QUALITY OF LIFE

“Daniel”, sixty years old, was diagnosed with End Stage Kidney Disease recently.  Daniel has spent many years living on the streets.  He recently had been living in a rooming house surrounded by drugs and crime.  Daniel’s only family is a cousin, “Gene” living about twenty miles south.  When the hospice nurse admitted Daniel three days ago to hospice, he did not know his cousin’s phone number.  Many patients at Joshua’s House have a history of drugs or poor choices.  They have burnt many bridges and are alienated from their families.

While meeting with Daniel today, I asked him about his emergency contact.  He then named his cousin Gene.  He then gave me Gene’s phone number.  After the visit, I called Gene.  Gene was so supportive and caring.  I gave him the address of our shelter, “Joshua’s House”.  He then lovingly said, “I will visit him tomorrow”.  I felt so good about this visit.  In the end, I believe most of us are good people.  We all do make wrong decisions at times, but for most of us, we learn and move on.  Good luck Daniel and Gene.

QUALITY OF LIFE

He's been homeless for many years.

He spoke about his hardships;

living in a rooming house;

drugs; theft and crime.

He now has end-stage kidney disease.

He needs to go on dialysis.

He chose not to as so strongly wants

                         “Quality of life.”

He is very weak and mostly stays in bed.

He is eating about one-fourth of his food.

He gets short of breath with exertion.

With no dialysis, his life is now down to weeks.

He was admitted to our hospice shelter

for terminally ill patients who are homeless.

Five cabins; three bedrooms in each;

along with a bathroom and kitchen.

Private rooms with a large closet.

A hospital bed with a TV nearby.

Free food and comfort along with

twenty-four-hour hospice care.

He denied any fears about it all.

He has a strong faith that supports him.

“This place is wonderful and comforting.

This truly does define so perfectly to me;

                         Quality of life.”

                         

 

AGE

I met two amazing patients and families today. Coincidences always catch my attention. I found many similarities between these two patients that I visited today. How each were coping is neither right nor wrong. Our hospice team wants to be right where the patient and family are without any judgment on how one should react. We all cope in a way that works for us. We all cope our way. That is how it should be, no matter what age one is.

AGE

 It is easy, at times, to guess someone’s age;
but then, personality plays such a strong part.
Often one can easily stereotype and be so wrong.
I have met old thirty-year olds and, in addition,
                         young ninety-year-olds.
 
Grieving any loss is so individual.
There is no particular pattern at all.
Young or old; grief is profound.
We all live, and we all will die, our way.
 
I did two back-to-back admissions today.
Both were diagnosed only three months ago.
My first visit was to a gal only forty-four years of age.
The second patient will turn 100 in five days.
 
Both were diagnosed only four months ago;
one with cancer and the other with heart failure.
Treatment is no longer working for either;
                         so now, comfort care.
 
Being young, you would think she would want to fight it,
but she is realistic in such an amazing, optimistic way.
“Yes, I know what is happening and it may not be too long;
but I have always had such a positive attitude about life.
That is what has always worked to keep me going.”
 
Being almost 100, one may think she would be ready to go.
She is legally blind, hard of hearing, and very short of breath.
Lying in her bed, she was frigidity while saying,
“I hurt all over.  Help me, I want to live!”
 
Whether old in a young body or young in an old body,
we all will thrive if we are true to who we absolutely are.
Respect others and do no harm; go with your flow.
Experience teaches; knowledge educates and wisdom thrives;
                         no matter what age you are.
 

NOTHING

"Elias”, aged sixty, was diagnosed with Liver Cancer one year ago.  He underwent chemotherapy, but his cancer continued to grow.  Reading his medical records that came with the hospice referral, it so appeared that his life was very challenging.  Upon meeting him, I was so amazed about his positive attitude about life.  His strong faith gave him tremendous strength.  “Way to go Elias!” 

NOTHING

 

He came to Joshua’s House this morning;
our shelter for homeless, terminally ill patients.
He was diagnosed with metastatic cancer last year.
He recently said, “No more treatment”,
                         as the cancer continues to grow.
 
He came to America in his early twenties,
sharing, “It was all about a special gal”.
He married another and had four children.
All of them are now estranged from him.
 
Years ago, he worked at a grocery store.
He also helped others with home repairs.
Those times and years somehow don’t count
as he now has no financial income at all.
 
Reading and hearing about his background;
one so easily can think, “He has nothing”;
but upon meeting him, one does instantly notice
his strong faith and positive attitude about life.
 
His voice is so soft and gentle as he shares his faith.
He has been a Seventh Day Adventist for his entire life.
He will frequently and quietly ask God for support
as so fully believes in a strong and loving God.
 
As I was leaving, I asked, “Is there anything else?”
He then asked if he could pray with me.
He closed his eyes and held my hand
giving thanks for my visit and support.
 
Driving away, I realized that, yes, his possessions are few;
his family and friends do not come around; and he is solo,
but then he strongly believes he has all that he will ever need.
His truth is that he has so much more than nothing;
                         he has everything.

 

SO SAD

I went out to admit “Ben” to our Palliative Care program today.  His situation is so sad, but then his family, so amazingly, focused on reality along with the good.  They have taught us all that the best gift anyone has is their heart and soul.  So often an illness can grab all of the attention as it is so visible and real.  This wonderful family was real but also focused on who Ben is as a person.  I feel so honored to have met all three of them.  Thank you.

SO SAD
 
It was just three years ago this month
while he was just driving home from work,
that a semi crossed over the double line;
                         hitting his car head on.
 
Now at age thirty-four, he is paraplegic.
He has a trach; a ventilator; a feeding tube.
He is forever bedridden as weakness stays.
He is non-verbal, but can blink his eyes for yes or no.
 
His mother and sister devotedly care for him.
They are so focused on following his wishes.
He simply told them recently, “I want to live”;
so, he is now Full Code and Full Intervention.
 
Before the visit, I read about his health history.
The emotion that totally embraced me was sadness.
He suffered a cardiac arrest two weeks ago.
Mom then said, “That is the third time he has died”.
 
Yes, his family feel sadness and grief too,
but focuses on the positives in his life.
They spoke about his children and his faith,
while strongly sharing his heart and soul.
 
Mom said he loved the show “Seinfeld”.
She then shared one of his favorite episodes.
It was then when he laughed with no sound,
but one clearly saw the humor in his eyes.
 
Yes, it is definitely a sad situation, but then;
his family has given his life purpose and meaning.
There is a reason why he is still here.
He may be our biggest teacher
                         of them all.
 

GRANDPA AND GRANDMA

“Jennie’s” grandparents are both critically ill.  Grandpa has respiratory failure while grandma has Lung Cancer.  Jennie is thirty years old and very mature for her age.  She tells her truth as is realistic regarding her grandparents’ symptoms and prognosis.  This is a very large family who are all so supportive to their grandparents and to each other.  Love will get them through.  I wish Jennie and her family the best for sure.

GRANDPA AND GRANDMA

She is the caregiver for her grandpa
ever since he has been so sick.
He is now extremely weak and lethargic;
no longer getting out of bed.

 “He is a very special grandfather
as all in our family love him so.
Grandma is also very sick with cancer.
She, too, is so ready for it to be over”.
 
“I don’t want them to give up.
I want them to fight to get better.”
I shared with her; “It is not giving up;
it is knowing when to let go”.
 
When asked what helps her cope, she said,
“I cry as am very emotional.
We had plans, and I truly know,
                         they will always be around.”
 
“I will always respect my grandparent’s wishes,
but I am not yet ready to say goodbye.
I strongly believe in God and the afterlife
and so deeply know and embrace,
both will forever, spiritually and always

                    be here”.

HER WAY

Penny, 85 years old, has suffered from Breast Cancer that has metastasized to her bones.  She suffered a femur fracture due to the bone Mets.   She has been bedridden for two months since that event.   Penny has always been so independent and lived alone until the fracture. 

I had not seen her since I did the admission over a month ago.  Today, she again, looked wonderful as was vital and spunky like before.  At the end of our talk together, she threw in some humor.  I then said, “When it is my time to be at the gate, please make sure it is unlocked.”  She, with a cute smile, answered, “I will surely do so”.

The nurse and I were there for two hours.  Walking out the front door is when sadness hit me.  She was such a wonderful human being.  What a loss for all of us.

 

Addendum: Three days later, I spoke with Penny’s daughter offering condolences and support.  She and her family wee “doing okay but having sad moments”.  The daughter thanked me for spending time with her mom.  Penny told them all that our talk was “comforting”.  This is, for sure, one patient and family that I will always cherish and remember.

HER WAY

 

 

She planned on taking the meds today
so asked for us to be there at 11:45.

Her three daughters and a niece were there.

“Mom needs to talk to Marilou now.

Let the rest of us leave the bedroom.”

She spoke about her endless suffering.

“Every moment is a continuous struggle now.”

She then shared stories about her daughters,

her grandchildren and great-grandchildren too.

I then thanked her for the gift she gave me; 

requesting that I come today to give support. 

“Please also give my daughters support. 

I want them to be okay after I am gone.”

 

She took the lone pill one hour before as directed. 

It is for nausea that is caused by the other pills. 

At 1:15, she so easily swallowed the EOL tablets.  

Within a few minutes she was unconscious.

 

I said goodbye to the patient as we were leaving.   

Let go when the time is right for you to do so.” 

The daughters really appreciated us coming while saying, 

Thank you so much for the support you gave our mom.”

 

We left at 1:45 and thirty minutes later, she was gone.  

The daughters weren’t surprised that she made this choice 

as she has always lived her life;

                   and now her death;

                                            Her Way.                               

 

 

 

TOMORROW

 California has the End-of-Life Option Act (EOLOA) allowing a terminal patient to take medication that will end their life.  There is a process when wanting this option.  Physicians want to make sure one isn’t taking the pills because the children want the money from the estate etc.   Many of our patients will go through the process.  They will have the pills in the home, but, in the end, do not do it.  They just want it as an option.  

I met “Penny” one month ago when the nurse and I admitted her to hospice.  It was, at that time, that she spoke about wanting to do the EOLOA. Penny’s daughter called me this morning and informed me that her mother plans to take the pills at noon tomorrow.  She then said that her mother wanted me to be there.   Her daughter asked that I arrive fifteen minutes early so I can talk with her mom.  I have no words but will speak from my heart.

TOMORROW

I met her about one month ago

when we admitted her to hospice.

She was bedridden due to a leg fracture

from the cancer spreading to her bones.

She has always been so independent

which was understandably important to her.

Now only seeing a dependent future,

the End-of-Life-Option-Act is for her.

Her daughter called me today, saying

“You said two hospice people can be here

when Mom takes the end-of-life pills.

She has chosen to take them at noon tomorrow.”

She then continued, “My mom wants you to be here.

You gave her so much comfort when you visited.

You were so supportive to us all.”

With tears in my eyes, I softly answered,

                         “Absolutely!”

I was so shocked and surprised;

hearing that I made such a difference to someone,

while doing something that I so deeply love.

All I can say is “Thank you”,

                         but it is so much more.

“You gifted me with witnessing your transition

This is something I will never forget.”

You shared, “I believe in a higher power”.

I deeply believe you will hear, “Well done”.

“But then, what is going through your mind tonight?

Do you have any fears or concerns?

You learned so much during your life that

you will soon know the truth and the love about it all

                         Tomorrow.”