I thank my God; my spirit daily.


DENIAL IS

Denial is an emotion.
It helps us cope in baby steps.
A new diagnosis is shocking and scary.
Denial allows us relief from reality.

Intellectually, we know the entire truth,
but emotionally, we can be all over the board.
Knowing the truth is important,
but it can also be overpowering.

When overwhelmed, we cannot think rationally.
We are captured; distracted; helpless.
Denial allows reality to slowly creep in
to gradually grasp what lies ahead.

Denial is an emotion.
It helps me cope in baby steps.
A new diagnosis is shocking and scary.
Denial allows me relief from reality.
 

Saturday, September 17, 2016

THE PERFECT ANSWER

We all have different levels of intelligence and memory. When a patient suffers from dementia or Alzheimer's, a Mini Mental Exam is a tool that can help determine how much a patient may understand. The exam consists of simple questions in a number of areas. The examiner may have a patient repeat a list of three words, spell a word backwards or name an article, like a watch, for example.

"Leo", ninety-four, was diagnosed with Alzheimer's Disease four years ago. Leo lives in the Memory Care Unit of a Residential Care Facility. Leo has been slowly declining to where now he is eating very little, getting weaker and sleeping more. Alzheimer's is a progressive disease which strongly impacts one's memory. Patients typically become more confused as the days and months go by.

The nurse and I went out to meet Leo and his family. Initially, we spoke with the family in a conference room nearby to explain our program. Leo was not able to participate in the admission visit due to his confusion. Quite often too much stimulation or conversation can frustrate the patient.

After the family signed the admission paperwork, we all went into Leo's room to meet him. The nurse asked Leo several questions and his last answer made us all laugh. It was so simple, but brilliant to me. Mostly though, it was so adorable It made me think that Leo still has some cognitive ability working inside. The best part of it all; Leo's heart continued to shine radiantly.


THE PERFECT ANSWER

He's ninety-four with Alzheimer's;
living in a Memory Care Unit.
He's been in a recent decline;
more confused; weaker; eating less.

She checked his heart for changes.
She checked his lungs for air.
She also wanted to check his memory,
so she asked him a few simple questions.

"How old are you?"
"I am one hundred and two."
"What is the date of your birthday?"
He answered like it was so obvious,
"One hundred and two years ago."

It made us all laugh.
It was so adorable; it was brilliant.
It was, without doubt,
          the perfect answer.



Sunday, September 11, 2016

NEW DIAGNOSIS

I found out today that one of my co-workers was just diagnosed with cancer. She called me into her office and shared her recent news. She said it felt so surreal; like we are talking about someone else. She knew that I would understand as I, too, recently got diagnosed with a new diagnosis; a growing, benign brain tumor.

Diagnoses such as these bring up so many questions. Why and what do you do with it? What is the meaning; the purpose. I know that it does feel surreal and it is shocking. I also know that no one in this life gets a free pass. We all have to deal with something as we travel along our own personal journeys.

The positive side of going through something like this; one feels so much love and support. I truly have an "Angel Village" surrounding me. One truly counts their blessings for all the folks around who care. Our support network is truly what gets us through tough times.

I learned from my new diagnosis that there are no words to be said. Nothing can take away the disease. I know that I only need someone to just be with me. Even knowing and living that, my first impulse was to say someone to ease her pain. It is our human nature to ease the suffering of those you love.

Maybe one day, we will know and understand why things happen and what it is all about. For now, I just know that it is the love and support of our village that helps us through tough times.


NEW DIAGNOSIS

She told me about her diagnosis.
I was shocked and quite surprised.
It brought up so many questions,
but comfort came first to my mind.

I wanted to make her feel better,
although there are no words.
I wanted to take her burden away,
but there is nothing one can do.

She said it felt surreal;
like we are talking about someone else.
I totally got what she was saying,
as I have my own recent diagnosis.

Neither of us want to go down that path,
but we have no other choice.
Avoiding that dark, unfamiliar road,
would make things so much worse.

One gets tired of thinking about it.
One gets tired of telling the story,
but by sharing the diagnosis,
we get the needed support.

I don't know why these things happen;
but what are we to do?
I would like to, one day, understand
the purpose for giving someone
             a new diagnosis.
 

Friday, February 26, 2016

SLEEP

We opened, "Jim" to our hospice program this morning. Jim was diagnosed with cancer that has spread to his brain. Because of this, he is confused, restless and agitated. Jim lives with his wife, "Julie". They have a lot of extended family living nearby. Multiple family members kept coming and going during our admission visit.

The entire time the hospice nurse and I were there, Jim slept peacefully. Julie said that Jim usually will sleep only thirty minutes and then be up and restless. Julie says she has not slept for three days or nights since this all began. Jim is very wobbly on his feet and has had some recent falls. He is not aware of his limitations.

During the course of the admission visit, I spoke with Julie about caregiver self care and encouraged her to hire attendant care overnight so that she could get some sleep. She liked that idea and was able to hire someone she knew who would start tomorrow night.

A few hours after the nurse and I left, Julie called hospice saying that Jim is restless, agitated and lashing out at her. She knows he is not aware of what he is doing, but she felt she could no longer manage him this way.

Another hospice nurse was nearby and agreed to go over to assist with the medications in order for Jim to get some much needed sleep. I was able to get there within the hour as well. I offered to try to hire an attendant for this evening, which she agreed would be a great idea. It was late in the day and I was not sure if I could successfully be able to do this.

The second agency I called was able to get someone out in two hours for an overnight shift. It all seemed to run so smoothly as it was meant to happen. As I was leaving, I asked Julie if there was anything else I could do for her. She said no and was so appreciative and thankful for hospice's support. I informed her that our evening nurse will make a visit in a few hours to check in.

This is a perfect example of what hospice is and how beautifully we work as a team. I am so proud of what happened today and so proud of being a part of an amazing team.


SLEEP

He is agitated.
He is restless.
He's uncomfortable;
he cannot sleep.

She keeps checking on him;
making sure he stays safe.
Trying to coax him to lie down.
She is up all day and night.

"I cannot do this any longer.
I need to get some sleep.
Give him something to calm him down.
I need a lot of help."

Family is rallying around,
but they don't know what to do.
The nurse went out to adjust his meds.
I urgently arranged for overnight care.

A quick hug to say goodbye.
She collapsed and sobbed in my arms.
So appreciative and thankful;
relieved to know she will finally get
          her much needed
                   sleep.
 

Saturday, February 20, 2016

NEVER ASSUME

The hospice nurse and I went out to admit “Ted”, to our hospice program. Ted has end stage kidney disease and decided to stop dialysis. He had been getting weaker making it too difficult to maneuver to the dialysis treatment center.

Ted lives with his grandson, “Donnie“; twenty-five. Donnie and his younger brother, "Louis", met us at the front door. The first thing once notices are all of their tattoos. The first impression I had was “These are tough guys?” Donnie sat down wearily in a recliner, while we stood in the living room. Louis started telling us about Grandpa and the recent weeks of his decline.

Once the boys started talking, their tenderness and love for Grandpa was so apparent. Donnie has lived with Grandpa for several years being his primary caretaker. A week ago, Louis drove up from his home an hour away to help out his brother. He will be staying for the duration. Both boys know that Grandpa cannot live more than a week or so without dialysis treatment.

Donnie and Louis are doing a wonderful job caring for their grandpa, although both are exhausted from lack of sleep. During the visit, Grandpa was asleep in the next room. Any time he awoke for a moment, either grandson would immediately go in to see if he needed anything. Their devotion to Grandpa was so beautiful.

Donnie spoke of his strong faith in God that helps him through tough times. Louis has cared for several other family members and is more confident in his role as caretaker. As Donnie and Louis are helping Grandpa, they also are helping each other. Any Grandpa would be proud to call them Grandsons.


NEVER ASSUME

We all probably do it now and then.
Assume a certain personality type
by how someone looks.
Their dress; their hair; their walk.

First impressions are powerful,
but quite often, I bet, we are wrong.
Our individuality is found inside;
our spirit; our heart; our soul.

They both met us at the front door.
Two young brothers; mid twenties.
Tattoos; piercings; shaved heads.
Home devoid of amenities.

Their hearts shown immediately.
Their devoted love for Grandpa.
Wanting to do the right thing;
but not quite sure what to do.

Exhausted from lack of sleep.
Grandpa is up a lot at night.
No complaints, just weary.
Appreciative of any help.

They’ll continue to support him.
They’ll continue to make Grandpa proud,
asking for only one thing,
          “Please pray for us.”

If you passed them on the street
you would never know.
Two amazing brothers
with hearts full of gold.

Never assume.
 

Saturday, February 13, 2016

FEARS

Ninety-one year old, "Albert", has had heart disease for many years. One month ago, he suffered a major heart attack, which required him to spend several weeks in the hospital for recuperation. Albert is single and lives with his sister, who is helping him with his daily needs.

Albert has lost a lot of weight and can walk slowly with a walker, although is at risk of falling due to weakness. Where Albert once had been independent, he is now dependent on his sister for help. He is not safe to be alone and can no longer engage in activities that he once enjoyed.

The first thing one notices when they walk into his home, is his sarcastic sense of humor. In addition, Albert is very realistic and matter of fact. He has accepted his situation, although never wanted to live this way.

As a social worker, I assess how patients and families are coping. One question, I frequently ask is, "Do you have any fears?". I never assume to know how someone will respond. Answers can be all over the board. So many of us feel that the worse thing would be death. With my years of experience, I have learned that there are a lot of things worse than death. Albert is one prime example.


FEARS

When asking patients about fears;
we never have expectations of how one will respond,
although are never surprised to hear
fears of leaving my family or of the unknown.

More often that not,
there are no fears at all.
They are at peace; total acceptance.
Many are quite ready to go.

A heart attack a month ago
changed his life dramatically.
Now dependent and needing a lot of help.
He doesn't like living this way at all.

He's traveled all over the world.
Teaching students "higher math".
He speaks five languages; adventures untold.
"I've lived a good and long life."

When asked about any fears,
he was determined and unfaltering in his response,
"I have no fears about dying;
my greatest fear is living this way."

Saturday, February 6, 2016

"BE HAPPY"

Fifty-five year old “Johnny, was diagnosed with bile duct cancer one month ago. The cancer had already spread to several other organs. Johnny started chemotherapy, but the treatment made him extremely ill. Johnny chose quality of life over quantity and stopped the treatment.

Johnny lives alone in the home where he was raised. His grandfather built the home one hundred years ago. The home has a lot of character, as it has many of its original cabinets, doors and charm.

Johnny is very close to his brother, “Mitch”, and daughter-in-law, “Heather”. Mitch and Heather plan on moving in to be able to give Johnny twenty-four hour care when needed. Mitch is a handyman and woodworker. While showing me around the home, Mitch would get excited while explaining how he was going to take that wall out or put an arch here.

Johnny, Mitch and Heather are very close as Mitch has always looked out for his younger brother. Johnny told us how he wasn’t educated and got poor grades in school. Johnny had this innocence about him, but he was so endearing. He appreciated everything in his life saying how he is so blessed.

Johnny has always been happy his life. He feels it is a choice one makes. Johnny did struggle with school and looks to his brother for help in any decisions that need to be made. When we spoke about Johnny’s wishes regarding end-of-life decisions, he would turn to Mitch for help and advice.

Even with these struggles, Johnny always had a smile. I loved his unconditional, positive belief about life. Many adults could learn a lot from him. Johnny does life so well.


"BE HAPPY"
 
The first thing one notices
is his big, easy smile.
Gladly welcoming you into his home;
making sure you are comfortably sitting down.

One also notices his quizzical look
when talking about our program.
He cannot seem to grasp things;
looking to his brother for help.

He says, “I’m not educated.
I got D’s and F’s in school.”
Reading does not come easy,
but he takes these things in stride.

He shares how his grandma had them all pray.
Kneeling down each morning and each night.
He continues with this practice still
knowing God hears and all will be okay.

A new cancer diagnosis
doesn’t rattle him at all.
“I try not to think about it,”
or it will get me down.”

He looks forward to each day,
smiling along the way.
His legacy is simple, but profound
          “Be Happy”.

And so he is.
 

Saturday, January 30, 2016

HER GIFT

"Margie", seventy-seven, suffers from dementia and lung disease. Margie is on continuous oxygen and gets short of breath with any activity. Recently she has been getting weaker and more short of breath. She spends her days sitting in her recliner watching television. Margie lives with "Jess", her husband of fifty-one years.

The hospice nurse and I went out today to admit Margie to hospice. The moment we walked in, Margie immediately started talking about her childhood. She bragged that her father had several PhDs and was very smart. She then shared that her IQ was documented at 150. Jess added that Margie always had a photographic memory.

If you asked Margie a question about what was going on today, she would maneuver the conversation back around to her past. With dementia, one's short term memory typically goes first. A patient with dementia may remember who lived next door when they were seven, but forget that they had lunch an hour earlier. Margie did fit that pattern.

Margie was devoted to Jess and knew she needed his help. It wasn't clear how much she understood that she was terminal. When speaking about our hospice team, I mentioned that a chaplain could visit. Margie's face just lit up and she said that she has a prayer partner and prays every night. It helps her sleep.

I asked her if she had any fears about what was happening and she struggled to answer as could not process her thoughts. It was then that she just started to cry so hard knowing she does not remember things. Margie is losing her greatest gift; her intellect. It likely will be a blessing if a day comes where she can no longer realize that tremendous loss. There truly are worse things than death for many of us.


HER GIFT
 
We all are given special gifts.
A beautiful voice singing soprano.
Fluid fingers gliding across a keyboard.
A brush stroke completing a work of art.

Her gift was her intellect.
She had a photographic memory.
A member of Mensa for years.
A recorded IQ of over 150.

She can no longer process current thoughts,
but will easily talk about her past.
She is forgetful; she doesn't remember.
The doctors say she has dementia.

She also has chronic lung disease.
She struggles to catch a breathe.
She is declining; getting weaker.
She knows she needs a lot of help.

I asked her if she had any fears.
She was aware she could not think.
She cried so hard as did clearly know,
"I can't remember. I am losing my brain."

To her, dying is not as fearful as forgetting.
She says she's had a good life.
Her Christian faith gives her peace,
but she is trying so hard to hold onto
her most cherished gift of all;
          her intellect.
 

Saturday, January 23, 2016

TO KNOW HER

"Deb", sixty-two, was diagnosed with cancer one year ago. Deb has one daughter, "Jan", who lives nearby. Jan and her mother have always been "best friends" and spend a lot of time together. Deb has lived in the same small town her entire life. She has a multitude of friends; many over a lifetime. Deb also is very close with her two sisters and several cousins.

Deb had been undergoing treatment for her cancer this past year. Two weeks ago, the doctors wanted to try a new chemotherapy, but after one treatment, Deb became weak and extremely ill. It was at that moment, Deb said she had enough and was ready to go. Deb has a strong Christian faith in God and the afterlife. She has no fears about dying.

Deb's daughter called late yesterday to initiate the hospice referral. Deb shared that her mother said that she would be gone before the week was out. The hospice nurse and I were able to admit Deb to hospice today. Deb's daughter and good friend, "Sandy" met us at the home. Deb was in bed and, due to her weakness, did not participate in the admission visit.

The family said that Deb was so weak and eating very little. Prior to sitting down and talking with Jan and Sandy, I went to meet with Deb. Deb was not interested in participating in the visit due to her weakness. I asked her about any fears and she said, "I am through here; I am done". With Deb's strong Christian faith, she believes that where she is going will be perfect for her.

During the ninety minutes the nurse and I were in the home, the doorbell did not stop ringing. So many people were dropping in to say goodbye. Deb's decline has been swift and so many needed to see Deb one more time.

I truly believe in Karma and seeing so many friendly, loving people coming and going, reflected all of them. In addition, it reflected Deb as well. I believe Like attracts Like and what goes around comes around. The love Deb gave out in her life, was reflected by all of the folks who were present. We all should have such an amazing legacy.


TO KNOW HER
 
Her time is near.
She's ready; she is done.
A few words only between us.
Not enough time to know her.

Her decline has been rapid.
It caught most off guard.
Friends and family dropping in
wanting to see her one more time.

There are many who adore her.
They can't say enough about her.
Her kindness; her love for them.
Coming to say one final goodbye.

Their presence does reflect who they are,
but it also reflects her.
The Law of Attraction; like attracts like.
Her Karma says it all.

Her time is near.
She's ready; she is done.
A few words only between us.
More than enough time
          to get to know her.

Saturday, January 16, 2016

JUST BE


 
"Randy", seventy-one, was diagnosed with cancer three months ago. Randy tried chemotherapy, but the side affects were horrendous and he chose to stop the treatment. Randy lives with his wife, "Becky". They have four children and a very large extended family. The majority of the family members live locally and were all in the home when I arrived this afternoon.

I heard from the nurse who had visited earlier in the day, that Randy was imminent, unresponsive and likely will die within hours to a few days. When I walked into the home, Randy's daughter escorted me to Randy's hospital bed where he was in a deep sleep. Becky was standing next to him holding his hand. Becky's face was red from crying.

Becky immediately asked me to sit with her at the dining room table nearby. Becky started to talk and shared these past few months of Randy's illness. She was trying to process and find some purpose and meaning of it all. Becky had been in a terrible car accident several years ago and had been questioning why she survived her car going over a cliff on a mountain road. She now feels that she survived to take care of Randy.

An important part of the Social Worker's role is active listening, validating and normalizing feelings. What one feels is so personal and it is their truth. As a Social Worker, it is not my role to fix or change anything, but to help guide another to their solution.

Becky was easy to be with and as I rose to leave, I didn't feel that I do all that much. Even with my training, one always wants to say something to make things better or fix things. It is our human nature I suppose. Becky has such tremendous supports, she will be okay. I felt honored to have helped her today.

ADDENDUM: Randy died the following morning with his wife at his side. I telephoned Becky to offer condolences. Becky said she was doing fine as her family was all around. She said she is making a list of things to do as "We always make lists." She said that she was by Randy's side when he took his final breath.

Becky shared that when she and Randy were first married, he was a trucker. Whether he was gone one day or a week, he always came home saying, "I love road trips." She added that they took a lot of road trips over the years. As Becky sat up with Randy throughout the night holding his hand, she knew his death was close as his breathing was very slow and erratic. She told Randy, "It is okay to take that one last road trip." The next moment Randy took his last breath. That experience gives Becky tremendous peace.


JUST BE

She needed to talk.
She needed someone to listen.
To hear her story;
to understand her pain.

There was nothing more to be done.
No words; no quick fix; no cure.
She needed to know she wasn't alone.
Someone to validate her sorrow.

I didn't say much, but mostly listened.
I did clarify her words saying I understand.
I normalized her grief, her coping; her faith.
But what she primarily needed from me was to
          "Just Be."

As I rose to leave her final words did surprise me.
I didn't feel like I did all that much.
"You are wonderful.
         Thank you so much."

We all want to be heard.
We all want to be counted.
But mostly, when in a crisis, all we need is another to
Just Be.
         Just Be with Me.
 

 

 

 

 

 

 

 

Saturday, January 9, 2016

TOTAL ACCEPTANCE

“Rosie”, ninety-two years old, was diagnosed with Pancreatic Cancer five days ago. The doctors informed her that the cancer has spread to her liver. Rosie declined any treatment as knew this cancer would likely take her life. Rosie is very independent and immediately knows what she wants and will easily express it.

Three years ago, Rosie moved to California to be near her daughter. She had been an artist in New York City and did say how she missed Manhattan. When one walks into Rosie’s home, your eyes are immediately drawn to her beautiful paintings displayed throughout.

Rosie laughs so easily and has totally accepted her terminal diagnosis without pause. Rosie started to tear up when talking about her family and friends and how so many care. I stated, “The support one has is what makes one cry.” It was then Rosie just broke down and had a good cry. She added that she hadn’t cried since the doctor told her about the cancer five days before.

The next moment, Rosie would laugh. She had an amazing sense of humor and such a positive look on life. She embraces her life and openly shares it with those around her. She is fun to be around and it is no surprise that she has an amazing network of family and friends as I truly believe; like attracts like.


TOTAL ACCEPTANCE

 She doesn't conform to society;
doing what others might typically do.
She lives her truth each day.
Not pressured by those around.

She is an artist by trade.
Her paintings reflect her free spirit beliefs.
Beautiful renditions of her life
displayed attractively throughout her home.

She accepts what comes her way,
no matter how grueling it may be.
Obstacles are never a barrier
as she will find her way around.

She was told last week she has cancer.
She adamantly said no to any treatment.
She looks at quality, not quantity of life.
Determined to do things her way.

I asked her how she is coping.
She denied any fears, stating,
“I am at peace and feel strong.”
Then laughing, “What is that all about?”

She cried because so many care.
She laughed because that is how she copes.
Living her life her way.
Total acceptance of what is to be.
 

Saturday, January 2, 2016

LIVING HER FAITH

"Pauline", eighty, suffers from stomach cancer that has spread throughout her body. Pauline was managing fine until four days ago when she could no longer eat due to nausea and not being able to hold any food down. Recently, her radiation treatments were stopped as were no longer effective.

Pauline denied any fears stating, "I am ready." Pauline was widowed four years ago and knows she will be meeting up with her husband in heaven. She was married for over fifty years stating that "He was my soul mate."

When Pauline was diagnosed a year ago, her daughter, "Debbie", retired from her job, sold her home and moved in to help her mom. Debbie and Pauline have a very strong Christian faith that helps them cope. Debbie has devoted her life to helping others. She will help another effortlessly as "It is the right thing to do." It is Debbie's faith that guides her.

A few years ago, Debbie put her life on hold to help a friend who suffered a broken back from a horrific fall. Her friend was laid up and needing help for over a year. Debbie is such an amazing example of someone living their faith.

As the hospice team and I were visiting, Debbie was sharing stories of her life. At one point she added, "There are angels around us. Sometimes we don't recognize them at the time, but realize it later." I told Debbie, "I met an angel today in you." She was shocked as doesn't recognize what she does as amazing, but again, "It is the right thing to do." We can never have too many Debbie's in this world.


LIVING HER FAITH

She's always had a strong faith.
Her belief in God consistently strong.
Living her life selflessly.
Devoted to others in need.

There's been some hard times along the way,
but she takes it all in stride.
"Don't tell God how big your storm is;
tell your storm how big God is."

She put her life on hold for eighteen months
to help a friend in need.
A horrible accident with a long recovery.
Continually staying by her friend's side.

Her mother's diagnosis of cancer a year ago
turned her life again in another direction.
Without hesitation, she retired and sold her home
to move in to help her mother.

Knowing her mother's time is near
will bring some appropriate tears,
but her strong faith continues to give her comfort
knowing Mom will soon be flying high,
"We're walking
          one another home".

Living her faith.