In Hospice: To Bed or Not To Bed?

hospital beds

The rational reasons for using a hospital bed make a long, persuasive list. But you don’t care . . .

Who would want one?

Does anyone really like ‘em?

They have cranks and levers, wobbly wheels, and are cumbersome to move or adjust. Newer models are often complex, with silent electric motors, links for computer cables, and (though pricey) lightweight metal alloy frames.

But who seeks to be horizontal in a hospital bed of any kind? Not for overnight, and certainly not for the remainder of your life. Whenever the hospice clinical staff discusses current patients, it’s nearly inevitable that at least one patient has recently balked at shifting to a hospital bed. I view the hospital bed as one of the intimidating symbols of hospice care. Of course, it’s more than a symbol once it arrives at your home.

Wouldn’t you refuse?

We like love our bed in our bedroom. It’s a sanctuary. Don’t all the health care experts tout the value of a good night’s sleep? Whether retired, in a part-time job, or with a stressful career (along with raising kids, volunteering, and don’t forget yard and house work), doesn’t everyone desire to sleep every day? Do the personal math: we’re on a mattress more than we eat, work, play, exercise, procrastinate, shovel snow, mow a lawn, or take a vacation. Hey, for some, a little sleep is as close as they’ll get to a vacation for long stretches of time. Work is demanding. Families are demanding. At least let me escape into my cozy bed! Read More →

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Hospice Decisions and Right Now

Decisions

When is the right time to ask about hospice?

Isn’t that the hardest of questions? For a potential hospice patient, the “right” or “best” time answer seems like a grim brew of unsettling, intimidating, and unfair choices.

Some would prefer their doctors provide the answer. Though there are exceptions, most physicians have spent scant time in training about “end of life” concerns. The lengthy education for a medical degree doesn’t leave much room in the schedule for learning about the dying and death of patients. Regardless of her or his specialty, doctors are oriented toward healing, cures, and the next best options to try. It’s nearly impossible for many physicians to view hospice as anything other than a defeat. Who wants a doctor that will “give up” on you?

There are likely patients that secretly—or not so secretly—hope a family member will make decisions about hospice. Do you truly want the people who blindly love you, who want you to “live forever,” and who frequently don’t understand the medical situation (with its strange terminology and complex treatments) to make your decisions? It’s nearly impossible for certain family and friends to view hospice as anything other than a personal version of the “end of the world.” In presidential politics, we laugh (and are deadly serious) about which candidate we want at the Oval Office in the awful event of national or global catastrophe. Who, in any family, wants to trigger the “apocalypse” for a loved one? Read More →

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The Skeleton Dance

Fox and Prince

How are your bones?

As in, all 206 of them. When born, babies have 270 bones. Some soon fuse together. The actual number depends on what you read, and how argumentative you like to be! Me, I wouldn’t want to be tested on the names or number of bones. In a single wrist, there are eight: capitate, hamate, lunate, pisiform, scaphoid, trapezium, trapezoid and triquetrum.

However counted, bones are the solid infrastructure of our bodies.

Once, in a hospice team meeting, as we reviewed a patient’s concerns, a nurse mentioned the ulna.

“What is that?” I asked, ever ignorant.

“It’s a bone in the upper arm,” answered another nurse.

“No,” the hospice physician said, “the lower arm has the ulna and radius. The upper arm bone is the humerus.”

All of us professionals smiled and chuckled. How . . . humorous? Come on now, and sing with me:

The foot bone’s connected to the leg bone.
The leg bone’s connected to the knee bone.
The knee bone’s connected to the neck bone.
Doin’ the skeleton dance.

The thigh bone’s connected to the hip bone.
The hip bone’s connected to the backbone.
The backbone’s connected to the neck bone.
Doin’ the skeleton dance.

The Skeleton Dance, a children’s song and a long 200+ list of Latin names we can barely remember and even a thoughtful nurse will occasionally mistake one for the other. Read More →

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