“Allen”, eighty years old, has been suffering from lung disease for many years. He has had poor health for years secondary to a traumatic accident years ago. His decline has been slow over the years. Allen lives with his wife, “Sandra,” in their home with their two little puppies.
As the nurse and I were approaching Allen and Sandra’s front porch, Sandra came out onto the porch and snapped at us, “Are you Hospice?” She was angry that we were there and did not want to sit down with her husband to hear about our hospice program. This visit was scheduled as an informational visit only. I love doing informational visits about hospice as it educates folks about the beautiful support that comes with our program. So many mistakenly feel that when hospice shows up, their loved one dies quickly.
As we all sat down in their living room, Sandra spoke sharply about Allen’s recent hospitalization. Sandra appeared to be so unhappy and angry. I started out by normalizing her anger while validating her fears. Over the course of our one hour visit, Sandra started to mellow as she trusted us to understand her emotions in a non-judgmental manner.
Before long she was sharing stories of her years working on a Fish Processing Boat in the Baltic Sea. Her stories were fascinating and so interesting. She shared a lot of emotion while speaking of those days past.
It was then that Sandra’s big, beautiful heart did show as we were responding in such a positive way to her. I truly believe that intellectually Sandra knows the truth, but just cannot believe that her husband might be terminal. She is dramatically displaying her strong love for him. Beautiful!
“HE IS NOT DYING!"
"Are you Hospice?
Why are you here?
He is not dying!
I won't listen to you, but he can!"
We walked into their home.
Two puppies ran to our feet.
Our full attention on her dogs
softened her tone a wee bit.
His frailty shows he's been ill for years.
Spending his days sitting in his room.
Slowly walking with a cane.
Content to just be.
We validated her fears.
We normalized her emotions.
Giving her permission to be angry.
Allowing her to be where she needed to be.
We gained her trust.
She began to feel safe with us.
She started to share life stories.
Her loving heart began to glow.
Intellectually she knows his prognosis is poor.
We are a strong reminder of that reality.
But emotionally she is fighting so hard
as she needs to truly believe,
"He is not dying!"
Saturday, June 9, 2018
Sunday, May 20, 2018
A THOUSAND FOLD
The hospice nurse and I admitted, "Christine", to our hospice program today. Christine was diagnosed with cancer a year ago. She underwent chemotherapy, but the side affects were disabling. She chose to stop all treatment as wanted quality of life, not quantity.
Christine lives with her son, "Matthew", who is her primary caregiver. She has a daughter living nearby who is also an active part in her mother's life. This is a very loving and caring family.
Christine has a strong Christian faith, but has some appropriate fears about dying. She knows she is going to a better place, but is not yet ready to go. We spoke about end-of-life support and the importance of having an Advanced Directive for Health Care and a POLST, (Physician's Order for Life Sustaining Treatment). I gently spoke of the importance of both of these legal documents. Christine allowed me to help her with the POLST. She stated she did not want any extraordinary treatment. Christine wasn't yet ready to talk about her Advanced Directive or funeral plans. I know with our hospice staff slowly guiding her and giving her the needed support, she likely will complete both tasks, when she is ready to do so.
When I returned to the office after this admission, I was asked to deliver some supplies to another patient, "Carol", whom I initially met three days ago.. When I walked into the home, everything flowed so beautifully. I strongly felt I was meant to be there. Carol's daughter felt it too as when she walked me to the front door as I was leaving she stated, "You were meant to be here today." I so strongly felt it too. Hospice work is so spiritual to me. It is what guides me and gives me such warmth.
Hospice work is my life's passion. It is the spiritual guidance from above that fills my heart a thousand fold.
A THOUSAND FOLD
We sat down in her bedroom.
We told her about hospice support.
"There is no right or wrong way to do things.
We want to help you; your way."
She just learned her cancer is growing.
No further treatment to be had.
She has fears, "God may heal me."
But then; "Heaven is there for us all."
I validated her fears; I normalized her emotions.
Wanting to give her the much needed support.
She totally surprised me when she said;
"You are so wise. This is your gift.
Keep doing what you are doing."
I first met her three days ago.
Her cancer has spread to her brain.
She understands clearly, but it's garbled at times.
She tries so hard to figure things out.
She couldn't admit any weakness.
She felt she had to be strong.
"I am fine. I can handle this.
Everything is going to be okay."
I spoke about grief's roller coaster ride.
Emotions are up and then down; right and then left.
I said it is wonderful how you are feeling,
but it is not a weakness if emotions crash down.
Her daughter said I was meant to be there today.
I spiritually felt the same way.
Guided by sacred beings.
Blessings received;
A Thousand Fold.
Christine lives with her son, "Matthew", who is her primary caregiver. She has a daughter living nearby who is also an active part in her mother's life. This is a very loving and caring family.
Christine has a strong Christian faith, but has some appropriate fears about dying. She knows she is going to a better place, but is not yet ready to go. We spoke about end-of-life support and the importance of having an Advanced Directive for Health Care and a POLST, (Physician's Order for Life Sustaining Treatment). I gently spoke of the importance of both of these legal documents. Christine allowed me to help her with the POLST. She stated she did not want any extraordinary treatment. Christine wasn't yet ready to talk about her Advanced Directive or funeral plans. I know with our hospice staff slowly guiding her and giving her the needed support, she likely will complete both tasks, when she is ready to do so.
When I returned to the office after this admission, I was asked to deliver some supplies to another patient, "Carol", whom I initially met three days ago.. When I walked into the home, everything flowed so beautifully. I strongly felt I was meant to be there. Carol's daughter felt it too as when she walked me to the front door as I was leaving she stated, "You were meant to be here today." I so strongly felt it too. Hospice work is so spiritual to me. It is what guides me and gives me such warmth.
Hospice work is my life's passion. It is the spiritual guidance from above that fills my heart a thousand fold.
A THOUSAND FOLD
We sat down in her bedroom.
We told her about hospice support.
"There is no right or wrong way to do things.
We want to help you; your way."
She just learned her cancer is growing.
No further treatment to be had.
She has fears, "God may heal me."
But then; "Heaven is there for us all."
I validated her fears; I normalized her emotions.
Wanting to give her the much needed support.
She totally surprised me when she said;
"You are so wise. This is your gift.
Keep doing what you are doing."
I first met her three days ago.
Her cancer has spread to her brain.
She understands clearly, but it's garbled at times.
She tries so hard to figure things out.
She couldn't admit any weakness.
She felt she had to be strong.
"I am fine. I can handle this.
Everything is going to be okay."
I spoke about grief's roller coaster ride.
Emotions are up and then down; right and then left.
I said it is wonderful how you are feeling,
but it is not a weakness if emotions crash down.
Her daughter said I was meant to be there today.
I spiritually felt the same way.
Guided by sacred beings.
Blessings received;
A Thousand Fold.
Saturday, May 5, 2018
ROUTINE
Yesterday, the hospice nurse and I admitted, “Betty”, to our hospice program. We met Betty and her two daughters, “Jeannine” and “Beverly” in the dining room of Betty’s home. Betty had been living alone until the past several months when her daughters moved in with her to share caring for her.
Jeannine shared that her mother is confused most of the time. Betty wasn’t quite sure why we were there. Betty’s husband died eight years ago. Sadly, in addition, her son passed away five years ago. Unfortunately, Betty became tearful when speaking about her husband and son. Her grief was strong, as due to her confusion, she thought both died only a few months ago.
The daughters shared that mom had moments of anger about her grief. Additionally, she also had strong frustrations over her limitations. During our visit, Betty had some moments of clarity. During one of those moments, she apologized to her daughters for being angry. Betty shared how she felt it was wrong.
Similarly, we admitted, “Joe”, a few days prior. Joe was only in his fifties and had liver cancer. Due to retention of fluids, it so limited him in his mobility to maneuver around his home. Joe was determined to remain as independent as able, and did move around, although slowly.
Joe, too had tremendous challenges, but his primary focus was on his wife and how she would be after he was gone. We told him about hospice’s bereavement follow up for thirteen months afterwards. Joe felt comfort in knowing that.
Both of these cases demonstrated what we, as hospice workers, see so frequently. Respect and admiration flows from our hearts when witnessing such devotion. It is so humbling and such an honor to observe such love.
ROUTINE
Meeting so many people,
one would think we'd see routine.
Normal emotions, common reactions;
typical behaviors while coping.
I am continually awestruck
on the love we see around.
Looking out for their loved ones,
even though their struggle is intense.
He was diagnosed several years ago,
but his decline has been swift.
He struggles to walk around,
but is determined to keep moving.
His primary focus is about his wife.
He worries about her after he is gone.
He has no fears or concerns about himself.
It is naturally all about her.
I would understand if he were angry.
I would also understand if he were afraid,
but my emotions are of admiration and respect.
He is demonstrating pure, unconditional love.
His actions are what we typically experience.
While he is concerned and caring for her,
she is just as much worried about him.
The more one gives, the more one receives.
I am so honored to witness such love.
It is what keeps me coming back every day.
Maybe it is routine,
after all.
Jeannine shared that her mother is confused most of the time. Betty wasn’t quite sure why we were there. Betty’s husband died eight years ago. Sadly, in addition, her son passed away five years ago. Unfortunately, Betty became tearful when speaking about her husband and son. Her grief was strong, as due to her confusion, she thought both died only a few months ago.
The daughters shared that mom had moments of anger about her grief. Additionally, she also had strong frustrations over her limitations. During our visit, Betty had some moments of clarity. During one of those moments, she apologized to her daughters for being angry. Betty shared how she felt it was wrong.
Similarly, we admitted, “Joe”, a few days prior. Joe was only in his fifties and had liver cancer. Due to retention of fluids, it so limited him in his mobility to maneuver around his home. Joe was determined to remain as independent as able, and did move around, although slowly.
Joe, too had tremendous challenges, but his primary focus was on his wife and how she would be after he was gone. We told him about hospice’s bereavement follow up for thirteen months afterwards. Joe felt comfort in knowing that.
Both of these cases demonstrated what we, as hospice workers, see so frequently. Respect and admiration flows from our hearts when witnessing such devotion. It is so humbling and such an honor to observe such love.
ROUTINE
Meeting so many people,
one would think we'd see routine.
Normal emotions, common reactions;
typical behaviors while coping.
I am continually awestruck
on the love we see around.
Looking out for their loved ones,
even though their struggle is intense.
He was diagnosed several years ago,
but his decline has been swift.
He struggles to walk around,
but is determined to keep moving.
His primary focus is about his wife.
He worries about her after he is gone.
He has no fears or concerns about himself.
It is naturally all about her.
I would understand if he were angry.
I would also understand if he were afraid,
but my emotions are of admiration and respect.
He is demonstrating pure, unconditional love.
His actions are what we typically experience.
While he is concerned and caring for her,
she is just as much worried about him.
The more one gives, the more one receives.
I am so honored to witness such love.
It is what keeps me coming back every day.
Maybe it is routine,
after all.
Sunday, April 29, 2018
THEIR FINAL GOODBYE
"Elizabeth", ninety-one, suffered from Alzheimer's Disease for years. She was widowed and resided in an Assisted Living Complex. Elizabeth needed help with all of her activities of daily living.
I met Elizabeth several months ago when we admitted her to our hospice program. The facility had the policy of leaving the resident's room doors open. A black cat lived in the facility and spent many hours in Elizabeth's room. Throughout the Admission Visit, the cat slept on Elizabeth's lap. Elizabeth found pure joy having that cat nearby.
Elizabeth was so adorable as she would try to keep up with the conversation around her. She struggled due to her forgetfulness; but even then, she had an easy smile.
Elizabeth died peacefully three days ago. I called Elizabeth's daughter, "Cynthia" to offer condolences. The words Cynthia used to describe her mother's final moments were beautiful. That special moment spoke loudly about how wonderful a person Elizabeth was and how well she raised her three children. It was a beautiful reflection upon all of them.
THEIR FINAL GOODBYE
She was a good mom.
She raised the three of them so well
That's why they were there by her side
to say their final goodbye.
She had been ill for quite a while,
although her decline had been slow.
Confusion and forgetfulness came first;
little by little slowing her down.
She was always in a good mood.
Not much made her sad.
No matter how dependent she became,
she always had a quick smile for all.
Her daughter was holding her hand.
All three were "clustered around".
"It was a real touching moment
when she took her final breath."
They found peace; they found comfort.
"It was the best experience you could have.
A real touching moment.
All the love was there".
Her disease process took years.
A very slow decline.
In the end, "It happened pretty quickly".
Finding beauty in the sadness of
Their Final Goodbye.
I met Elizabeth several months ago when we admitted her to our hospice program. The facility had the policy of leaving the resident's room doors open. A black cat lived in the facility and spent many hours in Elizabeth's room. Throughout the Admission Visit, the cat slept on Elizabeth's lap. Elizabeth found pure joy having that cat nearby.
Elizabeth was so adorable as she would try to keep up with the conversation around her. She struggled due to her forgetfulness; but even then, she had an easy smile.
Elizabeth died peacefully three days ago. I called Elizabeth's daughter, "Cynthia" to offer condolences. The words Cynthia used to describe her mother's final moments were beautiful. That special moment spoke loudly about how wonderful a person Elizabeth was and how well she raised her three children. It was a beautiful reflection upon all of them.
THEIR FINAL GOODBYE
She was a good mom.
She raised the three of them so well
That's why they were there by her side
to say their final goodbye.
She had been ill for quite a while,
although her decline had been slow.
Confusion and forgetfulness came first;
little by little slowing her down.
She was always in a good mood.
Not much made her sad.
No matter how dependent she became,
she always had a quick smile for all.
Her daughter was holding her hand.
All three were "clustered around".
"It was a real touching moment
when she took her final breath."
They found peace; they found comfort.
"It was the best experience you could have.
A real touching moment.
All the love was there".
Her disease process took years.
A very slow decline.
In the end, "It happened pretty quickly".
Finding beauty in the sadness of
Their Final Goodbye.
Sunday, April 22, 2018
ALWAYS
The hospice nurse and I admitted "Theresa", ninety-one, to our hospice program three days ago. Theresa lives in an Assisted Living Environment as she needs help with all of her daily needs. Theresa was eating lunch in the dining room when we arrived. We were meeting with Theresa's two children; her daughter, "Terri", and son, "Paul", who were sitting with mom. Theresa produced this beautiful smile when we walked up. She was so welcoming to the two of us, although did not understand who we were.
After a few moments, we all excused ourselves and went into a meeting room nearby to discuss hospice supports and criteria. Terri and Paul had such diverse personalities. As high energy and anxious Terri was, Paul was so calm and relaxed. Terri visits mom daily and stated that she has given up a lot of her life to be there for her mother. Paul lives out of state and visits for several weeks every two months or so.
Both of the children wanted what was best for mom, but totally disagreed on how to achieve that goal. We sat with them for over two hours explaining hospice support. Terri kept interrupting her brother and he, attempting to stay calm, would let her talk. By the end of our visit, the two of them were quarreling with each other. Paul said that the two of them never got along. But the one wonderful thing was, they both did agree on what was best for their mom.
Paul shared that his mother asked him if he would continue to visit after she is gone. He was surprised by her question, but answered it by what he thought she would want to hear. I shared with the both of them that their mom will let go when her work is done. She wants to make sure her two children will be okay.
Today, three days later, Paul called to share how impressed he was by what I told him about "Mom will always be a mom." It gave him some peace.
ALWAYS
She's been demented for years,
although recently in a decline.
She remembers years past,
but can't recall eating lunch.
Both her children are devoted to her.
They want to do what's best.
She lives nearby and sees mom daily.
He routinely visits from out of state.
He and his sister travel two different paths.
She is a worrier, anxious and concerned.
He, on the other hand, is calm, relaxed.
He's taught meditation for years.
Mom has some awareness of her decline.
She's talked about her dying, asking him,
"Will you still come visit
after I am gone?"
He was surprised by her question.
He didn't know what to say,
but told her what she wanted to hear,
"Yes, of course, I will still come out."
I said that even though she is confused.
Even though she doesn't understand.
In the end, she'll continue to perpetually
worry about the two of you.
As after all, she will always,
and forevermore continue
to be your mom.
After a few moments, we all excused ourselves and went into a meeting room nearby to discuss hospice supports and criteria. Terri and Paul had such diverse personalities. As high energy and anxious Terri was, Paul was so calm and relaxed. Terri visits mom daily and stated that she has given up a lot of her life to be there for her mother. Paul lives out of state and visits for several weeks every two months or so.
Both of the children wanted what was best for mom, but totally disagreed on how to achieve that goal. We sat with them for over two hours explaining hospice support. Terri kept interrupting her brother and he, attempting to stay calm, would let her talk. By the end of our visit, the two of them were quarreling with each other. Paul said that the two of them never got along. But the one wonderful thing was, they both did agree on what was best for their mom.
Paul shared that his mother asked him if he would continue to visit after she is gone. He was surprised by her question, but answered it by what he thought she would want to hear. I shared with the both of them that their mom will let go when her work is done. She wants to make sure her two children will be okay.
Today, three days later, Paul called to share how impressed he was by what I told him about "Mom will always be a mom." It gave him some peace.
ALWAYS
She's been demented for years,
although recently in a decline.
She remembers years past,
but can't recall eating lunch.
Both her children are devoted to her.
They want to do what's best.
She lives nearby and sees mom daily.
He routinely visits from out of state.
He and his sister travel two different paths.
She is a worrier, anxious and concerned.
He, on the other hand, is calm, relaxed.
He's taught meditation for years.
Mom has some awareness of her decline.
She's talked about her dying, asking him,
"Will you still come visit
after I am gone?"
He was surprised by her question.
He didn't know what to say,
but told her what she wanted to hear,
"Yes, of course, I will still come out."
I said that even though she is confused.
Even though she doesn't understand.
In the end, she'll continue to perpetually
worry about the two of you.
As after all, she will always,
and forevermore continue
to be your mom.
Saturday, April 14, 2018
I AM SO SAD
A co-worker was diagnosed with cancer two months ago. After weeks of tests, she will be having chemotherapy this week. Yesterday I drove her to the clinic to have a port placed for those treatments. Driving to pick her up, I felt so thankful that she knew I would be there for her. It was humbling, but also a wonderful feeling. Along with those feelings, I also feel very sad for what she has to go through these next months.
She and my friendship is so based on sarcasm and humor. The two of us laugh a lot when we are together. I am seeing a new side of her. She is sharing her heart and her soul with lots of tears. It has connected us on a deeper level. We work for an amazing agency as every single one of us under that roof are there for each other. It is our family for sure. She is adamantly embracing that love and support.
Today, I am feeling so sad about it all. Thoughts of my friend, Kate, who died twenty years ago of cancer, are flooding emotionally to me like it was yesterday. I am surprised as I have not felt that grief so strongly for many years.
I was part of a group of friends/caregivers for Kate. I did drive Kate to treatment a lot. I think driving my co-worker to treatment triggered the same emotions. This will be another learning chapter in my co-worker's and my life. Embrace the love and the knowledge. I feel so many emotions; many wonderful, but overall, I feel such sadness. I am so appreciative, though, that my friend is traveling her journey surrounded by love. We all wish her well.
I AM SO SAD
My thoughts were of appreciation.
So thankful I could help her.
Honored that she had asked,
but still saddened by it all.
I drove her to the clinic.
I waited nearby while thoughts
of my friend Kate's death
whispered softly by my side.
I am surprised by my emotions.
It has been over twenty years,
but the grief has rapidly returned.
Reruns of time past.
I know her journey will be challenging,
wherever her road may go.
It also will be nourishment for all of us
to flourish our souls.
For that I am grateful,
I am truly blessed.
But then again,
I am so sad.
She and my friendship is so based on sarcasm and humor. The two of us laugh a lot when we are together. I am seeing a new side of her. She is sharing her heart and her soul with lots of tears. It has connected us on a deeper level. We work for an amazing agency as every single one of us under that roof are there for each other. It is our family for sure. She is adamantly embracing that love and support.
Today, I am feeling so sad about it all. Thoughts of my friend, Kate, who died twenty years ago of cancer, are flooding emotionally to me like it was yesterday. I am surprised as I have not felt that grief so strongly for many years.
I was part of a group of friends/caregivers for Kate. I did drive Kate to treatment a lot. I think driving my co-worker to treatment triggered the same emotions. This will be another learning chapter in my co-worker's and my life. Embrace the love and the knowledge. I feel so many emotions; many wonderful, but overall, I feel such sadness. I am so appreciative, though, that my friend is traveling her journey surrounded by love. We all wish her well.
I AM SO SAD
My thoughts were of appreciation.
So thankful I could help her.
Honored that she had asked,
but still saddened by it all.
I drove her to the clinic.
I waited nearby while thoughts
of my friend Kate's death
whispered softly by my side.
I am surprised by my emotions.
It has been over twenty years,
but the grief has rapidly returned.
Reruns of time past.
I know her journey will be challenging,
wherever her road may go.
It also will be nourishment for all of us
to flourish our souls.
For that I am grateful,
I am truly blessed.
But then again,
I am so sad.
Saturday, April 7, 2018
TWENTY MINUTES
We opened an elderly patient to hospice yesterday. Today, our hospice nurse was with him all day trying to control his pain. The patient was moaning and crying out with any movement. I was asked to go over to give the nurse and the patient's daughter some support.
When I arrived, the nurse told me that they had called the paramedics. She strongly felt that the patient needed to go to the ER where, hopefully, his pain would be better controlled. The patient's daughter, "Emily", was her father's agent on his Advanced Directive. The patient was confused which automatically made Emily his spokesperson.
Once the paramedics arrived, they started to ask Emily so many questions. Emily knew her father's wishes of comfort care and no extraordinary measures. Emily turned to me as was upset because she thought they implied that she was wrong. I encouraged her to continue to be the strong advocate for her father. He chose her because he trusted her to express and follow his wishes.
Emily turned and hugged me so tightly thanking me for my words of encouragement. I was so amazed and honored that I was able to help and support her in only a few moments. It is humbling to have been able to find the right words for her and to be able to be with her at just the right moment. Spirituality at its best in only twenty minutes.
TWENTY MINUTES
The nurse was with him all day.
His pain was out of control.
She and the doctors struggled
with finding what medication to use.
Arriving only a few moments before the paramedics,
I went over to give support to his daughter.
Immediately they started to ask her questions.
Their reactions upset her greatly.
She felt they thought she was wrong.
I shared, "Medical staff often want curative steps.
Many do not understand hospice philosophy,
patient's wishes or comfort care."
I spoke about being her father's advocate.
"He trusts you to follow his wishes.
You are rightly handling things.
Keep doing what you are doing,"
She hugged me so long and so tight.
Thanking me for my validation and support.
It was only a twenty minute visit,
solid proof that confirmation and support
doesn't have to take very long.
When I arrived, the nurse told me that they had called the paramedics. She strongly felt that the patient needed to go to the ER where, hopefully, his pain would be better controlled. The patient's daughter, "Emily", was her father's agent on his Advanced Directive. The patient was confused which automatically made Emily his spokesperson.
Once the paramedics arrived, they started to ask Emily so many questions. Emily knew her father's wishes of comfort care and no extraordinary measures. Emily turned to me as was upset because she thought they implied that she was wrong. I encouraged her to continue to be the strong advocate for her father. He chose her because he trusted her to express and follow his wishes.
Emily turned and hugged me so tightly thanking me for my words of encouragement. I was so amazed and honored that I was able to help and support her in only a few moments. It is humbling to have been able to find the right words for her and to be able to be with her at just the right moment. Spirituality at its best in only twenty minutes.
TWENTY MINUTES
The nurse was with him all day.
His pain was out of control.
She and the doctors struggled
with finding what medication to use.
Arriving only a few moments before the paramedics,
I went over to give support to his daughter.
Immediately they started to ask her questions.
Their reactions upset her greatly.
She felt they thought she was wrong.
I shared, "Medical staff often want curative steps.
Many do not understand hospice philosophy,
patient's wishes or comfort care."
I spoke about being her father's advocate.
"He trusts you to follow his wishes.
You are rightly handling things.
Keep doing what you are doing,"
She hugged me so long and so tight.
Thanking me for my validation and support.
It was only a twenty minute visit,
solid proof that confirmation and support
doesn't have to take very long.
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