THE UNKNOWN

Yesterday, the hospice nurse and I went out to meet "Gary", and his wife, "Michele", at the local hospital. Gary was diagnosed with colon cancer one year ago. Gary had been through a lot of treatment to no avail. He has been in a rapid decline these past few weeks.

Gary was asleep during our visit, so we spoke with his wife, Michele, in a nearby meeting room. Michele's anxiety was intense. She worried about making the right decision of admitting Gary to a nursing home or bringing him home. She said she felt guilty not bringing him home, but was not sure if she had the ability to properly care for him as he needed.

We spoke about both options with Michele assuring her that there was no right or wrong decision to be made. We encouraged her to make the best decision for Gary and herself. Michele so strongly kept focusing on doing the right thing. We spoke about hospice support in the home and normalized her fears.

Gary was ready for discharge and the hospital discharge planning department was waiting to hear what Michele's discharge plan would be. One hour after the nurse and I left the hospital, Michele call to say she wanted to bring Gary home.

We met Michele and Gary at their home today. Gary had just arrived as the ambulance was still out in front when the nurse and I showed up. Michele was much calmer and did help Gary with a few needs while we were there. She did a great job.

Gary is so weak and speaks in such a soft tone. I spoke with Gary quietly to let him know how hospice will follow up for thirteen months to support his wife and his two daughters. Yesterday, I asked Michele about Gary's spiritual beliefs. She said he had Christian beliefs about God and the afterlife. Today when I asked him if he had any fears or concerns, I was not surprised hearing his answer.

We all have fears of the unknown. Unfortunately, we all will walk our last walk. It is a new experience for all of us. I know we all will do it our own individual way. God bless us all.


THE UNKNOWN　

We met her at the hospital yesterday.
Her anxiety was sky-high.
Worried about making the right decision;
admit to a nursing facility or bringing him home.

Her biggest fear was the unknown.
"Will I be able to care for him at home?
How will I change his colostomy bag?
How will I adjust him in the hospital bed?"

"What is the dying process all about?
How will I know when his end is near?
I want to be with him when he takes his final breath."
Unknown answers fueling her stress.

She was much calmer today;
feeling some comfort having him home.
She will hire caregivers to help out.
I know she'll do just fine.

He is bedridden and so very weak.
His recent decline has been swift.
I let him know that hospice support is for him,
his children and definitely his wife.

I asked him if he had any fears or concerns.
He quietly nodded his head yes.
He, just like his wife had felt,
"My biggest fear is truly
          the unknown."
 

HER VOICE

The hospice nurse and I went out to admit, “Sarah” to our hospice program. Sara, eighty-two years old, has struggled with Alzheimer’s Disease for many years. She lives with her husband, “Mitchell”, who is her primary caregiver. The couple have three children, but all live out of state and not able to help out as often as they would like.

Sarah has been in a rapid decline this past month. Where, one month ago, she was walking with a walker, now she needs her wheelchair. She is now totally dependent with all of her needs. Mitchell was so gentle; so soft; so loving with Sarah. His total focus was on taking care of Sarah.

Mitchell has a cute sense of humor which helps him cope. But the one thing that saddens him the most is that Sarah is using so few words now. There are times she does not talk at all, which breaks his heart. He has been losing Sarah for so many years as her needs increase, but she has always had her beautiful voice. Mitchell is now losing the one final piece of his wife.

Mitchell will become sad when talking about his wife turning within, then will use humor to break his sadness. Grief impacts us all in different ways. I am glad that hospice is now on board to support Mitchell as well. He is doing an amazing job caring for his wife.


HER VOICE
　

She's had Alzheimer's for many years,
but this past month has been hard.
She's been declining so quickly.
Becoming dependent all the more.

He's taken care of her all alone.
No family or other help around.
He's done an amazing job;
so loving; so gentle, so kind.

She requires help with all of her needs.
She cannot do anything on her own.
He feeds her; he dresses her, he helps her to bed.
His total focus is only on caring for her.

He told us that she is turning within.
Her face frequently expressing a flat affect.
She is sleeping more now than she is awake.
He is so saddened as her words are now few.

He is losing his wife slowly day by day.
She is not the woman he has loved all these years.
He is holding onto whatever she can give;
while using wry humor to lighten his load.

He will be by her side until the end;
while slowly letting her go.
But he knows what he will miss most of all
will be the beautiful sound of
          her voice.
 

MONKS

Often we meet patients while still in the hospital to explain our hospice program. "Rosa", ninety-three, had been in the hospital for three days with poor cardiac disease. She had been in a recent decline to where she was bedbound and dependent with all of her needs. Her daughter, "Sharon", told the hospice nurse and I that her mother's heart was causing her blood pressure to drop at night.

Rosa was asleep during the majority of our hospital visit, but would open her eyes and speak quietly. The hospice nurse told me that she thought Rosa had likely only a few days at most. After hearing that, I suddenly thought to ask about her religious or spiritual beliefs. I was hoping a minister or priest could visit her at the hospital.

Typically I ask about spirituality when sharing with the patient and family about our hospice team. A chaplain is a very important part of our team. I did not share much about hospice support while at the hospital as knew we would meet up again in a few hours once the patient returned home.

I truly believe I was spiritually guided to ask when I did. I feel so honored and humbled to have played a part in something so special that was meant to be. Coincidences are truly signs from above.

ADDENDUM: Rosa died the following morning shortly after sunrise.


MONKS

We met her in the hospital.
She so wanted to just be home.
Oxygen on board helping her breathe;
          her heart tiring her out.

The ambulance was coming in two hours
to transport her back to home.
We would meet up again at that time
to get the hospice paperwork done.

Something told me to ask about her spirituality then.
Typically I do so when talking about the hospice team
while doing the paperwork in the home.
She quietly said yes to a visit by a Buddhist Monk.

The hospital chaplain told me about the closest temple;
and how they never visit this far away.
The daughter then called the temple; hoping he was wrong.
They confirmed what the chaplain relayed.

Coincidently, though, two of their monks were driving back
from a city two hours north of town.
They have the time and will stop by to bless the patient
as it is on their driving route to home.

The nurse and I met up again in the patient's home.
She thought that the patient might die tonight.
While there, the two monks did show up
to bless the patient while easing her return
          to her sacred, spiritual home.