This past Tuesday when I first arrived at the Reception Desk of the Pickering House for my 4-8p.m. shift the grown son of someone on service came in and asked if anyone had jumper cables. He was parked in the visitor’s lot and his battery was dead. The temperature at that time was around 10 degrees. 

     The volunteer who was going off duty said that she did, so the two of them went out to tend to his car. He was from Michigan and worrying about getting back home. He knew that his father, “Ned” was end of life.

       He got his car started thanks to our volunteer, but said that he needed a new battery. I told him of an auto parts store on Main Street and gave him directions. Since his didn’t want to leave the Pickering House, and I knew that I wouldn’t be able to help him, I gave him my cell number to call me and check on his dad. He was gone almost an hour. 

     I mention this because his dad was involved in what was, for me, a blessed event later in the evening.
    
     Around 7:00p.m. I glanced at our security camera monitor and noticed a Portsmouth ambulance backed up to our patient entrance with the two attendants and an empty gurney waiting for someone to let them in. They were here to transport someone back to where they live.

     Since it looked like they’d been waiting in the frigid weather for a bit, I went back to the nurse’s desk to notify one of the staff. Nobody was there. I went to the ambulance entrance and let the attendants in and explained that the nurses and aides were tending to those staying at the facility. I told them that I would go down the hall and let a staff member know that you were here.

     As I was about half way down the hall nurse Gwen and aide Stephanie came out of room nine and approached me. They explained that the man in Room 9, “Ned”, was end of life but his fiance’ was tearfully begging him not to die. She was holding his hand with both of hers and wouldn’t let go. The nurses already had several urgent patient-care duties that needed attention including assisting the Portsmouth crew. The staff members were in a spot and asked if I would talk to the woman and try to calm her down. 

     As I headed to the man’s room, I glanced in the family area and noticed the man who had the car trouble was sitting on one of the sofas with his hands covering his face. I knew then it was his father who was the center of this situation. 

     When I entered Room 9 I could hear the woman begging Ned not to die. I walked around to the other side of the bed and crouched down so that I would be eye level with the man. His eyes were partially opened and all signs pointed to him being eminent.

     She was crying and saying she will try to be better if he’d just keep living. She was pleading with him and bargaining with him to give her another chance.

      Ned’s son, the man who needed to buy a new car battery, came in and said his dad has been in pain and he thinks that his fiance’ is hurting him by hold his hand. Ned had been fidgeting and turning his head back and forth sporadically every time one of us spoke.

     I had been silent up to that point but after he said that it seemed to be my que to talk to her. I mentioned that Ned’s son may be right.  She stopped crying but continued to grip his hand. There was more conversation as she then began to tell me about the man’s background and his very troubled life. She told how she wanted to help him overcome his troubled life but that she failed. I empathized with her and told her about the glory of Heaven and how he’s not leaving her, but that he will be in Heaven waiting for her; And through prayer her sins will be forgiven and they will be together again. (Let’s hope I was right about that.) Ned’s eyes were half opened and he made no movement.

     His son suggested that the three of us pray for him. The woman said that when Ned prays he lays one hand over the other. I suggested that she do that and proceeded to place his hands on his chest, hand over the other in that manner. She then hesitatingly let go of her grip on him. When she did that the room became quiet. I think we were waiting to see how Ned was going to react. Soon, there was a little more discussion about Heaven, and a little more silence. Gwen came in to check on Ned, administered his meds and made a few adjustments to his laying posture. She offered words of comfort then left. There was a little more conversation then silence. 

     In the next 4 or 5 minutes Ned made what looked like a couple of slight swallowing movements. Then there was a stillness in the room; No question as to what was happening. I felt his neck and did not feel a pulse. I didn’t want to say what I thought because I might be wrong. Finally, Ned’s son said, “It’s been three minutes.” I knew what he meant. I pressed the call button and Gwen came in and pronounced Ned deceased.

    As a FAIRHOPE volunteer, and as a follower of Jesus, it is not my purpose to tell a family member of someone how to feel when their loved one is dying. What “should of, would of, or could of” been done is not any of my business. It is not for me to have an opinion on anything that a family is feeling. That evening I listened to what was bothering her and just helped her focus on the present. I hope that she will be able to have a good life, a guilt free life, without Ned. 

     At home, I got on my knees and thanked God for directing me into this situation.

 

 

Author Rick Schneider 

 

     As a child I liked January. It seemed as if it was the month with the most “snow days” that closed our school. Since our treeless backyard sloped downhill it was the sled track for the neighborhood. There were many long afternoons and early evenings spent out there.

      As a teenager, during my senior year in high school and through a few of my college years, January offered the same thrill and group activity at a somewhat hilly golf course in the city I grew up. One hill was aptly named “Suicide Hill”. During that era of my life I worked on weekends as a bus boy at a night club.

      Myself and the three other guys I worked with got off work at 2:30 in the morning and would head over to. that golf course where quite a few high school and college age students would gather for a night of sledding down the hill. The white snow and the reflection of the city lights illuminated the course well enough to see. It was fun.

      As a parent, several January's later, I would take our young children to the Fairfield County Fairgrounds to go sled riding. It was not long until they went there on their own. The memories of those fun filled January's helped me to enjoy, or at least endure, so many more Januarys through the ups and downs of life.

      I know full well that January can be bleak. It can be especially bleak when you have lost someone close to you whether a life-long friend, a family member or a spouse. It may seem like there you were, and all of a sudden, it’s now here you are.

      As a volunteer at FAIRHOPE Hospice and Palliative Care I have witnessed and come to understand how weather, the seasons and the passing of time can effect both happy and sad emotions. And how the seasonal affective disorder, coupled with the grief for a lost loved one, can sometimes seem unbearable.

      For many of us, sledding down a hill after a January snowfall is not on the to-do list. However, do look for the beauty of snow on the branches a tree after a January snow. Know that you will eventually see the beauty of the snow and the beauty of life. In life we can love or dislike the snow, but either way we will still have the snow.

      It seems like we need to be reminded of things we already know more often than we need to be taught new things. Know that every year will eventually run out of Winter. We know April is on the horizon, as is a full and happy life. Everything is going to be okay. 

 

Author Rick Schneider 

 

An unusual event occurred in the Pickering House only a few years after it opened. The event was a Thanksgiving story that I don’t think will be made into a movie on the Hallmark Channel. It was, however, a nice illustration of how the importance of the Thanksgiving Holiday brings out the best in everyone.

When someone staying for a few days in the Pickering House has an unusual request, we will address it. What adds a little color to this particular event is that it occurred in the late afternoon on Thanksgiving Day.

The woman on service, “Kay”, was spending a few days at the Pickering House. She was depressed due to being alone on Thanksgiving. Her family was celebrating the holiday as they always did at her sister’s house several States away. Being alone in her room Kay just wasn’t in the holiday mood.

In the late afternoon of that particular Thanksgiving evening, one of our STNAs walked into her room and almost gleefully asked her if she was ready for a nice plate of turkey, dressing and mashed potatoes. Kay turned and looked out the window at the dark grey sky and said that she wasn’t the mood for “that type of food”, as she called it. Our kitchen staff had prepared a holiday banquet for all of the staff, visitors and people who were staying at the Pickering House on Thanksgiving.

“Well, what would you like? Our kitchen staff will prepare anything you’d want.”

“They can’t fix what I want.” After a pause and with a sarcastic tone of voice she said, “All I want is a pizza and a beer.” After a sympathetic conversation with our STNA, Kay decided upon some vegetable soup.

Leaving Kay’s room our STNA got to thinking that maybe this is one of those we’ll-see-what-we-can-do situations. She knew that beer was out of the question because of the medication the woman was taking….but….we can order pizza for her!

“Well, why not?” she thought.

The staff also thought it was a great idea and they all pitched in. They ordered several pizzas and a couple of six packs of root beer. When it arrived, the staff brought in extra chairs placing them around the woman’s bed. They began the “feast” by bowing their heads and giving thanks for the food they were about to receive.

What a Thanksgiving dinner that turned out to be! One of the staff members who attended said it was probably the most profound, meaningful prayer before a meal she had ever said. One of the nice things about this Thanksgiving dinner was that when done, no one had to do the dishes or clean the kitchen.

FAIRHOPE celebrates life up to the very end and this Thanksgiving “banquet” of pizza and root beer was a good example. In the gathering of our staff around the bed of someone in the last stage of life, there was joy, there was love and there was life. Yes, life with joy and giving thanks for each other’s presence in that room.

In the words of Charlie Brown’s friend, Marci, “Thanksgiving is more than eating, Chuck. You heard what Linus was saying out there. Those Pilgrims were thankful for what had happened to them, and we should be thankful, too. We should just be thankful for being together. I think that’s what they mean by Thanksgiving, Charlie Brown.” (– A Charlie Brown Thanksgiving, Charles M. Schultz)

Thanksgiving can be the nicest of the three holidays because it takes the littlest preparation. It can be celebrated extravagantly or it can be celebrated simply. The day’s festivities can be loaded with tradition or planned as painlessly as, “Well, why not?”

Happy Thanksgiving!! 

Author Rick Schneider 

One late afternoon a woman entered the Pickering House carrying two grocery bags filled with a variety of items. She told me she was returning the left over supplies we had given her to care for her mother whom she had been caring for at home. As she walked across the reception area she glanced to her left, looking out the window and stopped without saying a word. She was quiet for a moment, staring out the window at the bird feeder in front of Room 1.

Breaking her stare, she approached me at the reception desk. She told me that before she passed, her mom had stayed at the Pickering House in Room 1 for a short respite stay. She told me how important the bird feeder was to her mom, saying that her mom watched the birds every day from morning until after dinner.

“Then the deer would come over and clean the feeders out.” She added smiling.

Her mom said that watching the birds gave her peace and helped her sleep at night. It became obvious that bird feeder was calming the daughter even now as she watched the birds flutter around the feeder waiting for their turn.

When the Pickering House opened in the Spring of 2007 there was one bird feeder in the front yard. That single bird feeder became a focal point almost immediately. Those temporarily being cared for at the Pickering House, as well as the visitors and even our staff enjoyed watching them. And I think that it was more than enjoying it, as there seemed to be a need to watch them. So many commented on the feeders with the overriding theme being that after only a few minutes of gazing their stress seemed to fly way. Sometimes people would sit in the lobby of the Pickering House and just gaze at the birds; Deep in thought.

Realizing the obvious importance of the feeder to everyone at the Pickering House, one of our volunteers, Jason, brought up the idea of a bird feeder outside of every room. Soon, they were bought and set up within a few feet of each window in the 12 room facility. Each bird feeder is in easy sight of the person lying in bed and close enough so that chirping can be heard.

It can’t be emphasized enough that the natural conclusion of someone’s life involves peace. It involves silence. And it involves spirituality. Mother Teresa said, “God cannot be found in noise and restlessness. God is the friend of silence. See how nature – trees, flowers, grass grows in silence; see the stars, the moon and the sun, how they move in silence…”

Who would have thought that, those many years ago, when Jason’s idea of putting a bird feeder in front of each window was accepted that it would have such a positive effect on so many people for such a long time? After all, it’s just a bird feeder. 

Author Rick Schneider 

 

 

Sharon met the four volunteers at the door of her father’s hospital room one April afternoon. Her father, Len, was in one of the Palliative Care rooms of the hospital. The volunteers had been requested to honor her father, a veteran, for his military service with a brief military pinning ceremony.

While in the hall outside of her father’s room, Sharon told one of the volunteers that the room was packed and that there wasn’t any more space for even one person to stand in his room. She said if they’d wait for a minute she’d ask a few people to stand in the hall and watch the ceremony from there.

Soon, with a little bit of confusion and a lot of, “Pardon me”, “Excuse me.”, “I’m sorry.” and one “Oops”, the four volunteers threaded their way through the crowd of family members to get near Len’s bedside and begin the ceremony. Even though Len was in a deep sleep the facilitator introduced himself and explained what he and his cohorts were going to do.

Before beginning, the facilitator asked if any of the family members would want to perform the actual fastening of the pins to Len’s garment. This is a significant gesture because when someone enlists, the family is left behind and most likely experiences separation anxiety. And the same is most likely experienced by the one who enlisted. By fastening the pins to the garment the family experiences the joy of honoring their loved one just as the loved is experiencing the joy of being honored.

Len’s grandson, Chris, serving in the Air Force stationed at Grand Forks Air Force Base, had flown in to be able to witness the ceremony honoring his grandpa. Sharon said Chris idolized his grandpa and always said when he grew up he was going to enlist in the Air Force.

The family insisted that his grandson, Chris, should be given the honor of fastening the pins.

The ceremony began and soon it was time for Chris to fasten the pins. He crouched down at his grandpa’s bedside so that he was eye to eye with his hero and carefully fastened the American Flag pin to his garment above the heart. Then the Branch of Service pin was fastened below the flag. After he finished, he hesitated then put his head down on his grandpa’s chest and softly said, “I love you, Grandpa.” He stood up and took a half step back. Visibly holding back tears he stood at attention. There was a stillness, a deep sense of oneness prevailed in the room for those few moments.

The ceremony continued as one of the volunteers read the certificate and presented it to Len’s wife. The volunteers then individually crouched down to be at eye level to Len and thanked him for his sacrifice to our country.

Five family members in Len’s family were veterans. The facilitator asked if the veterans present would want to join our volunteers in saluting their dad/grandpa/brother to conclude the ceremony. All agreed. They unanimously voted Chris to command the salute since he was active duty.

All of the veterans formed around the foot of Len’s bed. Chris stared at his grandpa, took a deep breath and barked, “A-ten-shun!” The men snapped to attention.

“Present Arms!”

They brought up their right hand and held their salute. Five seconds later Chris commanded, “Order Arms” and their hands came down to end the salute. Chris returned to his grandpa and again crouched down and laid his head on his grandpa’s chest saying, “I love you, Grandpa……I love you.” There were sniffles, and tears were wiped. The salute concluded the ceremony.

There is no calendar and no clock at the end of life. So for FAIRHOPE Hospice, every holiday is celebrated when appropriate. Celebrating a holiday brings a sense of normalcy to a family in crisis. The volunteers were part of FAIRHOPE’s “We Honor Veterans” program and in this case they singularly celebrated Veterans Day in a hospital room on a nice April afternoon with one veteran and his family. It was good.

FAIRHOPE is grateful to all veterans for their sacrifice and we will celebrate their service and their life regardless of the hour, the day, or the month. 

Author Rick Schneider 

 

I have been a patient-contact volunteer for over twenty-four years. During so many of my visits, when the spouse is preparing to leave, she will give her husband (who is on our hospice) the shortlist of hospice staff who may be stopping by. Experience has shown me the most important person expected to visit is no surprise. It is the man or woman who is the nursing assistant. 

Being in the forefront as a somewhat passive observer to hospice, I have learned much about everyday hospice care. A good percentage of what I have learned is not so much what is in the books and brochures about amazing care by amazing staff; rather it is about what is most important to the person receiving the care. Not only is the person receiving a great deal of attention, but so is the family. To see so much attention focused on a loved one gives the family assurance that they are not alone. 

Each hospice generally assigns a registered nurse (RN); possibly a licensed practical nurse (LPN), also known as a licensed vocational nurse (LVN); a nursing assistant (aide, CNA, STNA); a social worker; and the offer of a chaplain and a volunteer to be of assistance. The one who makes the most favorable impression, by my unscientific study, is the nursing assistant. Theirs is a title that varies by region: nurse aide, certified nurse aide (CNA), nursing assistant, certified nurse assistant (CNA), patient care assistant (PCA), and state-tested nursing assistant (STNA). I’m sure that I have left a few titles out, but at the core they are the angels of hospice care. Probably the easiest way to describe what they do is to use the short version of the Prayer of St. Francis. It follows:

Lord, make me an instrument of Your Peace: where there is hatred, let me sow love. Where there is doubt, faith, where there is despair, hope. Where there is darkness, light. Where there is sadness, joy.

O Divine Master, grant that I may not so much seek to be consoled as to console; to be understood as to understand; to be loved, as to love; for it is in giving that we receive, it is in pardoning that we are pardoned, and it is in dying that we are born to eternal life.

Let’s take a look at that prayer line by line, from the perspective of a nursing assistant:

Where there is hatred, let me sow love. Since the late 1990s, I am aware of only two people with AIDS who have been under the care of my hospice’s service. Both of the people, by their own admission, had become infected with AIDS as a result of their lifestyle. And they felt they were now paying the price.

However, their parents were also paying the price, although they had done nothing to deserve it. The parents heard derogatory comments about AIDS patients wherever they went. They hurt because their sons were suffering and because no one seemed to care about them.

No one cared until the families called my hospice and our staff entered their lives. I remember when one of our STNAs gently, tenderly put salve on one of the men’s sores. I felt as if I was watching Mother Teresa doing it. The STNA told me she only sees the need, not the cause.

Where there is injury, pardon. Our home-side nursing assistants visit the people on hospice wherever they live. In one particular setting, a newly hired nurse assistant had a difficult person she was caring for. After a few months, when the dying process started, the man reached for her arm and, in a barely audible voice, said, “Thank you. I love you.” The nursing assistant had taken the brunt of his anger over her previous visits with him. She endured much but understood where it came from. Those five words confirmed that this was where she belonged.

Where there is doubt, faith. People always think of the future, perhaps thinking of an upcoming vacation, a special outing with friends, or simply a day to enjoy one of life’s pleasures. When someone becomes terminal, everything changes because the person runs out of future. Doubt begins to settle in rather than looking forward to what lies ahead. Our nurse assistants remove a person’s doubt and fear by looking at the individuals with the eyes of faith. By their presence, nurse assistants bring emotional and spiritual comfort to those at the end of their life.

Where there is despair, hope. Often, terminally ill people have been lying in bed for an extended period. Often they may experience depression. The anticipation of the nurse assistant’s arrival gives them something to look forward to as a ray of hope.

Where there is darkness, light. I was talking to one of our nurse assistants, Stephanie, and she said that whenever she tells someone she works in hospice, she gets admonished in some fashion. “That’s so depressing.” “How can you work there? Can’t you find something better?” Truth is, Stephanie has been with us for quite a few years, and she told me she wouldn’t want to be anywhere else. She lights up the lives of the people on service with her unconditional and empathetic love.

Where there is sadness, joy. A woman was brought to the Pickering House for symptom management. She seemed depressed. Talking to her, one of the nurse assistants discerned that she had been engaged for quite a while, and now it looked like she and her fiancé would never get married. Hearing this, our STNA initiated plans that were quickly carried out by the staff of the Pickering House, the in-patient facility of my hospice. And the couple was married that evening. While the ceremony was taking place in the Sun Room, the staff eagerly made the new bride’s room into a “honeymoon suite.” Through tears of joy, the woman said, “Now I am complete.”

Grant that I may not so much seek to be consoled as to console. Patsy, one of our nurse assistants, walked into a person’s room to give her a massage. The lady was curled up in a ball, not from pain, but from fear. Over the next hour, as Patsy gave her a slow, gentle massage, she sang and prayed for her. The lady relaxed to the point that Patsy said she would lift the woman’s arm a tiny bit, and it would “plop” down on the bed. The woman went to sleep as Patsy was shampooing her hair. When Patsy told me about this, she said it had been a rough day up to that point, but the ill person came first, and Patty came second.

To be understood, as to understand. Near the end of her shift, Carla, a Pickering House nurse assistant, was pushing a man on service in a wheelchair. He had been restless, and she was hopeful this would relax him. The man noticed a woman carrying her purse, a floral arrangement, and a shopping bag. He asked if he could take them to the door for her. “Sure, I could use the help. I hope my purse isn’t too big,” she said with a laugh. He placed the three items on his lap, and Carla pushed him to the front door, where the woman thanked him. Earlier the man felt that he was “wastin’ away,” as he put it. Intuitively, Carla understood his need to be needed.

To be loved, as to love. I was talking to a woman whose mother had been on hospice. She mentioned that she had never forgotten how tenderly Kelly, the nurse assistant, would touch her mother. She also mentioned that when her mother wanted to talk, Kelly would pull up a chair and sit next to the bed so that she would be at eye level. “Where do you find people with so much love?” she asked.

It is in giving that we receive. Every nurse assistant I have talked to has told me they receive much more than they give. A family member told me that she was “almost startled” by the cheerfulness of our aides.

It is in pardoning that we are pardoned. Our nurse assistants sometimes may deal with difficult people. It is a part of the job. They understand the emotion of a person losing control of his or her life. They easily pardon any negative emotion because it is not aimed at them.

And it is in dying that we are born to eternal life. Angela, a longtime nurse assistant, told me about a woman she was tending to at an assisted living community. When Angela visited one afternoon, she noticed that the dying process had started.

The woman always had a two-bulb lamp lit next to her bed, but as Angela approached the woman’s bed, one of the lights went out. She didn’t think too much about it at the time. Sensing that the woman’s final hour was approaching, Angela sat at the woman’s bedside. At almost the same instant that the woman took her last breath, the second bulb went out. The room was now dim, and Angela was enveloped by the spirituality of the moment. She was there at the most important moment in the woman’s life, as she entered eternal life.

What does a nurse assistant do? I think the quickest way to find out is to listen to the words of St. Francis.

Author Rick Schneider

 

     One of the misconceptions, or myths, of hospice is that it’s a place; some sort of medical building. The notion is that if you sign on to hospice service you will have to go somewhere. With many hospices, you don’t go anywhere. In fact, you stay where you live whether it is your home, a family member’s home, a friend’s home, a nursing home or an assisted living facility.

   However, not to muddy the waters, there are some hospices in America that do operate care facilities for those on their patients. When the famous Washington Post columnist, Art Buchwald, admitted himself into a Washington D.C. area hospice he moved into their facility. That particular hospice didn’t visit people in their home, as the hospice where I volunteer does. Our hospice facility is, at its core, a short term respite facility.

   And when we care for people who live in their house, we understand that it is their house and not ours. Therefore, they may have their bed set up where ever they want. As a hospice volunteer, several of the people I visited preferred to sleep in their living room recliners because they were more comfortable. It’s their home, after all.

   In your home, the feeling of who is in control is brought back to you. In a hospital, or in any type of institution, you are not in control. In your home you are in control and can stay in any room you prefer. During this stage of your life, being in control is one of the most important aspects of life. 

Author Rick Schneider