CHARLIE

Sixty-seven year old “Duane” suffers from colon cancer. Duane lives with his wife, “Barb”, their adult daughter and son-in-law, plus three boarders. Duane and Barb have been married 49 years, although their relationship has been rocky at times. They have lived apart many of those years and have dated others, but both have always felt emotionally married.

Duane moved back in with Barb a few weeks ago when his health started to decline; whereas he was needing more help. Duane and Barb have owned boarding homes over the years, renting to disabled adults. Because of this, Barb is an excellent caregiver for Duane.

I went out to do a routine visit today and sat down with Duane to check in as to how he was doing. Due to tumor growth, his stomach is swollen, but he is good natured about his situation. He patted his stomach and said that he calls his cancer “Charlie”. Duane uses a lot of humor to cope. He has no fears about dying and has accepted his fate. He shares that there is not much he can do about it.

Barb and Duane are both strong willed with personalities that often clash, but one can see the love they have for each other. They met in high school and married when both were quite young. They have a lifelong commitment to each other and Barb will support Duane until the end.

The family is very open with their feelings toward each other, good and bad. It makes for a lively household which works for all. 


CHARLIE


He named his tumor Charlie.
He thought a fitting name.
It helped him put a handle on things.
It helped him direct his thoughts.

He is never angry at Charlie,
but he tells him how he feels.
How he has come and disrupted things;
how he has yanked his life around.

He talks to Charlie all the time,
using humor to ease the pain.
He knows it won’t change the inevitable,
but it is something he can do.

He knows his future if grim.
He knows his time is short,
but sharing his thoughts with Charlie this way
gives a feeling of some control.

So he’ll continue to talk to Charlie,
as Charlie continues to grow.
He’ll live his life the best he can,
until Charlie is no more.

WHEN I NEED YOU

Eighty year old “Dolores” suffered from lung cancer that had spread to her liver. Dolores was widowed and lived with her daughter. She had one other daughter who lived about five hours north. Dolores had such a gregarious personality, that everyone just loved her. Her family was very close and devoted to her. Not surprisingly, she also had many friends in her life.

Dolores was admitted to hospice while I was away on a two week vacation. When I returned, I made an appointment to go out to meet her and to see how I could help her. The moment I walked into the door, she wanted to know all about my vacation. She was so interested in others, but also would share these amazing stories about her own life. She had a great sense of humor which was sprinkled throughout her stories.

On that first visit, I explained my role on the hospice team and ways in which I could help her. She said that she didn’t need anything right at the moment, but would let me know when she needs me.

I only made three visits to her home. On the first two visits, we just talked about life and adventures. A big part of the role of the hospice social worker is relationship building. These conversations helped me get to know Dolores better in order to assist her, when needed, in the future.

Dolores stopped eating six days before she died. Over a weekend she declined so quickly to where she became unresponsive. I called the family to set up a time to visit and we agreed on noon the following day. I later heard from the chaplain that the family thought I was coming at ten that day. I rearranged my schedule as I had a feeling that the sooner I could get out there, the better. The hospice nurse showed up about thirty minutes into my visit. I believe the family confused my visit time with the nurses.

I walked into a house full of family and friends. Dolores was in a hospital bed in the living room. She was in a coma with labored breathing. I was able to offer support to all of her family and friends. Before I left, I was also able to say goodbye to Dolores. An hour later, Dolores’s daughter called me to say that she had died.

I left a message about Dolores’s death on our chaplain’s phone as I knew he was headed over to her home. He called me later to say he walked in five minutes after she had died. He was then able to offer well needed spiritual support to the family.

It got me to thinking that Dolores did tell us when she needed us to come. If I had come at my original scheduled time of noon, the chaplain and I would have been there at the same time. Being available separately at those particular times somehow seemed like the best way to give the most effective support. Dolores did tell us when she needed us there.


WHEN I NEED YOU


One couldn’t help but love her
the moment you walked through her door.
She was social, she was gregarious.
She welcomed you into her home.

I told her how I could assist her.
I told her about the hospice team.
How we would walk along side of her
easing the way that best fit her needs.

She said she’d ask when she needs us,
but for now, she was doing quite well.
So we spent time sharing stories about family,
about friends and everything else.

The end came quite suddenly.
It caught everyone by surprise.
I planned on visiting at noon that day,
but the family thought I said ten.

I knew they could use some help,
so I switched my schedule around.
I was then available to comfort her family.
An hour later, she was gone.

The chaplain showed up soon after she died.
He blessed her on her way.
He was then able to pray with the family.
Something so helpful at that crucial time.

The timing for all was perfectly set.
I know it was directed by her.
She called us all there one after the other,
as today was the day
she needed us.

"MISCHIEF"

“Ben”, an eighty year old widower with multiple medical problems, came onto hospice today as his health has taken a recent toll on him. Where once he was up and around, he is now wheelchair bound and spends the majority of his days in bed. Ben suffers from cardiac disease, lung disease, Parkinson‘s, diabetes and kidney disease. He is on continuous oxygen to help him breath. He gets short of breath very easily which limits his mobility.

The nurse and I went out this morning to open Ben up to hospice. He was sleeping during our visit, so the nurse and I sat with Ben’s daughter, “Mary” in the kitchen. Mary is the oldest of Ben’s eight children and has always had the role of caretaker. When Mary was twelve, her mother went back to work and Mary had to get her siblings up and ready for school. None of her siblings help out with dad’s care, even though six of them live nearby. It seems they still see Mary as the family caretaker.

Mary’s daughter and two grandsons moved in recently to help out. Mary says her daughter is her only support. Mary has had a lot of tragedy in her life. She is sixty-one and has suffered from two strokes as well as two heart attacks. The most recent was two months ago when she said she suffered a cardiac arrest. In addition, Mary’s ex-husband was murdered by a jealous ex-boyfriend of his then girlfriend.

Mary never complains as she is determined to care for her father no matter what. Mary will cry when talking about her siblings and how disappointed she is in all of them for their lack of support.

After all of the admission paperwork was signed, the nurse and I went in to check on Ben. He woke up easily and gave us a smile. He said he was doing fine. Mischief, his cat, was lying in the crook of his knee. Mischief meowed quite loudly when we all walked into the room.

Mary then shared the story of how Mischief will meow loudly into the baby monitor near the bed to warn her that her dad’s blood sugar is high. The nurse said that the cat likely is smelling the fruity scent of acetone on Ben’s breath, which is what happens when someone’s sugar runs high. Mischief also will go find Mary and meow loudly at her when Ben is ready to get up.

I was amazed by Mischief and also amazed by Mary and her determination to care for her father in spite of all the odds against her. Both are incredible.



“MISCHIEF”


Hello, my name is Mischief.
I am a brownish tabby cat.
I am sixteen years old
and have a very important job to do.

I live with “Papa” as some call him.
Others say “Dad” or “Grandpa”.
I just know he is slowing down
and he needs me around.

He stays in bed a lot now.
I sleep in the crook of his knee.
It is comfortable and warm there,
but I am always on alert.

Sometimes he is not okay.
I have to be around just in case.
When I get a whiff of something sweet,
then I know I must be quick.

There is this box next to his bed.
I heard her call it a baby monitor.
I know when I meow loud into that box
she will quickly come.

She then picks me up and pets me.
She thanks me for letting her know.
She relies on me to protect him.
so I’ll continue to remain alert.

I answer to the name of “Mischief”
and I have an important job to do.



.

BELIEFS

Fifty year old “Mike” suffered from esophageal cancer that had spread to his brain. Mike was single and lived alone. He came onto hospice when it became apparent that he was declining and could no longer be alone. Mike had a large, supportive family who rallied to support him as needed.

Mike’s brother, “Kevin”, moved in to help. Kevin lived two hours north, but took a leave from his job to assist his brother. In addition, Mike’s girlfriend, “Kristy”, was over daily to help out as well. Kristy and Mike dated in high school, but after graduation they both went their separate ways. They met up again eighteen months ago and realized that the spark was still there. They started dating again and within two months, Mike was diagnosed with his cancer.

Mike had a strong belief in Daoism and was a very disciplined man. He had no fears about dying and accepted each day as it came. When he had some difficulty processing thoughts due to the cancer in his brain, he never became frustrated when he couldn’t find a certain word. He had total peace and acceptance. In the two weeks he was on hospice, there was a daily decline. Mike accepted all of this without fear or complaint.

Mike’s strong belief system helped him cope with his dying. He really was one with the moment. His family respected his beliefs and supported his decisions. They knew Mike would live and die his way, which gives them peace. They believed it was the only way he knew how.


BELIEFS


He had a strong belief in Daoism.
He lived what he believed.
“This moment is an illusion.
We are all spiritual beings.”

He learned martial arts.
He learned discipline.
He lived with harmony in his reality.
He believed in the yin and yang.

Cancer didn’t altar his beliefs.
In fact he became more determined.
Determined to die the way he lived;
with discipline, compassion and humility.

He sought out a medical intuitive.
He received comfort from her words.
It was to be his final outing.
Something he already knew.

He came home and told his family,
“I’m done here. I’m ready to move on.”
He stopped eating, he stopped drinking.
In forty-eight hours, he was gone.

His family describes his death as inspirational.
“It was clean from so many different angles.”
They say it gives them total peace
as he died how he lived;
true to his beliefs.

LAST WORDS

“Bruce”, sixty-seven, was diagnosed with lung cancer three years ago. He had been managing his illness without any limitations, until recently when he started to slowly decline and become weaker. Bruce lived with “Monica”, his wife of fourteen years. Monica was seventeen years younger than Bruce, but the age difference never impacted their relationship.

They were devoted to each other and often talked about being soul mates. This was Bruce’s third marriage and Monica’s first. Monica always said that Bruce was married twice before, but I am his first wife. She was determined in her role to take care of Bruce and their home.

Bruce’s family owned a restaurant, but when he could no longer work due to his illness, he sold the restaurant. His father had died ten years prior and his mother was in her late eighties and living in a facility. No other family member was interested in keeping the restaurant in the family. Bruce had no regrets about selling the business. He looked at life in a very practical manner and had few regrets about any decision he made in his life.

Bruce was very upbeat and loved to talk. He would share amazing stories about his life, the good and the bad. always with a positive spin. He laughed easily and really enjoyed his life. He had no fears about dying and accepted his situation as it was.

One day Bruce was up sitting in his recliner chair in the family room and the next day he was bed bound and actively dying. Within a week he was gone. He stopped talking three days before he died and Monica shares that it gives her peace and comfort knowing his last words to her were the last words she heard every night of their marriage before she fell asleep.

Monica has excellent supports from her family and friends. I know the days ahead will be hard on her, but she is very open with her emotions and feelings and easily accesses her support. I know she will do well.


LAST WORDS


They met later in life.
She knew he was the one.
They were soul mates, lovers.
It was meant to be.

She was from the old school
as felt it was her duty
to take care of him and their home.
She was determined in her role.

Each night when they went to bed,
his last words to her would be,
“I love you. Sweet dreams,”
while she drifted off to sleep.

He never missed a night
to wish her those sweet dreams.
It gave her comfort, it gave her love.
A perfect ending to her day.

They shared his illness together.
She was devoted and by his side;
caring for him, attending to his needs.
Making sure he was always okay.

He slipped away quietly
while she held his hand at the bedside.
It gives her comfort and great peace
as the last words he spoke to her were

“I love you. Sweet dreams.”

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”.