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.
Friday, February 26, 2016
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.
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."
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.
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.
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