Archive for Questions

Let Me (Not) Give You Some Advice

Advice

Giving advice starts early!

I resist giving advice.

I relish giving advice.

Both statements are true.

Obviously, I spend considerable time with advice-giving by posting regular essays about hospice. I want those considering hospice (for themselves or others) to have resources during this crucial time. I want to offer suggestions—through questions, concerns, insights—for families currently served by hospice. Whether wondering about odd medical terms or nudging people to be honest about dying and death, I hope my views (advice!) help a few readers.

But advice is inherently tricky. What works for me may not work for you. At times I’ve asked friends if they’d like my advice about a situation they are facing. If they nod assent, I respond with, “Don’t trust anyone else’s advice but yours.” We laugh. We roll our eyes. It’s a joke! However, it also rings true. Follow your heart. Take the time to listen to your inner voice. If you are a person of faith, pray . . . and then be open to the ways the Holy provides guidance. Carefully seek input from trusted family members, friends, and professionals. Cautiously use the Internet with its smorgasbord of bad/good, weird/wonderful, fickle/fact-filled viewpoints. (Which includes my website on advice about hospice!) Read More →

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4 (Not So) Simple Questions

Is the patient alert and oriented?

That was the first official “hospice type” question I learned when I was a hospice chaplain way back in the late 90s. (Yup, last century!)

Are they alert and oriented times 1, times 2, times 3, or times 4?

Ah, it gets more complicated! Here, as I understand it, are the key questions for determining if a patient is alert and oriented:

  1. Who are you?
  2. Where are you?
  3. What time is it?
  4. What just happened?

These are very basic, universal, and essential health care questions—and not just meaningless jargon—to aid in discerning the current mental status of a patient. Ideally, we all “know” these four answers. I am Larry. I am in Fresno, California. It is about 5:00 in the morning (or it’s an early Tuesday morning if you’d prefer me to be general about when I wrote some of these words). And, finally, not all that much is happening in my (see #1) home (see #2) at this pre-dawn hour (see #3), other than I just heard our kitty Milo slink down the hallway, probably headed toward the back of the house to bother my slumbering wife.

In hospice, #4 is often less a concern. Many hospice patients won’t necessarily know what “just happened” because of medication or temporary disorientation from the recent and unsettling changes in their lives. Even in so-called normal circumstances, we are hard-pressed to recall what has happened earlier today or earlier in the week. What did you have for breakfast this morning? What about your lunch selections three days ago? Details can blur for everyone. Read More →

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The Evil Twins that Stalk Hospice

Shining Twins

The twins from 1980’s The Shining

Like evil twins in a horror movie, fear and ignorance stalk those in hospice care.

This happened: [Disclaimer]

A hospice nurse described one of her patients—let’s say this was a mother of several adult children and also a wife of four plus decades—who lay dying in a rented hospital bed in the living room. Most of the family had gathered at the home. Most talked with their loved one or did chores like cleaning the bathroom or preparing meals. But one family member—let’s say it was the oldest daughter—arrived, but never entered the living room. Never offered to help. This daughter surveyed the activity around the metal-framed bed from the entryway, and then hurried down a hallway, away from her family, away from her mother.

Was she afraid of death? Read More →

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