THREE WEEKS

Fifty-nine year old “Chuck” was diagnosed with colon cancer eight months ago. Chuck was an engineer by trade and had a very precise, exact personality. He was very logical and handled his diagnosis the same way. Patients die the way they live and Chuck was a perfect example of that.

Chuck had many questions for his doctors throughout his disease progression. He wanted precise answers that could not be given. He came onto hospice about two months before he died. Once he was on hospice, he would ask the hospice staff these same questions hoping to get exact answers.

Chuck’s decline was slow, but steady while on hospice. He got to the point where he needed help walking and his appetite was poor. He was losing weight and sleeping more throughout the day. He got it in his head that he had three weeks to live and called his family to inform them of that fact. I happened to be visiting Chuck that Friday and he also shared with me that he had three weeks left to live.

The family, at first, was upset as they thought hospice told him that he had three weeks to live. Chuck then clarified that hospice did not tell him that, but he knew he had just three weeks to live.

Not surprisingly, Chuck died on a Friday exactly three weeks later. I truly believe that many patients have insight to how long they will live. Patients do let go when the time is right for them.


THREE WEEKS


He had always been very precise.
He had patience with fine detail.
He was exact and linear with his thoughts.
It worked well for him this way.

He was an engineer by trade
which fit well with his personality.
His days were filled with charts
full of diagrams and numbers to sort out.

The moment he was diagnosed
he wanted to know the truth.
What was in his future;
how much time did he have?

He was looking for the answers
to a question that wasn’t precise.
He needed to sort things out
the only way he knew how.

He was in a steady, but slow decline.
He knew he didn’t have long,
so he told his family he had three weeks.
It gave him comfort to know.

He was determined in his belief,
even though no one told him an exact day.
But somehow he knew the time to let go
as he died peacefully like he predicted,
with his family at his side,
in exactly three weeks.

LONG DAYS

Fifty-three year old “Brenda” suffered from ovarian cancer. Brenda lived with “Chuck”, her husband of thirty years. They had no children, but had a huge network of supportive friends. Brenda’s only family was her sister, “Betty”, who was two years older. The girl’s parents died when they were teens, which brought them close together.

Betty lived nearby and the moment her sister was diagnosed, she accompanied her to doctor’s appointments and treatments. Brenda had been doing quite well until a few weeks ago when she suddenly declined. She became bed bound and needing help with all of her needs.

Betty started coming in the early mornings and stayed throughout the day and evening to help out. Quite often she stayed overnight as she had the need to be near her sister. One would also find the home filled with many of Brenda’s and Chuck’s friends at all hours of the day helping out as well. Over the course of a two week period, once vital and active, Brenda became dependent with all of her needs. She slept most of the day and it was getting difficult to wake her up. She stopped talking and it appeared she wasn’t aware of her surroundings or what was being said to her.

At that time, the family understood that Brenda was near the end of her life. Brenda died peacefully with her sister and two friends at the bedside. I called Betty to offer condolences and she described the last hours of her sister’s life. Betty easily talks about her feelings and does reach out to her husband and friends for much needed support. I know she will be okay in time as she was totally there for her sister. She says the difficult part is that she is the only remaining member from her immediate family.


LONG DAYS


Her days were long,
but she never complained.
Her sister needed the help.
Sibling love guided her way.

She had to be there.
She couldn’t stay away.
But the days were hard.
The nights even more.

Their parents died
when they were teens.
It made them close.
It’s just been the two of them.

She came every day.
She held her hand.
She whispered softly
telling her it was okay to go.

Now that it is over,
she’s looking back.
“These past two weeks
was one long day”.

A GIFT

Sixty-seven year old “Vic” suffers from prostate cancer. Vic has been married to “Mary” for thirty years. Vic has several children from a previous marriage who all live out of state. Mary has two sons from two previous marriages who also live hours away. The extended family is very close to Vic, Mary and each other.

Mary says that Vic is her soul mate. She adores him and loves being by his side. She says he came into her life at the perfect time. Vic is devoted to Mary and appreciates all that she does for him.

Vic is very weak and needs assistance with all of his needs. He has some days now that he doesn’t get out of bed. He has a poor appetite and is so thin one can see his ribs. Mary worries about him, but understands that the decline will continue.

I went out today and Vic needed to talk about his family. He wanted to know what to tell his family when they call. He doesn’t know when to tell them to come visit. He would like to have a chance to say goodbye. I asked him what he wanted to do. Did he want to see them when he was alert and awake to enjoy the visit or at the end of his life where he may be sleeping most of the time?

Vic thought about what I said and then asked me, “When will I die?” He wanted to know how long he had to live to determine when to tell the family to come out for a visit. I spoke about the end of life and what to expect. I said he would let go when the time is right for him.

I talked about the clinical process of dying and then spoke about my experience as the non-medical member of the team. I shared that if he saw monthly changes, he has months. If he sees weekly changes he has weeks; daily changes; days and hourly changes; hours. I shared that a guideline for me is how much someone is still eating or drinking.

He was quiet for a moment while he thought about what I had said. He started to cry and then said, “Thank you. You have let me know.” I was tearful as well as he told me I had made a difference to him today. I felt touched by God for finding the right words to say to him.

I asked Vic if I could give him a hug before I left. He said yes. He is so weak, but he was determined to stand up and hug me back. Our hug was so tight and long as I believe we were both thanking each other for the gift we received from each other.

Mary walked me out and said “Isn’t he an amazing man?” I couldn’t have agreed more. Somehow we were meant to connect today in a very special way. Thank you Vic and God for the amazing gift you gave me.


A GIFT


I hadn’t seen him for a few weeks.
I was surprised by his decline.
He is weaker; he is thinner.
He has trouble processing thoughts.

He knows he is going downhill.
He knows he will never get well.
He knows his time is limited.
He’s getting ready to let go.

“When should I tell them to come visit?
When is it the right time?
I don’t know what to tell people.
When will I die?”

I spoke about the end of life.
I spoke about the changes and decline.
I was honest and straightforward.
I allowed the words to just flow.

He was quiet for a moment
letting my words sink in.
He started to cry and then thanked me.
“You have let me know.”

I asked if I could give him a hug
for the gift that he gave me.
Telling me I made a difference.
Helping him to know what to say.

He slowly stood up and we hugged.
The hug was tight and long.
He was thanking me for my gift.
A shared exchange between two souls.

COINCIDENCES

I have experienced so many coincidences in the work that I do. I have often been delayed which puts me in a patient’s home later than scheduled. Frequently that later visit ends up being the perfect time to be there. I walked into a home one time to open them to hospice. The elderly wife was so stressed over what to do when her husband died. Thirty minutes into the visit, the husband quietly died and I was able to handle all the details for her, thus relieving her of all the stress. I am never surprised when these things happen, although am in awe as I feel that a higher power is guiding it all.

Normally I schedule a visit a day or two ahead. I had two morning appointments scheduled for tomorrow and was about to schedule another for the afternoon. My instinct told me to leave that time available. I trust my inner voice and after several times thinking I should schedule something for the afternoon, I kept thinking that I need to leave that time alone.

Later this afternoon, one of the hospice nurses called me about “Sheila” one of our patients. She said that Sheila fell and was ready to talk about setting up a plan for care. Part of my job as a social worker is to discuss long term planning with the patients and families. Even if the patient doesn’t need twenty-four hour coverage at the time, it is good to have a plan in mind so when that time does come, it can be a smooth transition.

Sheila suffers from ovarian cancer. Sheila’s son, “Jeff”, lives in the home and has been her caregiver. He works nights, but is available during the day when he is not sleeping. That plan has been working fine as Sheila is able to walk slowly around her home and manage many of her needs. I have attempted to discuss a long term plan with Sheila several times. She would always respond saying her family and friends will help out. She never would clarify a definitive plan.

Sheila asked the nurse to call me so I could come out to help her and her family set up a workable plan. Sheila’s daughter lives nearby and also works. Tomorrow afternoon worked well as it gave her daughter time to arrange time off work in order to be present during the visit.

Somehow I wasn’t surprised that something like this happened as I listened to my inner voice to keep time available. When I listen and follow its guidance, I am never steered wrong. Coincidences, I believe, are powerful signs from above.


COINCIDENCES


It happened again today
like many times before.
An unexpected coincidence
falling perfectly into place.

I trust my inner voice; my instinct.
It speaks to me loud and clear.
It guides me to where I need to go.
It never steers me wrong.

Quite often when I am delayed,
it gets me there at the perfect time.
Words popping into my head
become the perfect thing to say.

My days typically fill up rather quickly
with pre-scheduled appointments.
Visits planned a day or two ahead
focusing on patient and family needs.

I left tomorrow afternoon open
which is not my typical routine.
I felt I needed to set aside the time,
but really didn’t know why.

She called to say they needed help.
They hoped that I could come soon.
I said I’ll be there tomorrow afternoon.
The perfect time for all.

I do not work alone.
I am guided from above.
The magic of the work that I do
is all wrapped up in
coincidences.

KINDRED SPIRIT

I have known “Nora”, eighty-eight, for eighteen months when she first came onto hospice. She suffered from colon cancer and had been doing well until the last six months when she started to slowly decline. With each visit, one would find her in a recliner in her family room. She always had a smile and her face just lit up when she saw you walk in. She made one feel like they made her day by visiting. She had such love in her heart.

Nora lived with “Jack”, her husband of sixty years. He was in good health and was able to care for Nora. In the past two weeks, Nora would spend her days in bed as she was too weak to sit up. Nora and Jack’s two sons started being more available which was a great support to the couple.

With each visit, Nora would ask about how I was doing and what was going on in m life. She was always so interested in others, but also was able to share her life. She and Jack would tease each other and laugh so easily. At one point, I said that they could adopt me and Nora quickly stated, “You’re adopted.”

During my visit last week, I shared that I would see her in two weeks right before I took off for a two week vacation. I said I will stop by, even if it is an informal visit on my own time, to say goodbye before I left on my trip. Nora then said that she would be here when I got back. I believed her as I needed to believe her. Seeing how quickly she was declining, deep inside I knew it would not be. I just wasn’t ready for the reality of the situation.

Nora died yesterday afternoon. I called the home and spoke with Nora’s son, “Mark”, to offer condolences. Jack is hard of hearing and has difficulty talking on a telephone. I told Mark to let him know I called and if there was anything I could do for him. Mark then told his father that I was on the phone and if he had any questions for me. I then heard Jack ask, “When is she coming over?” I will be going out to do a visit tomorrow afternoon. Somehow it is as much for me as it is for Jack. I need to give him a hug as I need a hug too.


KINDRED SPIRIT


I am still shocked.
I can’t get her off my mind.
She said she’d be there when I got back.
I believed in my heart all that she said.

I knew she was getting weaker
but it’s been such a slow decline.
I thought we’d have more time together.
I wasn’t yet ready to say goodbye.

I just saw her last week.
We talked and laughed like usual.
I don’t remember what was said,
but will always cherish the love in her heart.

She took me under her wing.
She always asked about my life.
What was I doing, what was new?
She really wanted to know.

She is someone whom I‘ll never forget.
Her legacy in my heart will remain.
She was so special, a kindred spirit.
So goodbye for now,
til we meet again.

SHE REMEMBERS

Sixty year old “Leann” was diagnosed with pancreatic cancer six months ago. Leann has such a positive and gregarious attitude toward life. She has had some difficult times as was diagnosed with diabetes as a young teenager. She has always accepted her life’s challenges without complaint.

Leann lives with her husband, “Bob”. They have been married thirty years. They have no children, but Leann has a large, extended family nearby. When her family gets together, all one can hear is laughter, noise and lots of commotion. Leann’s family has always been very open about their feelings and emotions. The family easily talks about Leann’s diagnosis and poor prognosis.

When I went out to do a visit today, Leann shared the story about the moment she learned she had cancer. She related, as she calls it, the “prescience moment.” She then laughed as she thought how ironic that the word prescience means insightful in a spiritual way, which she felt was the exact opposite of the meaning of science, which is based on fact.

She said the occurrence in the emergency room has given her peace and comfort as she knows where she is going and that it is going to be amazing. She knows she would have had many fears by now without that experience.

Our conversation turned to her beliefs about life and what she felt was important. With a grin, she shared what she thought the question that one will be asked by God when entering heaven will be “What color do you want your mansion to be?” She then turned serious and said that the question is, “What regrets do you have about what you have done and what regrets do you have about what you didn’t do?”


SHE REMEMBERS


She remembers the moment she was diagnosed.
She remembers the date and the exact time.
She remembers lying on a gurney in the ER
hearing the doctor say they found a mass.

She remembers feeling total peace.
Wrapped in a glorious embrace.
All over, throughout and within.
A golden love she’ll never forget.

He was watching her face, worrying
as the doctors shared the bad news.
A subtle change came over her face.
He saw tranquility, an inner glow.

They gave her less than four months.
They said nothing could be done.
Chemo may slow down the growth,
but in the end, the cancer will win.

Each day she remembers that special moment.
The embrace from something beyond.
She believes a preview of what’s waiting for her.
Without it, fears would have already come.

Six months later she’s a bit weaker.
Her appetite’s poor, she’s slowing down,
but her inner peace continues strong
as she knows where she’s going
and the beauty beyond.

She remembers.

HOME

Eighty-three year old “Donald” suffered from Parkinson’s Disease and Dementia.  He had been in a slow decline for years to where he now was bedridden and dependent with all of his needs. He was confused and could not carry on any meaningful conversation.

Donald lived with “Loretta”, his wife of sixty-two years. Loretta, eighty-one years old, was in good health with lots of energy which enabled her to care for Donald. They had one son, “Devon”, who lived across the street. Devon had been laid off from his job and was available to help his parents on a daily basis.

Donald’s needs were increasing to where Loretta could no longer care for him at home alone. It broke her heart to place him in a Skilled Nursing Facility, but she knew she had no other choice. Loretta didn’t drive so Devon would drive his mom to the facility where she would spend the day. Devon would return to pick her up at dinner time.

Donald was in the facility for about a week when he went into a coma. The family knew he was dying and remained at his bedside. Devon’s son was away at college and was able to fly home to visit his grandfather before he died. When his grandson walked into the room, Donald woke up for a few minutes and smiled at his grandson. Donald died the next day never awakening again. It comforts the family knowing that he was able to acknowledge his grandson‘s presence.

As a hospice social worker I contact families twice after a death. The initial call is a condolence call when the patient first dies. I make another call two to four weeks later to check in and see how the family is coping. I called Loretta today and she shared that she had just picked up Donald’s ashes and how it gave her comfort.

She is coping appropriately with excellent support from her family and her many friends. She was able to talk about her grief quite easily. She was aware that she will have some difficult days ahead, but also knows that it is the normal process of grief. With her outgoing personality and her willingness to reach out to her family and friends, I know she will be okay. She also knows she can call me or hospice if ever needed. I wish her well.


HOME


She wanted him to remain at home.
She hoped she could care for him there.
But his needs became too much for her.
She could no longer manage him alone.

She had to place him in a facility.
She knew she had no other choice.
She saw the good care he was getting,
but still it wasn’t like he was at home.

He was confused and didn’t understand,
but he must have known when she was there.
He would calm down when she entered his room
with her soothing words and gentle touch.

He died quietly one evening
with his family at his side.
She said it was peaceful.
It was good for us all.

She brought his ashes home today.
She said that something had been missing.
She placed them gently on the mantle.
“It’s so good to have him back home.”