Playing the Cards We Are Dealt: Reflections of a Granddaughter

By Meghan Mirsch

Saying our last goodbyes to those deepest in our hearts is a day nobody hopes for. And, too often, we don’t take the opportunity to say a proper goodbye before it is too late. As Randy Pausch stated in his memoir The Last Lecture, “Time is all you have, and you may find one day that you have less than you think.”

When acting as a caregiver for a loved one or family member, especially under hospice, time seems to tick away faster than ever before. Plans once made become lost, the questions we never dared to ask remain unanswered, and we struggle to make every moment count at a time when there are so few moments left. But during these times, one thing we often overlook is opportunity—opportunity to create one last memory, opportunity to answer the questions we always had, and opportunity to say those last words to our loved ones we may never have had the chance to say before.

But… won’t hospice kill Dad?

by Terre Mirsch

“I’m not ready for hospice yet. My neighbor had hospice and she died a day later.”

“The doctor suggested hospice care for my wife but someone told me that they would just pump her full of medications until she dies.”

“Medications, like morphine, hasten the dying process. I’m not going to let Hospice give any pain medications to my Mom.”

“We really need some help caring for Dad, but won’t hospice kill him?”

Sadly, I hear these, and similar, statements often. In fact, one of the greatest barriers to hospice care is the commonly held misconception that hospice hastens the dying process. Some even believe that hospice administers medications with the intent to cause death. This practice is called euthanasia, and is illegal in the United States. It is also in direct conflict with hospice philosophy, which is to help people live each day as fully and comfortably as possible.

Bathing in the last days of life

by Valerie Hartman

I have been a nurse’s aide and a hospice nurse since the grass roots movement of hospice philosophy took hold in America.  Those years taught me a lot about providing personal care and bathing with sensitivity. A bath can, and should, be more than a daily head-to-toe routine. It can provide a presence that brings dignity and respect during a time of vulnerability. Adapting the bath creates a gentle nurturing experience for both you and your loved one, especially during the last days of life.

The art of simple caregiving: Hand massage, hand holding, and meaningful presence

by Valerie Hartman

“Simple, careful touch of the human hand is one of the most ancient and effective means for relieving discomfort in the body.”

                                                                                                      Dawn Nelson, Massage Therapist, 2002

In February we talked about the benefits of complementary therapy in hospice care. While complementary therapies are usually provided by skilled or certified therapists, many techniques can be adapted and used in daily caregiving. Holding or massaging hands, is one natural way to develop meaningful connections and demonstrate care for the ones we love.

At a loss for words…practicing ‘Quiet Presence’ in hospice care

By Valerie Hartman

There have been moments in this work when I cannot find the words to console someone at life’s end.  Times occur when loved ones struggle to find the right words, and the beloved who is dying will also struggle to express the experience of their own dying.

I remember when my mother was sick, living everyday with serious illness. Our family surrounded her, each one of us playing a part in helping her through that difficult experience. We tried to do it in ways that were as natural as possible, focusing on our relationships rather than our new roles as family caregivers. There were emotional moments that overwhelmed her, she would cry in ways that I had never heard her cry before. I instinctively knew I could not understand her depth of sadness while at the same time, I knew what her sobs meant.

When dying is not easy…

By Terre Mirsch

Sometimes it is just not easy. In fact, dying can be incredibly hard–and for some the road is harder than others.

Sometimes, one may be emotionally and spiritually ready to die, but the body is not—and the process of shutting down lingers in a way that is incomprehensible to those who watch and wait. Such was the case for my father, and for many that I have cared for. Occasionally, the journey is hard because illness creates devastating symptoms and complications that cannot be prevented despite the best medical or hospice care. Thankfully, this is rare and most of the time hospice and palliative care professionals are able to quickly bring these symptoms under control.

Listening to hidden messages: nearing death awareness

By Terre Mirsch

I worked with a hospice patient named Annie who, like far too many, was taken from us at a young age—eighteen years ago, when she was only 42. Eighteen years ago…why is it that I remember that moment, standing at her bedside, as if it happened just yesterday?

What she said to me was simple, and so her message was easy to miss: “Thank you,” she said as I was leaving that Friday afternoon. Annie was sitting at the side of her bed, awake and alert, weaker, but she did not ‘appear’ to be significantly different than my prior visits.

“No problem, Annie- I’ll see you on Monday. Do you remember how to call our 24-hour number if you need anything?”

“Yes,” she said, “but I really want to thank you for everything you have done for me and my family.”

“You’re welcome,” I said, and off I went after giving a brief update to her young daughters.

In hindsight, I recall wondering why she made it a point to ensure that I heard her thank you.