Compassionate transitions in hospice care and in nature

by Valerie Hartman

Yesterday was a beautiful day in Bucks County, Pennsylvania.

It was the first day of spring, and the sun was shining.  The white snow drops have been in bloom for over a week, weathering two temperature drops and a snowfall.  They remain tall and strong as I walk by and notice them in home gardens this week.  The snow drops are first in the sequence of blooming events that the avid gardener measures via nature’s timeline.  A stroll around the flower beds is like glancing at a wrist watch.  What I love the most about the snow drop is the flower’s constitution to rebirth right through the snow in winter.  They seem so relaxed about it too.  Just one tiny, pure white, fragile drop of closed flower petals, will hold your eye to such beauty against the backdrop of winter.  Stark and peaceful.

Many people are feeling the renewal of energy this week.  Even when physical energy is down, spiritual and emotional energy around this change of season can go up.

Promises to the dying: in hospice and in life, the need to be realistic

By Ron King

Live out your deepest devotion with the courage of remaining in the moment and choosing to love through each day with the best you have to give.

A friend of mine promised her husband that she would never marry again so they could be together forever because that was his wish and he was dying.  Three days later he died when he was 41 and she was 39.  Today she is 64 and still single.  No one can question the loyalty or sacrifice of another, but we do need to test our own readiness and ability to make final vows and keep them.

That sticky ‘stage theory’ of grief

By Leanne Billiau

“Every one can master a grief but he that has it.”
-William Shakespeare

This week we re-post one of the most talked-about posts from the Caring with Confidence archives. 

Those of us who are passionate about hospice admire the ground-breaking work of Swiss American psychiatrist Elisabeth Kubler-Ross. She was part of the hospice movement and her work with the dying put the topics of death and grief on the table for many. Even though she studied people who were dying and the emotional impact of getting that kind of traumatic news, her theory is prevalent in pop culture as “The Five Stages of Grief”.

It is in our nature to try and make sense of our world. We attempt to create order out of chaos, and the world can feel very chaotic and out of control for those who are grieving.

Why is my loved one so tired since we started hospice?

By Lorraine Thayer, CRNP

One of the questions I hear frequently as a nurse practitioner working in hospice is: “Why is my loved one sleeping so much since hospice came on board?”

Families question the pain medications or the hospice team’s suggestion that a patient be permitted to nap as they choose. Patients and families frequently focus on the symptom rather than its underlying cause. Many believe that a person’s strength is under his or her control, and feel that the patient is “giving up,” “not fighting,” or “not eating enough.” This is not the case.

The gift of conversation in and before hospice

Whether or not you had an actual conversation with your loved one about their end-of-life wishes, here you are: a hospice caregiver. You probably never expected this job, and whether it is a joy, a duty, or a heart-wrenching, difficult task—or all three—it is probably a tad easier if you know that the hospice patient you care for chose this path.

The Conversation Project is a website, an on-line community, and an invaluable tool to help families have the sometimes uncomfortable discussion about their end-of-life wishes. Ideally, this conversation happens when everyone is well and not during a medical crisis. But realistically, even when all is well, no one really wants to talk about death or serious incapacitation.

Can I pray for death to come soon?

By Ron King, Hospice Chaplain

When a hospice patient or family member expresses doubt or guilt about hoping death will come quickly and ask what God might think, we face a hard decision together.  It isn’t a question that can be answered with medical or scientific certainty. Different opinions and convictions may prevail in the same house or even in the same person from one moment to the next.  Moral codes and spiritual practices fail to provide a definite and satisfying solution. Past experience is rarely helpful and advice we seek is often contradictory.  Still, we seek out some authoritative answer or reliable guidance to help us navigate a host of conflicting thoughts and feelings.

Hospice caregiving and love

by Valerie Hartman

Mr. and Mrs. T were married for 65 years when hospice care was arranged for Mr. T at home.  He had cancer, bone pain, felt weak, and since he had practiced stoicism since his tour of duty in WWII, he rarely complained.  He started having restless nights after he returned from war, so his wife took it upon herself to monitor his sleep.  His rest improved over the years under her watchful eye, because she made it a habit to wake him at the first sign of a bad dream.  She cared for him in the last weeks of his life with the same skill she developed while overseeing his dreams.  She was attentive, on duty, sensitive to every non verbal sign of discomfort, and had the communication style that brought him dignity and security each changing day.  Mrs. T needed the support of the hospice team to manage everything that was changing day-to-day, and that allowed her to provide the kind of care she knew best, the care she provided out of loving her husband year after year.

A debatable issue – Is it mandatory for hospice patients to have caregivers at home?

By Patty Ayers

You’ve been through the emotional process necessary to make the decision for hospice care with your loved one. Imagine if when you said “yes” to hospice, the agency you were considering said “no.”

Apparently, 12% of hospices nationwide do say “no” when the hospice patient doesn’t have a caregiver at home 24/7.

After reading the recent NPR article Why Some Hospices Turn Away Patients Without Caregivers At Home, I’m left with mixed feelings of confusion and frustration.  I can say with the utmost certainty that the hospice I work for does not turn away patients who do not have adequate caregivers at home!

Just the right environment for hospice care

We are pleased to share a post from you from Ira Woods, who blogs at Conscious Departures.

When it comes to going out to eat, whether it be a restaurant or someone’s home, many people find that the environment plays a big role in the enjoyment of the food. I once heard a comment attributed to a friend that when asked what he thought of the restaurants in New York City he said that it was hard to enjoy food when eating in a toilet (sorry New Yorkers, no offense meant). I never found out if he actually said this but it definitely got a laugh out of me and a nod towards the spirit of the statement. So what about the environment when we are caregiving? What about the environment when a person is going through an end-of-life process?

My time as a cancer caregiver

By Cameron Von St. James

Cameron Von St. James is an experienced caregiver for a loved one with advanced illness, in this case, his wife, Heather.

My wife is a cancer survivor.  Seven years ago, she was diagnosed with a rare lung cancer called mesothelioma.  Ever since then, she has devoted much of her time to sharing her story with others currently fighting cancer.  I realized that my story as a caregiver could also be very beneficial to those caring for those cancer fighters. The journey can feel very lonely, so I hope that others can be comforted by reading my story.