Category Archives: Hospice

Heavy Thoughts

Last week we had some very intense visits at West Pines as well as our regular rotation at hospital and hospice. It’s taken a few days to try to sort through the feelings those visits left and I’m not sure they can be adequately conveyed even after much reflection.

Whenever we visit hospice I already know each patient is on the last journey of their lives. Yes, it’s sad when anyone passes even those that are elderly and have led a long and hopefully fruitful life. There have been a few young patients that touch my heart. How could this happen? A young person, who life hadn’t filled all its promise, cut short. And yet, intellectually I know it happens; it’s all part of life. I know intellectually it’s not fair. It’s not comforting to see such inequity, but know the important part is not how long of a life, but how amazing it was, right?

Indeed, I was not at all prepared for Thursday’s visits. When I checked with the nurses down the first corridor, they said to be sure to visit with the lady in 220 as she was sitting in her recliner. As soon as I knocked on the partially opened door, a woman’s voice trilled for us to come in. Once inside, an extremely over-sized, round-faced woman greeted us with “ooh, a doggie!” as my “Good morning” greeting barely left my lips. This woman with her pale face and rosy checks reached out to run her fingers through Sam’s hair. It took us a couple of moments to arrange to get into the corner, moving her bed tray and IV pole out of the way.

Whenever I visit hospice, I contemplate about the lives of the patients we see. What were they like, did they grow up on a farm or were they native to the city? Most of the older patients tend to have grown up in rural settings and when conscious, regale me with stories of hard work and strong morals, most often with stories sprinkled with tales of tails…dogs, cats, farm animals…I enjoy them all. With the woman we were visiting, it was hard to tell what kind of life she’d led…it seemed she was well in the advanced stages of confusion and dementia in addition to her medical condition. Still we are always delighted when a patient is awake as most are not and I know Sam’s visits brighten their hearts. With patients suffering from dementia, I let Sam take over and allow them ramble on to him and smile a lot, not saying much. What else can you do when comprehension is fleeting? After a few minutes we could tell she was tiring, and thus bid our farewell and moved on to the next corridor.

To get an understanding of what the layout of hospice looks like, think of a building built like a wagon wheel with the spokes being the corridors. The center area houses the main nurses stations and each ‘spoke’ has a small private room with comfortable seating, a mini-nurse’s station near the pharmaceutical cabinet, a restroom and shower area, a small sitting area at the end of each hallway with chairs and end tables that families can use to regroup, make phone calls, etc. with access to a private outside garden. Whenever we move to a new hallway, I access what we might encounter. Often there are groups of visitors mingling about and a nurse or two filling out charts, preparing medications, etc. This particular hallway had a small little boy at the end of the hallway, crawling around on the chairs. He was alone so I figured his family was in one of the rooms nearby. Surprisingly, there were 4 nurses gathered at the mini-station, an unusually large group, chatting and entering data. When I asked them for details about the floor, two of them said they were fairly full, but we should definitely visit with Meike who loved nature and had just asked to be moved outside to the garden. “Of course,” I said. “We’re happy to visit with her.” Then one of them said, “I’ll bet Adler would love to meet Sam!” ‘Adler’ turned out to be the young boy at the end of the hall. She called him over. The shy little boy let his small fingers twirl through Sam’s ears. The nurse asked Adler if he liked Sam and he shuffled from one foot to the other and demurred, “Sure.” His mind seemed elsewhere, but then again I may have been projecting. He talked for a few moments and I learned he was 9 years old. ‘Meike’ was his mom. Gulp. I wasn’t prepared for that detail. After he walked back to the end of the corridor, we made our way out to the garden to visit with his mom. It was a lovely day, despite being cloudy with a hint of welcome rain. After many days of warm temps, the cooler day with its slight breeze felt good. Meike’s back faced us as we quietly moved toward her.

The enclosed garden area was quiet and beautifully landscaped with flowers around a large  gazebo with numerous chairs. It’s a peaceful area and a lovely spot for patients or their visitors to commune with nature for a few moments, away from beeping machines and a harsh medical setting. I’m sure it has comforted many during those final visits with loved ones. As I moved toward Meike, I noticed her eyes were closed as if she were contemplating her remaining time and soaking up the nature around her. I watched her for a few moments and my thoughts immediately moved from her to her young son. It was hard to tell her age as her head was buried deep within the covers but I couldn’t let go of the fact this was all wrong, young mother’s weren’t supposed to leave their small children to a world that could easily swallow them whole. Who would protect young Adler? Who would teach him how to ride a bike, throw a ball, how to solve math problems, and more importantly how to kindly treat people? You know, all those life lessons necessary to living in a meaningful way. My imagination got carried away and my troubled energy clearly rubbed off onto Sam. He leaned against my leg waiting for a petting and startling me into returning to the present moment. We stood there for a few more seconds watching Meike breathe and then we quietly left the garden making our way out of the building. I couldn’t even begin to work the last corridor but as we were leaving, a couple of women on their way to the kitchen stopped to ogle over Sam. They sincerely thanked us for coming. I could only half-heartedly smile and let them chat Sam up marveling at his calmness. While not on the verge of tears, my heart was heavy and sad and truthfully, I had no words in me. I kept asking myself why this little boy and his mother had made such an impact on my heart and mind. Clearly we’ve encountered others close to death’s door but none had affected us as much as these two. Energy was the only explanation I could figure. But it ended up being the cosmos’ way of saying, “But wait…there’s more…”

As we left the parking lot for home, I couldn’t surrender my shaken core. When I got home, in a moment of hopeful escape, I went to Facebook. Surely there’d be something to distract my heavy heart. And right there, first post on my wall, was the photo of a dear acquaintance dressed in a hospital gown with an IV pole next to him, ever so thin and pale, nearly bald, and standing next to his partner reciting wedding vows. I hadn’t seen Howard in a few months but knew his treatment for melanoma was taking its toll, yet had no idea of the degree of seriousness. Ugh, my heart heaved…another gentle soul, leaving too soon. Despite months and months of surgeries, chemo, experimental treatment, Howard’s condition had not changed and as he faced the end of the road, he had decided to marry his love and then checked into hospice for the final days. The end was near and I didn’t need his partner’s words to tell me that. I could see it in the expression on Howard’s face. As long as I’ve known him, his wicked, rapier wit and acerbic humor camouflaged the sadness I now saw on his face. He was tired, tired of fighting an enemy who was stealing his very essence and yet I knew it would be this man who would bring together hundreds of friends and acquaintances mourning the loss of a bright, funny man we would all miss very soon. And as I processed this additional cross to bear, my thoughts turned back to little Adler, all alone at the end of a hospice corridor, his mom alone in a quiet garden. I could only hope they had as extensive and supportive network as Howard did. And then I wept with tears flowing down my checks, burning my eyes and being dried by Sam’s kisses.

Maybe it was just a confluence of sadness after intense visits with pet therapy and the news about Howard simply made it all too raw for me. But what this jumble of emotions tells me, that just like my Sam experiences when he works to negate sadness and strife, our hearts become weighted with energy of a surrounding world where bad things happen to good people, and where it’s important to make sure to spend time trying to make a difference in the lives of those whose paths cross ours. I pray we do justice…for the lady in Room 220 and the Adler’s of the world by sharing a few moments with a goofball sweet dog whose tail can’t seem to stop wagging when he ministers to them.

We’ll be taking this week off to spend as much time as possible hugging my son extra tightly as he visits for a few days and to share the deep connection our entire family has when we all get together for these reunions. There probably won’t be posts the rest of this week, but I will do my best to try to keep up with what’s going on with you. What this past week has shown me if anything, is the best way to feel alive and minimize pain is to focus on others and share the beauty of their lives, their stories. For us around the Ranch, this will involve sharing smiles and telling funny stories of past get-togethers. Our family will talk, laugh, and share more than a few beers with memories that have provided us meaning and purpose. I hope little Adler has someone equally as special to hold him and be a true compass as soon as his mom leaves this mortal world.

Post script.  Howard passed away Saturday evening. He was 50 years old. The FB page announcing his passing displayed this image which is a good reflection of his outlook. He was all about the best parts of life. Comedy, Improv, Music (oh sooo much music), Film, Friends, Blogs, Animals and endless amounts of kindness, grace and love. He will be sorely missed by so many. In memory of Howard and so many others like him, make someone laugh today. #f*ckcancer

Live, love, bark! ❤︎

Reflections on Life and Death

Life and death. We tend not to think about them until they are thrust upon us. And yet…they are in our sphere every moment of every day. This week we spent a lot of time at the hospital and hospice. And because of our experiences there, this post has been more than a challenge to share what it meant in an adequate way. This is in fact, the third draft and I’m still not convinced it’s conveyed well enough yet.

While volunteering over the past 4+ years, we’ve had many encounters where we’ve seen the impact of a death on those actually there. We’ve been in a room when a patient passed away, a mere 90 seconds after Sam allowed a relative to place the hand of the patient on his front paws. We have visited hospice moments following a patient’s passing and have tried to provide compassionate support for the family and staff. I’ve reflected in past posts how stark I found the fact that some people, despite being surrounding by the most caring staff, too often die with no relatives nearby. I’ve lamented that others have had their loved ones glued to an electronic device rather than being part of a ritual that we all will go through. It’s been confounding and troubling at the same time.

Yet this visit, things played out differently. We arrived slightly before our shift began and knew the hushed convening of people at the front desk signaled something had ‘happened.’ A group of long faced relatives stood outside the closest room with a large man dressed in a dark suit. The nurses behind the desk all softly smiled at the sight of Sam and his tail wagged wildly but something was clearly different. And then it began to unfold.

Lutheran has an amazingly compassionate staff who provide comfort, dignity and support for those spending the final stage of life with loved ones in familiar surroundings. With each patient’s passing, they conduct a beautiful ceremony with a Tibetan singing bowl as the body is removed and carried out to the transporting hearse. We had never experienced this somber spiritually touching ceremony before but that was about to change. This video will give you an idea of the sound (although there is no running water or crickets but I think you can get the picture and feel the peacefulness).

This week our interactions were quite intense as we witnessed the honoring of a life who passed with family and friends nearby, just the way it should be. Sam sat very erect next to me somehow sensing the reverence required despite being among some of his favorite nurses. Any other time, he’d be moving from one to the other engaging them and relishing the ear scratches but when the bowl started its melodic tone, he was still as a statue. The tones were soothing and continued rhythmically until the body and the family walked down the long hallway to the exit where the hearse was parked outside. I was so moved and it took both Sam and I several long minutes to gain our composure for what was to be yet another remarkable encounter.

Today’s visit was met with lots of hushed quiet voices, more so than usual. It’s understandable. Everyone there knows when a patient dies and they all honor the dead with quiet deference. And yet life goes on in areas throughout the facility. Housekeeping continues to clean, patients are tended to, reports filed. Care provided. We received the usual comments about Sam’s calmness and sweet nature, his freshly trimmed haircut. We were told to visit with a fellow in a room down the hall from the patient who had passed away. As I walked by, an older woman sat reading a book, glancing up and smiling broadly. She gestured for us to come in and tried to rouse her friend. Sadly, “Earl” did not open his eyes despite pleas from his friend, “Valerie.” Next to his chest was a large stuffed cat, the kind of stuffed toy that makes noises when there was movement nearby. “Meow, meow.” Sam did the classic dog head-tilt which made Valerie chuckle and I introduced us as she apologized, saying, “Oh, that silly cat. I don’t know why he has it…he raised show dogs for years. Guess he just wanted to create some racket when he first came in a week ago.” While he may have been more animated a week ago, it was clear Earl was not the same man today. A frail small man lay in the bed, his eyes semi-closed, breathing deeply. She laughed about Earl’s sense of humor and I sat down next to her as she talked while Sam sat between her knees. She gently petted him, staring deep into her eyes and he moved even closer. I could tell we’d be there a while as Sam sorting out and addressed her ‘needs.’ Never mind Earl. It was all about ministering to Valerie in Sam’s mind. We talked about how they met, how long they had known each other and their days in the world of dog shows. Earl had had a black standard poodle up until recently who had been the apple of his eye. She chatted as if we were old friends and as I listened to her tales about Earl. Sam stayed focused on her face and she just kept repeating how wonderful he was. After quite some time, he slide down in front of her and curled up between her legs. We weren’t going anywhere soon. And so we continued to chat. She shared her thoughts about the book she was reading and was delightedly to learn the author was also one of my favorite mystery writers, Donna Leon. Many of her novels have been transformed into the PBS series, Brunetti, about an Italian police commissioner in Venice. After a long visit, she said how much she wished Earl could see Sam and expressed regret that Earl didn’t get a chance to say hello to Sam. We wished her well, finished up at hospice and then made our way over the main hospital for even more moving and intense visits with many people. Sam was on his best behavior and totally crashed when we arrived home hours later. We were both fully spent after a day sharing stories about the living and paying homage to the dead.

Hopefully I can continue to rot out my thoughts about our visit even more and share our experience from West Pines which was truly amazing. I am still trying to wrap my head around the intensity and how to share them adequately so that they do in fact convey the incredible privilege we have visiting with the most vulnerable and the needy. 

Live, love, bark! ❤︎

Tongue Out Tuesday

It’s not a full tongue out, I’m just practicing to get ready for my week at the hospital so if you don’t hear from us, you’ll know why. Today’s gonna be a hot one but I’m looking forward to seeing my friends at the hospital and hospice. Stay cool and look for us in a few days. 

Live, Love, Bark! ❤︎

Healthcare and Life Intersections

Earlier this week Sam and I went to the hospital for our regular visits. And what visits they were. I knew this month would be challenging different as we have a new required protocol for entering each room known as BioVigil. What the heck is BioVigil you ask?? It’s a hand washing monitoring system designed to remind healthcare workers (included pet therapy volunteers) to ‘wash’ going in and out of a patient’s room. The device triggers an alarm to sanitize one’s hands whenever entering patients’  rooms when not properly activated and will be a good reminder for those who may be somewhat lax about the requirement and figured initiating something new hospital-wide might have a few hiccups associated with it while being rolled out. The training demo was laden with challenges (under-charged base units which wouldn’t demonstrate how they work, electronic keys not unlocking units, etc.), but the beta group who tested it noted there was a 30% reduction in sick days alone with staff so clearly this will be a good thing in the long run (great way to stem C-Diff) once it’s got all the bugs worked out. If you have failed to properly sanitize, a door sensor sound an alarm upon entering a patient’s room. No doubt it’ll be a little nerve-wracking for patients to hear more alarms but with practice and diligence, it should get better for them as people become more familiar with the procedure well as reducing healthcare associated infections.

This week we were assigned the Internal Medicine floor but were hardly able to spend any time with patients since so many were in isolation with the flu. As volunteers we are not permitted to enter any isolation room unlike nurses who must. Luckily Sam garnered the attention of six nurses who were more than happy to fawn over him when it was clear there were few patients for us to visit. The ooh’s and ah’s over this goofball added to his self-assurance (as if that was ever an issue!). Sam owned the 6th floor nurses and staff and was in hog heaven because of it.

We were able to have a nice long visit with one patient whose daughter I ran into as we were about to leave. She said she hoped her mom hadn’t missed the dog visits and would be so grateful if we would swing back by before we left so we headed back toward her room. “Mrs. D” was reading a book and excitedly invited us in when she saw Sam. He trotted right over to her and sat next to her chair letting her run her fingers through his hair, eyes nearly rolling back in his head with pleasure. Clearly the dude was in 7th heaven. Mrs. D told me about dogs she and her family had, how much they enjoyed them and how much of a dog lover she was. Sam was mostly interested in the nice thigh he could lay his head on while being petted. After a long session visiting, we let Mrs. D get some well deserved rest.

Karen GrantThe next day we went back to our favorite place, the Senior Behavioral Unit. It’s always a roll of the dice when we go there. These patients which I’ve written about here and here can be more than uncertain but they either love dogs or loathe them. We managed to win this dice toss with Jay, David, Norma and Mary Anne. Each patient had their own individual mental health issues but each of their faces lit up when they saw Sam. While those suffering from emotional and behavioral issues may have difficulty expressing themselves with a therapist, they easily and happily relate to an animal. David was first, asking if he could spend time with Sam and walked over and sat on the floor next to us. I got down on the floor with him and he talked. And talked. Sam patiently and intently listened to every word, confused as some of them were. Then Jay came over and talked to Sam as if he was his best friend in English and German. Jay’s story was he had been a professional skier at one time in Austria, and a decent one at that. A hard life of living had affected his mental acuity but the kindness and soulfulness of this man was readily apparent. Mary Anne leaned over and asked if we’d spend some time with her and of course, Sam was easily convinced. A sweet, tiny elderly woman she pushed her snack aside and smiled broadly when Sam sauntered up to her side, tail wagging. Her eyes twinkled while she thanked us for visiting with them. Norma came over with questions. Lots of questions. What’s his name, how old is he, where did I get him? A bubbling fountain of inquisitiveness with loads of love as she stroked him and smiled broadly in his eyes.

Sam in uniformWhen you’ve been working with patients you begin to read their body language for clues as to when enough is enough. I can also tell with Sam. That day’s visits took their toll on his energy level yet he stayed and listened to each of them as he slid into a full down position next to each one. He remained as long as it took for them to tell their stories and share their life experiences. Clearly there was a lot of released endorphins that afternoon which had a very positive effect on us all. By focusing on him, their minds were drawn away from their own life happenings whatever they were. These kinds of interactions help them develop and fine tune nurturing skills and encourages them to share their humanity.

Have you ever noticed your dog ‘listening’ to someone they encounter and lifting their spirits with their total focus?

Live, love, bark!

The Dog Who Saves Lives

With our hospital therapy work, it was ironic to come across this news video recently. How fabulous is it dogs like Angus are able to contribute such ‘pawsitive’ work on behalf of us uprights?

Our family experienced first hand the impact of that all too familiar infection know as Clostridium difficile (often referred to as C. difficile, or C. diff for short) while being treated for an entirely different illness in the hospital. Did you know that around a half a million patients per year become infected with C diff while in US hospitals with some 15,000 deaths. Earlier in the year, my own mom was hospitalized with a case of pneumonia a few months after suffering a gastric aneurysm. While in the hospital she contracted a case of C diff which made recovery from the pneumonia as well as ongoing gastrointestinal issues all that more problematic. Too bad  ‘Angus’ or some other trained pup would have been wandering around the hospital when mom was there; she might have avoided an extended and very unpleasant stay and might have been able to recover from the pneumonia, an already tough illness for elderly patients to recover from, rather than the double whammy of dealing with C. diff on top of it weakening her immune system all the more.

We have hospital duty later this week and while the hospital where we volunteer has a very good record when it comes to secondary infection rates, I couldn’t help but wonder if a dog like Angus or his brother could make a significant impact in infection rates among hospitals in general. It’s made me curious enough to look into how to get into nose work. We’ll keep you posted on the possibilities that nose work might have in therapy work. Have you ever had any experience with a super sniffer like Angus?

Live, love, bark! ❤

Deja vu memories…all over again

In honor of the World Series starting yesterday and as an homage to one of my all time favorite baseball players’ quotes by Yogi Berra, we’re departing from our typical Wordless(y) Wednesday post to share a “deja vu memory…all over again”…one that came full circle last week when we volunteered with other pet therapy members selling our 2017 pet therapy calendar. We set up our display near the entrance as visitors arrived when a kindly older man strolled into the lobby and walked past us. He smiled and I thought, hmm, well that guy sure looks familiar but like so many other interesting faces you encounter daily, you dismiss the notion immediately and re-enter reality to concentrate on the present. A few moments later, he turned around and came back. He kept looking down at Sam with a cocked head and said, “I think I know that dog, yes…I’m sure I’ve met that dog before.” Sam began his furious tail wagging salute while simultaneously leaning against the man’s thigh. The man smiled broadly and said, “Yes, I do know this dog; he came and visited us at hospice a couple of years ago!” Recognition from another person especially at hospice is sure to take anyone by surprise but there was something special and familiar with his face and the certainty of which he spoke that made me want to dig deeper in the my memory banks. Then it hit me. Of course, now I remember!

hospiceOn one of our first hospice visits we visited with one of the truly nicest couples we’ve ever met. They made such an impression on me at the time. And while it took me a while to hunt down the photographic evidence of our visit back then, it made me smile once I found it, recalling a lovely visit at a serious time. He was so kind and so complimentary of Sam and his wife was thrilled to have the canine concierge visit and we stayed longer than usual with a hospice patient. They were both so gracious, so warm and inviting. They exuded a great love for each other and for life. Our conversation was of other dogs that had made an impression in their lives but they kept going back to how truly special Sam was. Far be it for me to disagree with someone who thinks this knucklehead was a 4-legged special gift. The essence of humanity oozed from both of them and Sam knew it. While Sam couldn’t heal her, he was able to provide a smile in both of their hearts and a beautiful memory for a chance meeting a couple of years later.

I remembered how excited he was when we visited them wife back then. Even in her weakened state, she was, for a few minutes happily content during our visit. And I couldn’t have been happier to have Sam put a smile on their faces back then and definitely again during this chance reunion with the husband. We chatted and caught up as much as you can with an acquaintance who you’d met years ago. But he was genuinely glad to see Sam again. Likewise, Sam was equally thrilled with the reunion and seemed to remember him too. We always remember those ‘good’ encounters and the lives of those who touch us in special ways and who provide us with beautiful memories then and always.

Live, love, bark! ❤

 

Alright Mr. DeMille, I’m ready for my closeup

We recently were invited to participate in a photo shoot for the hospital’s ongoing efforts touting our group on the website. Hi there, Sam here. Because I’m one dashing looking dude, I volunteered immediately. Here’s a collage of some of the many pics the photographer took of our group. Some of us were so excited (Fergie, the American Bull Dog never stopped wagging her tail while she was visiting with the “Dogtor.”) and others were so happy to get to lay on top of with patients. Even Pepe, the party colored Standard got to met with a cute little girl in the lobby. You should be able to click on each pic for a bigger view. So, who do you reckon is the fairest one of all? Think I’ll get the call from general casting for more closeups?

collage-with-title

All of us enjoyed showing off ourselves, and visiting with the people and staff who helped complete our stagings. A big thank you to each and every one of the dogs and their uprights who take the time to visit patients, staff and visitors at the hospital throughout the year. You guys are the best!

Have you ever seen pet therapy at work in a hospital or at a nursing home?

 

P.S. Sam’s mom here. Many thanks to everyone who left such sweet comments about “Elsa’s coming out” post. One week with us and she’s doing great, has gained some weight to go with her improved confidence and has taken to liking furniture.

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Live, love, bark! ❤