911

Ten weeks ago, we admitted “Jan”, eighty-four, to hospice secondary to metastatic pancreatic cancer.  Jan underwent treatment to no avail.  Jan and her family are from Asia.  Jan lives with her daughter, “Ellie”, who struggles with understanding English.  Fortunately, with each hospice visit, Jan’s adult granddaughter, “Ira”, is always available.  She is fluent in English and able to easily translate. 

When we admit patients to hospice, we ask if they are okay not calling 911 but hospice.  Hospice is not a curative program, but beautifully offers comfort care.  Our phone gets picked up and answered twenty-four hours a day.  We encourage patients and families to call us at any time as it helps us help them when we know what is going on 

It is hard for all of us to let go.  Age does not matter as Jan is always a mother, a grandmother, a great-grandmother.  I have never met anyone who loved being dependent.  Jan has been becoming weaker to where now she is bedridden and sleeping most of the day.  Although, when the nurse and I walked in, Jan was lying in her bed moaning from pain.  The nurse immediately gave pain medication.  The family had not been giving it to her as didn’t understand the process.  

Due to Jan being imminent, hospice will visit daily for the needed support.  Jan has a very large, embracing family who all support her and each other.  They all will continue to grieve, but do reach out to each other as needed.  I wish them well. 

ADDENDUM:  Jan died peacefully two days later with her family at the bedside. 

911 

 

We admitted her to hospice just ten weeks ago.

Two months later, they called 911.

She was admitted into the hospital overnight.

We discharged her due to Medicare guidelines.

 

We re-admitted her again four days later.

They agreed not to call 911, but hospice.

But then, one week later, they dialed 911.

Then again, we had to discharge her.

 

Now, two days later, they want to return to hospice.

We cannot admit her if they habitually call 911.

Hospice patients wish for comfort care, not cure.

Families want their loved one’s journey to provide peace.

 

We went out today for the third time.

She is imminent with only days to live.

She has stopped eating and is drinking only sips.

The hospice nurse helped control her pain.

 

The family is aware she only has days to live.

They strongly told us, “We will only call hospice.”

The conversation now is about arranging a quick burial;

which is their cultural and Muslim belief.

 

Intellectually, we all know the truth,

but the emotions of grief are so powerful.

They all knew she was terminal,

but, like most of us, struggled with the actuality.

 

Today, they all deeply know

it is now their time

                    to simply just allow her

                              to let go.