Archive for Dying

A Hospice Chaplain is Quantifiably Wrong

(*Photo by John Rothwell.)

“The nurses do things that can be quantified,” one of our hospice chaplains announced, “which is not like what us chaplains or the social workers do.”

With hospice, a patient is supported by a “team” of doctors, nurses, social workers, chaplains, home health aides, and volunteers.

Was the chaplain, a person and a professional I respect, correct?

What is quantified? It’s a word describing precision, numbers, and comparisons.

A nurse may ask a patient what her or his pain is like on a scale of 1-to-10 or (especially if a patient can no longer talk) to choose from a range of emoji faces depicting happy smiles to grim anguish. Nurses increase or decrease the precise dosages of medications based on experience, information, and established guidelines.

The medical staff in hospice—and this is one of the tough parts of patient care—needs to regularly report how a patient is declining. If a hospice patient demonstrates consistent improvement in their physical health, they certainly still have an illness (and can’t stop the aging process), but they may no longer be eligible for the hospice benefit.

  • Is the patient losing weight?
  • Does he require stronger doses of pain medication?
  • Is she eating less, or only liquids, compared to last week or month?

Yes, nurses quantify, with specifics, to discern a patient’s changes. Read More →

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World’s Best Pie and a Perfect Death

At a weekly hospice patient care meeting, the medical director shared about a patient longing for one last overnight trip to the family’s mountain cabin. The drive would take a couple of hours from his home to the place the patient’s grandfather had built before World War II.

“I’d like to sit on the front porch again,” the patient had said. “In the early morning, you can always see deer grazing on their way to the lake.” The patient then added, “And there’s a diner not too far away with the world’s best berry pie. I’d like to share a slice with my Annie for old time’s sake.”

Annie was his wife of five decades.

“Would it be okay if we go?” Read More →

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There’s No Gift Like Cancer?

This is what a hospice nurse said the patient said:

“My cancer is a gift from God.”

What is your first reaction to that? How about something like, You’ve got to be kidding!

Or . . . Does that patient have a terminal and mental illness? Or you’d be speechless and roll your eyes . . . or shake your head and mutter several tsk-tsks . . . or clamp your jaw shut because Mom told you that if you didn’t have anything nice to say, don’t say anything.

Or would you nod your head in reluctant agreement?

Can you imagine that last reaction—nodding and agreeing—to the patient’s pronouncement? I can, though it helped to hear the nurse’s report of the patient’s complete sentence . . . Read More →

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