LETTING GO

"Wendy", fifty-two years old, was diagnosed with brain cancer seven years ago. Wendy lived alone and, until one month ago, was managing her life well. She had to stop working a few months ago due to treatment options that were available.

Wendy has two young children; a son, "Mitchell; 22 years old, and a daughter, "Vickie: who is 28. Both children are devoted to their mother. This past month has been difficult as Wendy was slowly becoming weaker and needing more help. Ten days ago she was hospitalized due to needing urgent treatment.

Yesterday Wendy was transferred to a Skilled Nursing Facility. Wendy is imminent and no longer eating or drinking. She sleeps most of the day, awakening up for only a few moments. The two children are very realistic and are aware of their mother's status and very poor outcome. They wanted to be able to see their mother to say goodbye. Due to the Corona Virus and "Social Isolation", the facility did not allow any visitors or families.

I was able to talk to the Administrator and was informed that a Doctor's note was required stating that the patient was "Actively Dying". Hospice works so strongly as a team. I was able to call one of the nurses, who was in the hospice office, to assist with getting our Medical Director to sign such a note.

I spoke with Vickie this evening. She and her brother were able to go in and say goodbye to their mother. Vickie said that both of them told their mom that is was okay to let go. Vickie had tears while sharing that visit. It is such a perfect example of how strong the impact of "Social Isolation" affects each and every one of us. I am so grateful that they were able to have that last visit with their mom.


LETTING GO

Her decline was so rapid.
In one month, so much has changed.
Where she was living alone; managing her life;
now imminent with only a few days.

She was transferred to a facility yesterday
so she could receive that special care.
No longer eating or drinking.
          Sleeping most of her days.

"Social Isolation" has changed all rules.
No visitors or families allowed.
Requesting a doctor's note that clearly states,
          "She is actively dying."

The note was quickly faxed.
It allowed she and her brother inside.
They were able to say those special words.
They were able to say "Goodbye".

"Mom, go when you are ready to go.
We are going to be alright."
They shared their grieving hearts
giving her graceful permission to go.

Seeing her suffer is so terribly hard;
but then you don't ever want her to leave.
Unfortunately you know there is no other option
but for both of you to allow her
          to peacefully;
                   to lovingly let go.
 

SOCIAL ISOLATION

So many of us are staying home secondary to the Corona Virus precautions. We were recently informed that this may go on for another month. As we are social beings, it is one of the hardest things to ask any of us. I talk frequently with family, friends and patients on the phone, but it is so not like being with them in person. 

No one wants to catch the Corona Virus, so we do what was asked of us. It is stressful times for sure. I so believe that the majority of us use humor to cope. When speaking with a patient or a family member, their humor frequently does rise up to lighten the load.

I spoke with, "Caroline" today to check in and assess how she was doing and if she had any needs. Not surprisingly, the impact of her social isolation became the subject of our talk. She lives in a cottage on the property of a very large retirement center. Caroline would eat her dinner meal in the dining room in the main building each night for dinner. That is now on hold as the facility delivers her dinner meal to her. Many activities were offered each day for fun and socialization. All of that has been cancelled until it is safe again for all of us to resume our life in our normal way again.

What was wonderful was her humor. We would talk about the impact of the virus on everyone's life and she would have me laughing. Thank goodness each of us has humor to help ease the difficult reality. Thank you Caroline for lightening my load.



SOCIAL ISOLATION　

We all have been advised
to stay home; stay safe.
Only go outdoors if it is essential;
to the grocery store, to the pharmacy.

I can only telephone my patients now.
No visiting to their home; their facility.
By the end of each conversation, I typically hear,
"Thank you so much for the call; the support."

We are all social beings.
We love being with our family and our friends.
Yes, we can talk to them on the telephone;
but it is not like being with them in person.

It has become the major topic of each conversation
as it has completely changed the way we live.
I hear a lot of humor in my telephone calls
as laughter is a great antibiotic for stress.

She lives alone which makes it hard.
She longs for having people visit; to be around.
"I only see someone when I go get my mail.
Otherwise there is no one here but me."

"I do talk to my children all of the time,
but it's not like they are standing here."
Her humor did rise late in our talk
as, while laughing, she ended with
"It's seclusion,
          it's seclusion;
                   it's seclusion." 

TEE SHIRT

Due to the Corona Virus Pandemic, I have been home for several weeks. I am doing my work at home and not visiting patients or families at all. Hospice is considered an “Essential” agency and so we remain open during this health crisis. Only the hospice nurses and our Home Health Aides are allowed into the patient’s home or facilities.

I have been doing the hospice admissions over the telephone. I so feel that visiting folks in person is so much more supportive, but all of the patients and families so understand and appreciate the call.

I have been wearing blue jeans and a tee shirt each day as remain home to do my work. “John”, seventy-six, suffers from dementia. He had been doing quite well, even though was getting more and more forgetful. He needed supervision from his wife, “Carolyn”, but did manage quite well.

A week ago, all that changed. He declined rapidly to where now he is no longer walking. His appetite has declined and he is much more confused. His speech is now garbled and not making much sense. Carolyn is struggling as she is trying to process this rapid change.

Carolyn and John live about a mile from my home on a beautiful ranch with acres of trees. Carolyn asked if I could come in person. She said that we could do the visit on her porch. I asked her, “Is it okay if I am wearing blue jeans and a tee shirt?” She answered, ‘Absolutely”. As I was driving over, I realized I had no jewelry on along with wearing my comfy shoes.

Carolyn and I connected instantly as she was so truthful about everything. She was direct about John’s decline and poor prognosis. She was so honest about who she was and how she copes with life. It was then I realized, it is not the clothes that defines who you are, but your heart; your soul. Thank you Carolyn for that beautiful reminder.


TEE SHIRT　

We are all socially-isolated.
Staying away from others; washing our hands;
avoiding exposure; remaining at home.
The Corona Virus now has all the control.

I have been working from home.
Not seeing patients or families at all;
but calling them to introduce myself.
Doing the hospice admission over the phone.

I stay comfortable wearing casual attire.
It is consistently blue jeans and a tee shirt that I grab.
Why wear nice clothes, dress shoes or jewelry
if no one sees me doing my work each day.

He's been sick with dementia for so many years.
He had been doing quite well until last week.
No longer able to walk, so he stays in bed
requiring assistance with all of his daily needs.

They live a mile away from me
on a twenty acre ranch with lots of trees.
She asked that I meet with her on their front porch.
Cabin fever has hit, so I enthusiastically agreed.

We sat on her porch among the trees;
feeling the beauty; the comfort; the peace.
She told me about her family; her work; her pain.
She needed to talk and I quietly listened.
So easy to do while nature embraced our souls.

We connected on a spiritual level.
She so thanked me for listening to her.
She saw my heart and not my clothes
as I am a Social Worker through and through
even while wearing
          my best T-shirt.

HER HOME

Three days ago we admitted, "Julie", eighty-one, to hospice. Julie has a long history of lung disease. Julie has been widowed 42 years and has three children. Julie has been healthy most of her life and able to manage independently with all of her needs.

In the recent past, Julie has become weaker and aware that she may not be able to care for herself without help. Four weeks ago, she moved into a Residential Care Facility around the block from her home. It was there she would get meals and support as needed. She had a room on the second floor which gave her privacy and a view of a small garden on the grounds.

Julie's health continued to rapidly decline. She was becoming more dependent, eating less and sleeping a lot more. Our hospice nurse went out to see Julie and her son, "Matt", three days ago to admit her to our program. Due to the Corona Virus, the facility is not allowing staff other than a hospice nurse or home health aid to visit. Hours before the hospice admission three days ago, Matt wheeled his mother home the two blocks in her wheelchair.

I called Matt today to introduce myself and to educate him on the Social Worker role and support. One could hear the love in his voice. His total focus was on his mother and to lovingly support her; which he was doing so beautifully. I praised him for being a strong advocate for his mother. He thanked me for that as I am sure he did not hear those words from the facility.

Matt and his wife live locally and are available to help as needed. Both of them have moved into his mother's home to stay for the duration of her illness. This is a awesome example of those beautiful moments that fill my heart with joy. I feel so honored to have met Matt and to have witnessed his loving heart.

ADDENDUM: Julie died four hours after Matt's and my telephone conversation. She died surrounded by unconditional love from her family. It doesn't get any better than that.


HER HOME　

She's been widowed over forty years
so has spent a long time with just herself.
Recently, her health has limited her independence
so she moved into an Assisted Living Center
          around the corner from her home.

These last few weeks have been hard
as she is rapidly declining; needing more and more help.
The Corona Virus is strongly looming around,
so the facility is allowing no visitors; no family.

Her son's heart was breaking.
He so wanted, and needed to be by her side.
He broke their rules and went indoors to her room.
Hence: he wheeled her around the corner to her home
making sure she would never again be alone.

Some folks may think he was wrong,
but I see him as a strong advocate
totally doing, by far, the right thing
in simply needing and caring for his mom.

His true thoughts are doing what is best
for her, for him, and for the family.
She is now unresponsive with labored breathing.
He and the family knows it is just hours to only a few days.

I shared that she was giving he and the family time.
Time to say those words you want her to hear
as it takes no energy to listen to heartfelt words
          or to feel a soft, gentle touch.

I praised him for what he had done.
It was a perfect example of unconditional love.
She is not alone, upstairs in a stark room,
but surrounded by her loving family
with the best thing of all being;
          she is home.