HER WAY

"Betsy”, eighty-one, was admitted to hospice two days ago.  Betsy had never married and had no children.  Her “family” were her two closest friends; “Ellie” and “Anna”.  Ellie was the agent for her Health Care and legally was able to express Betsy’s health care wishes.   

 

One week ago, Betsy became extremely ill due to an infection.  She was hospitalized and never recovered.  She was discharged home three days ago with our hospice program support.  We met Betsy, Ellie and Anna, in front of Betsy’s home as the ambulance drove up to bring her home from the hospital.  Betsy was minimally responsive and so very weak. 

 

Our hospice nurse knew that she was imminent, but Ellie and Anna, were still processing this dramatic change from one week ago.  Ellie and Anna told us wonderful stories about Betsy.  Her home was so artistic and decorated beautifully.  Betsy was a musician and had also taught piano. 

 

Ellie and Anna spoke about Betsy’s estate.  They said that Betsy wanted to change a few things which would require her signature on notarized paperwork.  Ellie was hoping that Betsy would be more awake the following day.  The nurse and I knew she was imminent and likely that would not happen. 

 

Knowing how strongly Betsy’s friend wanted to follow her wishes, I offered another alternative by just telling Betsy all of the paperwork was complete.  Whether Betsy’s signature was on the paperwork or not, I knew that Ellie and Anna would always follow her wishes. 

 

Betsy died peacefully the following afternoon.  I spoke with Ellie this morning to offer condolences and support.  It was then that Ellie thanked me for suggesting they tell Betsy that the paperwork was completed.  She said that she and Anna comfortably shared that information with Betsy.   

 

Ellie said that Betsy died peacefully.  She felt good by telling Betsy that all of the paperwork was complete.  Ellie said that with that knowledge, Betsy was able to easily let go. 

HER WAY 

 

She had been healthy her entire life; 

living and loving her way. 

She spoke her truth to those around 

letting them know how things were to be. 

 

Her life changed dramatically one week ago. 

A major infection mowed her down. 

She was hospitalized to no avail. 

Two days ago, she was discharged to home. 

 

Her two friends were totally there for her.  

They were her strongest advocates. 

They wanted to help as she would say; 

focused totally on doing things her way. 

 

She had wanted to change a few subtle things 

on the paperwork of her estate. 

They needed her notarized signature, 

but it seemed likely that could not be. 

 

It was then I suggested they tell her it was done; 

as they wanted her to peacefully let go. 

Whether she signed the paperwork or not; 

I know they would see that it would be. 

 

I called to give my condolences; my support 

as she died peacefully just yesterday. 

They thanked me for giving them guidance 

as they both told her the paperwork was complete. 

 

It gave her comfort knowing all was done; 

making it easy for her to let go; 

ending her life like she has always lived; 

               Her way. 

 

SOB

In our hospice, we have a policy that when a patient becomes imminent; a nurse or a social worker will visit daily.  Hospice defines imminent when a patient has two weeks or less to live.

“Elena”, thirty years old, was diagnosed with cancer three years ago.  It has now spread to other organs.  Elena is eating only bites and is becoming very weak.  She is bedridden and sleeps throughout most of the day. 

Elena, and her sister, “Mari”, speak English.  Fortunately, when I did my visit today, Mari was there.  As I walked up to the front door of the apartment and introduced myself to Mari, she laid her head on my shoulder, hugged me and just sobbed so strongly.  Elena has declined so rapidly.  The family is appropriately struggling with this rapid decline. 

Mom was sitting on a bed next to where her daughter was sleeping.  My goal was to offer comfort to both of them, using Mari as a translator as Mom did not speak English.  It was difficult as I could not tell how much Mom could clearly understand what we were saying. 

The family had not yet selected a funeral home, which often is best to do ahead of time.  If one waits until the day they need to call a mortuary, they are numb, in shock, and may make a decision they normally wouldn’t make. 

As I tried to softly bring up that topic, both Mom and Mari cried to deeply.  I just held onto both of them; saying nothing.  I hoped that Mom felt my compassion; my sorrow for what she was experiencing.  It was when I got up to leave, that Mom let me know that she understood every word.  It gave me such peace and comfort knowing that I did the right thing for both of them.  And yes, for me as well.  Thank you so much, Mom.

SOB

 

I went out to give Mom support.

To offer compassion; to offer empathy.

To give the comfort she so needed.

Struggling with having to say goodbye.

 

Her daughter was asleep nearby;

looking so peaceful; so beautiful.

Mom was sitting next to her

trying so hard to hold back tears.

 

Suddenly the sobs came so strongly.

While placing her hands over her eyes;

her body trembled so rapidly.

There were no words left to say.

 

I had no words to offer either

as we did not speak the same language.

I just held on to her so tightly

wanting to give her comfort; to give support.

 

I hoped she felt my compassion.

I hoped she knew I cared.

We could not talk to each other,

although body language expresses to all.

 

She came up to me as I got up to leave.

While laying her head on my shoulder,

she wrapped her arms completely around me;

and, again, she sobbed so deep from her heart.

 

It was then when she expressed to me;

in a way we both would know;

“Yes, you did comfort me.

               I felt your every word.”

 

CONTRAST

I did two admissions today; one for our Palliative Care Program and one for Hospice.  “Jimmy”, sixty years old, has a very lengthy health history.  Fifteen years ago he received two cancer diagnoses.  While undergoing chemotherapy, he suffered a major stroke.  The stroke has paralyzed his left hand along with his left side.  That weakness impacts his ambulation, making him a bit wobbly on his feet. 

Jimmy was diagnosed with throat cancer six weeks ago.  He will be undergoing seven weeks of daily radiation starting next week.  The treatment will impact his swallowing.  He recently had a feeding tube inserted into his stomach because of that.  Jimmy has a past history of using illegal drugs and alcohol.  His family lives out of state, but he does have a few friends nearby.  

He will need help while receiving his treatment.  There are so few options available to him, but I have already spoken with the Palliative Care team about the urgency of his needs.  

The second admission I did today was for, “Ruth”, ninety-nine years old.  She looks twenty years younger while Jimmy looked twenty years older than his stated age.  Ruth’s memory is slowly declining to where she is becoming a bit forgetful.  She is slowly getting weaker and eating about half of what she used to eat.  

Medicare is very strict about hospice guidelines, but the hospice nurse and I both felt that Ruth and her daughter, “Grace”, would greatly benefit from our services.  We were able to admit Ruth to hospice, while admitting Jimmy to our Palliative Care program. 

The contrast between these two patients was amazing.  Why does one have such struggles, while the other has tremendous family love and support?  Is it fate?  Is it life choices?  Is it DNA?  Likely there are no answers as I hear often from hospice patients, “It is what it is”. 

CONTRAST 

 

He has an extensive health history;

three cancers, a stroke, migraine headaches.

While she, on the other hand,

               has very few.

 

Another new diagnosis of cancer has hit him again.

It’s in his throat this time; affecting his swallowing.

He will now be needing a feeding tube,

               while undergoing radiation treatment.

 

She amazingly, will soon be 100 years old.

She though, has been in a slow, recent decline,

but we struggled with finding a diagnosis

that will meet hospice’s Medicare guidelines.

 

His family lives in another state.

He has only a few friends around;

while she is surrounded by her loving family.

It is her family that helps her get by.

 

He is forty years her junior,

but has a lifetime of struggles.

His great sadness; depression, makes him cry;

while she embraces all the love she has nearby.

 

Do we choose our journeys?

Are they lessons in disguise? 

What surrounded her with love, compassion,

while so much for him has been left behind?

 

Likely there are so many more questions

with no answers to be found.

Each deserves to travel their journey with

much love, support, embracement;

no matter what the contrast

               that anyone finds.

 

THIS IS WHAT IT IS ABOUT

Eight years ago, I was in the Emergency Room secondary to a ruptured appendix.   I was septic with a very low blood pressure.  While in the Emergency Room, I had an out-of-body experience.  It was the most normal and yet, the most amazing experience.  There was this beautiful arc of light which was pure spirit.  I knew the answers to the universe.  I instinctively knew that life is not that complicated. 

When I came back to the Emergency Room, I was more interested in what was going on there.  With the out-of-body experience being so normal, I naturally just moved on.  I had surgery that evening and was on life supports until the following day.  It was after the removal of the life supports, when the reality of my experience hit me. 

It was only for a moment and, at the time, felt so normal, but afterwards I had so many questions of “What was this all about?   What was the purpose of such a profound experience?” 

During an admission visit today, I was touched and moved by the love that, “Dean” had for his wife, “Heather”.  Even though he tried to hide his pain, it was all over his face and emotions.  Dean and I had a private moment in the kitchen where he spoke about his wife and asked me, “Why is this happening to her?”  He believed in afterlife, but, like most of us, did not have a clear understanding about the reality of it all. 

I was guided from within to share my experience of crossing over.  His grateful comments brought tears.  It also brought the realization of the reason why I did experience being, if only for a moment, on the other side. 

“Thank you Spiritual Guides”, but also so strongly, “Thank you Dean.”

THIS IS WHAT IT IS ABOUT

 

It has been almost eight years

that I crossed over to the other side.

It was so profound, although lasting

               just a minute or so.

 

Immediate questions arose;

“What was that all about?

What was the purpose?

What do I do with it?”

 

He is grieving so deeply.

Her decline has been swift.

No longer eating much; becoming weaker.

Not much time left at all.

 

He had to leave the room several times;

returning with eyes moist and red.

He has no words; no understanding;

“Why is this happening to her?”

 

I am guided by my spirituality.

It never leads me astray.

I told him about my crossing over.

It was so normal and beautiful at the same time.

 

He turned to me and softly said,

“Thank you so much for sharing.

It gives me great comfort.

               It gives me peace.”

 

I crossed over for a purpose.

To share my experience when guided from above.

“This is what it is about.

               This is what it is all about.”