AN INDEPENDENT SOUL

I met “Stella”, a ninety-five year old, who deeply touched my heart.  Stella has been very independent her entire life as never married or had children.  She has always lived alone allowing her the luxury of being strongly independent.  Stella’s actions in her home reflected that strength in her. 

When the hospice nurse and I asked her a few questions regarding paperwork, Stella knew exactly where to go to produce that paperwork.   Stella took a fall a month ago and has been weak since that time.  She struggled a bit walking with her walker, but it did not stop her from doing what she had to do during our visit. 

Stella knew she was becoming weaker and needing a bit more help this past month.  She so struggled with needing assistance from her niece, “Cathy”, who lived nearby.  This dependence triggered Stella’s thoughts about dying and the afterlife.  Stella’s spiritual words were deep from her heart and soul.  She was comfortable sharing them with me, which made them even more powerful.  

She sees death as a recovery from becoming dependent.  Her strong faith gives her peace and hope.  I wish you all the best Stella.  God bless you.

AN INDEPENDENT SOUL

 

The moment I walked into her home,

I was immediately drawn to her.

She embraced her life so fully,

knowing she always had complete control.

 

She’s never been married or had any kids;

which allowed her, for decades, to be on her own.

She took a fall just four weeks ago.

A catalyst that so completely;

               stole her autonomy away.

 

Weakness has made her less active;

making it more difficult to walk.

Her appetite is all but gone.

She eats because she knows she must.

 

She has always been so independent.

She’s never experienced anything else.

Her strong Christian faith, though, gives her hope,

               “God always knows what to do.”

 

She has no fears about dying

as feels it will save her from needing support.

“If God gives me life, or takes it away,

               I will be okay”.

 

Her biggest fear is dependency

as she’s never needed others to care for her.

As I was leaving, she turned and softly said,

“I so want to peacefully just die in my sleep.”

 

Truthful words from a very determined woman;

               An Independent Soul.

 

QUALITY OF LIFE

I did two hospice admissions today.  Both had a lot in common regarding their cancer journey and their readiness to “let go”.  Both were diagnosed with cancer only a few years ago.  “Diana”, fifty-two, was diagnosed with liver cancer only five years ago; while “Danny”, with his cancer just four years ago. 

Both have had a sudden and dramatic decline two weeks ago; to where they are both needing help with all of their daily needs.  Diana is still walking very slowly and very wobbly.  She is not safe without someone by her side holding onto her.  Danny, too, had been walking short distances in the same manner.

 Like Danny, Diana is no longer eating or drinking.  Danny is totally alert and able to express his wishes for this to be over.  Diana is confused and no longer talking.  Her mother, “Celeste”, is by her side, knowing her daughter’s time is short.  Celeste has had many losses in her life and knows what is coming.  It doesn’t ease her heartache and grief.  Likely her other losses may fly back like they all happened just yesterday.  Celeste’s husband died two years ago on hospice.  Celeste’s eldest daughter was murdered five years ago while at her place of work.  And then just recently, her three-month old grandson died of SIDS. 

Even though she is familiar with the emotions and grief of loss, it does not ease her pain of losing her second daughter.  Both patients have a similar health history.  The thing that amazed me the most is how both of these patients were such a perfect example of what we all need; and what neither has; Quality of Life.

 

QUALITY OF LIFE

 

Her cancer has been around for five years.

She had been doing quite well until

suddenly and dramatically, all has changed

               in just two weeks of time.

 

Her mother stays faithfully by her side;

knowing her time is coming near.

She’s familiar with the end-of-life process

as her husband died two years ago on hospice.

 

She has experienced many other losses in her life;

her eldest daughter; her youngest grandson.

“I’ll feel relief when my daughter goes

as she will no longer be suffering.”

 

He was diagnosed with cancer just four years ago.

He, too, was living his life and also doing quite well.

Again, in two weeks, all has suddenly changed.

He is no longer eating or walking; needing much more help.

 

His deep faith gives him hope of afterlife.

“Each day I am miserable.  It’s the same day after day.

I want all of this to be over.

               I am so ready to die”.

 

They are each experiencing the same thing

with not being able to manage their own needs.

Both likely missing and wanting so strongly;

something so powerful; so credible; so coveted;     

and yet so clearly needed,

                         Quality of Life.  

 

COWBOY

 “John”, eighty-two, lives out in the country on a five-acre ranch.  The ranch has several horses along with a few cows.  John resided in a small town forty-five minutes from the hospice office. It was not a straight route to his home.  I turned on many country roads which each getting narrower.  The white line was difficult to see many times.  The road looked like many tractors and trucks had driven this way. 

The last turn was onto a dirt road.  The home was still about two miles away.  Making that turn gave me a thought of, “This looks familiar,” but then, I would think that it was a typical county road.  As I approached the entrance to his home, I again had thoughts that I had been here before.  The thoughts were not strong, so I easily dismissed them. 

When I drove around the back of the house to park, I parked next to a stable.  I once more had  those same thoughts that it looked familiar, but again not paying much attention to my thinking. 

John was in a hospital bed in the family room.  He was a bit confused and his daughter, “Patty” thought it best that we talk about hospice support in the kitchen.  Toward the end of the visit, Patty mentioned that her mother was on our hospice six years ago.  She pointed to the bedroom off the kitchen and said, “My mom was in there.”  At that moment, my memories all came rushing back.  I had been the hospice admission social worker for her mother.  

Strong wonderful memories came to me about her dad talking with me out by the stable.  He had such a love for working with animals.  It was his calling and he so dearly embraced it.  What a blessing for him to find his calling.  He gave me great memories.  Thank you, Cowboy John.

COWBOY

 

We knew he lived out in the country,

but driving to his home was an adventure.

Each county road I turned onto

became narrower with repeated potholes.

 

The last turn on a dirt road, seemed familiar,

with signs saying, “Dead end; with no turn around.”

I passed acres of farmland with few houses,

but then turning onto his property brought a thought,

               “Have I been here before?”

 

I drove around to the back, parking next to a stable.

It all felt so familiar, but then it was a typical farm.

He said he was a cowboy, working 35 years

               on a nearby Cattle Ranch.

 

His daughter said her mother too was on our hospice.

She died six years earlier after a short illness.

Pointing to her bedroom, it all came back.

I was here then, admitting her to our hospice.        

 

I so strongly remember this cowboy,

walking me to my car near the stable.

He spoke of his love for horses; for cattle,

while wearing this huge cowboy hat.

 

He is a father, a grandfather, a great-grandfather.

He was a husband for over fifty years,

but so deep in his heart, he has always been,

and forevermore will always be,

                A Cowboy!

ALZHEIMER'S

We admitted “Terri”, seventy-three to our hospice program today.  Terri was diagnosed with Alzheimer’s Disease twelve years ago when she was only sixty-one.  Terri is married to her husband, “George”, who met us at the front door. George immediately started to tell us all about Terri.  It was so obvious how much he loved her.   Terri has been in a recent two month decline to where she is becoming weaker and needing more help with her daily activities. 

George was hoping, with hospice support, Terri might get better.  He has done thorough research on Alzheimer’s Disease, but still, each day, is looking for a piece of his wife at how she was before.  Deep down, I know he is aware that that will not happen, but emotionally, he is still hoping for a peek of her “old self”. 

It was so obvious that George knew all about the disease.  He so thoroughly researched as was hoping to understand the disease.  But emotionally, he still had hopes of the wife he knew, would one day return. 

George does reach out to his two children, who are so supportive to their parents.  I cannot even imagine what he is going through.  He is in the process of arranging for caregiver support as knows he has to take care of himself as well.  George did say, “I don’t want to get mad at her for not being able to do things”.  I need to have energy to care for her.  

George is very realistic about her disease, but, on the other hand, hopes that she will get better.  That is what likely helps him to get through each day.  There is no right or wrong way to grieve; to survive.  Hospice is available to George as much as we are to Terri.  I know if Terri could understand, she would want us to help her husband too.  That is called unconditional love; and that doesn’t get any better.

ALZHEIMER’S

 

Twelve years ago, they both heard,

“You have Alzheimer’s Disease.

There is no cure for this illness.

There is nothing more to be done.”

 

She was only sixty-one.

She had been so healthy for years.

She was hoping for a full life ahead.

Now life appears to be just a huge struggle.

 

She’s been in a steep decline lately.

She’s become much more confused.

Only speaking in two to three words.

Becoming so wobbly when she walks.

 

He is struggling with these changes.

He keeps hoping she’ll come back around;

be a bit more like her old self,

but then, knowing that she can’t; she won’t.

 

She is up at night, becoming afraid and anxious.

She is seeing things; hallucinating.

He doesn’t want to believe; but so truly is aware,

as has researched thoroughly on the computer.

 

He strongly remembers what her doctor said

in response to her anxiety; her fears;

relating to the heartlessness of Alzheimer’s Disease.

“She is looking for happiness and not finding it.”

 

That is the simple definition;

          the power;

                    the strength of

                                   Alzheimer’s Disease.

 

I WANT TO

Being a hospice admission social worker, my days are frequently full.  Now and then, I reach out to my social work peers to see if there are any visits or phone calls that I can help with.  Today one social worker asked if I could visit two patients in a local nursing home.  Our hospice has a policy that if a patient has less than two weeks to live, a nurse or a social worker need to visit on a daily basis. 

Each patient I visited had a family member sitting by the bedside.  “Nancy”, eighty-five, was in a deep sleep.  She appeared to be unresponsive.  She has not eaten for four days as, per her daughter. “Julie”.  Nancy chose to stop eating as has told her family, “I want all of this to be over.”  She was very depressed over her dependence.  Julie and her two sisters, all wanted what was best for their mother.  They all supported their mother’s way of wanting it to be over. 

I next went to visit, “Darlene”.  Darlene resided only a few rooms down from Nancy.  She too, was unresponsive.  She did appear imminent as her breathing would stop for thirty seconds or so routinely.  Her son, “Dennis” was sitting by her side.  He pointed out to me her breathing pattern.  He, too, knew that his mother likely only has one to two days at most.  All of Darlene’s children live out of state.  Dennis informed his mother, this morning, that all four of her children will be by her side tomorrow.  Dennis is hoping his mother will hold on.  

Both of these children were focused on following their mother’s wishes.  Both easily verbalized their emotions and thoughts.  It was so obvious how much both of these children did love their mother.  I felt so honored that both, Dennis and Julie, thanked me as I was walking out the door. 

As I was driving away, my heart was so full of love and grace.  I feel so honored to do this work.  These two visits today are the perfect example of why.  

I WANT TO

Today I visited two elderly women.

Each living in the same Skilled Nursing Facility.

Both with likely just days to live.

I, wanting to give the family needed support.

 

Both women were unresponsive,

looking so comfortable without any pain.

At most, eating and drinking only sips and bites.

Sleeping most all of the day.

 

She sat so patiently next to her mother;

knowing her mother’s time is quite near.

She is at peace about it all

as this is so what her mother wants.

 

He just flew in from Alaska this morning.

So happy to be by his mother’s side.

So gently, he has whispered into her ear,

               “It is okay for you to let go.”

 

Both are happy to be by their mother’s side.

Both were deeply grieving, but able to let go.

Each did say the same thing as I was leaving,

“I want to thank you for coming.

               Your support has meant so much”.

 

My heart, so full of warmth, as I drove away.

Two back-to-back visits surrounded by love.

Both easily telling me how much I did help.

               I truly felt exactly, the same way.

 

“I want to thank you, as well,

for welcoming me into your life.

I so appreciate you sharing your truth.

This has been perfect for both you and I.

From the deepest part of my heart and soul

I want to simply just say, Thank you!”

 

AS WOULD I

We admitted, “Annie” to our hospice program today.  Annie, ninety-seven years old, suffered a major stroke one month ago.  She had been living her life independently until that time.  The stroke has left her weak and needing to ambulate using a walker.  Annie walks slowly as is a bit wobbly on her feet. 

Annie has moved in with her daughter, “Jennie”.  Jennie is her mother’s primary caretaker.  Annie struggles with feelings of being a burden to her daughter.  She is having such a hard time being dependent.  She misses being the one able to help another.  She was able to talk about her wonderful ninety-seven years, but what she is facing today has so much power over her. 

While Annie was talking about her life before, and now how it currently is, I could so relate to what she was saying.  I had the thought that if I were in her shoes, I bet I would be feeling quite the same.  Her words made a lot of sense to me.  

Annie was a Social Worker, as am I.  Annie felt fulfilled helping another, as do I.  Annie hated not having those opportunities any longer; as would I.  I have shared with others, “I want to die the day before I become dependent.”  I validated and normalized Annie’s emotions, but was able to turn to the good she has done in her life.  We were able to talk about her wonderful and supportive family.  

I would love to return for another visit to give her the needed support.  I told her that I so admired and respected her for being able to speak her truth.  But then more, for the good she has done in her life.  I added, “You are one tough and strong woman and that is a huge compliment.”   I wish her peace and comfort.

AS WOULD I

 

She has been, oh so healthy

her first ninety-seven years.

Now, one month ago,

all has so dramatically changed.

 

She suffered a major stroke;

leaving some weakness; some confusion.

But the worst for her is being “a burden”;

needing to rely on her family for help.

 

She feels so sad about what has happened;

knowing her life will never again be the same.

“I can’t call it depression;

               I am just feeling low.”

 

She was the one everyone turned to

when needing some help or support.

She was always there for everyone,

but now struggles being the one in need.

               As would I.

 

She is so familiar with helping another;

not being the one needing the help.

When asked about her spirituality;

she wholeheartedly answered;

                “I believe in people”.

 

We spoke about her goals of care.

“What can we do to help you best?”

She calmly said, “I’ve had a good life.

I just want to die in peace”.

               As would I.

 

YES

I have done hospice work for over eighteen years.  The rewards of this work are amazing.  I meet so many wonderful patients and families.  Hospice’s philosophy is to allow the patient to do things their own unique way.  Dying is such an individual experience.  The large part of the Social Work role is to validate, normalize and paraphrase emotions, feelings and statements.  Hospice staff come with knowledge and support, but the most priceless give we bring is our caring hearts. 

Most of us easily see kindness and love that comes to us, but we, so often, do not recognize the love and kindness we hand out to another.  I am so honored to meet so many beautiful people.  Families know that I care, because my heart deepens upon meeting someone struggling with a terminal diagnosis. 

This family that I met today, has experienced so many losses in their life.  The patient, “Elisa”, eighty-one, had nine children.  Four of her children have preceded her in death.  Elisa, and herd family, have a very strong Christian faith that supports and guides them.  The patient’s surviving children all live nearby.  They are all so involved and supportive to their mother and so lovingly to each other. 

I received the gift of being present and witnessing such love.  The patient’s words about life were so beautiful.  That, along with the daughter’s kind words to me, so clearly is why I continue with my hospice work.  I tell others, “When this becomes work, then I will know to quit.”  Right now, is so strongly to me a YES to continue.  And that I will.

YES 

 

All of us cope so individually.

We follow our path as guided.

What is right for one of us,

may not work for another at all.

 

She is two months older than me;

making me aware of my life’s blessings;

as she has struggled with cancer

since her diagnosis just three years ago.

 

She has totally accepted it all;

her decline and her dependence.

She embraces the love that surrounds her,

thanking her family each and every day.

 

She denied any fears or concerns.

Her strong Christian faith helps her cope.

“If God gives me life, I will live.

If not, then there no longer is any support.”

 

Her daughter spoke of fears about death.

I counseled on loss and anticipatory grief.

I spoke about other family’s experiences;

including a few stories of my own.

 

Her reply gave me gracious tears.

“After talking with you today,

my fear of death is totally gone.

My mother’s spirit will always be around.”

 

These beautiful gifts always amaze me.

This patient taught me grace with total acceptance;

while her daughter, gave me deepest thanks for my words.

This is why I continue to do my special work.

             Yes, it truly is.