Tis a puzzlement

So, here's an interesting tidbit. A patient of mine "Sally," was recently released from the nursing home rehab center after having surgery on her back. After her surgery, her family, which consists of a sister and some nieces and nephews really pushed for her to go into an assisted living home. Sally didn't want to leave the home that she owns and worked hard all her life for. So she went back to her home and has been under the care of our home health nurses for the last few weeks. Her nurse referred me to her after she started talking about how she doesn't have any food or money.

Sally is an interesting woman. She likes to have people take care of her, and she is very limited in what she can do, yet at the same time she insists that she does not need help. It's kind of a puzzlement to me. Sally was also very affluent in her earlier life, and she is used to having all kinds of luxuries that she does not have access to anymore. She is frustrated with herself for not being as independent as she used to be. Her family is frustrated with her for not listening to them and moving to an assisted living facility. Her nurses, occupational therapist, and I are all a little frustrated with the whole situation because she has a right to stay in her home if she chooses, but we can see how enhanced her quality of life would be if she chose instead to move to a place where she could get the care she needs. The nurses and therapists are ready to dscharge her, and once they are gone, I can't continue to see her. But I can't in good conscious leave her alone in her home with no assistnce or care. I don't think she'll realize how much help she really needs and make an effort to get it until we discharge her, but I don't feel good about discharging her until she has that help. But she won't ask for it until we're no longer making visits.

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Posted in: hospice,social work ethics

This life is the time to prepare

I can see where working with terminally ill patients can be difficult. The first patient that I ever visited as a hospice social worker passed away last week. She was a lovely patient to visit, and she has a wonderful, supportive family. Four days prior to her passing, I visited her and she was sitting up in her chair applying makeup and chatting amicably with us. Three days later, the nurse informed me that she was on her way out. That evening, she was gone.

Having never really dealt with the death of a loved one in my life, I have a hard time understanding the emotions that go through an individual’s mind as they watch their loved ones decline in health. Grief is a complicated thing. A lot goes into the process. I recently got put in charge of the grief and bereavement process, and so I am learning a lot about how people grieve. I work real closely with a chaplain and I absolutely love the fact that I can bring spirituality into this. People are so close to God at this unique time in their lives, and so I love the fact that we can freely discuss spiritual principles in a public setting.

I am looking for more information on the bereavement process. I am trying to study and learn about how different people grieve and how they heal. I am getting the hang of the healing process myself, but I need to learn more about the grieving process. Interesting. Hmm. I think I need to study more.

One thing I’ve learned in the month of living and working here is that there are many things that we can do to prepare ourselves so that the end of our lives are as non-stressful as possible. People on their deathbed shouldn’t have to worry about Medicaid applications. They shouldn’t have to worry about paying for a Notary or appointing a power of attorney. They should all be able to focus their energy on their family, preparing for the next life, and dying peacefully, pain-free, and worry-free. It really is important to figure those things out now, so that we have the time and energy later in life to focus on what really matters at that time.

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Posted in: Elderly,hospice