WHO HE IS

The hospice nurse and I went out to admit, “Josh”, fifty-five, to our hospice program.  Josh was diagnosed with cancer just two years ago.  It has now spread to his bones.  Josh has been married to his wife, “Tracy”, for over thirty years.  They have two sons who live nearby.  Josh is one of seven children.  Three of his siblings were at the bedside; along with Tracy and their two sons.  They all started to share Josh stories.  They proudly stated, “He is the Patriarch of the family”, while adding, “He always made everyone laugh.” 

The family brought out photographs to share with us while telling us stories about “the true Josh”.  In all of the photos, Josh looked so robust and handsome with an amazing smile.  They shared so many stories, while laughing at the antics that Josh had up his sleeve.  One so felt the love between all of them in the home. 

I often tell families, that their loved one’s disease is such a small portion of who they truly are.  Patients are so much more.  This family surely expressed that in such an amazing and beautiful way.  I hoped Josh heard our conversation as their stories so truly state what a wonderful man he is.

WHO HE IS

 

He has declined so quickly

in these past few weeks.

Where up and walking a month ago,

he is now totally bedridden.

 

He stopped eating yesterday;

while drinking no fluid at all.

He’s unresponsive most of the time.

The family is aware and gathering around.

 

His wife and sons are at the bedside;

as is his six siblings from afar.

Two live out of the country;

while the others many miles away.

 

We all stood around his bedside

so aware that his time is short.

They started telling us his life stories;

how he would always make everyone laugh.

 

They showed us dozens of photos

of family gatherings, weddings and trips.

With each photo they shared his stories

while pointing to him in healthier days.

 

What we first saw was an imminent patient

who likely only had days to live;

but hearing their amazing stories and love for him,

we truly saw a beautiful husband, father and family man.

 

They wanted us to see the person whom he truly is;

not the unhealthy man he has recently become.

They were so perfectly letting us know;

               “This is truly

                               who he is!”

 

HER LIFE

I went out to admit, “Randy”, fifty-nine years old, to our hospice program.  Randy has suffered from cardiac disease for many, many years.  He had to go on disability over ten years ago due to his health.  He and his wife, “Angela”, live on forty beautiful acres outside of town.   They have lived there for almost thirty years; the number of years they have been together. 

Randy and Angela have a son, “Scott”, who attends college in another state.  Due to his father’s recent and rapid decline, he has come home to stay for the duration.  He wants to be there to support both of his parents.

 When I walked into their home to do the admission, Randy was in a deep sleep.  Due to his pain, Angela was giving his medication on the hour.  He had stopped eating and drinking for several days.  I knew his time was short. 

Angela was so realistic regarding her husband’s status and prognosis.  She was very practical about it all.  She said that sitting out on their front porch was so spiritual for her.  It gave her comfort.  In addition, she has several friends who live nearby; along with other extended family.  She has tremendous support which I know will help her cope after his death. 

I called her this morning as I found out two days ago that he quietly died.  Her being realistic, I wasn’t surprised at how she was coping.  She spoke so naturally about her emotions along with explaining her husband’s death.  I know she will have some heartbreaking moments, but also will be blessed with some beautiful memories.  She knows she can call hospice for bereavement support as needed at any time.

HER LIFE

 

They live out in the country

on forty acres of agricultural land.

The ambiance of nature enhanced by

fruit trees, goats and even two llamas.

 

They have lived there for almost three decades;

the length of time they’ve been together.

She copes by sitting out on the wooden front porch,

while allowing nature to embrace her soul.

 

He’s been sick for half of those years;

but still able to do quite a bit.

She always knew she would likely outlive him,

while still not wanting to face that day.

 

Their son came home from college;

to emotionally support his mother and his dad.

When I asked her how long she has been married;

I was so surprised when she happily said, “Yesterday”.

 

I called today to offer condolences and support

as he died two days ago, shortly after my visit.

She shared, “I am doing okay,

               but I have my moments.”

 

“I am less anxious and stressed

as he is no longer suffering.

I also have a lot of relief

as he passed very peacefully.”

 

She’s thought about this day for many years

but the reality of it all is so powerful and strong.

“I guess now I am living alone in this ranch house.

This is the first day of

               My New Life.”

 

ALL ALONE

“John” was diagnosed with Alzheimer’s Disease five years ago.  John lives with his wife, “Annie”, in a Residential Care Facility, which offers a lot of support with John’s care.  Annie said that in two days they will have been married sixty-nine years.  The couple have two sons who both live nearby.  Both of their sons are very involved and supportive.  

Annie also has three sisters living about half a mile away.  Her sons and sisters call frequently and are very supportive as the need arises.  This is a very large, supportive, involved and loving family.  Annie said that they moved into the facility about five months ago.  She already has made so many friends due to her bubbly personality.  Annie herself is ready to help anyone, but like most of us, finds it difficult to ask for help. 

Annie lovingly spoke about her three sisters.  One of her sisters became widowed about two years ago and offers a lot of support having experienced herself the loss of a spouse.  Annie and John are so blessed with their family and the facility’s support.  But, in the end, Annie is losing the love of her life.  Her grief, not surprisingly, is very powerful.  After sixty-nine years, it won’t be easy, but I so appreciate her insight regarding her emotions.  I know she will reach out as needed.  I wish her all of the best.

ALL ALONE 

 

She is the primary caregiver for her husband.

They’ve been married sixty-nine years.

He was diagnosed with Alzheimer’s a few years ago.

His decline is slow; but constant.

 

He is becoming increasingly weaker.

He can no longer walk alone.

They cut up his food into small pieces

as he struggles with swallowing at times.

 

They reside in an Assisted Living environment.

The staff help out with a lot of his care.

Both of their sons live nearby

and offer tremendous support.

 

She also has three sisters

who all live just down the road.

They call and visit all of the time.

She so values their help and comfort.

 

I asked her what helps her cope

when she hits a bump in the road.

She said she loves to do puzzles;

while so embracing her family and friends.

 

But then, she slowly turned inward

and with a soft voice quietly said,

“It’s not easy, as when I think of him dying,

I truly will be

               all alone.”

 

IT IS WHAT IT IS

A large part of a Social Work assessment is to ask about how the patient and family are coping.  There is no right or wrong way to cope. I tell patients and families, “However you are coping or feeling is called “normal”. 

Today I went out to admit, “Lily”, seventy years old, to hospice.  She was diagnosed with ALS or Lou Gehrig’s Disease over three years ago.  She lives with her husband, “Eddie”, who is so focused on how he can help her.  He recently retired and is home to help her as needed.  Fortunately, the couple have funds to pay for hired caregiver support. 

Lily is totally dependent with all of her needs.  She can only move her head.  She is no longer able to speak and can only communicate using head movements.  She appeared calm and relaxed which represents her strength.  One must feel so trapped into their own body. 

Eddie was a matter-of-fact person.  He wanted the truth and accepted whatever came his way.  He has researched ALS thoroughly as wants to know what to expect and also how he can help her.  He accepts reality as stated, “It is what it is”.  He may have no control over ALS’s power, but he looks to what he does have power over.  

When I asked him what helps him cope, he spoke about life after her death.   He honestly shared, “I would love to learn how to play the piano”.  Then quickly adding, “I must get a new hobby.”  

I so admired his honesty.  When one tells you their truth, it so gives you ways to help him back.  It struck me today when he said, “It is what it is”.  I am never surprised when I hear that statement as I do hear it a lot.  I view it as one looking at ways that can be helpful and not trying to knock down a brick wall.  

I cannot even imagine, but I know Lily and Eddie’s journey is so challenging.  I hope we can help both of them the best way we, as an agency, can; because to us too, “It is what it is”.

IT IS WHAT IT IS 

 

Three years ago, she heard,

“It is Lou Gehrig’s Disease.

There is no cure, only decline.

So heartlessly, it impacts everything 

               but your brain.”

 

Her decline has been constant since then,

with precious moments of stability.

He feels the more he knows,

the better he can support her

during her expected downhill ride

 

He’s researched the disease.

He is a realistic while grasping the truth.

He wants to know all about it;

while accepting the grim facts.

 

She is totally dependent.

Now only able to move her head.

She is alert and oriented,

but no longer able to speak.

 

When asked how he is coping,

he honestly replied;

“It is what it is.

               I have no control.

                             I don’t dwell on it.”

 

He is also realistic regarding her needs.

“She was a very active person.

This must be so hard for her."

Then one more time softly stating,

               “It is what it is”.

 

IN THREES

 “Harold”, eighty-one, has suffered from heart disease for many years.  He lives with his wife, “Annie”, in their cozy home with their fluffy puppy, “Max”.  The couple have five children who are loving and devoted to their parents.  Three of the children live locally and are wonderfully9 supportive. 

The moment I walked into their home, I immediately spotted Harold.  He was in a deep sleep lying in his hospital bed in their living room.  The family shared that he has been declining for several months, although now, “We are seeing a daily decline.”  Harold has not eaten for two days.  He is only taking in sips of water.  He was in a deep sleep the entire time I was visiting them. 

Harold and Annie’s daughter, “Paula”, shared that her father has been “talking to someone” while asleep these past several days.  Both Annie and Paula are realistic regarding knowing that he likely has only days to a week left to live. 

Paula and Annie had me laughing the moment I walked into their home.  They were so sarcastic in such a loving way.  It was great being with them.  Humor is such a wonderful coping skill.  So many folks that I meet, use humor to cope. 

I was with Annie for a few moments in the kitchen.  She started to tell me about her daughter who died a few months ago.  It was then that I witnessed her appropriate tears.  She is still so strongly grieving her daughter while knowing it won’t be long when she will be also grieving her husband’s death.  She knows it while not wanting to experience it; as we all would likely feel. 

There is something to be said about a mother’s intuition.  Raising children brings out that amazing instinct of knowing what may be around the corner.  I wish her the best and hope that our hospice program can help her through this painful ordeal.  Our bereavement department follows family for thirteen months afterwards.  God bless you Annie. 

ADDENDUM:  Harold died six hours after I left their home.  I have spoken with Paula who shared that they are busy with paperwork while arranging his memorial.  She shared that her mother is doing” okay, but grieving”.  They are aware that they can contact our hospice bereavement for any support that arises.  Their love for each other will hopefully help them through this difficult time.

IN THREES 

 

He suffers from heart disease.

It has been, oh so m any years.

He was doing just fine until

only a few months ago.

 

It was then, his struggle arose.

He began needing more and more help.

The family say that now

they are seeing a daily decline.

 

When I saw him today, I knew.

He has not eaten for two days

while drinking only a few sips of water.

He is imminent; his time is short.

 

She spoke about her eldest daughter,

who just died a few months ago.

“Her, and now it’s happening to him.”

While softly adding.

              “Things happen in threes”.

 

Her younger daughter walked me out.

She told me about her brother.

He fell a few days ago and fractured his leg.

Test results show cancer that has spread.

 

“He needs chemotherapy and treatment.

I don’t know how to tell my mother.

She’s been through way too much.

I don’t want to hurt her more”.

 

I feel that she probably already knows.

She is trusting her heart; her sixth sense.

A mother’s instinct is oh so strong.

Things so often happen

               In threes!

SMALL TOWN

We have lived in this small town almost 20 years ago.  Previously, we lived in a town with a population of 900,000 people.  What is so wonderful about this town is that we are about twenty minutes from two large, active cities. 

Yesterday, we admitted “Marie”, ninety-one, to hospice.  Marie had been living independently until recently as she struggles with many of her daily activities.  Marie is a strong and very independent woman, but with her lung disease, she is becoming more short of breath with exertion.  

Marie has two daughters, who both live nearby.  They are now rotating while staying overnight with their mother.  Marie has seven adult grandchildren; who too; all live nearby.  Her grandchildren, along with her daughters, are with Marie during the day as well.  She is never left alone. 

We also admitted, “Doug”, ninety-two, to hospice today.  Doug lives on a ranch about two miles away from Marie.  He also has been in a recent decline.   He suffers from Alzheimer’s Disease, but is still very alert with mild confusion.  He lives with his wife, who herself is frail, and unable to care for her husband.  The family has hired caregivers during the day.  Doug has three children; of which two live locally.  One of his daughters, “Carol”, moved into her parent’s home two years ago to help as well. 

Both families have lived in our small town for generations.  Doug lives on a walnut ranch, that he now leases out.  Marie and her family also lived on a walnut ranch in this small town, although Marie stated that they sold the ranch and moved into town fifteen years ago. 

So many similarities between these two families, but the biggest one of all was where Marie’s daughter and Doug’s son lived.  Both live only a few blocks from me.  These two families so represent the luxury and blessings of living in a small town.

SMALL TOWN 

 

We moved to this small town

almost twenty years ago.

The population sign then said 6,900.

Even with many more new homes,

               it still states that today.

 

We admitted her to hospice yesterday.

She is slowing down and no longer living alone.

Her two daughters rotate to care for her,

along with many other local family members.

 

We also admitted him to hospice yesterday.

He lives on a 28-acre ranch, two miles away from her.

His family too, all reside nearby.

They, like her supportive family, are rallying around.

 

Both patients are in their early nineties.

Both still able to walk with their walker.

Family is all nearby and supportive.

The beauty of living in a small town.

 

Her daughter and his son

both live about half a mile from me.

But most surprising and coincidentally of all,

the two live next-door to each other.

 

I am surprised I have never run into them before;

either in the grocery store or post office in town;

as families reside here for generations.

That, so wonderfully, can be the beauty

and comfort of living in

                              a small town.

 

I PRAY

I met, “Claudia” a few days ago.  She lives in an apartment in a local Assisted Living Home.  Claudia’s husband, “Bill”, who suffers from Alzheimer’s Disease, has a room in the Memory Care Unit just down the hall from Claudia’s apartment. 

Claudia is able to walk with her walker down the short hall to sit by her husband’s side during the day.  Bill was diagnosed with Alzheimer’s Disease eight years ago.  He had been in a long, slow decline for many years, until recently, when he took a fall and hit his head.  Sense then, it has been a whirlwind of a decline for him. 

Bill is now bedridden while eating and drinking very little.  Claudia was realistic and realized that his days were short.  Claudia has a lot of support from family, but when I asked her what helped her cope, it was her faith which gave her amazing comfort.  

Bill died peacefully the following day.  I gave Claudia a call a day later to give her support and to let her know about hospice’s bereavement follow up that is available.  The words she spoke were so beautiful and heartfelt, it gave me goosebumps.  I know Claudia will grieve the loss of Bill, but she will also receive much comfort from her family and, especially, her faith.  I know she will embrace it always. 

I PRAY

 

They’ve been married over seventy years.

They’ve been through a lot together;

building a life; raising three kids.

So many experiences, so many stories.

 

Now it’s near the end for him as

Alzheimer’s Disease is winning the war.

He’s unresponsive in the Memory Care Unit;

while she’s in an Assisted Living apartment

              just down the hall.

 

She stays by his bedside during the day

giving him support; giving him comfort.

When I asked her, “What helps you cope,”

she so strongly replied, “I pray!”

 

She knew his time wouldn’t be long

while sharing stories about his life.

She embraced all the good times they had.

It made her smile while she recalled.

 

I phoned to offer condolences and support

as he peacefully died the following day.

I knew her Christian faith gave her strength,

but was so moved by what she said.

 

“I am really doing very well,

but I want to always remember

what he looked like the day before he died.

               He looked so lost.”

 

“I am happy he is not in that body any more.

He is with the flow.

He is keeping me peaceful.

               I pray!”