Archive for Caregiver

We Are All Fractured

X-ray of a patient's pathological fracture . . .

X-ray of a patient’s pathological fracture . . .

Along with the primary diagnosis of cancer, a hospice nurse rapidly and efficiently listed her patient’s other health issues at our team meeting. One of the patient’s concerns was . . . “pathological fracture.”

To which I thought, “Huh? What?”

I first thought of pathological liar, a phrase I’ve read in novels and seen in films. Jim Carrey’s Liar Liar from 1997 humorously came to mind. There he played a lawyer who frequently and thoughtlessly lied. Lying for Carrey’s character was no different than breathing. But did the familiar “pathological liar” have anything to do with “pathological fracture?”

In the realm of words, there’s a common ground because of “pathology,” or the study of diseases. Lying about everything, though funny in a movie, will hurt, and can be diagnosed as an illness. Lying cripples a person and profoundly impacts every relationship. A pathological fracture literally cripples a patient. When cancer and other diseases weaken the body, a costly side effect may include fractured bones. I’ve broken a finger, nose and leg and know how painful a break can be. But some kind of foolishness or unavoidable accident caused my problems. My bad bone history involved bike rides, basketball games and a tumble down a mountain slope. From minor to major inconvenience, they were all part of an “Oops!” However, “Oops” doesn’t seem an appropriate response for a bone fractured because cancer has ravaged an arm or leg. Read More →

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Oops!…Is Part Of Being Human

People say it all the time . . . That’s perfect!

  • How’d the apple pie she made taste? It was perfect!
  • Did you have a good time on the date? Everything went perfectly!
  • Did you like that new restaurant? What a perfect place!

Not long ago, during a hospice team meeting, we reviewed a family’s struggle to care for a dying loved one. Since hospice isn’t present 24/7 in the home, we are on-call to answer questions from the patient’s caregivers . . . their sons, daughters, spouses, parents and friends. This particular family kept calling, early and often. They wanted to be sure medications were properly given. They were concerned when their loved seemed too drowsy or didn’t eat as much as expected. Several family members debated about giving too much or too little of a particular medication. None of their concerns, and none of their debates, created serious problems for the hospice patient; she likely never knew how many calls were made to clarify decisions.

You-are-not-perfectOur hospice doctor listened to the nurses and social worker’s describe the family’s quest for doing everything right. At one point, the doctor said, “Isn’t there some catchphrase about ‘the perfect is not as good as the good’?” Then the doctor grinned. “No, that’s not quite it. Maybe it goes, ‘Good is better than perfect’ . . . no, that’s not it either . . .”

After giving up on recalling the exact words (the good doctor was far from perfect in his memory!), the hospice team continued to chat about how family’s feel when caring for a parent, grandparent, child, spouse or dear friend. Too often caregivers do seek the impossible . . . being perfect.

Later, I searched for the phrase the doctor stumbled over:  The perfect is the enemy of the good. Read More →

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I Feel So Lucky

Once I was a hospice chaplain . . .

In the kitchen, after a visit with a new patient, I said good-bye to the caregiver, the patient’s daughter.

I told her about my visit, mentioned her mother and I had discovered that years before we’d lived in the same town. We’d happily swapped stories about familiar people and places. It seemed a pleasant, about-to-leave chit-chat.

Then she said, “I feel so lucky being able to take care of my mother.”

Based on what the nurse and social worker had already told me, I was confident the daughter knew what her next days and weeks would be like. Her mother would need constant attention and care. There would be long nights, fitful sleep (for daughter and mother) and much, much more. And yet, with all the overwhelming commitment her mother would need, there was that gracious phrase, “I feel so . . .”

Lucky. Which is to say, blessed. Which is to say, fortunate.

Choose whatever truthful word you wish, but her phrase seemed to invite joyous bells ringing and celestial lights casting away shadows. Silly me. There was only the rumble of distant, occasional traffic. And the kitchen’s light—from an overhead fixture to the sunshine filtering through windows—remained the same before and after her statement. Or did it?

Of the many insights hospice has given me, some of the most significant are recognizing the parallels between birth and death, between growing-up and dying. A hospice patient becomes extraordinarily dependent upon his or her caregiver. The parent and child relationship flip-flops as the child tends to the parent’s needs.

My times with patients and their families remind me of my parents and my growing up. Those remembered moments are precious . . .

My mother kneeling beside me while I planted bulbs for a Cub Scout project, her hands flecked with dirt, working near mine. My father tossing a ball in the air and, with a controlled swing of the bat, smacking a hit toward me so I could run it down. Standing in their midnight dark bedroom, blubbering about a scary dream or monsters under the bed and hearing words of comfort from them. As I was lovingly escorted back to my room, I don’t recall worrying about how I ruined their sleep.

Mom and Dad changed my endless diapers, cleaned-up my vomit, clapped loudest at my school plays and displayed my elementary-aged artwork on their walls long after I’d left home. I was lucky, blessed, fortunate. I know some children have parents that weren’t there, or never cared. For some, memories are awful or absent.

Part of hospice’s fragile gift to everyone—from patient through caregiver to medical staff—is that the time of living with dying invites all into a vivid present. Regardless of what your childhood was like, what will you do now? What decisions will you make to create life or death? In Deuteronomy 30:19, God declared, “I call heaven and earth to witness against you today that I have set before you life and death, blessings and curses. Choose life so that you and your descendants may live.”

Choose life.

Lucky. Blessed. Fortunate. Now that I think back, bells did ring in that caregiver’s kitchen. New light shined. It’s like that when true love is glimpsed, when now is where we live.

(Like all medical fields, hospice vigorously protects a patient’s privacy. I’ll take care with what I share. Names will be changed and events combined and/or summarized.)

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