Because The Hearing Is Last To Go

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One thing I try to remind families before they go in to say final goodbyes to a loved one, is that he/she can hear you even if they don’t respond. Speak from your heart, speak in love, let them know it is okay to let go.

I always allow for privacy and will exit the room for however long goodbye will take. I am very aware that I am already neck deep in these most intimate affairs, and I know my place.

I enjoy every aspect of my job from the physical caring, to the emotional connections, to the paperwork and organizational aspects. The one thing I haven’t touched on is the spiritual and eternal responsibility that isn’t outlined in any contract I have signed . The one you didn’t hire me for, but the one your dying family member will get. It might be considered controversial and inappropriate, unprofessional and just plain wrong to many, but, I will admit that I always get a moment alone with my patients, towards the end and I tell them a few things.
First I say what an honor and privilege it has been to have been a part of this process. I may refer to some special memories we shared together and what it meant to me. And I always end with the message that they need to hear last, or as close to last as circumstances allow. The message never changes from one patient to the next, because it`s one of those truths that stands the test of cancer and car wrecks, Alzheimer’s and ALS, Sarcoma and heart disease. Everything. Even death. Mine. Yours. All of ours.

I tell them ,” I want you to know that Jesus loves you. He loves us so much that He died on the cross and took all of our sin so that we could stand worthy before God. He wants a relationship with you so that when you meet Him tonight you can know you will be with Him forever. He wants you to know that even if you had been the only person in the world He would have died for just you. If you haven’t asked Jesus in to your heart and want to, it isn’t too late. Ask Jesus to come now. Ask for forgiveness for sin and invite Him into your heart. Believe that He died for you and that the only way to Eternal Life has been paved through Jesus sacrifice and defeat of death. If you will do that now and pray with me, Jesus is waiting to take you home.”

And I pray with them. For them. It is so wonderful to get the chance to say final goodbyes to a loved one. It is quite another, to have that confidence that you will see them again. I have no possible way of knowing what takes place between a person I pray with and his maker. I don’t know if they quietly reject or curse God in those last moments. I don’t know if they say ” Come Lord Jesus”.

I can say without a doubt in my mind that in one of those moments, I felt the presence of God so definitely that it filled the room and shook me to my very being. It was undeniable and so palpable, trying to describe it…impossible.

I may work very hard and tirelessly, no doubt, to do justice to those I serve, to be a comfort and a source of relief to the families that let me in to there lives. But, truly, the last thing I want to be heard when the world gets dim and still is the hope and promise and peace that comes from knowing Jesus Christ.

If I don’t let that be known, then I haven’t done my real job or fulfilled my greatest calling.

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Holding the Hand You`re Dealt

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I never paid much attention to my hands until I was holding my moms in those last few days before she passed away.

She was 48 years young, and in the prime of her career and life when she started to feel tired and noticed a small lump above her collar bone. I don’t know for sure how long she had felt unwell before she started going to the doctor. My mother was a private person, career driven,fiercely competitive, and very much in control of her life (and anyone else’s life if she had her say). Or so she thought.
After a series of appointments with the family physician, that left more concerned questions than answers, she eventually got another few opinions, and a diagnosis. Synovial Sarcoma. Soft tissue cancer. Rare and unforgiving. Surgeries,chemo,radiation,pills, faith and a thousand prayers, gave time and took it away for a two year period, until they could give no more. Cancer and Jesus took my mother early in the morning, January 28, 2008.
And I had held her hands in mine and kissed them, held them to my cheek, lacing her fingers in mine. We had both been nail biters. Short, stubby fingers. Hands just like her father,who often looked at his daughter, perhaps remembering the day he first held her in his arms, and now he finds himself asking God to just take her.

I kissed my mom just moments after she took her last breath, and though her appearance was lifeless, skin transformed from clammy and jaundiced to marble, just one final blow to our memory of our brown eyed girl. But her hands were unchanged. They are the only part of her physical being that I remember as they always had been in sickness and in health and even till death.

Maybe God was letting me have this one thing. One part of my mom that cancer hadn’t taken from me. We never saw eye to eye, my mother and me. We were both strong willed and ready with the last word. I wanted things from her she couldn’t give to me. But we had our hands.
My hands are the last thing I have to offer my patients. When the drugs don’t work and words fail, I have my hands. Hands to cool a fever with a cloth. Hands to offer a drink. Hands to wipe your child’s tears. Your tears. And when I am alone, my tears. My hands have made a thousand phone calls to cousins and aunts and uncles to brothers and sisters, mothers and daughters, to tell them the time is drawing near, please come soon.
I do really well in those moments. Death suites me, I guess. I have no idea how, when God weaves his creations, he decides to sew into the sinews of some, the guts or love or morbidity or grace, to be on the death watch and the ability to do it right. And to breath in to them, no greater purpose than in those moments that leave one person breathless and the onlookers, heartbroken.
Somehow He chose me to be that, and in it, I have found my purpose.

I did, for a brief time, question whether or not I could ever do hospice work again, after pronouncing my own mother dead, in our family home, in our living room, with my sisters and dad, my mothers only brother and hardest of all, my mothers parents. Everyone looking on for confirmation of what we already knew. My fingers, grasping the stethoscope she bought me for the graduation she wouldn’t live to see. My ears listening for a source of life that did not come.

But as much as it wounded me it compelled me to keep going.

To think I cannot fulfill my purpose without another losing ground and life, is just one of those circle of life, creation, something- bigger- than- me, kinda things, that perplex me and amaze me and keep me focused. And grateful for the hands that my life, and yours sits in.

Things That Make You Go Hmmmmm

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I noticed a memo that was left on the table for one of my residents last night. It stated that the AFC was going to host an event for the community at 5 pm the following evening( to market the facility and hopefully get more residents), and therefore, all residents were going to be served a sack lunch in there rooms.

When I got to work tonight, the kitchen staff was busy cleaning up from the event. I noticed all the tables had beautifully pressed, crisp, white linens on them and carefully selected flower arrangements in the centers. Every patron that came to this open house was given a company logo bag, filled with wine and treats. The staff were told to have all residents in there room by 4 sharp and all the doors had to be closed at all times.

There is so much wrong with this scene. Number one, this is the residents home, and yet you make them eat supper , in a sack, alone while strangers roam about? Number two. If I was a person shopping around for a place for mom, wouldn’t I wonder where all the folks were? Who were these people that my mom might live with, how are they cared for, are they cleaned up nicely? Do they look content?

I didn’t have to even ask how the residents felt about this arrangement, either. I was bombarded almost immediately by questions and concerns. “Who was coming here, so important, that I had to eat a sandwich and drink Gatorade for supper?” ”

Gatorade?  My wife and I didn’t get ANYTHING to drink with our food!”

The staff had a conversation about how we felt about  what had taken place and how the residents were affected by it all. We all echoed the same thoughts. First of all, our residents don’t get white linens, so why should anyone else that comes here get better service than the ones that PAY to live here? Two. What message are we sending our elderly? That “the best way to market a caring and compassionate community for seniors is to lock them away with a sack lunch while we wander the halls and spew fantasies about how compassionate we all are.” Give me a break!

I wish I had been working when all those residents were hidden away while this fiasco was happening. I imagine my resolution  being similar to that scene in Lady and the Tramp, when all the animals from the pound got let loose and ran all over, accept these caged beings are PEOPLE!

It is in moments like these that I just want to pull my hair out or burst into someone’s office and say,” What were you thinking?”

I am certain that if I shared the residents perspective, that they would agree. Right? I mean, they weren’t even consulted. It was just told to them and that was that. How can you be in the business of elderly people and not even consider the basics, like feelings, perspective, respect, empathy? Maybe it just doesn’t occur to them. I don’t know and truthfully, what’s done is done. But I will be leaving a note for the manager of this house in the morning. I will be respectful and to the point. Something along these lines,

” Dear Manager,

I understand that you hosted an event last evening to market this facility. I do hope you had a great turn out, as I was able to see that you had worked very hard to make these prospects feel at home. However, I thought I should bring to your attention that the current residents were very disappointed that they were not consulted or included in this event and have very strong opinions about how similar events will be coordinated in the future. I know that a month ago,  Mr.G requested a suggestion box for the residents to drop off there ideas, but I couldn’t help but notice that we still don’t have one. I am sure that this was just an oversight, but I wanted to bring it to your attention so that it can be made available to all the residents, for instances such as your event and how they feel in regards to it, as well as other things that may arise over time. Thank you for a prompt response. ”

 

 

                                                                                                                                                                                                                                                                                                                                 RML

 

 

 

you had to be there

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Folded into the mix of elder care, are the quotable quotes, bizarre accusations, laugh out loud phrases that punctuate even the most exhausting days or totally uneventful days.
Here are a few highlights.

I awake Miss. K, 83 years young, for her scheduled bath but she slept just awful and” a simple whores bath will do, do you know what that is Hon? Just my pits, tits and pussy. ”

Miss. J is 94 and never spoke to anyone. Not a peep. Even her own son, whose home she lived in for six years never got more than a nod of yes or no. You can imagine my surprise the day I wasn’t in her view and she yelled in a PERFECT Gilbert Goddfried tone, ”I GOTTA CRAP!”. She never spoke another phrase again.

Miss. L R was a 400 lb, 86 year old, bed ridden, control freak that treated her husband terribly and belittled me as often as she could. I often questioned my motives for staying on her case until one day, Miss L R informed me that I was no longer allowed to be alone in the same room with her husband because we had been having sex behind the pantry door! She would have none of it. She accused me of this numerous times and one day, while she was asleep, her husband approached me and asked,
with a straight face, ”Hey, Kiddo, I’ve been meaning to ask you, am I any good?”

\kəm-ˈpa-shən\

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Over time I have observed an increase in a culture of convenience as it relates to elder care employees. This culture rears its ugly head in various ways in care facilities. My most recent experience was just the other day, when I was asked to take the day shift. We have pagers and the residents have pendants that they press if they need assistance. One gentleman on our rounds, 91 years old, has an arm in a sling, one leg that doesn’t move, and is bound by a wheelchair. He keeps the staff hopping all day by alerting our pagers. He only needs one thing. To go to the bathroom. Simple enough.
However, most of the staff find his perpetual bodily functions to be most annoying, inconvenient and purposely intended to aggravate THEM.
So they silence the pager and say, ” Oh, it’s just Shelby, he can wait!” And wait he does. Not because of another emergency but because they have grown tired of being inconvenienced. Because they have the power to ignore.

Another time, same day, same needy man, Shelby was tended to in a timely manner, and once he was toileted and helped to his easy chair, he felt the urge to go again. With exasperation, he was put back on the toilet and left there.

Awhile later my pager went off and it was him. I was across the way from my coworker and she yelled out, ” um, you can go deal with him, I already dealt with him once and he made me angry so I am not going back to help him. I need to calm down!”

Calm down, you say?

This man is completely helpless, would love nothing more than to help himself, especially because you treat him like a burden, roll your eyes and shame him when he needs you the most.

Management had gotten so many complaints from disgruntled staff that they put this poor man on a schedule. Every two hours he was allowed to go to the bathroom. The intention was to train his bladder and bowels to wait. His nearly century old bladder and bowels.
If he paged before the two hour schedule, they would go into his room and as he leaned forward to prepare for transfer, he was told he would have to hold it! Compassion.

Mr. Crowe is 87 and is supposed to walk three times a day with assistance so that he may gain the strength to eventually leave our facility and move back to his home. This annoys some staff members to no end. When he speaks up about not getting his walks they snap at him. One employee actually said, ” if he is gonna behave like that he should just die”.
Compassion.

Incidents like the ones I have just described, happen all too often.

Why are you here, I want to scream! How can you be so cruel to the most helpless individuals?

The best part of my week is the three, 12.5 hour shifts I am able to do damage control. To love and serve. To be inconvenienced and paged till dawn. To get feces smeared on my scrubs, to look for lost eye glasses, to dispense morphine or sleeping pills. To be called upon. Sometimes for no reason at all. To chase away the strange man in the closet and to tell the marching band that keeps Miss. B up all night, damn it, to simmer down. Damn marching bands anyway!

The worst part of my work week, are all the hour I cannot make it better and know that the staff that can, aren’t scheduled.

It’s a continuous battle many of us fight in nursing homes the world over. It’s why we keep showing up, and if you have a family in a place like where I work, you need to be vigilant and listen and observe. Show up unannounced and be persistent. Be a voice for those who can’t speak for themselves. We will all be old someday.

Willing, Able, Totally Unprepared

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When I got my first over night , private duty job I was so ready to go and care! I imagined this female client would be so sweet and open. We would have long and meaningful chats, sip coffee and bond.
She would tell me all about her family and I would share about mine. It was going to be so great for me.

One of the first things she ever said to me was that I could stand to lose about 50 pounds. I quipped that it was probably closer to 75 in an attempt to let her think she had met her match, but inside I was broken. After all, I had come to rescue her and be her friend and she was going to embrace this part of her journey and …

And very stoically and angrily she explained that after having cared for her husband for 15 years, who suffered with Huntingtons Disease, he had died and she had just retired from 30 years of services at GM. She had been at her cottage and become short of breath. After brushing it off for a week, she had gone to the doctor, and following a long battery of tests, had recently been diagnosed with Mesothelioma. End stage lung cancer. Three months to live.

And she was pissed.

She went on to explain how unfair her life was and how cruel her circumstances. She wanted to know exactly what I thought I was going to do for her! She didn’t need ANYTHING right now and if she did she could damn well do it herself.

Bubble, burst. Mind, blow. Spirit, broken.
What in the hell was I thinking coming here?

I went to my guest room that was directly across from hers. I lay silently and motionless.

This routine continued for a few weeks. She let me do very little and when I could make contact, it was brief and awkward. I would sit in my bed listening to the hum of her oxygen machine and the gravel like sound of her breathing, that worsened over time.

One day I got a call that I didn’t need to report to her house anymore. She had decided to go to a hospice house. Six weeks later I learned that she had gone into a coma and never come out. She had died just as angry as she had been the day I met her. She died alone.

I have had many years to reflect on that first client. How foolish I was back then to think I could sweep in to a total strangers life make her my friend without earning her trust. She had terrified me with her insults and bitterness and I had been paralyzed.

I failed the test. I had missed the point. Lost my purpose. It had never been about me or how her place of self loathing and emotional injury had made me feel. And yet , all those days, those opportunities, to sit by her side and simply reach out my hand, were spent in absolute isolation and despair.

It haunts me to this very day to consider what she must have been thinking back then. A stranger in her home. Her utter fear of impending death. I wonder if she cried alone while I cowered. Did she pray at night? Did she know deep down that I really wanted to help her, but had not the slightest experience to guide me?

I carry her memory with me. It is those painful memories that compelled me to learn all I could about a person before I entered there world. I became a student of the human experience, of family dynamics, of expectations and mostly of purpose. Not mine, but the ailing and dying, the families they are letting go, and the finality of it all. It is a gritty and raw profession some days but it is the greatest and most humbling place that God lets me stand in and my patients have without a doubt, given to me so much more than I could ever offer up.

Stop, Drop, and Roll With It

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I have been moved to Williamston, Mi. with my family for a couple weeks now. I am managing a six bed assisted living facility and am loving it. It has been a difficult adjustment for the kids, since we live at the place I work. Summer is a difficult time for kids to meet new friends, but they are keeping busy.

I have a lot on my plate right now. I am learning all about my residents, their schedules, meds, routines, etc. I am also learning about the staff here, and trying very hard to balance easing into the changes that will be taking place without making enemies, and the task of making a few immediate changes, without rocking the boat. I realize that you can’t make all the people happy all the time, but it is of the utmost importance to create a team atmosphere, while putting in to place necessary changes that will provide a continued happy and healthy environment for both my residents and the staff as a whole.

The owner of the home has been very helpful in guiding me through the tricky parts of managing and” bringing along”. I have so many ideas and directions that I would like to go with this group of people, and I am so ready to go, but I have found myself thinking,”Stop, drop, and roll with it”

STOP! with any  preconceived notions that I may have had about how smooth or bumpy this process would be.

DROP!on my knees a lot and thank God for this opportunity and face each new day with the assurance that God is in control at all times, and He will be with me in this.

ROLL WITH IT! Just because I may be meeting considerable resistance from some right NOW, doesn’t mean that won’t ease with time, LATER ON. I may not get it right on the first or second or third try, but I will keep trying and praying and seeking guidance, and believing in my abilities, because I wouldn’t be here if others didn’t believe in me also!

I truly enjoy the busyness of my days and nights. I welcome the challenges and have no doubt this is EXACTLY what I am supposed to be doing.  I want more than anything to have a positive impact on the people in this place and I look forward to each new day.

 

allthedrugsmymomison

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I'll take two of those, in Pink, please

This will be the last today.  I promise.  Something about carrying laundry up the stairs reminded me…

My mom is taking The Chemo Pill.  I have to tell you that I don’t actually understand the whole of The Pill.  And, its not one pill, ducks.  It is minion.

The side effects should be lesser.  And, that is terrific, for sure.  She seems to be doing well on it, though it has only been this week.  We will see.  By “we” I mean “she”.

They gave her methodone for pain.  They being her oncologist.  When she told me this, I asked her if she had a heroin problem that we weren’t aware of.  I told her if I found her tapping her arm for a good vein, she’s in big trouble.  She found this mildly humorous.

Through this all, we kids have made numerous references to drugs.  Especially Rachael and I. …

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I Came In Like A Wrecking Ball

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So much is right and good and beautiful about the people I work with and for. I get that. I appreciate it. It hasn’t been missed by me. But, man, I am really struggling tonight. I do rant about the social injustices that the elderly have to endure and I may focus too much on the negatives, but please remember, if you are reading this blog, that I vent here as well as tell the stories of these often voiceless individuals.

I think the one thing that bothers me more than things not being done well, is stupidity. I hate stupid people. I hated the first couple hours of this shift. I could here my coworker talking on her phone from across the building. She is outside some residents rooms, carrying on about an abuse case with her ex and court dates and stalking and blah blah blah. Before you count me as insensitive, understand that she was passing medications while talking on her cell phone about all her personal family drama. Not to mention that she had dispensed all of the residents medications into individual cups, WITH the names of each person, and LEFT the pills, ON TOP of the med cart, and then WALKED AWAY. For those of you who don’t understand what is wrong with this picture, let me break it down for ya.

No personal calls in front of residents. Its against company policy and also perilously unprofessional and inappropriate.

Leaving medication in a cup with the persons name on it is a violation of HIPPA laws…Google it.

Leaving pills, NEVER, period. These folks wander about and take things all the time. It is dangerous and neglectful and also there is the possibility a resident could ingest a medication that makes them very sick or kills them.

I told the employee that she should put the medications in the cart before a resident made off with them and she ignored me. That pissed me off, because apparently she would rather break the rules to spite me then follow them. And no, I am not the boss or shift supervisor. But I do have a sense of duty and responsibility to the people I serve. I have BEEN the boss, and I will be the first to admit that I had a lot to learn about leadership in those early days.

I have a very….robust personality. And I know a lot about what I know. It took me a long time and a few professional blows to my ego to teach me how to be a leader and not a force to be reckoned with. It wasn’t that I thought I knew it all, because , who does?  It was that I actually thought that my employees knew everything I did. And when they messed up on even the slightest thing, I could not understand HOW they could mess up on the slightest thing! And instead of leading from the front, I showed little mercy and infuriated the people that I should have been bringing along. This does not make for a great team player atmosphere. I know that now. I did not understand it then. Passion can be blinding and what begins as eagerness and drive can end in absolute failure.

Failure because you can’t do what you love, because you bring down the house. Failure because you build trust with vulnerable people, and then are forced to leave them without notice or explanation. Failure because your boss sees your potential and determination, but you have bowled over her ability to validate you to corporate.

I have been that person. I am not that person now. It was a journey I had to go through, to get perspective and to be useful. If we are powerful but not useful, what good are we? And if we are useful but use the power we have to boost our ambition, we fail.

I have an opportunity coming that I desire very much. I feel that everything I have learned up to this point, has prepared me for it. This opportunity is actually the dream I have had for a long, long time. It is the repeated prayer that’s answer  whispers,’ wait’, year after year. And now, as the time is drawing closer, I feel that the time has finally come and my prayers are being answered.

I am ready.

 

 

Know A Guarantee And Bet On Her. A Letter To My Patients and Families

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I am the real deal. I truly love my job as a hospice and health worker. I am not wandering through the hallways of this facility with blinders on. I don’t day dream about what I would like to be when I grow up. I don’t work the night shift because it’s the only available shift or for the premiums that go along with it. I don’t say I care and then do the opposite, I don’t slack off or fall asleep on the job. I don’t give your mom the wrong medications because I wasn’t paying attention, or forget to reposition your dad every two hours. I don’t leave the building or abandon my colleagues to do my share of the work. I answer you when you page for me and when I say I will be right back, I promise I will. If you call me to work an extra shift, chances are I’ll take it. I never show up late. I would never treat your grandparent like I would want to be treated, because I have learned that we all want different things. If I make a mistake, I promise that I will own up to it.

I have had the privilege to work with and learn from some wonderfully amazing people. And I have worked with some real phonies. I have watched them complain about other staff after they just got written up for some really terrible offense. I have seen people that accept a hug from your aunt and then snicker about how crazy and annoying she is.

I guarantee you that if an employee verbally or physically hurts your loved one, I will end it. I am not at all concerned about saving face or my job. I hate bullies. It unnerves my sensibilities to witness unloving, unfriendly, uncaring, unprofessional  scum, walk the halls of your family members home, and disrespect or belittle them.

If you stick around long enough, I will learn all about your family and what you did for a living. I want to know what makes you tick. I am curious about everything YOU, and if you don’t mind, I would love to listen to the same story over and over. Please call me if you are lonely or afraid, or bored or too hot or too cold or want a midnight snack. Please know that if you spill your coffee or don’t make it to the bathroom in time, that you never have to say “I am sorry”.

You are a person to me. Not the number on your door. You are NOT a problem to be fixed, but an opportunity I cherish. You are not the means of which I make my living, but rather, much of what I live for. I enjoy coming to see you at 7 pm till 7am. I am sure you would rather be at your own house, and have privacy, to have certainty about who your neighbors are, to make your own meals and care for yourself. I can’t make all that is wrong, right. But you do have a guarantee, someone you can bet on. You have me. I hope that means something to you. Every one of you are a part of my Legacy. You have helped me find my purpose and I am grateful to have met you on this journey.