Archive for Speaking Truth

The Best Time to Consider Hospice is ______

When is the right time to ask about hospice?

Isn’t that the hardest of questions? For a potential hospice patient, the “right” or “best” time answer seems like a grim brew of unsettling and unfair choices.

Some would prefer their doctors provide the answer. Though there are exceptions, most doctors have spent scant time in training about “end of life” concerns. The lengthy education for a medical degree doesn’t leave much room in the schedule for learning about the dying and death of patients. Doctors, regardless of her or his specialty, are oriented toward healings, hopes, cures, and the next best option to try. It’s nearly impossible for physicians to view hospice as anything other than “giving up.” Who wants a doctor that will “give up” on you?

There are patients that secretly—or not so secretly—want a family member to make decisions about hospice. Do you truly want the people who blindly love you, who want you to “live forever,” and who frequently don’t understand the medical situation (with its strange terminology and complex treatments) to make your decisions? It’s nearly impossible for many family and friends to view hospice as anything other than a personal version of the “end of the world.” In presidential politics, we laugh about (and are deadly serious about) which candidate we want in the Oval Office in the awful event of nuclear war. Who, in any family, wants to trigger the “apocalypse” for a loved one?

But I will give you an answer. Read More →

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In Hospice: Should You Titrate?

What does titrate mean?

What does titrate mean?

Until working in hospice, and hanging around nurses and doctors, I’d never knowingly heard or used titrate in a sentence.

With no medical or chemistry background, I have darn good excuses for my ignorance.

In a patient care meeting, when a nurse asked a doctor about titrating the new medication for a patient, I’d keep a straight face. I’d maybe give a brief neutral nod, and then hoped there wouldn’t be a snap quiz after the coffee break.

Fortunately, while ignorant of many things, I’m equally curious about nearly everything! I own bunches of dictionaries and thesauruses! I can search the web! I can ask a nurse!

I eventually asked a nurse. Talking to a nice person is far better than aiming the dusty magnifying glass at a page in my Compact Edition of the Oxford English Dictionary. The definitions are printed in fonts so tiny an eagle would struggle to read a sentence.

So a friendly RN told me that many drugs should be titrated whenever introduced or discontinued as part of a patient’s care. In other words, she explained with a kind smile, there should be a gradual increase or decrease in the dosage over a period of time.

Why? Read More →

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8 Helpful Things To Say To Grieving People

From #7: Take a walk together. Sharing silence can be comforting...

From #7: Take a walk together. Sharing silence can be comforting…

In a prior post I identified comments and questions not to say to those who are grieving.

But what might be helpful things to say or do? Below are eight suggestions.

With these eight, I’m reminded of a theme in the grief support groups I’ve led: everyone’s grieving is different. None of my proposed “good” words or actions represents a magic formula. Don’t (oops, a “don’t!”) literally or figuratively copy and paste this list to any situation. Adapt it to who you are. Adapt it for the grieving person you seek to support.

(And as with the “bad” list, these sentences aren’t ranked from best to worst, or vice-versa.)

#1  I can’t imagine how you feel. Your friend/family member is flooded with powerful emotions, memories, and reactions unique to them. Often they don’t know how they feel, or why a few good hours or days in a row collapsed back into misery. But be ready to respond if your compassionate recognition of their distinctive grief leads them to ask how you coped with personal loss. If you’re able, carefully share your experiences. But honor the huge difference between telling someone what you think they should feel/do versus describing how you handled your difficult time. Read More →

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