I had met "Johnnie" only two times. Three months ago I went out to meet with Johnnie and his wife, "Grace", to give information about our Hospice program. Johnnie was a very young eighty-seven year old. He wasn't ready for hospice, but wanted to know what our program was all about.
Johnnie owned a nearby retail store. Johnnie's son worked there full time. Every noon hour, Johnnie went over to the store to give his son a lunch break. Johnnie appeared so weak at the time, but helping out his son was that important to him.
One month later, I went back out to Johnnie's home to admit him to our hospice program. In that short period of time, Johnnie had declined to where he was so much weaker and had lost weight. His body had aged, but Johnnie still had that inner strength to continue to do those things he wanted to do. Johnny died a few weeks later with his family at his side.
Today I was given the Thank You card that Grace wrote to thank the hospice team for all the support. Her words brought tears to my eyes. I feel so grateful and pleasantly surprised that I made a difference in Johnnie's life. It doesn't get any better than that.
Driving home after work, I thanked God for letting me know to continue to do this blessed hospice work. The rewards are amazing. Yes, us hospice workers do give to others, but we so get it back a thousand fold. Thank you all.
DETERMINATION
We often get asked,
"How can you do hospice work?
It must be so depressing.
It has to be so hard."
I easily answer,
"It is so rewarding.
We meet wonderful people.
We get it back a thousand fold."
We all easily feel what comes in,
but do not normally know what we give out.
Hearing a "Thank you" is so humbling.
Often thinking not quite deserved.
She wrote a thank you note today.
Thanking the staff for all that they have done.
I was only out there two times,
but her words brought instant tears.
"You gave him the determination
to live every day he had left.
He continued to go to the store everyday;
up to the final ten days."
She was so grateful to what I had given him,
but her words have given me so much more.
Validation to continue to be where I need to be.
Determination.
Sunday, March 4, 2018
Saturday, February 17, 2018
KARMA
The hospice nurse and I went out to admit, "Rosa" to our hospice program. Rosa, eighty-seven years old, had been very independent one week ago. Suddenly she became extremely weak and was admitted to the hospital for several days. The doctors feel she likely has a cancer, but Rosa chose not to have any further tests. She just wanted to go home.
Rosa has a very large, extended family, who all live nearby. This is an extremely connected family who are so focused on what is best for Rosa. The family is very realistic regarding her recent decline and poor prognosis. One might look at this family and only see what the family does not have monetarily. But to me, I saw millionaires of love intertwined with each and every one of them.
Rosa does not speak English, but she would grab my hand and say "Gracious" over and over. She had the most beautiful smile. Her heart was huge. She is the matriarch of such a wonderful family. She taught them all well.
"Catherine", ninety-six, was admitted to hospice today for end stage cardiac disease. She too, had a rapid decline, although had been needing help for quite a while. I spoke with Catherine's son on the phone after the visit. He lives several hours away but does visit often. His primary focus is making sure all of his mother's needs are met.
He arranged for twenty-four hour care in the home. Two friends of Catherine are sharing that support. One stays with Catherine four days a week, while, "Lorraine", her friend of sixty years, is with her the other three days. Lorraine totally amazed me with her enthusiasm and determination to make sure Catherine is well cared for. I was more surprised when Lorraine shared that she just celebrated her ninety-first birthday.
Lorraine may not be biologically related to Catherine, but she definitely is family. Lorraine supporting Catherine says a lot about Lorraine, but it also says a lot about Catherine. Again, Karma. It gives us all hope.
KARMA
I am a strong believer of Karma.
"What goes around, comes around."
Families strongly advocating for a loved one.
I amazingly see it every day in my work.
A week ago, she was doing just fine.
Then suddenly all that changed.
Now bedridden; not eating; totally dependent.
A likely cancer diagnosis if they ran more tests.
She has no income as was a homemaker by trade.
Widowed years ago; raising her five kids alone.
All, four generations of family, live nearby.
Loving her, caring for her, faithfully by her side.
She, on the other hand, has no family in town.
Her son, who loves her unconditionally, visits when he can.
Her friend of sixty years though, is very involved.
She, and one other, are with her full time.
She's been her friend for over sixty years.
She stays with her three days each week.
She is devoted and believes it is for her to do.
She has so much energy for someone ninety-one.
These two families are so full of love.
I feel so honored to witness such devotion.
Two prime examples of why I strongly believe,
"What goes around, comes around."
Rosa has a very large, extended family, who all live nearby. This is an extremely connected family who are so focused on what is best for Rosa. The family is very realistic regarding her recent decline and poor prognosis. One might look at this family and only see what the family does not have monetarily. But to me, I saw millionaires of love intertwined with each and every one of them.
Rosa does not speak English, but she would grab my hand and say "Gracious" over and over. She had the most beautiful smile. Her heart was huge. She is the matriarch of such a wonderful family. She taught them all well.
"Catherine", ninety-six, was admitted to hospice today for end stage cardiac disease. She too, had a rapid decline, although had been needing help for quite a while. I spoke with Catherine's son on the phone after the visit. He lives several hours away but does visit often. His primary focus is making sure all of his mother's needs are met.
He arranged for twenty-four hour care in the home. Two friends of Catherine are sharing that support. One stays with Catherine four days a week, while, "Lorraine", her friend of sixty years, is with her the other three days. Lorraine totally amazed me with her enthusiasm and determination to make sure Catherine is well cared for. I was more surprised when Lorraine shared that she just celebrated her ninety-first birthday.
Lorraine may not be biologically related to Catherine, but she definitely is family. Lorraine supporting Catherine says a lot about Lorraine, but it also says a lot about Catherine. Again, Karma. It gives us all hope.
KARMA
I am a strong believer of Karma.
"What goes around, comes around."
Families strongly advocating for a loved one.
I amazingly see it every day in my work.
A week ago, she was doing just fine.
Then suddenly all that changed.
Now bedridden; not eating; totally dependent.
A likely cancer diagnosis if they ran more tests.
She has no income as was a homemaker by trade.
Widowed years ago; raising her five kids alone.
All, four generations of family, live nearby.
Loving her, caring for her, faithfully by her side.
She, on the other hand, has no family in town.
Her son, who loves her unconditionally, visits when he can.
Her friend of sixty years though, is very involved.
She, and one other, are with her full time.
She's been her friend for over sixty years.
She stays with her three days each week.
She is devoted and believes it is for her to do.
She has so much energy for someone ninety-one.
These two families are so full of love.
I feel so honored to witness such devotion.
Two prime examples of why I strongly believe,
"What goes around, comes around."
Saturday, February 10, 2018
SHE NEEDS CONTROL
"Jennifer", forty-seven, was diagnosed with cancer years ago. She had been in remission, but found out eight months ago that her cancer is back. Jennifer has such a strong spirit and fought to live her life to the fullest. She thought hard about how she could live her life her way, in spite of her illness.
Jennifer said she has always known she would not live a long life as cancer runs rampant in her family. Both her parents have preceded her in death. She spoke about many other family members who died from the same illness. Jennifer felt a strong need to control her disease in order to live her life to the fullest.
She had planned on working three more weeks, but with sudden, dramatic symptoms leading her to the ER last night, she knows her time has been cut shorter than she dreamed. We all die the way we live and Jennifer is no different from the rest of us. She continues to strive for ways to remain in control.
She is realistic about her poor prognosis and recent decline while continuing to find ways to manage her deadly disease. I wish her peace in her heartfelt journey.
SHE NEEDS CONTROL
She is not surprised she has cancer.
"Cancer runs rampant in my family.
My mother died at age fifty-seven.
I have always known I would never live long."
She planned on working another three weeks,
but last night she ended up in the ER.
Weakness, pain, shortness of breath.
The reality of her disease screaming loud.
Making plans, doing tasks, being in charge.
She's tried so hard to remain in control.
Now knowing that her cancer is progressing,
it is winning the battle, not her.
Like her mother, she thought
she would have fifty-seven years.
Now aware she will die ten years sooner,
is tough for her to grasp; to believe.
She asked about the End-of-Life Option Act.
What and where does she need to go?
Making decisions, making plans.
She needs control.
Jennifer said she has always known she would not live a long life as cancer runs rampant in her family. Both her parents have preceded her in death. She spoke about many other family members who died from the same illness. Jennifer felt a strong need to control her disease in order to live her life to the fullest.
She had planned on working three more weeks, but with sudden, dramatic symptoms leading her to the ER last night, she knows her time has been cut shorter than she dreamed. We all die the way we live and Jennifer is no different from the rest of us. She continues to strive for ways to remain in control.
She is realistic about her poor prognosis and recent decline while continuing to find ways to manage her deadly disease. I wish her peace in her heartfelt journey.
SHE NEEDS CONTROL
She is not surprised she has cancer.
"Cancer runs rampant in my family.
My mother died at age fifty-seven.
I have always known I would never live long."
She planned on working another three weeks,
but last night she ended up in the ER.
Weakness, pain, shortness of breath.
The reality of her disease screaming loud.
Making plans, doing tasks, being in charge.
She's tried so hard to remain in control.
Now knowing that her cancer is progressing,
it is winning the battle, not her.
Like her mother, she thought
she would have fifty-seven years.
Now aware she will die ten years sooner,
is tough for her to grasp; to believe.
She asked about the End-of-Life Option Act.
What and where does she need to go?
Making decisions, making plans.
She needs control.
Saturday, February 3, 2018
THEY DON'T KNOW
We admitted three patients to our hospice program today. Two suffered from Alzheimer’s and were quite debilitated, while the other had a cancer diagnosis.
I have always thought that not knowing how forgetful and dependent one was, it might be a blessing. Meeting these two confused patients today made me stop and think a bit more about that thought. Both of them were struggling with not knowing what to do and not being able to communicate their questions or thoughts.
The gentleman with cancer was also struggling with what was happening to him. He totally knew his prognosis and poor status. He knew what the two patients with dementia did not. All three were struggling with, "Why?" and "What is it all about?" Whether one understands or not, it became clear a bit more to me today, that no one ever knows. I truly believe there is no simple answer to such powerful questions.
THEY DON'T KNOW
She was diagnosed years ago.
Her symptoms increasing over time.
Alzheimer's, dementia, forgetfulness.
Somehow it is just all the same.
She has no short term memory.
No recollection of anything past.
She just doesn't know while asking,
"What do I need to do?"
He no longer talks, but shouts out.
Mumbling words with no meaning.
He has lost one of his greatest gifts;
his intellect; his mind.
He has a PhD in history.
He has always sought out answers.
No longer able to do so.
Is it a blessing in disguise
that he doesn't understand why?
He was told yesterday his status is terminal.
No more treatment to be done.
He is processing all of this information.
He too, wants to know why.
Being aware or not aware,
it somehow seems the same.
Asking questions with no answers.
All struggling to regain control.
They just don't know,
but then, neither do we.
We likely never will.
I have always thought that not knowing how forgetful and dependent one was, it might be a blessing. Meeting these two confused patients today made me stop and think a bit more about that thought. Both of them were struggling with not knowing what to do and not being able to communicate their questions or thoughts.
The gentleman with cancer was also struggling with what was happening to him. He totally knew his prognosis and poor status. He knew what the two patients with dementia did not. All three were struggling with, "Why?" and "What is it all about?" Whether one understands or not, it became clear a bit more to me today, that no one ever knows. I truly believe there is no simple answer to such powerful questions.
THEY DON'T KNOW
She was diagnosed years ago.
Her symptoms increasing over time.
Alzheimer's, dementia, forgetfulness.
Somehow it is just all the same.
She has no short term memory.
No recollection of anything past.
She just doesn't know while asking,
"What do I need to do?"
He no longer talks, but shouts out.
Mumbling words with no meaning.
He has lost one of his greatest gifts;
his intellect; his mind.
He has a PhD in history.
He has always sought out answers.
No longer able to do so.
Is it a blessing in disguise
that he doesn't understand why?
He was told yesterday his status is terminal.
No more treatment to be done.
He is processing all of this information.
He too, wants to know why.
Being aware or not aware,
it somehow seems the same.
Asking questions with no answers.
All struggling to regain control.
They just don't know,
but then, neither do we.
We likely never will.
Saturday, January 27, 2018
HIS HABITS
"John", sixty-four, suffers from chronic lung disease. John has been on oxygen for quite a few years. John is single and has no children. His only family is his sister who lives several hundred miles away. John started drinking and smoking as a teenager. Throughout the years, he has never stopped.
The hospice nurse and I went out to admit John to our hospice program today. We noticed that he continues to drink and smoke. During our discussion with John, he constantly drank his cranberry juice. Every so often, he would pick up the Russian vodka bottle nearby and add it to his juice. In addition, several dirty ashtrays were within his reach. We spoke about the dangers of smoking with oxygen around. John is aware and said he doesn't worry about it. John had a very sarcastic sense of humor. He wanted to shock the two of us, while trying to make us laugh.
He spoke of regrets due to the poor choices he has made throughout his life. This past month the reality of his health has impacted him due to his recent decline. It has made him aware of his poor prognosis and terminal status.
After we left John's home, with his permission, we spoke to his sister on the phone. She stated how she does not understand why her brother continues to drink and smoke. John is addicted to alcohol and has been a smoker for decades. For all of us, old habits are so hard to break. I wish him all the best.
HIS HABITS
He started smoking as a teenager.
Alcohol came a bit later.
His habits continue today;
for more than fifty years.
He's never married
He has no kids.
His only family is his sister.
She helps as best as she can.
He's on continuous oxygen
due to chronic lung disease.
His life has been greatly impacted
by his habits of so many years.
We admitted him to hospice today.
He is very weak; spending most days in bed.
He spoke about life's regrets
while adding vodka to his juice nearby.
Several dirty ashtrays were within his reach.
He continues to smoke with his oxygen on
even though fully understanding
just how dangerous that can be.
His sister wishes he would stop drinking and smoking
but habits, whether good or bad ones,
for each and every one of us
are all so very difficult
to break.
The hospice nurse and I went out to admit John to our hospice program today. We noticed that he continues to drink and smoke. During our discussion with John, he constantly drank his cranberry juice. Every so often, he would pick up the Russian vodka bottle nearby and add it to his juice. In addition, several dirty ashtrays were within his reach. We spoke about the dangers of smoking with oxygen around. John is aware and said he doesn't worry about it. John had a very sarcastic sense of humor. He wanted to shock the two of us, while trying to make us laugh.
He spoke of regrets due to the poor choices he has made throughout his life. This past month the reality of his health has impacted him due to his recent decline. It has made him aware of his poor prognosis and terminal status.
After we left John's home, with his permission, we spoke to his sister on the phone. She stated how she does not understand why her brother continues to drink and smoke. John is addicted to alcohol and has been a smoker for decades. For all of us, old habits are so hard to break. I wish him all the best.
HIS HABITS
He started smoking as a teenager.
Alcohol came a bit later.
His habits continue today;
for more than fifty years.
He's never married
He has no kids.
His only family is his sister.
She helps as best as she can.
He's on continuous oxygen
due to chronic lung disease.
His life has been greatly impacted
by his habits of so many years.
We admitted him to hospice today.
He is very weak; spending most days in bed.
He spoke about life's regrets
while adding vodka to his juice nearby.
Several dirty ashtrays were within his reach.
He continues to smoke with his oxygen on
even though fully understanding
just how dangerous that can be.
His sister wishes he would stop drinking and smoking
but habits, whether good or bad ones,
for each and every one of us
are all so very difficult
to break.
Saturday, January 13, 2018
WE NEVER KNOW
As hospice workers, we often get asked, "How much time do I have?" We have no answer to give. We can offer a "guestimation", but we truly do not know. We all die the way we live. We grab all the coping tools we need. It is so different for each of us. One truly does it his or her own individual way.
We admitted, "Julia", to our hospice program today. Her symptoms appeared last week. The doctors thought it likely was a rare cancer. The only option was a clinical trial. Julia declined any further treatment as the treatment would only give her a few more months at most. She knew her cancer was not curative. She did not want to suffer any side affects of treatment. She wanted quality of life, not quantity.
The doctors confirmed her diagnosis only yesterday. She was not surprised as this past week has been a downhill journey with increased weakness and pain. The hospice nurse addressed her pain and weakness issues quickly. Hospice nurses are so gifted with giving comfort care. I have done hospice for years and truly know that the number one gift hospice gives to patients is definitely comfort care.
I heard that she died in the wee hours this morning. I was so taken by surprise. I thought she had weeks to live, but it must have been her time. For her, the swiftness may have been a blessing, but for her family it will be hard. Her husband declined any bereavement follow up, but I will call him to offer support.
I truly believe that for all of us, when it is our time, we will let go. It gives me comfort knowing she is in peace. Her family will grieve and cope the best they can. Our hospice bereavement department is there for them whenever they need.
WE NEVER KNOW
She was walking around one week ago.
She was living her life as usual.
Symptoms appeared; likely cancer.
Confirmed yesterday afternoon.
We admitted her to hospice today.
She declined the option of a clinical trial.
She was so weak and in pain.
Her decline has been extremely rapid.
They both used humor to cope.
Being realistic, but laughing a lot.
It was all so new; so surreal.
They had planned on many more years.
He handles his emotions intellectually.
He declined any bereavement follow up.
"I will call if I need anything.
I am really doing okay."
She died early this morning.
Two days after her diagnosis.
It took all of us by surprise.
No time to prepare oneself at all.
I believe we all go when it is our time,
although it takes so many by surprise.
Embrace each and every moment
as the truth indisputably is;
We truly never know.
We admitted, "Julia", to our hospice program today. Her symptoms appeared last week. The doctors thought it likely was a rare cancer. The only option was a clinical trial. Julia declined any further treatment as the treatment would only give her a few more months at most. She knew her cancer was not curative. She did not want to suffer any side affects of treatment. She wanted quality of life, not quantity.
The doctors confirmed her diagnosis only yesterday. She was not surprised as this past week has been a downhill journey with increased weakness and pain. The hospice nurse addressed her pain and weakness issues quickly. Hospice nurses are so gifted with giving comfort care. I have done hospice for years and truly know that the number one gift hospice gives to patients is definitely comfort care.
I heard that she died in the wee hours this morning. I was so taken by surprise. I thought she had weeks to live, but it must have been her time. For her, the swiftness may have been a blessing, but for her family it will be hard. Her husband declined any bereavement follow up, but I will call him to offer support.
I truly believe that for all of us, when it is our time, we will let go. It gives me comfort knowing she is in peace. Her family will grieve and cope the best they can. Our hospice bereavement department is there for them whenever they need.
WE NEVER KNOW
She was walking around one week ago.
She was living her life as usual.
Symptoms appeared; likely cancer.
Confirmed yesterday afternoon.
We admitted her to hospice today.
She declined the option of a clinical trial.
She was so weak and in pain.
Her decline has been extremely rapid.
They both used humor to cope.
Being realistic, but laughing a lot.
It was all so new; so surreal.
They had planned on many more years.
He handles his emotions intellectually.
He declined any bereavement follow up.
"I will call if I need anything.
I am really doing okay."
She died early this morning.
Two days after her diagnosis.
It took all of us by surprise.
No time to prepare oneself at all.
I believe we all go when it is our time,
although it takes so many by surprise.
Embrace each and every moment
as the truth indisputably is;
We truly never know.
Sunday, January 7, 2018
FIFTEEN MINUTES
Late last week, the hospice nurse and I went out to admit, "Neal", a seventy-eight year old suffering with serious lung disease. Neal was discharged that afternoon after a five day hospital stay. The doctors did not think Neal would ever survive to make it out of the hospital. Neil is tough and determined and was so happy to be back home.
We met with Neal and his daughter, "Christy" in Neal's living room. Christy was a strong advocate for her father. She wanted to know every detail about hospice coverage and support. I spoke about hospice's twenty-four hour coverage. I added that we are just one phone call away. If someone needs to make a home visit, it will happen. I added that our hospice covers five counties and it may be an hour before a nurse would make it to the home.
Christy was upset about that one hour time frame. She felt someone should make it to their home in a fifteen minute time frame. She didn't understand that her father's wish of having no life sustaining treatment, calling 911 might jeopardize his wishes. Christy was not ready for hospice support for her father. In addition, Neal also was not ready. He was hoping for physical therapy to help make him stronger.
Neal was so short of breath with any movement or endurance, it is unlikely that he would even be able to participate with physical therapy. The plan was for Neal to call his doctor regarding the follow up request for therapy. We encouraged the family to call hospice with any follow-up questions, needs or concerns.
We only want to admit patients when they and/or their family are ready for our support. It is not right or wrong at all. I always feel thankful that with the information we give the family, they will be aware of our program and can always call when ready.
FIFTEEN MINUTES
He was just discharged from the hospital.
They weren't sure if that would ever be.
He is strong; he got his wish.
He came home late this afternoon.
When meeting folks for the first time,
we want them to understand hospice philosophy.
"Do you want no further hospitalizations?
Do you wish to die in comfort at home?"
We spoke about twenty-four hour coverage.
"Just call hospice with any needs.
Someone would be out within an hour."
She wasn't happy with what we said.
"Where does everybody live?
They need to be here in fifteen minutes!"
We informed her we cover five counties.
Fifteen minutes would likely never be.
We didn't admit him to hospice.
He wasn't quite yet ready for our support.
But, thirty-six hours later, he died at home.
Peacefully, in comfort, with family at his side.
She must have later realized our support
as called and thanked us for being there.
I am sure she was also relieved,
she didn't need us to rapidly come
in our one hour estimation,
or even quicker
in her fifteen minute time.
We met with Neal and his daughter, "Christy" in Neal's living room. Christy was a strong advocate for her father. She wanted to know every detail about hospice coverage and support. I spoke about hospice's twenty-four hour coverage. I added that we are just one phone call away. If someone needs to make a home visit, it will happen. I added that our hospice covers five counties and it may be an hour before a nurse would make it to the home.
Christy was upset about that one hour time frame. She felt someone should make it to their home in a fifteen minute time frame. She didn't understand that her father's wish of having no life sustaining treatment, calling 911 might jeopardize his wishes. Christy was not ready for hospice support for her father. In addition, Neal also was not ready. He was hoping for physical therapy to help make him stronger.
Neal was so short of breath with any movement or endurance, it is unlikely that he would even be able to participate with physical therapy. The plan was for Neal to call his doctor regarding the follow up request for therapy. We encouraged the family to call hospice with any follow-up questions, needs or concerns.
We only want to admit patients when they and/or their family are ready for our support. It is not right or wrong at all. I always feel thankful that with the information we give the family, they will be aware of our program and can always call when ready.
FIFTEEN MINUTES
He was just discharged from the hospital.
They weren't sure if that would ever be.
He is strong; he got his wish.
He came home late this afternoon.
When meeting folks for the first time,
we want them to understand hospice philosophy.
"Do you want no further hospitalizations?
Do you wish to die in comfort at home?"
We spoke about twenty-four hour coverage.
"Just call hospice with any needs.
Someone would be out within an hour."
She wasn't happy with what we said.
"Where does everybody live?
They need to be here in fifteen minutes!"
We informed her we cover five counties.
Fifteen minutes would likely never be.
We didn't admit him to hospice.
He wasn't quite yet ready for our support.
But, thirty-six hours later, he died at home.
Peacefully, in comfort, with family at his side.
She must have later realized our support
as called and thanked us for being there.
I am sure she was also relieved,
she didn't need us to rapidly come
in our one hour estimation,
or even quicker
in her fifteen minute time.
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