"Richard", fifty-two, was diagnosed with brain cancer two months ago. The doctors tried many treatment procedures with no positive outcomes. Richard is now in the hospital ICU and unresponsive. Richard's three siblings, are by his side. They have told the hospital staff that they want to take their brother home.
There was concern that Richard may not be strong enough to survive an ambulance ride home. The hospital staff heard what the family was saying and totally supported them in doing what needed to be done for Richard to be able to go home.
I was asked by hospice to meet with the family to discuss the positives and negatives that could occur with this plan. Meeting with the three siblings at the hospital touched my heart so deeply. Their total focus was on their brother and his wishes. It was so beautiful. I spoke of the many options that may occur; one being Richard may die prior to discharge or on the journey home. The family were aware and understood, but having their brother home was their foremost objective. They were so focused on fulfilling their brother's final wish.
I was saddened to hear their story, but my heart was also touched so deeply by their love for their brother. I was so determined to do what I could do to help get their brother home. I encouraged the siblings to inform Richard to hang in there as he will be home tomorrow. The hospice nurse and I will be at Richards home tomorrow morning waiting for his arrival. I know he will let go when it is right for him. I so hope he does make it home.
ADDENDUM: Richard was safely discharged to home. He died peacefully the following morning with his family at the bedside.
WANT HIM HOME
A recent cancer diagnosis
has left him hospitalized for weeks.
No treatment was effective.
He's just been getting worse.
He is now minimally responsive,
but knows his family is all around.
He likely has only a few days at most.
They just want him home.
I met with his family and three nurses today
in a private space near his room.
We spoke of his terminal prognosis
and options on how to safely get him home.
They spoke with their hearts about their brother,
while loving him completely with their souls.
The truly know what his wishes would be;
"We just want him home."
Hearing their story left me feeling so terribly sad.
Wanting to do what I could do to support this family.
But on the other hand, their love was truly amazing
embracing me with pure beauty.
He will be discharged to home tomorrow morning.
We will be there when he arrives
offering all of them comfort and support.
But most important, we'll be able to say,
"Welcome home."
Sunday, September 23, 2018
Saturday, September 15, 2018
HER BASIC NEED
We received a referral from a local hospital to meet with one of their patients and talk with her about comfort care measures and hospice support. Our hospice often does "Informational Visits" to educate patients and families about our program. I love doing these types of visits as it gives family knowledge about our program and answers a lot of questions for them. It helps patients and families know if and when they are ready for hospice.
"Jeanine, sixty-four, had a long history of lung disease. She was admitted into the hospital due to a respiratory emergency. She was in the ICU as needed a lot of medical attention. I spoke with the staff who informed me that Jeanine was declining on a daily basis. She was becoming weaker by the day.
Jeanine had family living several hours north of us. She knew she needed Skilled Nursing Placement and was hoping the staff could locate a facility in that area near her family. Due to Jeanine's medical needs, it will be a huge challenge in just finding a facility. After talking with Jeanine, I sensed she knew she likely would never leave the hospital.
It was a bit difficult talking with her as she spoke so softly and slowly. I held her hand while we spoke hoping to give her comfort. It just broke my heart seeing what she was going through. She had so much taken away from her due to her illness that her only want was her basic need of not being short of breath.
I hope Jeanine finds her comfort and her peace. I am praying and rooting for her.
HER BASIC NEED
They said to talk about hospice;
about comfort care and her grief.
Her daughter died four years ago.
"She'll mention her when you talk."
She was just lying quietly there
as I walked into the hospital room.
Almost too weak to talk.
Long pauses between each word.
She spoke about being short of breath,
but then quietly told me about her daughter.
Truly believing she's in a better place,
while her face just shined motherly love.
She immediately changed the subject back
to how hard it was to breathe.
She wanted to be strongly sedated
so the struggle would go away.
I spoke about hospice support.
How comfort care is what they do best.
Physical, spiritual, emotional.
They are so successful in what they do.
She was declining rapidly.
Getting weaker by each day.
I sensed she knew she wasn't getting better.
Also aware she'll never make it home.
She appeared content after we spoke.
I hope I gave reassurance about her basic need.
There is treatment so that never again
will she ever have to be
short of breath.
"Jeanine, sixty-four, had a long history of lung disease. She was admitted into the hospital due to a respiratory emergency. She was in the ICU as needed a lot of medical attention. I spoke with the staff who informed me that Jeanine was declining on a daily basis. She was becoming weaker by the day.
Jeanine had family living several hours north of us. She knew she needed Skilled Nursing Placement and was hoping the staff could locate a facility in that area near her family. Due to Jeanine's medical needs, it will be a huge challenge in just finding a facility. After talking with Jeanine, I sensed she knew she likely would never leave the hospital.
It was a bit difficult talking with her as she spoke so softly and slowly. I held her hand while we spoke hoping to give her comfort. It just broke my heart seeing what she was going through. She had so much taken away from her due to her illness that her only want was her basic need of not being short of breath.
I hope Jeanine finds her comfort and her peace. I am praying and rooting for her.
HER BASIC NEED
They said to talk about hospice;
about comfort care and her grief.
Her daughter died four years ago.
"She'll mention her when you talk."
She was just lying quietly there
as I walked into the hospital room.
Almost too weak to talk.
Long pauses between each word.
She spoke about being short of breath,
but then quietly told me about her daughter.
Truly believing she's in a better place,
while her face just shined motherly love.
She immediately changed the subject back
to how hard it was to breathe.
She wanted to be strongly sedated
so the struggle would go away.
I spoke about hospice support.
How comfort care is what they do best.
Physical, spiritual, emotional.
They are so successful in what they do.
She was declining rapidly.
Getting weaker by each day.
I sensed she knew she wasn't getting better.
Also aware she'll never make it home.
She appeared content after we spoke.
I hope I gave reassurance about her basic need.
There is treatment so that never again
will she ever have to be
short of breath.
Sunday, September 9, 2018
MOM'S WISHES
We admitted, "Linda", ninety-two, to our hospice program today. Linda has five daughters. Two of her daughters live nearby; while the other three reside out of state. Linda has been in a recent decline due to heart disease. She was hospitalized last week and discharged back home today.
All five of her daughters were at her side. Mom's biggest complaint is weakness and having trouble swallowing. Her diet has to be pureed in order for her to get any nutrition. Two weeks ago, Linda was able to walk independently. Now she struggles to get up out of her chair needing a lot of assistance.
Linda easily verbalizes her wishes. She is ready for this all to be over. She has strong spiritual beliefs and has no fears about dying. Today, she expressed to her family that she will stop eating and drinking, hoping it will hurry her death along. All of her daughters, lovingly claim they want to follow Mom's wishes, but each of them have a different interpretation of what she wants.
The patient's words are so direct and clear. The hospice nurse and I totally understand that she is ready to die and wants to do what she can to hurry things along. We spoke with the daughters about hospice's goal is to follow the patient's wishes. On the other hand, we also understand that it is not an easy thing for any of us to allow someone we love to go.
The patient has no quality of life and strongly does not want to live this way. Hopefully with hospice's support and guidance, we can help the patient and her family to cope with what lies ahead for all of them.
MOM'S WISHES
She's been so independent
for all of her 90 plus years.
She has always done life her way;
being determined, focused and strong.
That's what her daughters love about her.
She always speaks her truth.
A wonderful, loving mother to them,
but now she is taking care of herself.
Her recent decline has been swift.
She's become dependent and needs a lot of help.
She doesn't want to live this way,
"I am so ready for all of this to be over."
She has chosen to stop eating or drinking
hoping it will hurry things along.
"I didn't think dying would be this hard.
When will I be done?"
Her five daughters want to follow Mom's wishes,
but none can agree with the others.
They ask her and listen to what she says,
but each clearly defends what they hear in her words.
They will bicker; they will fight
trying to strongly defend their side.
All knowing she is ready to die,
with none able to let her go.
There is no right or wrong way to die.
It is such an individual want.
We will continue to follow her wishes;
while helping her daughters
to follow and respect them too.
All five of her daughters were at her side. Mom's biggest complaint is weakness and having trouble swallowing. Her diet has to be pureed in order for her to get any nutrition. Two weeks ago, Linda was able to walk independently. Now she struggles to get up out of her chair needing a lot of assistance.
Linda easily verbalizes her wishes. She is ready for this all to be over. She has strong spiritual beliefs and has no fears about dying. Today, she expressed to her family that she will stop eating and drinking, hoping it will hurry her death along. All of her daughters, lovingly claim they want to follow Mom's wishes, but each of them have a different interpretation of what she wants.
The patient's words are so direct and clear. The hospice nurse and I totally understand that she is ready to die and wants to do what she can to hurry things along. We spoke with the daughters about hospice's goal is to follow the patient's wishes. On the other hand, we also understand that it is not an easy thing for any of us to allow someone we love to go.
The patient has no quality of life and strongly does not want to live this way. Hopefully with hospice's support and guidance, we can help the patient and her family to cope with what lies ahead for all of them.
MOM'S WISHES
She's been so independent
for all of her 90 plus years.
She has always done life her way;
being determined, focused and strong.
That's what her daughters love about her.
She always speaks her truth.
A wonderful, loving mother to them,
but now she is taking care of herself.
Her recent decline has been swift.
She's become dependent and needs a lot of help.
She doesn't want to live this way,
"I am so ready for all of this to be over."
She has chosen to stop eating or drinking
hoping it will hurry things along.
"I didn't think dying would be this hard.
When will I be done?"
Her five daughters want to follow Mom's wishes,
but none can agree with the others.
They ask her and listen to what she says,
but each clearly defends what they hear in her words.
They will bicker; they will fight
trying to strongly defend their side.
All knowing she is ready to die,
with none able to let her go.
There is no right or wrong way to die.
It is such an individual want.
We will continue to follow her wishes;
while helping her daughters
to follow and respect them too.
Saturday, September 1, 2018
SHE CRIED
We received an urgent referral to admit, "Kathy", sixty-two years of age, to our hospice program. Kathy was diagnosed with brain cancer one year ago. Even though Kathy had been through continuous treatment., her cancer continued to grow. Kathy and her husband, “Ken”, were just informed two days ago that there is no more treatment available to help her.
Reading Kathy’s chart, prior to going out to do the visit, made me so sad. As it spoke about her symptoms, it added anxiety, depression and how often she cries. Reading that in her chart, my thought was, “I don’t blame her. I would likely feel the same way."
Kathy earned her PhD in Psychology and did so much amazing work with children. She was renowned for creating multiple children’s programs. She was published and taught classes at the local State University.
Kathy’s suffered from right sided paralysis and needed a wheelchair to maneuver around. She needed help with navigating her wheelchair. Kathy also suffered from expressive aphasia which meant she totally understood what was being said to her, but could not verbalize or speak any proper words to reflect what she wanted to say.
The hospice nurse and I sat around the kitchen table with Kathy and Ken. Throughout the visit, Kathy quite often would cry. She would try to verbalize a thought and could only speak one word or two. You could see frustration in her face. She and her husband are still processing the news they received two days ago. In addition, I am sure by the nurse and I describing hospice supports, reality burst forth as well.
My goal, as with every hospice patient, is to give them support to deal with their illness in the way that works for them. With my words to Kathy, I was wanting to give her much needed support. After the visit, the sadness I felt remained. I hope and pray I was helpful and not hurtful. If not my words, I hope the softness in my voice gave comfort.
SHE CRIED
Reading her chart
before I met her,
I felt so sad.
Life can be so unfair.
A brain cancer diagnosis
only one year ago this month.
Chemo, radiation, medication.
Her cancer continued to grow.
She has right sided paralysis.
Needing a wheelchair to get around.
Depression, anxiety, memory loss.
Frequent charting of how she cried.
She totally understands what you are saying,
but cannot express any words.
Her brilliant mind is trapped inside her body.
Throughout the visit, she so easily cried.
I shared that her family and friends so love her.
Not because she's published a book, or set up programs,
but because of who she is; her heart and her soul.
of which she will always and forever be.
I don't know if she was comforted or saddened
as I expressed my words of support.
It broke my heart to see her pain
as it was again that her emotions did show
as she suddenly
and so tearfully cried.
Reading Kathy’s chart, prior to going out to do the visit, made me so sad. As it spoke about her symptoms, it added anxiety, depression and how often she cries. Reading that in her chart, my thought was, “I don’t blame her. I would likely feel the same way."
Kathy earned her PhD in Psychology and did so much amazing work with children. She was renowned for creating multiple children’s programs. She was published and taught classes at the local State University.
Kathy’s suffered from right sided paralysis and needed a wheelchair to maneuver around. She needed help with navigating her wheelchair. Kathy also suffered from expressive aphasia which meant she totally understood what was being said to her, but could not verbalize or speak any proper words to reflect what she wanted to say.
The hospice nurse and I sat around the kitchen table with Kathy and Ken. Throughout the visit, Kathy quite often would cry. She would try to verbalize a thought and could only speak one word or two. You could see frustration in her face. She and her husband are still processing the news they received two days ago. In addition, I am sure by the nurse and I describing hospice supports, reality burst forth as well.
My goal, as with every hospice patient, is to give them support to deal with their illness in the way that works for them. With my words to Kathy, I was wanting to give her much needed support. After the visit, the sadness I felt remained. I hope and pray I was helpful and not hurtful. If not my words, I hope the softness in my voice gave comfort.
SHE CRIED
Reading her chart
before I met her,
I felt so sad.
Life can be so unfair.
A brain cancer diagnosis
only one year ago this month.
Chemo, radiation, medication.
Her cancer continued to grow.
She has right sided paralysis.
Needing a wheelchair to get around.
Depression, anxiety, memory loss.
Frequent charting of how she cried.
She totally understands what you are saying,
but cannot express any words.
Her brilliant mind is trapped inside her body.
Throughout the visit, she so easily cried.
I shared that her family and friends so love her.
Not because she's published a book, or set up programs,
but because of who she is; her heart and her soul.
of which she will always and forever be.
I don't know if she was comforted or saddened
as I expressed my words of support.
It broke my heart to see her pain
as it was again that her emotions did show
as she suddenly
and so tearfully cried.
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