"John", sixty-four, suffers from chronic lung disease. John has been on oxygen for quite a few years. John is single and has no children. His only family is his sister who lives several hundred miles away. John started drinking and smoking as a teenager. Throughout the years, he has never stopped.
The hospice nurse and I went out to admit John to our hospice program today. We noticed that he continues to drink and smoke. During our discussion with John, he constantly drank his cranberry juice. Every so often, he would pick up the Russian vodka bottle nearby and add it to his juice. In addition, several dirty ashtrays were within his reach. We spoke about the dangers of smoking with oxygen around. John is aware and said he doesn't worry about it. John had a very sarcastic sense of humor. He wanted to shock the two of us, while trying to make us laugh.
He spoke of regrets due to the poor choices he has made throughout his life. This past month the reality of his health has impacted him due to his recent decline. It has made him aware of his poor prognosis and terminal status.
After we left John's home, with his permission, we spoke to his sister on the phone. She stated how she does not understand why her brother continues to drink and smoke. John is addicted to alcohol and has been a smoker for decades. For all of us, old habits are so hard to break. I wish him all the best.
HIS HABITS
He started smoking as a teenager.
Alcohol came a bit later.
His habits continue today;
for more than fifty years.
He's never married
He has no kids.
His only family is his sister.
She helps as best as she can.
He's on continuous oxygen
due to chronic lung disease.
His life has been greatly impacted
by his habits of so many years.
We admitted him to hospice today.
He is very weak; spending most days in bed.
He spoke about life's regrets
while adding vodka to his juice nearby.
Several dirty ashtrays were within his reach.
He continues to smoke with his oxygen on
even though fully understanding
just how dangerous that can be.
His sister wishes he would stop drinking and smoking
but habits, whether good or bad ones,
for each and every one of us
are all so very difficult
to break.
Saturday, January 27, 2018
Saturday, January 13, 2018
WE NEVER KNOW
As hospice workers, we often get asked, "How much time do I have?" We have no answer to give. We can offer a "guestimation", but we truly do not know. We all die the way we live. We grab all the coping tools we need. It is so different for each of us. One truly does it his or her own individual way.
We admitted, "Julia", to our hospice program today. Her symptoms appeared last week. The doctors thought it likely was a rare cancer. The only option was a clinical trial. Julia declined any further treatment as the treatment would only give her a few more months at most. She knew her cancer was not curative. She did not want to suffer any side affects of treatment. She wanted quality of life, not quantity.
The doctors confirmed her diagnosis only yesterday. She was not surprised as this past week has been a downhill journey with increased weakness and pain. The hospice nurse addressed her pain and weakness issues quickly. Hospice nurses are so gifted with giving comfort care. I have done hospice for years and truly know that the number one gift hospice gives to patients is definitely comfort care.
I heard that she died in the wee hours this morning. I was so taken by surprise. I thought she had weeks to live, but it must have been her time. For her, the swiftness may have been a blessing, but for her family it will be hard. Her husband declined any bereavement follow up, but I will call him to offer support.
I truly believe that for all of us, when it is our time, we will let go. It gives me comfort knowing she is in peace. Her family will grieve and cope the best they can. Our hospice bereavement department is there for them whenever they need.
WE NEVER KNOW
She was walking around one week ago.
She was living her life as usual.
Symptoms appeared; likely cancer.
Confirmed yesterday afternoon.
We admitted her to hospice today.
She declined the option of a clinical trial.
She was so weak and in pain.
Her decline has been extremely rapid.
They both used humor to cope.
Being realistic, but laughing a lot.
It was all so new; so surreal.
They had planned on many more years.
He handles his emotions intellectually.
He declined any bereavement follow up.
"I will call if I need anything.
I am really doing okay."
She died early this morning.
Two days after her diagnosis.
It took all of us by surprise.
No time to prepare oneself at all.
I believe we all go when it is our time,
although it takes so many by surprise.
Embrace each and every moment
as the truth indisputably is;
We truly never know.
We admitted, "Julia", to our hospice program today. Her symptoms appeared last week. The doctors thought it likely was a rare cancer. The only option was a clinical trial. Julia declined any further treatment as the treatment would only give her a few more months at most. She knew her cancer was not curative. She did not want to suffer any side affects of treatment. She wanted quality of life, not quantity.
The doctors confirmed her diagnosis only yesterday. She was not surprised as this past week has been a downhill journey with increased weakness and pain. The hospice nurse addressed her pain and weakness issues quickly. Hospice nurses are so gifted with giving comfort care. I have done hospice for years and truly know that the number one gift hospice gives to patients is definitely comfort care.
I heard that she died in the wee hours this morning. I was so taken by surprise. I thought she had weeks to live, but it must have been her time. For her, the swiftness may have been a blessing, but for her family it will be hard. Her husband declined any bereavement follow up, but I will call him to offer support.
I truly believe that for all of us, when it is our time, we will let go. It gives me comfort knowing she is in peace. Her family will grieve and cope the best they can. Our hospice bereavement department is there for them whenever they need.
WE NEVER KNOW
She was walking around one week ago.
She was living her life as usual.
Symptoms appeared; likely cancer.
Confirmed yesterday afternoon.
We admitted her to hospice today.
She declined the option of a clinical trial.
She was so weak and in pain.
Her decline has been extremely rapid.
They both used humor to cope.
Being realistic, but laughing a lot.
It was all so new; so surreal.
They had planned on many more years.
He handles his emotions intellectually.
He declined any bereavement follow up.
"I will call if I need anything.
I am really doing okay."
She died early this morning.
Two days after her diagnosis.
It took all of us by surprise.
No time to prepare oneself at all.
I believe we all go when it is our time,
although it takes so many by surprise.
Embrace each and every moment
as the truth indisputably is;
We truly never know.
Sunday, January 7, 2018
FIFTEEN MINUTES
Late last week, the hospice nurse and I went out to admit, "Neal", a seventy-eight year old suffering with serious lung disease. Neal was discharged that afternoon after a five day hospital stay. The doctors did not think Neal would ever survive to make it out of the hospital. Neil is tough and determined and was so happy to be back home.
We met with Neal and his daughter, "Christy" in Neal's living room. Christy was a strong advocate for her father. She wanted to know every detail about hospice coverage and support. I spoke about hospice's twenty-four hour coverage. I added that we are just one phone call away. If someone needs to make a home visit, it will happen. I added that our hospice covers five counties and it may be an hour before a nurse would make it to the home.
Christy was upset about that one hour time frame. She felt someone should make it to their home in a fifteen minute time frame. She didn't understand that her father's wish of having no life sustaining treatment, calling 911 might jeopardize his wishes. Christy was not ready for hospice support for her father. In addition, Neal also was not ready. He was hoping for physical therapy to help make him stronger.
Neal was so short of breath with any movement or endurance, it is unlikely that he would even be able to participate with physical therapy. The plan was for Neal to call his doctor regarding the follow up request for therapy. We encouraged the family to call hospice with any follow-up questions, needs or concerns.
We only want to admit patients when they and/or their family are ready for our support. It is not right or wrong at all. I always feel thankful that with the information we give the family, they will be aware of our program and can always call when ready.
FIFTEEN MINUTES
He was just discharged from the hospital.
They weren't sure if that would ever be.
He is strong; he got his wish.
He came home late this afternoon.
When meeting folks for the first time,
we want them to understand hospice philosophy.
"Do you want no further hospitalizations?
Do you wish to die in comfort at home?"
We spoke about twenty-four hour coverage.
"Just call hospice with any needs.
Someone would be out within an hour."
She wasn't happy with what we said.
"Where does everybody live?
They need to be here in fifteen minutes!"
We informed her we cover five counties.
Fifteen minutes would likely never be.
We didn't admit him to hospice.
He wasn't quite yet ready for our support.
But, thirty-six hours later, he died at home.
Peacefully, in comfort, with family at his side.
She must have later realized our support
as called and thanked us for being there.
I am sure she was also relieved,
she didn't need us to rapidly come
in our one hour estimation,
or even quicker
in her fifteen minute time.
We met with Neal and his daughter, "Christy" in Neal's living room. Christy was a strong advocate for her father. She wanted to know every detail about hospice coverage and support. I spoke about hospice's twenty-four hour coverage. I added that we are just one phone call away. If someone needs to make a home visit, it will happen. I added that our hospice covers five counties and it may be an hour before a nurse would make it to the home.
Christy was upset about that one hour time frame. She felt someone should make it to their home in a fifteen minute time frame. She didn't understand that her father's wish of having no life sustaining treatment, calling 911 might jeopardize his wishes. Christy was not ready for hospice support for her father. In addition, Neal also was not ready. He was hoping for physical therapy to help make him stronger.
Neal was so short of breath with any movement or endurance, it is unlikely that he would even be able to participate with physical therapy. The plan was for Neal to call his doctor regarding the follow up request for therapy. We encouraged the family to call hospice with any follow-up questions, needs or concerns.
We only want to admit patients when they and/or their family are ready for our support. It is not right or wrong at all. I always feel thankful that with the information we give the family, they will be aware of our program and can always call when ready.
FIFTEEN MINUTES
He was just discharged from the hospital.
They weren't sure if that would ever be.
He is strong; he got his wish.
He came home late this afternoon.
When meeting folks for the first time,
we want them to understand hospice philosophy.
"Do you want no further hospitalizations?
Do you wish to die in comfort at home?"
We spoke about twenty-four hour coverage.
"Just call hospice with any needs.
Someone would be out within an hour."
She wasn't happy with what we said.
"Where does everybody live?
They need to be here in fifteen minutes!"
We informed her we cover five counties.
Fifteen minutes would likely never be.
We didn't admit him to hospice.
He wasn't quite yet ready for our support.
But, thirty-six hours later, he died at home.
Peacefully, in comfort, with family at his side.
She must have later realized our support
as called and thanked us for being there.
I am sure she was also relieved,
she didn't need us to rapidly come
in our one hour estimation,
or even quicker
in her fifteen minute time.
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