Archive for Questions – Page 2

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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How Long Have You Been Playing?

At the net

A man and a woman were several courts over… [Photo Credit: Getty IMages/Tim Clayton]

In hospice, time rules.

A hospital’s old-fashioned wall clock’s blood-red second hand seems to circle faster than a Daytona racecar. Or in the dark of the darkest night at home, a blue, glowing digital number blinks from one second to another with an agonizing sluggishness. Time roars by. Time grinds to a halt. Time marches on. Time freezes. Time is our friend. Time is our adversary. Time never stops. It’s never the right time.

  • How long will it take for her to die? I don’t want Grammy to suffer anymore.
  • The doctor said Daddy has six months or less to live. Is that true?
  • This grief is horrible, and I can’t sleep or eat. How long before I’m “normal” again?
  • Some friends don’t like to spend time with me because I still want to talk about my spouse. And it’s only been a year since the death.
  • My boss gave me two weeks off for bereavement, but will I ever be ready to return to my desk?
  • Who can grieve with so much work to do? (And if I keep working all of the time, I can avoid my feelings.)

*          *          *

Many years ago, I headed to the public tennis courts to play a few sets with a buddy. Though early in the morning, we weren’t the only ones there. A man and woman were several courts over, already deep into a match. As my friend and I warmed up, we heard the other players announce the score after each winning shot, saw them protect the net or drift back for lobs. It looked like an equal contest and I wouldn’t want to bet against the woman or the man. I was impressed, more than a little awed by their skill and energy. Both were obviously in their seventies. Read More →

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