Archive for Patient’s Wishes

In Hospice, Don’t Be Ruled by the Rules

During a patient care team meeting, the hospice medical director explained that he’d broken one of his rules.

My distant impression of the doctor—physically distant because of where he and I sit in the meetings and professionally distant since he cares for the patients in their dying while I support grieving families after death—is that rules are critical values for the way he lives his life.

However, the soft-spoken physician felt he had to break a rule. Instead of providing key information about the disease process, and the options for comfort care so the patient could make choices about the next steps, the doctor bluntly told a patient that he must be transferred from his residence to our in-patient hospice home. Now! There, the patient would have a better level of care for his needs. Moving was not his choice; it was the doctor’s demand.

The patient died before the next sunrise. He died with the sole member of his local family at bedside. For weeks, his dying had been lonely, problematic, and anguished. In his last hours, dying became peaceful. The doctor had used good judgment. But the doctor had also wrestled over “breaking” a personal, essential rule: whenever possible, let a patient take the lead in making an informed decision. Read More →

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From the Mouths (and Gift Cards) of Children

The nine-year old kid wanted to give a newly born cousin a present by using the gift certificate he’d just received.

But I’m cynical and suspect people (even kids with ages based on single digits) have an agenda—usually a self-serving agenda—when they help others.

The nine-year old kid wanted to give a newly born cousin a present by using the gift certificate he’d just received. The certificate was for $20 and would allow him to buy anything at the local Walmart store.

Yeah, but this likely me-first little kid probably didn’t like stuff at Walmart and was only dumping an unwanted gift on the family of his unsuspecting infant cousin.

The nine-year old kid wanted to give a newly born cousin a present by using the gift certificate he’d just received. The certificate was for $20 and would allow him to buy anything at the local Walmart store. The boy had received the gift card, along with a basket of other goodies, from the Make-A-Wish Foundation.

Any-who, I’ve lived into my sixth decade and have witnessed or read about everything. There’s nothing much—good or bad, joyful or perverse—that surprises me anymore. Read More →

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Christmas Promise

On a long-ago Christmas Eve, I did my last visit to a patient as a hospice chaplain.

I was honoring a promise.

All I did was hold a hand in a dark bedroom while storm clouds trudged across the night sky. In the nearby houses, seasonal lights flickered in the rain, inflatable Santas and snowmen waved their greetings, and outdoor ornaments sparkled as the gusting wind teased them.

In the patient’s room, it was quiet.

In the patient’s room, she now mostly slept.

I’d already started working as a church’s “new minister.” It had been a tough decision to leave hospice—an intimate ministry—for a mid-sized church with hundreds of members, a sprawling budget, and endless obligations. So many decisions are a combination of guesses, selfish and selfless reasons, and trying to do the right thing at the right time of life. I didn’t know then (and I don’t know now all these years later) if it was the best choice . . . but it was my faithful risk to say “yes” to serve a congregation.

Some of those “endless obligations” during the first days of church work were the Christmas Eve services. There I would preach. There I’d read the ancient stories of Jesus’ birth. There I’d seek to connect an old, familiar tale to the daily hurts and hopes of modern folks. There I’d help a congregation light candles and proclaim the “light of the world.” Read More →

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