TO BE HOME

"Evelyn", ninety years old, fell four days ago and sustained a right knee injury. She was walking into the kitchen when she tripped and tumbled to the floor. In the past year, Evelyn has been needing more help with her daily needs as was becoming weaker and a bit confused. Her three children, who all live locally, rotate taking turns to care for their mother so she is never alone.

Evelyn has always worked hard and did things the best way she knew how. The family has been processing this rapid change and decline since the fall. The hospital made a referral to hospice for support upon Evelyn's discharge to home. The hospice nurse and I met the family in the hospital. Evelyn was lying sound asleep in her bed. She looked so frail and appeared to be imminent.

 Evelyn has been eating and drinking very little while in the hospital. The family said that they are seeing a daily decline. As we spoke about hospice, it became clear that the children knew that mom just wanted to be home. All three of them were so lovingly focused on meeting their mother's needs. 

The children wanted to know how much time their mom had left. In hospice, when we get asked that question, we have no answer. I told them that mom will do it her way. I said she may have just days to a week or so. I shared with them that she may peacefully let go once she is home.

In hospice, we are so privileged to experience and witness patients doing their life and death their way. People die the way they live. It was so beautiful to see Evelyn's children focusing on helping their mother the way they knew she would want for it to be.

 TO BE HOME

She turned ninety a few months ago.

A quiet family gathering to celebrate her years.

She has worked hard during her life.

Focusing always on what needed to be done.

In these recent years, she's become a bit weaker; 

needing a little more help each day. 

Her three children all take care of her; 

rotating hours so she is never alone. 

Four days ago she fell walking into the kitchen. 

Her right knee became swollen causing her pain. 

She went to the emergency room for treatment. 

Not broken, but she'll need time for it to heal. 

The family worried about caring for her at home. 

Her discharge from the hospital dependent on that. 

Each day she's weaker, more confused; not eating. 

She's become non-verbal with this rapid decline. 

The family agreed to hospice. 

They know she just wants to be home. 

We did the paperwork in the hospital. 

The nurse to meet up again when she discharges to home. 

The family asked for a Catholic priest to come visit her. 

They all now realize that her time is short. 

Our chaplain spoke to the local Parish Priest. 

He came out for The Sacrament of the Sick. 

She arrived home mid afternoon. 

Hours later she was gone. 

It became so obvious to all 

that she just wanted to be home;

       in order to peacefully let go. 

Her way; 

    her time; 

         in her own home.

TO BE THERE

We admitted, "Kirsten", aged thirty-eight, to hospice today. Kirsten was diagnosed with breast cancer three years ago. She underwent chemotherapy and radiation treatment to no avail. The cancer has now spread to her lungs, liver and bones. Our Medical Director and hospice nurse read the patient's medical records prior to our visit. Pain stood out so strongly as her biggest concern.

Typically when the nurse and I walk in, we may answer questions for a bit, but then will explain the support and philosophy of hospice making sure the patient and family are on the same page. You could see the pain in Kirsten's face. She was lying in bed, but kept moving trying to get comfortable. When asked how she is doing, she said while laughing, "Shitty!"

Kirsten was so honest and true to who she was. I so admire folks who can be honest to whom they truly are. She used swear words in a way that would make me laugh. It was her way of taking the edge of the seriousness of it all.

Kirsten was so spiritual and we instantly connected in an amazing way. She had a great sense of humor and was so real about her illness, her family and friend support. Hospice work is so spiritual for me. I easily will connect to a spiritual being naturally. I was sad when I heard about this referral due to her young age, but the moment I walked in, I strongly felt, "I was meant to be here."

I felt honored to have met Kirsten and her family. She is someone I so admire and respect. I will carry her heart and soul with me. Thank you Kirsten.


TO BE THERE

She was diagnosed with her cancer a few years ago.
She's had chemotherapy and radiation,
but unfortunately her cancer continues to grow
invading multiple organs all over her body.

She has totally accepted her disease.
Her strong spiritual beliefs relieve any fears.
Her biggest complaint is about her uncontrolled pain;
giving it an "8-10" degree; the highest level of all.

She said her pain is constant.
It keeps her awake every night.
It exhausts and drains her stamina.
"I don't ever know what to do."

I spoke about hospice's number one gift to her.
Comfort Care is what we so effectively achieve.
With our Medical Director on the speaker phone and the nurse,
they set up a new medicinal regiment that hopefully would work.

As I was leaving, she reported her pain at a "5".
She hugged me so tightly and softly said,
"You were meant to be here".
I had been feeling exactly the same thing.

I drove halfway back to the office and suddenly realized,
I forgot to have them sign the admission paperwork.
We did not do the admission in our traditional way;
as did patient care first before explaining our program.

Forty minutes later I was back.
She was resting and look so relaxed.
"My pain is now a zero.
I haven't felt this good in years!"

I was able to inform the nurse and Medical Director
about what an amazing job they both had done.
Forgetting the paperwork took me back to their home;
as I so truly was meant, again, to be there.

REMAIN SAFE

We admitted, "Ted", sixty-seven, today to hospice. Ted was diagnosed with lung cancer late last year. They treated him with chemotherapy, but still the cancer spread to his bones. Ted's biggest complaint was pain issues. He felt relieved when I informed him that hospice's number one priority is pain control and "they are very good at it." I added that over my career I have made hundreds of condolence calls after the death and I hear approximately from 85-90% of families, "It was peaceful."

Ted has lived next door to his mother for years, but today he moved into her home in order for his care needs to be addressed. Mom, eighty-seven, has full time caregivers that now can help both mother and son.

During the admission, Ted sat on the couch while mom sat at an angle next to him in her wheelchair. All four of Ted's children were there offering support. While the nurse and I were educating them about hospice supports, one could see the anguish and grief on Mom's face. She would continually pat Ted's knee as that is what she could reach. At times, she would try to pat his hand, but often he wasn't looking at her as was listening to us, and she couldn't reach her hand that far.

It just broke my heart as here she was the loving Mom who so instinctively wanted to take care of her son; to keep him forever safe. She saw that as her life’s priority and goal. It is now her family that has that priority and goal; to keep Grandma safe.


REMAIN SAFE

She always wanted to be a mom.
That was the primary goal in her life.
She raised her three sons so gently;
they, never forgetting, they all were loved.

She never missed a chance to hug them.
Her soothing hand giving them a soft pat.
But she had house rules they needed to follow.
She taught them love with guidance;
         wanting them to always remain safe.

In a few years now, she will be ninety.
Her health has been in a slow decline.
She is wheelchair bound and weaker
needing assistance with all of her needs.

The family all live within an hour away.
They visit her as much as they can.
They have hired full time care for her
making sure she will always remain safe.

Her eldest son now has terminal cancer.
We admitted him to hospice today.
She sat sadly right next to him,
while keeping her hand softly on his knee.

"My other two sons have already died.
Why is this continuing to happen?
It is so unfair; so cruel, but then,
they are in heaven watching over me."

She was hurting from grief so deep inside.
Her expression strongly exhibiting emotional pain;
when she turned to her son and softly said;
         "Don't go, please. Not yet."