Moments of Forever

Listening closely to the RN’s hushed request, I glanced down at my uniform to see it was clean, crisp and fresh. Like somehow, that would matter. The room appeared darkened, with all curtains drawn. What, behind this door would be the level of intensity, now all too familiar, even for my brief nursing experience? Calmly opening the door, my senses absorbed the scene within.

She sat on the edge of his bed, rocking in slow rhythmic circles to inaudible cadence. Long dried of tears, briefly looking up at me, her silent eyes screamed beneath her tussled hair. Traces of faint daylight squeezed through draped edges of the windows. In two steps I sat a few feet from her on the day bed. Quietly breathing, occasional routines muffled through closed doors, filtered into our space. We sat, we breathed, and waited.

Slowly, accommodation revealed swaddling white lumpy blankets and tiny tufts of blond. Her arms, trembling from hours of resisting, relaxed in renewed strength. Her encircled embrace, sheltering precious dreams, allowed a free left hand for softly stroking silky hair. Her face, partially hidden by her precious bundle, glowed soft in dim light. She never looked away.

Eventually, my imagination strayed, and quickly jumped into doubt and fear. What right did I have to be here? In sacred rituals of ancient people, only those specialized appointed souls were permitted access to such private encounters. Where would there be a wealth of powerful words and offerings worthy of my presence? How could I administer purposeful delegation of tangible value when there was no preparation?  Her shifting of positions awakened me from my dream state. My focus returned with each heartbeat as the gift of humanity began kindly quieting my thoughts.

Together, welcomed only by the passing time, we lived there in this room. What thoughts, memories, hopes, dreams or fantasies had once existed here? Reaching into an abyss of questions, my only answer was to remain present. Despite my racing thoughts, my heart was stilled. My relief at her acceptance of my invasion began to strengthen my ability to act, by doing nothing. It would bring no one comfort now, to announce some benign task requirement. To enlist some formal offering of well intended words, felt grotesque and cruel.  Pretending anything but being numbed by this reality, seemed insensitive and calculating.

Mechanical ticking of a clock on the wall pulsed with phony certainty as time ground monstrously past us. Never once weakening, never once, acknowledging our presence upon its inescapable equality. Eventually, it felt like we became as one. As if beings, in electric form, we maintained a balanced energy between us. My heart ached for her as I lived in her grief. Incomprehensible sadness painted each pixel before me. Life vibrated within me in circulating waves of acceptance. Each moment was becoming more vivid in clarity, as I honored them with my silence.

Suddenly, almost as if on secret cue, we simultaneously sighed. Looking deep into my soul, she smiled. I said, “I bet you have to pee?” My words slid from my vocal cords with a shocking unedited ease. She nodded in quick embarrassed relief while looking down at her child. “Let me hold him for you.” Without hesitation, she gently placed her son in my open arms and walked calmly over and opened the door. Tears dripped freely from my face as the RN who had requested my visit, entered the room and thanked me.

Brush with Mortality

At the end of every year, we see lists of “people we’ve lost” during the year.  These lists are usually comprised of Hollywood celebrities, athletes, music artists, literary giants, etc.  Generally, these are people we don’t know on any personal level other than being an admirer of their creativity, their acting, their prowess on whatever sports field, or their words on printed page.  The product of their lives has touched ours in numerous ways, but their lives never truly intersected with our own.

We look over these lists with wonder and amazement of how our childhood idols, teenaged crushes, or influential beings are leaving us and we notice that it feels alarming to us.  How could they be gone “so soon?”  We feel a sense of loss and tragedy; perhaps not so much for them but for the memories their work helped to create for us.  We recognize a glimmer of our own mortality when our icons die.

In 2017, I felt sadness for the deaths of icons and idols from my life whose work left an impression on me:  Mary Tyler Moore, Adam West, Mike Connors, Richard Hatch, Erin Moran, Tom Petty, Malcolm Young, David Cassidy, Jim Nabors, Monty Hall (who didn’t love Let’s Make a Deal?!), Spencer Johnson (have you read Who Moved My Cheese?), Don Rickles (you hockey puck!), J. Geils, Joni Sledge, Dallas Green (Go Phils!), and Bill Paxton to name just a few.  I didn’t know these people personally, of course.  My connection to them is in my memories of watching their TV shows with my brother and our parents, or seeing them play (or manage) a game in Philadelphia, or reading his book with a great group of colleagues at Susquehanna University.  Jim Nabors was one of my mom’s favorite singers.  David Cassidy and Richard Hatch were among my early teen crushes.   My friends and I cruised local streets to the music of AC/DC and Tom Petty (among others, of course).  Oh, the sweet memories!

While the deaths of celebrities and athletes may impact us, our bereavement is fleeting.  We muse over their influences on our lives, we might say a prayer, or recognize their deaths in some quiet way.  But we go on relatively easily with the normalcy of our lives.  We feel the brush of mortality more keenly when someone dies whom we know personally.

On December 23rd, I learned that a man who had touched my life personally had died suddenly and unexpectedly the day before.  Although we hadn’t seen or spoken to each other in decades, I felt an enormous sense of loss and mourning for Jack’s son and daughter, his mother, his sister and brother and their relatives and friends who had the pleasure of spending their lives with him.  I also felt mourning for myself that caught me a bit off guard – because our relationship was so long ago and we’d had no contact over the years.

When we have loved someone, I believe we carry a portion of that love with us.  Sometimes, it is deep in our hearts especially when the relationship ended long before a life ended.  It’s that deep, tucked away portion that is unexpectedly awoken when someone we loved dies.  It certainly awakens a sense of mortality and brings it to the forefront of our thoughts.  This awakening of mortality occurs when death separates us from long-ago loves or our parents, siblings, friends, and, in my case, hospice patients.

Today, I can be grateful for the love and experiences that my long-ago relationship taught me – thankful for the threads that added to the tapestry of who I am.

I hope that Jack, and each who died in 2017, now rests in Peace.  I hope that the people who loved them may find comfort in loving memories.  I hope that brushes with mortality enable us to live more fully and love more deeply until we are the ones resting in Peace.

© 2018 Caring Choices

I remember you

I haven’t forgotten you.

Despite all the months and years that may have gone by. No matter how many ups and downs there have been. Even with all the life changes, personal celebrations and tragedies that have occurred. I still remember.

Perhaps there is now even a poem or song in your honor. Certainly there is a part of my soul that will always remain with you. You were likely a total stranger to me when we first me. You could have never guessed in a thousand years that one day I would be crossing your doorway carrying that bag slung over my shoulder. The one filled with the tools to help the needs of many.

There are times when something triggers my memory of you. Possibly a winding country road, a certain song, a snow storm, a soft breeze or the quick glimpse of a familiar neighborhood during a drive. I remember. We likely shared laughter, we certainly shared tears.

I cried a lot, but you maybe never knew this. I often would keep myself composed until I left your bedside. But there were times, especially while hooking up a new infusion, I would be unable to hold back. Then the wet glistening eyes, somber nods and quiet whispers were really me wailing inside. Filling up with the emotion of how much love surrounded us. Overwhelmed with the stoic bravery from such an unlikely source.

You will never be forgotten. I still remember you. I remember your smile, I remember your pain. I remember the look of concern in everyone’s eyes. Oh I know, I may not remember when, or possibly, may not even remember your name. But I remember the gift of time we shared.

No, I haven’t forgotten you. And, I never will.

The Mess of Doing Nothing

“I’ve noticed that it’s become easy to do nothing lately.”

These words took effect this afternoon while Cindy and I were driving back from the pizza shop with our Saturday “cheat.”

For months, possibly even years, it has been an awareness I only paid half attention too. As far back as maybe a decade ago, I had become aware that occasionally I would relish the idea of actually “doing nothing” as if that alone were an accomplishment. I would contemplate the options of “maybe tomorrow I will do absolutely nothing?”

Tomorrows come and todays go and before too long what started out as an unavoidable down time, crisis only option (due to illness or injury) shifted to willful decision. I would stay home,  watch a movie, play a video game, or scroll randomly through vintage footage of concerts, history documentaries, or scientific extrapolations on what, why, when, how,  where, and who. To some, this is “doing something.” In regard to an end result or specific goal of actually accomplishing something – the highest score or fleeting knowledge of trivia – my “doing nothing” produces the same.

Let me define my understanding of “doing nothing.” To me, doing nothing means that in place of doing something that can, should, or needs to be done, one simply does anything but.

To the bold-faced seeker of meaning, the reality of doing the things described above, may in fact be “somethings” each and every one. Granted, doing nothing itself is actually doing something right?

Do not discount the benefit of mindless distraction or enjoyable relaxation. One recipe of good heath is rest, exercise, and eating healthy. Volumes of data, debate, and proclamation stand ready to service your needs in these areas. But here is the problem with all this.

Doing nothing in the sense of leaving unattended a wider and larger portion of life’s responsibilities soon becomes more than just chill time. It leads to crisis.

Objects degrade, function declines, or conditions adapt to unsustainable proportions of endurance and stamina to perform basic tasks of life. Now things have become a mess. Just recently I used that phrase to describe the discovery of how to do something new with ease, “That was as easy as making a mess.”  It stands to reason that the 2nd easiest thing to do, besides nothing, is make a mess.  

When weighing the outcomes of a given situation using the choice of doing nothing, compared to doing something with effort, hard work and attention, well, it is pretty obvious where the more positive resolution will exist. What healthy adult does not want a positive solution? Just look at the world today; look at the potential all around you for positive outcomes. Generalized in the world I bet there are millions of people going to bed every night hoping for just such a change. Yet how many are doing nothing?

I once went to see a speaker with very well established charitable efforts already existing in the treatment of the sick and poor. He had founded a free hospital and named it Gesundheit. His question to the group of attendees was “What are you doing?” There is always something that can be done to help others.

During one of my afternoon web scrolling marathons, I came upon an interview with Suzanne O’Brien RN who had started a group of End of Life Doulas. She was discussing the growing interest for more personalized control over the outcome of how we are coping and preparing for mortality. She teaches hope of peaceful surroundings and thoughtful arrangements for the often overlooked tasks of caring for a dependent loved one while their journey ends here with us. In addition to the professional guidance of a hospice, palliative medicine team, specialist, or family practitioner, trained Doulas educate, demonstrate and advocate for the care of patients, family and caregivers. Special lighting, music, and chosen items arranged in almost sacred tenderness,  aid possible relief of symptoms that may occur. Suzanne’s doulagivers.com™ have become a worldwide network of loving hearts, “doing something.”

The basics of care for your loved one, friend, or client are detailed and offered for free. After reviewing the material Doulagivers™ provide, I eagerly joined and have become certified as a Level 3 Doula. Originally I had found this group by a desire to advance my own skills as an RN with end of life symptom management.

Now I wish to share this knowledge in hopes of helping those who do not wish to allow the “mess” that “doing nothing” can create.

In addition to our Elephant in the Room conversation guide elephant-inthe-room.org caringchoices.org Caring Choices offers experience and compassion within the complexities of dealing with death. Don’t let “nothing” stand in your way. Hope for the best, prepare for the worst. Just think about it. Knowing you’re safe and accepted for your wishes can lessen anxiety and stress. Knowing everyone around you is prepared brings peace of mind and comfort. Appreciation of the love makes the loss more palpable and even visceral, but is life at its fullest when facing the unknown absence of it? We comfort each other our whole lives.

Epiphany

Epiphany:  Merriam-Webster    3a (1) : a usually sudden manifestation or perception of the essential nature or meaning of something (2) : an intuitive grasp of reality through something (such as an event) usually simple and striking (3) : an illuminating discovery, realization, or disclosure b : a revealing scene or moment.

Sometimes I think my synaptic junctions are widening to basically affect a 20 year delayed response to stimuli. Recently I was re-recording a song I had written back in 1998 called Love You Forever. The lyrics were intended for a young couple anticipating the birth of their first child. Unfortunately, the soon to be Dad I had offered to write the song for was transferred out of the area and we lost touch before I could deliver it to him. So basically the song sat in my studio storage box ever since.

Recently, a friend I had met through my End of Life Doula group (Doulagivers.com), had posted a request for music CDs for use at an inpatient Hospice. I wanted to send her some of the instrumental songs I had written over the years and thought I would throw in a few with vocal tracks also. She had said both types, and any style was welcome. As I was sifting through hundreds of old cassettes and CDs of songs I had written over the past 40 years, I came upon this particular one, (mentioned earlier), that was written with the lyrical content designed to be as if it were the parents singing to their newborn. Simple, assuring, warm.
I cued up the CD. As I listened I was struck with an overwhelming epiphany. Although intended for birth, this song, when applied to a Hospice setting at end of life, was so emotionally powerful I repeated out loud “Oh My God”, over and over as I listened. It hit me in the pit of my stomach like a wave of healing calm, soothing a weary soul. Life at the point where Hospice is required is every bit as precious as birth. And the reality of this had never been so brilliantly clear to me before. My eyes welled up with tears of literal relief as if I could see the circle of life completing itself. These words, written for the beginning, were just as meaningful and important at the end. Maybe these words are even more important for this time. They represent the continuation of love and joy for life at its fullest. A time that is just as scary, bright, cold, loud, and painful as birth itself.

This is not a time for avoidance and fear. Our life is lived right up to the very moment of our last breath….and even beyond. Are not gifts of time and love we have shared with each other, the emotions and rewards of a lifetime much greater at this end then at any other point in our life? The volume of such exchange in many cases is incomprehensible. To task one with the counting of every deed, moment of joy, laugh, shared triumph, healed sorrow and broken or fulfilled dream is astronomical to even comprehend. Although I know some memories are lost and forgotten, others are honored, and span generation after generation throughout human history.

So why is it then that we shy from death as if it were an enemy? It seems like the relationship between life and death, are one in the same. Balance: as left is to right, as up to down, and as sadness is to joy. Are we so greedily selfish that we only love what is new and living? We only celebrate the win? Not the daily sacrifice, work, effort, strain and dedicated loyalty of life. This is just taken for granted? Struggle is nothing to worry about? Expected? Living is just the business of survival right?

Well my friends. Death is not losing as if life were some game. It is the next level of reality. It is so strong of an event that it generates billions of books, movies, and internet hits. Millions of dollars of speculation, prediction, evaluation, commentary and research have been poured into death, or the afterlife, or whatever belief one fancies. But the truth remains equal for all. No one can buy their way, beg their way, or cheat their way out of it. What I believe we can do, is to enrich it with the same genuine love and attention we give to a birth. What can change is that the same generous level of resources for care, comfort and quality can be just as welcome and available as you are helplessly taking your last breath as they were when you helplessly took your first. After a lifetime of living in this hard world, no matter how long that is, it is the least compassionate act of love we can do for one another.

Love You Forever

Thank you, you’ve touched our world. Listen, Have you heard

We are the ones who will, love you forever

Rest here, by my side. Sleep now, close your eyes

We are the ones who will, love you forever

JMD 7-1-1998

The Grass is always Greener

The Grass is always Greener….

This phrase is one of many old adages expressing how the reality of something is really quite different than what you may have initially expected. A list of examples is unnecessary in this case as I am sure most everyone can come up with quite a few on their own.

The point, however, is expressly different. 

Imagine what you think your death will be like. Will it be at home? Will you be surrounded by loving family, friends and cherished memories of your long and prosperous life? Will you be at peace with yourself? Will you be warm and comfortable in a soft cozy bed? Will there be the sweet fragrant aroma of incense permeating the air and tranquil melodies floating between hushed whispers of thanks and gratitude? Will you feel a growing excitement at joining the billions of other souls who have made this unique journey to a better place?

What wonderful ideas, right?

The reality of death is not quite so pretty for many people. Far from the above descriptions of how things could be are the actual ways many people face their last moments on earth.

My life experience including 10 plus years working Hospice (23 total years in nursing) have led me to this place today. A place where I am trying to help everyone understand that the above desires for end-of-life experiences are only possible with conscientious effort, planning and above all else CONVERSATIONS with others.

Too many people suffer needlessly at the hands of a system designed to keep people alive “no matter what.” Mechanical interventions replace natural processes.  Legal checklists become substitutes for conversations and making real choices. Heathcare algorithm “clickfests” take the place of tender touch and genuine human interaction.  These “interventions” are manipulating dying and death into becoming situations of cold, sterile, expensive states of suspended animation in order to wring every last breath out of a body long overdue for its final “resting place.”

Does this sound too harsh? Maybe an acronym to lessen the intensity of suffering? What could we call a system focused on longevity and not quality of life? What could be appropriate in our acronym-infested healthcare system? I know!  Let’s call it,

S-ervices, A-gainst, D-eath … and what it really is: SAD!

 

Do not misinterpret my compassion for minimizing suffering as a fatalistic wish to end all happiness by “killing” everyone before their time. Such an assumption could possibly give strength to what pushes death even further into the abyss of denial.

There are wonders of technology and dedicated people everywhere that can save lives. The resources are almost limitless in both material effort and will when saving lives.  When there is an opportunity, we almost all rush to the aide of anyone in distress.

But isn’t dying simply just life at its most amplified state? Isn’t everyone’s emotional, mental, physical, and spiritual culmination of lifetime energy at its most powerful when people are dying? Why is it that the one moment in life – that we get no other chance at repeating – is stripped of resources when they are most needed? 

What I support is a preservation of that kindness and love we seek. While still capable and healthy, there is still time to offer a greater acceptance of dying and recognize it as the catalyst from which all appreciation of life began. When we can accept our limited existence, it intensifies each moment and delivers the “spirit” of living as no other act can. We can then set aside our fears and embrace the loss of a loved one with a renewed understanding of how important this end time is.

We have tossed death into the cold, damp corner of our minds where we hope we will never need to go again. We label our relief at not having been struck by lightning as good luck or the Grace of God, and some say we have “survivor’s guilt.”  We feel even more relief to be alive. 

Hourglass of Life and Death

We can learn to die better in this world. There are exceptions, for sure:  trauma, sudden onset of disease, and the hateful violence of some people. But for the majority of human existence, there is a natural compassion and concern to help one another. Consider the shape of our life to look more like an hour glass instead of a funnel. Instead of narrowing options and resources as we circle nearer the tapered end there is an acceptance and an expansion of personal options once we pass through that point where quality of life reigns over quantity of days. We are embraced and comforted approaching the natural end of our life. Please have meaningful conversations with your family friends and loved ones about how you would want to die. Do not look across the fence of death and think that the grass will be any greener, less complicated or less problematic than the reality you live in here.

Your Wishes are Important, But They’re NOT the Only Consideration

In my role as a hospice social worker, I have encountered patients who have an able and involved network of family and friends in caregiving roles.  They are the fortunate few.  More often than not, the situation is an elderly married couple whose children live in other states and who have a dwindling network of friends who are able to assist.  Or, the patient is a middle-aged person who is riddled with cancer or an advanced illness needing 24/7 care and the only person available is their 20-something child or their spouse.  No one person can provide 24/7 caregiving for very long.  There’s no shame in admitting that help is needed; there’s no shame in accepting when help is offered.

Much of the focus on end-of-life healthcare planning is centered on the patient’s choices.  Caring Choices advocates strongly for patients to consider their options and discuss healthcare choices with their healthcare team and people they love.  We also, however, advocate for meaningful conversations that encompass not only the healthcare choices but also the caregiving needs, the availability of options, and how those options will be financed.

Depending on which article you ready, 75-90% of Americans wish to die in their own home.  Dying in your home, for those who want that, can be a peaceful, comfortable end if there are adequate planning conversations long before the chronic illness progresses or the terminal diagnosis is pronounced.

In order to remain at home through the end of life, you will need help.  This is a fact that you need to wrap your brain around before you read further.  YOU WILL NEED HELP whether you are the patient or the caregiver.

My first recommendation is to look within your family/friend circles to find private duty caregivers.  Typically, these are people you already know and trust.  Some will supplement caregiving out of the goodness of their own heart; others may ask for (or you may offer) minimal remuneration ($10-18/hour).  This is also the network who will most often provide meals, run errands, visit and provide some relief of the caregiving role.  They key is to ASK them for the help you need; people don’t know until they’re asked.

A second option is hiring caregivers privately through homecare agencies. These caregivers help provide care for yourself or your loved one at home in addition to enlisting hospice services.  Many agencies provide in depth training on how to provide care from bathing/dressing to bedsore prevention and caring for people with dementia.  Some agencies, however, do not provide much training.  You want to be certain you are asking agencies about the training they give their staff.  In our local area, these agencies typically charge between $22-25/hour depending on the level of care needed.  That adds up to a lot of money pretty quickly.

A third option is to qualify for Medicaid (Medical Assistance, MA) Waiver services but be prepared for this process [from application to approval] to take about 90 days.  Unfortunately, many people who elect hospice do not have 90 days to wait for caregiving help (but that’s for another blog).  In order to qualify for MA, you (the patient) must: (1) meet income and asset guidelines; (2) submit an application which can often include a myriad of paperwork including 6 months of bank statements, life insurance and investment valuations, and proof of income to mention a few of the requirements; and (3) have time to await the approval process.   Once qualified for MA Waiver, your options for caregivers expands to usually cover whatever hours you need (up to and including 24/7) and whatever services you need (personal care, light housekeeping, errands, companionship, etc.)

So, those last three paragraphs talk about the “who.”  Your next consideration is “who will do what.”  The language you use in these discussions needs to be very clear and not open to interpretation.  [Remember the Abbott & Costello “Who’s On First” routine.  Language is important.]  As the dying process progresses, patients typically become less able to do things on their own:  walking independently progresses to using a walker/wheelchair to being bedbound or unable to move on their own.  This typical progression often results in needing assistance with other Activities of Daily Living (ADLs) like bathing, dressing, and toileting.  This is where the really important caregiving questions begin.  Who among your family and friends will be able (willing, comfortable) to help you bathe?  Who will be able (willing, comfortable) to wipe and clean you after toileting?  Who will have the physical strength to help you get up out of a recliner and into the bed, or to turn and reposition you in the bed?  Who will be able (willing, comfortable) giving you specifically measured doses of comfort medications as your end draws near?  (There are many other caregiving questions to consider but if you can answer these four most challenging queries, the other caregiving roles will likely “fall into place.”)

These are important conversations to have now with your family and friends.   That way, when the time comes that you or a loved one decides to stay at home through end of life, you’ll already have the structure in place.  Everyone always says “I don’t want to burden my family.”  Having these conversations and getting a plan is place is exactly how you alleviate much of that “burden.”

Embrace the elephant in the room.  Start talking about healthcare choices, but also talk about who can provide caregiving assistance and when they are available to provide it.

© 2017 Caring Choices

Dinner Date

Please don’t turn your head down, and quickly look away
You’re all going to die, someday…

Woke up here this morning my dream’s message, still quite clear
Not all full of worry, in denial’s hopeless fear
Melody still in my head of word’s so soft and kind
Our end of lives in comfort, safe with peace of mind

The dream had special meaning of the beauty of this life
And the need to represent it as with marching drum and fife
Let me tell the story of waking from this dream
Singing “you’re all going to die”, in crescendo to a scream

I was….

Sitting in a restaurant, the evening crisp and cool,
Gentleman all laughing, at the bar no empty stool
Ladies all so lovely, faces bright and flush
Their picking at their salads, sipping on their blush

I overhear the comments, and preparation’s planned
To spend the lifetime gathering, more valuables and land
It suddenly tears into me, like hot iron through my brain
Is assuming that there’s time enough, all we can attain

Please don’t turn your head down, and quickly look away
You’re all going to die, someday…

Living in each moment, like it’s precious, pure and dear
Don’t be caught in prisons, made of- denial’s fear
Live your every minute, like its precious, dear, and pure
Hoping for the future, and what may be in store

Please don’t turn your head down, and quickly look away
You’re all going to die, someday…

© Caring Choices  2017

Uncomfortable

I consider conversation between people to be one of the most rewarding and exciting aspects of life. Recordings of the written word comes in second in my humble opinion due to the fact that what is written is subject to misinterpretation depending on many factors. Not to negate the misunderstanding caused by language barrier and incoherent speech patterns, but generally when you hear something it is pretty much just “what you heard.”

At no other time in history have I been more aware that there is such a massive amount of uncomfortable conversations occurring. Sadly, much of the most offensive exchange we are currently exposed to is not verbal but texted, posted, printed, or pre-recorded. The convenience of these methods of information exchange is undeniable. The quality is questionable.

The volume of discourse over the current political landscape is beyond comprehension, not only in America, but across the globe. The shifting sands of opinion and time will eventually settle, and new dialogue will resurface about whatever balance human existence regains.

Having witnessed these tumultuous events, and recognizing the multitude of newly vehement revelers of political opinion which had never, before now, given the topic much consideration, I began to wonder: Why? Why now? Have there not been millions of debatable issues over the past 40 years that failed to become more than a C-Spanned, red-eyed, remote flip of boredom? Certainly we have all been affected by this shuffling of interests in world affairs both public and private. But in the past many of those personally involved were understandably limited to the professions directly designed to be appropriating the need.  This political slugfest seems to have engaged everyone, from every perspective and every varied opinion into an extremely uncomfortable national discourse.

Yet when attempts are made to encourage everyone to become involved with their own end of life issues, the resistance is equally universal. Very few people seem to want to begin discussions with a loved one; that is until an acute trauma or terminal diagnosis is ripping the lives of their family, friends, and acquaintances apart.  As is common within proper social etiquette, there is a general outpouring of prayer, shared grief, and unified offers of support.

What will it take to make this “uncomfortable” conversation as popular as the raging debates around the world today over truth, rights, and political control? It is every bit an undeniable fact that we have a new President as it is that everyone will eventually die. Life goes on, and ends; the disproportionate lack of acknowledgement of death will not change the fact that it will occur for all of us.

What can help make conversations about death more comfortable? I believe it is honest, compassionate examination and understanding of the emotional, physical, and psychological needs of each other coupled with genuine, meaningful communication before a medical crisis occurs. Enough can never be said to help each other with what is often the most frightening, “uncomfortable” event we all will ever (and must) face.

The outcome of these “uncomfortable” discussions may even be peace of mind, increased knowledge of legal and financial responsibility, understanding of desired preferences for services and care due to changed independence, emotional release, insight into unanswered concerns, repaired personal conflicts and family dynamics, expression of personal choice, acceptance of everyone’s opinion, etc. You will never know if you don’t ask.
Just start talking!

© Caring Choices 2017

Animal Intuition

My husband, Jim, and I have been on the receiving end of caring kneading from some of our cats over the years.  Mercie (rest her soul) used to knead the back of my neck in bed at night which was especially welcome when I had a headache.  The methodical push of her soft-padded paws accompanied by her melodic, low purring was better medicine than the ibuprofen I’d taken before going to bed.  Just the other night when Jim wasn’t feeling well, Sundae seemed to sense this and kneaded his stomach in all directions with positive effect.  We know others who have similar stories about the comfort and care they receive from their furry friends.   It’s not difficult to find a story online about a cat in a nursing home who lays on the bed of a resident as they take their final breaths; or a dog that can sniff out cancer.  Animals are so well connected to the metaphysical; they just seem to “know” when it’s time to provide comfort or time to let go.

A few weeks ago, we chose to end the suffering of our oldest cat, Soxie, whose final seizf639e582_1028976ure was so intense and vivid, she seemed possessed.  It was horrifying to watch and hear; it will be a very long time before I can close my eyes and not see what she experienced.  When she was able, she retreated to an odd location where she’d typically go when she wasn’t feeling well.  She knew it was her time and she was “going inward” to prepare herself … and us.

Animals just seem to “know.”

We humans are animals too; some would say more evolved than cats and dogs.  Perhaps we’re more evolved in matters of business, literacy, art, and intelligence, but I’m not certain we are more emotional or more compassionate.

Some of us have such difficulty listening to our intuition when someone we love is sick or dying.  We tend to pursue all possible healthcare options until there are no more medical interventions to impede the natural progression of disease or age.  We focus on the next treatment option, the next surgical procedure, or the next drug; sometimes at the exclusion of the emotional and metaphysical components of the one who suffers.  This focus is sometimes so intense that we forget to look at the person right in front of us (or in the mirror) and ask “what do you need at this moment” or “how can I care for you today.”

Some people spend so much energy waiting for the other shoe to drop, we forget that there’s already one foot immersed in the disease and daily symptoms, or contemplating their final hours.

We need to pay more attention to our “animal” intuition.  We need to listen to those we love who are living with a chronic illness or a terminal disease.  We know our bodies and our minds better than anyone else in our life – family, friends, healthcare professionals, clergy.   Be mindful of the one who suffers and seek to understand what they need.  We need to recognize when it’s time to stop doing and just be still.   Then, provide care and compassion like we just seem to “know.”

©2017 Caring Choices