Archive for Fears

Yes, Some Leave Hospice Care

The Seventh Seal

As with the stark chess game in Ingmar Bergman’s classic The Seventh Seal (1957), death doesn’t lose.

We got rid of a few people in hospice this week.

Oh, and several lovely, beautiful patients also died. More on death in a moment.

I attend several of my hospice’s interdisciplinary groups, which are usually called IDGs. They are weekly patient care meetings, a required review of those under the care of our agency. Since all patients in hospice much be reviewed by the hospice team—led by a physician—every 15 days*, we discuss and update the needs for everyone in the course of a typical month.

Some patients are relatively stable, and can go for weeks and months with minimal input.

There are “focus patients” with issues—family conflicts or finding the right medication dosages or ________ (fill in the blank)—that must be immediately addressed.

There are new admissions to discuss.

Quite a few patients need to be recertified. Is this patient still hospice appropriate? Every few months (there is actually a precise schedule), this question will be asked and answered. Hospice care is for those with an illness giving them six months or less to live. There are always patients that continue in care over six months. However, like everyone, they will be routinely reviewed.

With some, still alive and kicking, we bid adieu. Read More →

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Hospice and (Not Calling) 9-1-1

Helicopter rescue

Not long after, a helicopter plucked me from the wilderness…

What should you do when the awful and unfortunate happens? For example:

  1. Heart attack.
  2. Car accident.
  3. Criminal activity.
  4. Lost child.
  5. House on fire.
  6. An associate pastor leading a youth group backpack in an isolated mountain location tumbles down a snowy slope and breaks several bones.

Hurry! Call 9-1-1!

Yeah, you guessed it, #6 happened to yours truly. I busted my leg on a backpack in the 1980s. Several in my group returned to the trailhead—a six-mile slog—and found a phone. They, of course, called 9-1-1. Not long after, a helicopter plucked me from the wilderness and flew me to a hospital in Lake Tahoe.

If something bad happens, punch in 9-1-1. Except if you’re a hospice caregiver or patient: please don’t use those three life-saving numbers. Read More →

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I Know More than the Hospice Staff

YouTube Expert

When first admitted into hospice care, one of the patients mentioned they looked forward to the chaplain’s visit. In recent years, before and especially during his illness, this person told the admitting nurse about reading (and re-reading) the Bible cover-to-cover.

“There’s nothing the chaplain can say that I don’t already know about the Bible.”

Really?

Did humility, humor, or hubris influence our new patient’s claim? Were the words boastful or spoken to avoid more difficult emotions? What is easily said on the “surface” may hide deeper questions or concerns. Like, Won’t someone please listen to me? or perhaps Let me start with a subject I can control—knowing the Bible—to eventually risk revealing what is out of control . . . my fear of dying.

Many of the people all hospices serve have faith traditions with a unique book. The Hindu reveres the Bhagavad-Gita. Jews claim the Torah. Christians embrace the New Testament. Muslims honor the Koran. Some patients may know little about the sacred text at the center of their religion, while others might possess a scholar’s awareness. A life-threatening disease can cause one person to explore—for the first time, or with renewed energy—the words of her faith, hoping to uncover answers or encouragement. The next person might scorn his religion’s traditions because the illness proves God doesn’t care or never existed.

A hospice chaplain enters into a person’s life, from hours to months. The chaplain has no interest in interpreting, defending, or condemning any scripture. Instead, what is important to the chaplain is what is important to the patient. Even more essential, what are the real hurts and hopes in the shadows behind a patient’s knowledge, ignorance, or doubts about their faith?

What are the deeper questions? Read More →

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