Eighty-six year old, "Bea", suffers from many chronic health problems including diabetes and depression. Bea has a history of several suicide attempts. She has had intensive treatment in the past. Her doctor prescribed anti-depressants, which Bea refuses to take. She also refuses meals, but her diet consists of ice cream, chocolate and cake. That sugar diet is the exact opposite of what a diabetic should eat. Bea has no concerns about that at all.
Bea's doctor referred her to hospice, although she did not meet the criteria for our program. Our hospice also has Palliative Care support. We referred Bea to that program in order for medical staff to be more involved to hopefully help Bea and her family.
Bea has poor memory and may suffer from early onset of dementia. It also appeared that her forgetfulness may also be that she doesn't have any energy to put into her thinking. Bea has been passive and depressed for twenty-five years. These are the only emotions she knows at this time.
Bea's husband felt so helpless as he could not force her to take her medication. We offered many tactics, but Bea's depression has such a strong hold onto her that she is determined to just be with it.
I walked away feeling so sad for Bea and her family. I only hope that our Palliative Care Program can help Bea make even a small positive change in her life. My heart goes out to her and her family.
POWERFUL DEPRESSION
When you first meet her, you know.
She will smile and talk to you,
but her movements are slow
with a speech that is faint.
She will talk about her depression
sharing that she has been sad for many years.
Her family knows the exact date it began;
twenty-five years ago when her son committed suicide.
She refuses to take any medication,
although is told it will help her.
She has tried to overdose in the past
and has been hospitalized each time.
She is grieving her son's suicide
knowing the impact on those who loved him.
Her current behaviors are passive suicide,
although she can't face that reality.
She loved to garden; she loved to play the piano.
Activities no longer in her days.
She spends most days in bed,
while being up throughout the night.
I likely was unsuccessful,
but tried so hard to help her.
I walked away with feelings of sadness,
hoping there was one small thing
she may have heard.
Her normal is now continued sadness.
That is the only emotion she knows.
She is enslaved, captive and driven by
the powerful Depression.
Sunday, March 19, 2017
Sunday, March 12, 2017
HIS GRACE
I went out with the hospice nurse yesterday to admit "Wayne" to our hospice program. Wayne had struggled for years with lung disease. He had been bedridden for several years and on continuous oxygen. Wayne lived in the home with his wife, "Laura."
Laura and Wayne are from very large families, who all live nearby. There were many family members in the home yesterday as all felt that Wayne was near death. They felt that Wayne was waiting for his grandson, who lived in Illinois, to come, and then he would go. During my visit yesterday, his grandson called to say he was getting on the plane.
I learned this afternoon that there was a wrong date on one of the admission papers. I needed Laura to change it to the correct date and initial the change. I arrived at the home late this afternoon. Like yesterday, their home was full of family. Laura corrected the date and initialed the paperwork. Seconds later, family became alarmed as Wayne's breathing dramatically changed and he quietly died.
I called the hospice office for a nurse to come out to pronounce Wayne's death. I was able to be with the family and offer support for their loss and their emotions.
I was feeling that I was meant to be there and was guided from above. Laura and several other family members confirmed my thoughts by saying how it was a blessing that I was there. This is such a perfect example of what hospice is all about. I am so thankful to be able to experience such spiritual moments.
HIS GRACE
I first met him yesterday.
His time seemed near.
He wasn't talking or awake much,
but one saw his beautiful smile.
His heart shone through
while he quietly laid there.
Surrounded by spirit,
his grace was amazing.
I went back to his house today
for a five minute paperwork need.
Moments after I arrived,
with all of his family around,
he quietly died.
Their home was filled with family.
Their home was full of love.
He left at the perfect time for him
knowing they all had the needed support.
They thanked me for being there.
They said it was God's spirit at work.
I can't thank them or God enough
as His grace is
truly amazing.
Laura and Wayne are from very large families, who all live nearby. There were many family members in the home yesterday as all felt that Wayne was near death. They felt that Wayne was waiting for his grandson, who lived in Illinois, to come, and then he would go. During my visit yesterday, his grandson called to say he was getting on the plane.
I learned this afternoon that there was a wrong date on one of the admission papers. I needed Laura to change it to the correct date and initial the change. I arrived at the home late this afternoon. Like yesterday, their home was full of family. Laura corrected the date and initialed the paperwork. Seconds later, family became alarmed as Wayne's breathing dramatically changed and he quietly died.
I called the hospice office for a nurse to come out to pronounce Wayne's death. I was able to be with the family and offer support for their loss and their emotions.
I was feeling that I was meant to be there and was guided from above. Laura and several other family members confirmed my thoughts by saying how it was a blessing that I was there. This is such a perfect example of what hospice is all about. I am so thankful to be able to experience such spiritual moments.
HIS GRACE
I first met him yesterday.
His time seemed near.
He wasn't talking or awake much,
but one saw his beautiful smile.
His heart shone through
while he quietly laid there.
Surrounded by spirit,
his grace was amazing.
I went back to his house today
for a five minute paperwork need.
Moments after I arrived,
with all of his family around,
he quietly died.
Their home was filled with family.
Their home was full of love.
He left at the perfect time for him
knowing they all had the needed support.
They thanked me for being there.
They said it was God's spirit at work.
I can't thank them or God enough
as His grace is
truly amazing.
Saturday, March 4, 2017
COMPELLING EMOTIONS
"Theresa", fifty years old, was diagnosed with stomach cancer four months ago. She was discharged from the hospital yesterday after a two week stay for surgery. Theresa has been in a rapid decline since her diagnosis to where she is now bedridden/chairbound and maximum assist with transfers. Theresa needs assistance with all of her needs.
Theresa has four children; three adult and one six year old daughter. Theresa’s eldest daughter, “Janice”, has moved in for the duration in order to care for her mom. Theresa is aware and realistic regarding her increasing needs. She will talk openly and freely about them, but will not talk at all about her terminal prognosis. Denial is such a powerful emotion, it helps one cope in baby steps. Theresa will talk about her needs and share how it is so overwhelming to talk with her six year old daughter about her terminal prognosis. Her denial helps her cope with it all.
We completed a new POLST (Physician’s Order for Life Sustaining Treatment) form following Theresa’s wishes of full code and full treatment during the visit. Theresa stated she did not want to go back to the hospital if hospice can treat her in the home, unless she stopped breathing. At that point, she wants full treatment and care. Theresa will complete her Advanced Directive for Health Care this week naming her daughter Janice as her agent.
We discussed that her agent can override what is on the POLST if a situation arises when Janice would know that her mom wouldn’t want full treatment. Theresa was aware and understood. Theresa is still processing her diagnosis and will continue to cope her way. Life hands all of us bumps in the road, but some bumps are so much larger than others. I pray Theresa is able to cope with what comes her way.
COMPELLING EMOTIONS
She has a powerful personality.
She will easily speak her truth.
One knows exactly how she feels
as she clearly shares her compelling emotions.
A recent diagnosis of cancer
with surgery only last week.
Her prognosis of six months or less
led hospice to her front door.
Her decline has been swift.
Her symptoms overriding each day.
She will talk honestly about her needs,
but strongly will not discuss her probable death.
She wants hospice support of comfort and treatment
knowing we are not a curative program.
She is okay calling hospice and not 911
unless she has a time that she stops breathing.
Then she will want life supports and CPR.
She’ll want a feeding tube to give her more time.
It is all so overwhelming for her,
especially telling her six year old daughter goodbye.
Hospice will support her where she is.
We honor her to do things her way.
Her heart is full of so much emotion,
but the most compelling emotion of all
is her very strong and powerful;
Denial
Theresa has four children; three adult and one six year old daughter. Theresa’s eldest daughter, “Janice”, has moved in for the duration in order to care for her mom. Theresa is aware and realistic regarding her increasing needs. She will talk openly and freely about them, but will not talk at all about her terminal prognosis. Denial is such a powerful emotion, it helps one cope in baby steps. Theresa will talk about her needs and share how it is so overwhelming to talk with her six year old daughter about her terminal prognosis. Her denial helps her cope with it all.
We completed a new POLST (Physician’s Order for Life Sustaining Treatment) form following Theresa’s wishes of full code and full treatment during the visit. Theresa stated she did not want to go back to the hospital if hospice can treat her in the home, unless she stopped breathing. At that point, she wants full treatment and care. Theresa will complete her Advanced Directive for Health Care this week naming her daughter Janice as her agent.
We discussed that her agent can override what is on the POLST if a situation arises when Janice would know that her mom wouldn’t want full treatment. Theresa was aware and understood. Theresa is still processing her diagnosis and will continue to cope her way. Life hands all of us bumps in the road, but some bumps are so much larger than others. I pray Theresa is able to cope with what comes her way.
COMPELLING EMOTIONS
She has a powerful personality.
She will easily speak her truth.
One knows exactly how she feels
as she clearly shares her compelling emotions.
A recent diagnosis of cancer
with surgery only last week.
Her prognosis of six months or less
led hospice to her front door.
Her decline has been swift.
Her symptoms overriding each day.
She will talk honestly about her needs,
but strongly will not discuss her probable death.
She wants hospice support of comfort and treatment
knowing we are not a curative program.
She is okay calling hospice and not 911
unless she has a time that she stops breathing.
Then she will want life supports and CPR.
She’ll want a feeding tube to give her more time.
It is all so overwhelming for her,
especially telling her six year old daughter goodbye.
Hospice will support her where she is.
We honor her to do things her way.
Her heart is full of so much emotion,
but the most compelling emotion of all
is her very strong and powerful;
Denial
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