Taxi cabs were still an important part of the cityscape in 1972. In an effort to pay my way through college, I drove a Yellow Cab in Dayton, Ohio during part of that year. My cab was #30 and that has been my lucky number ever since. Those seven months behind the wheel of a taxi exposed me to every facet of life. And as I look back on my cab driving career, one fare that took 20 minutes from start to finish eventually brought me to my last career position; volunteering and working for a local hospice.

On a very drizzly, dreary, dark evening in late February, I was dispatched to the Emergency Room of Miami Valley Hospital to pick up a fare. Since the location of a hospital’s Emergency Room is familiar to everyone that was where most taxi related hospital pick-ups were. Emergency Room fares were always interesting because I never knew if the fare would be a banged up Emergency Room patient being released, a staff member needing a ride home, or any of a myriad of reasons someone needed a ride.

As I pulled up, a small, frail woman probably in her 80’s approached my cab. I got out and assisted her into the back seat. Her address was on Xenia Avenue, just east of downtown. Since we were heading to an older part of the city I asked her about the neighborhood, how long she lived there, etc. I always enjoy hearing about the “good ‘ol days”. She talked for a bit about the neighborhood then gently turned the conversation towards me. I told her that I was recently married and my wife had been a nurse for about a year.

“Oh, you two have your whole life in front of you.” She sounded so happy and excited.

Then, as she gazed out the side window of the cab, said that she had been at the hospital visiting her husband of 63 years and that he was very sick. I wasn’t sure how to respond. But after a few seconds of quiet, she continued talking, almost wistfully, about her husband and their life together. Being newly married, I found it fascinating.

“His nurse said that he wasn’t doing very well and that he needed his rest. Someone came in and said that visiting hours are over and that maybe I should go home and get some rest, too.” Talking softly, as if to herself, she said, “He is going to die tonight, I know it. They wouldn’t let me stay.” I thought to myself, “After an entire life together, on a day that was just as important as their wedding day, why did the hospital staff send her home? Why separate them when their need for each other is so intense?”

I pulled up to their house, the house they moved into as young-marrieds over 55 years ago. Low clouds and drizzle muffled the sounds of the city and dimly reflected the lights of downtown onto the small front yard. Hurrying around the cab, I opened the taxi’s rear door for her and she slowly got out. I instinctively put my arm around her and walked her up to the front porch.

She gave me the house key and I let her in. She wished me and my wife a happy life together and as I turned to leave she embraced me, pressed her head in my shoulder and started to sob. “He was such a good man. I’m going to miss him…I’m so scared.” Caught off guard, I held her for a bit. I did not want to leave her.

Again she said, “He’s going to die tonight. I know it. Why wouldn’t they let me stay?” Again, I had no reply. She turned, went in, and I stood there as the door closed. After a moment I turned and took a few steps toward my cab. I stopped. My bottom lip started to quiver and my eyes moistened. Gazing back at the dark silhouette of her house I realized her life was ending, mine was beginning. It was as if she passed the baton of life to me.

A lot has changed in the medical field since 1972, but the change in the medical field has not just been in technology or pharmaceuticals. There has also been a change, albeit a small one, in the thinking on the part that the family plays when dealing with a serious illness. Through the hospice philosophy, we are turning back from medical invincibility to reality.

When I think of that woman I picked up from Miami Valley Hospital, I think how different it would have been had hospice come to America by that time. Hospice care has brought some common sense into what modern thinking had turned into a clinical event: the end of life. Common sense, or maybe I should say “hospice sense”, tells me that the woman’s husband did not need rest. Rest for what? He needed his wife and she needed him. She needed to be with him and to comfort him. Couldn’t the hospital staff have bent the rules just a little for her? All these years later, I still think of her. Little did I know that that short fare would eventually bring me to hospice.

Twenty five years later, in January of 1997, I saw an ad in the paper about hospice seeking volunteers and instinctively knew that I had to do it. I didn’t know much about hospice then but I did know that hospice care focused on people. That it encouraged family and friends to gather when someone was approaching the end of their life, and not send family home to “get some rest”. In fact, many times at the hospice where I now volunteer, our staff has helped a spouse get in bed with their dying partner so that the one could comfort the other.

When I got back in my taxi that night the dispatcher was calling my number. He had a pick up for me at the Galaxy Club on Linden Avenue….It was a “go-go joint”…. And life went on.

Late on a recent Tuesday afternoon a text was received by one of FAIRHOPE Hospice and Palliative Care’s military pinning volunteers. The text, sent by one of our social workers read, “Are you available for a pinning tomorrow, by chance? The family is flexible with time. In town.”

The volunteer immediately replied to the text with a, “Yes.”

That simple text exchange between one of FAIRHOPE’s social workers and a volunteer got the ball rolling. In other situations where the end of life is eminent, our volunteers can immediately leave their homes to arrive at the veteran’s bedside as soon as possible.

The text from the social worker was alerting the volunteer that a Vietnam veteran, Bill, had just been admitted to our family-centered care. Upon learning from the social worker that we offer a military pinning ceremony for veterans on our service Niki, Bill’s daughter, eagerly agreed to it.

“We knew he wanted to be honored for his service.” Niki said.

Adding, “I’d never heard of it. I didn’t know such a service was offered.”

In this case the veteran was at the very end-of-life and the Military Pinning Ceremony would have to be performed soon.

The volunteer quickly sent a group text to the other three FAIRHOPE volunteers who have dedicated themselves to honoring our veterans. The text alerted them to the time and location of the event.

All of the pinning ceremonies are performed where the recipient lives and in this case the location was Bill’s house across the street from the fairgrounds. His bed was in a small room at the front of his house.

Arriving early in order to learn a little bit about the recipient, the four volunteers and Bill’s family gathered around his bedside. That little room quickly filled with laughter and war stories as the volunteers and Bill’s family realized that all had ties to each other through, believe it or not, the crossroads hamlet of Maxville.

Being a military family, military pictures and medals from all of the family members were prominently displayed on one of the walls of the room. No hall, no stage, no parade ground could have matched the feeling in that little room. There simply could not have been a better location.

One of the hallmarks of FAIRHOPE’s pinning ceremony is that any family member is encouraged to participate by fastening one the pins to the recipient’s garment. They, also, were affected by their loved one’s tour of duty so they, also, are given an honor. George, one of Bill’s nephews, a Marine veteran, and Niki agreed to do the actual pinning.

Throughout, Bill was in the deep sleep that is characteristic of the end of life. But even at this stage of life, he could still hear.

The ceremony began when one of FAIRHOPE’s volunteers, acting as the facilitator, told Bill that he was being honored for his service. As he lay silently in bed, hands crossed on his chest, Niki reverently fastened the American Flag pin on her dad’s garment, over his heart.

Then his nephew, George, fastened the Branch of Service pin beneath the flag pin, briefly fumbling with it due to tears blurring his vision. Only a few faint sniffles disturbed the silence.

Following the actual pinning, the facilitator expressed FAIRHOPE’s appreciation for Bill’s honorable and faithful service to our country. Another of FAIRHOPE’s volunteers read the official certificate from the “We Honor Veteran’s” program and presented it to Niki.

The ceremony was closed as all veterans present formed around the foot of Bill’s bed. When Bill’s nephew, Will, gave the command, “Present, Arms” all veterans snapped to attention. They saluted and held their salute. After a few seconds, Bill’s right hand moved slowly up his chest to his chin and after barely touching his nose, it plopped back down. With literally every ounce of energy in his body, he had returned the salute.

If there was ever an example of “Once a Marine, Always a Marine” that was it.

Niki said the military funerals with the presentation of the flag, the 21 gun salute, etc. are for the benefit of the surviving family and not seen by the veteran. But as she watched our ceremony unfold she realized that, “Bill was fully aware of what was happening.”

“He knew he was being honored. In his final moments he saw that he was appreciated.”

“There is no doubt that this ceremony helped him to let go; Helped him to know he was honored.” Niki remarked.

This event occurred a month before Veteran’s Day, but on that October afternoon, all present agreed they experienced one of most profound Veteran’s Days of their life.

Many aren’t aware of FAIRHOPE Hospice and Palliative Care’s military pinning ceremony. It is part of the “We Honor Veteran’s”, a program of the National Hospice and Palliative Care Organization (NHPCO) in collaboration with the Department of Veterans Affairs. Veterans from all branches of the military, including the Coast Guard and the National Guard are honored.

FAIRHOPE Hospice and Palliative Care focuses on what makes life significant.

Bill died in peace the following evening.

One of the central reasons that FAIRHOPE Hospice and Palliative Care is such a blessing to families is that we redirect attention away from the illness and back to the person on service.

For example part of our intake process is to discuss various aspects of the ill person’s life, including if they were a veteran. Realizing the sacrifices incurred as a member of the military, FAIRHOPE Hospice and Palliative Care offers a military pinning ceremony to individually honor each veteran under our care. This ceremony emphasizes that the veteran is appreciated.

This ceremony is part of the We Honor Veterans program of the Department of Veterans Affairs and is in association with the National Hospice and Palliative Care Organization (NHPCO). The ceremony takes place where the veteran lives and is performed on a 24/7 basis. The actual pinning ceremony itself is not hurried. Time is often given to listen to the veterans stories, whether told by the veteran or the family. We listen to the stories and ask questions. This part of the event can be lively, especially when FAIRHOPE’s volunteers, themselves veterans, share war stories with the honoree.

To give you an idea of the stories told by local veterans, the following are mostly snippets of some of the veteran’s stories and memories they’ve told us over the years. As you read these, you’ll notice that some experienced active combat and some “only” saw the aftermath and horror of combat. Some were in the military during peace time, yet experienced apprehension due to a world crisis that potentially could involve the military. Some were prisoners of war, many never left our shores. Some of the veterans want to talk about their experiences, even combat; I don’t want to think about the stories of those who don’t want to share.

To wit, a fragment of their experiences:

-A veteran on our service was a tail gunner on a B-17 bomber in WWII. He said he felt like he was bravely serving his country until a German fighter shot the tail off of his plane about three feet over his head. “That’s when it became war....and frightening.” he said. Upon landing after each mission, his crew always kissed the ground…evidently the Pope wasn’t the first.

-A veteran told me, at one of our military pinning ceremonies, that his job was to pick up bodies floating in the water, the day after the Normandy invasion. He said he’d scoop up a body, “or body part” put it on the floor of the boat. Take a swig out of a bottle of wine then scoop up another body, or body part, out of the water. Then he’d the take another swig of wine. He said the job took a few days.

-Another guarded the A-Bomb and the plane that delivered it before it took off for Hiroshima.

-During the Korean War, a veteran’s duty was to open body bags containing those killed in combat and confirm they were properly identified. He said often when he opened the bag, “I didn’t know what part of the body I was looking at.”

-Another veteran was a tank mechanic and a crane operator during Korean War. He lifted Ted William’s F9F Navy fighter out of a ravine after it made a belling landing. The event was national news because Ted Williams was a nationally famous professional baseball player. (He was the last player to hit over .400)

-When asked about his service, a veteran told one of our nurses, “I killed people.” Then began to cry.

-The son of a veteran said that his dad always kept their refrigerator stuffed with food. Later in life he learned his dad had been a starving POW and never wanted to be out of food again.

- The family of a veteran on service told me he was the actual person whom the movie “Platoon” was based upon.

-A veteran on our service said in late 1959 he was in the honor guard when Cuban dictator Fidel Castro arrived in Washington D.C. to meet with Vice President Nixon. He said he stood directly behind Castro and said he had a “…bad case of dandruff.” (Well, now we know.)

-Speaking of Castro, a veteran on service in the National Guard during peacetime was deployed combat ready, to the Gulf Coast area during the Cuban Missile Crisis in the Fall of 1962.

-A veteran told me he was in Vietnam’s DMZ during 1969-1970. All he said was, “A very dangerous place.” He then looked away.

-The wife of a veteran we pinned said her husband was a crew member “ of a submarine in the River” in Vietnam. Their mission was to drop off Navy Seals involved in covert operations.

-The wife of a Vietnam War POW told me that many years later her husband mentioned that surviving the experience proved he was stronger than he thought.

-One of those honored with our military pinning ceremony had served several years as part a security detail that kept constant vigilance of the airspace over Washington D.C. During 9/11 the security detail was ordered to shoot down everything they saw in the air. The plane that hit the Pentagon was undetected because it flew below the radar. He said that he was so afraid that he would have to kill innocent civilians.

The stories I’ve heard convince me that the transition from military service to civilian life is never fully complete.

Thank you, veterans.

 

    

“This may be a dumb question, but…” That preface to a question is something FAIRHOPE Hospice’s staff hears frequently from family members of those on service. They might be asking about the illness, if there is more they can do to care for their loved one, or if they are “allowed” to do something in particular.

There are no dumb questions for us. We understand the family is under strain and sometimes aren’t thinking as clearly as normal. Depending upon the question we give an honest answer or reply with a, “We’ll see what we can do.”

Since our care of the person and their family deals with all facets of life, the questions asked might not necessarily be of a medical nature. Often the questions deal with last wishes. Surprisingly, questions regarding last wishes, or Bucket List type questions, most often deal with one-last-time desires. Many people on hospice service want to do something one last time. My experience has been not many people want to “See Rock City” at the end of life.

Recently, Tammy, one of our nurses, completed arrangements to transport a man on service from his home to The Pickering House. The man was born and lived most of his life in rural Perry County. He and his son loved to fish together and as the years went by, his grandson joined them. After retirement he and his wife moved to Florida.

When the man became seriously ill, he and his wife moved back to their beloved Perry County to be cared for by his son and daughter-in-law. Their plan was to stabilize his health so that they again could go fishing; at least once more. Regretfully, things didn’t work out as planned and he was admitted to FAIRHOPE Hospice.

He was bedridden when we admitted him and remained so. His wife and grown children cared for him at home. In time it became necessary that he was brought to The Pickering House, our in-patient facility. His health was deteriorating and additional nursing care could be administered there.

Arrangements were made and the next morning the transport ambulance arrived and preparations were completed. As the man was placed in the back of the ambulance, his wife joined him. She had the empty feeling that this was their last ride together. His son and teenaged grandson were to follow in their car. Our nurse Tammy, who was the man’s nurse and assisted the family prepare him for the transfer, was to follow in her car.

But before everyone got in their cars, the son asked them to wait. Hesitantly he asked Tammy, “This may be a dumb question, but…can we stop by the lake? It’s on the way and I’d like to take Dad fishing one more time.”

“Sure.” was the quick reply from Tammy. As a FAIRHOPE Hospice nurse, Tammy instinctively knew the importance of that question. Jubilant, the son exclaimed, “Dad, we’re going fishing!”

Initially, the ambulance driver was stunned by the seeming absurdity of the question. However, remembering the many hours fishing with her dad while she was growing up helped her to understand the importance of the request. This was not going to be just another patient transfer.

After notifying her dispatcher of the change in plans, the impromptu “fishing trip” began. A few miles out of town the entourage turned off US 22 and followed the narrow country road to Rush Creek Lake; the lake where they spent so many lazy days fishing. The slight sound of the gravel crunching and popping under tires broke the silence as the vehicles slowed to a stop in the parking area near the shore. I can’t imagine what was going through each person’s mind as they stared at the lake.

After a brief silence, the son asked, “Dad, do you want to try near the standing trees, or fish off the dock?” Even though his dad was semi comatose he knew his dad could hear. The son was painting a picture, reliving their many hours spent together fishing.

“Would you like to be near the water?” asked the driver.

Ever so carefully, she backed the vehicle toward the small boat dock. A tear blurred her vision as she realized that she was allowed a part in this intensely sacred event. Gingerly, everyone helped move the gurney onto the pier then stepped back. Words were not necessary. I’ve heard it said when a dad gives to his son, both laugh; when a son gives to his dad, both cry. There wasn’t a dry eye.

“This looks like a good spot, Dad.” Since childhood, how many times had he said that to his dad?

“You find a good place to sit down, Grandpa, I’ll get the tackle box.”, said his grandson.

They were creating another day at the lake. The son then cupped his hands to bring up some lake water. As he let the lake water roll over his dad’s hands, he could sense a smile on his face. For his dad, it was obvious that the frustration he experienced in his final months of not being able to go fishing was gone.

To those present, the entire Universe boiled down to just that scene on the dock; Grandpa, son, grandson fishing. Observing this his wife, almost whispering, said, “This will be forever in my heart, I will never forget this.”

What started as a simple transfer from home to The Pickering House unfolded into an event that made a lifelong, life changing impression on all of those involved. Tammy, the FAIRHOPE nurse, did not hesitate when the son asked if he could take his dad fishing one more time. She knew that fishing doesn’t just mean fish. She sensed that fishing must’ve been an important part of this father/son relationship. It was just that simple.

The patient was non-communicative, but that didn’t matter because men communicate through an activity more than they communicate by talking. This last fishing trip was a way for father and son to reminisce about their life together and to say a final good bye. The man’s son and grandson talked to him as if they were all fishing, but in reality they were communicating a life time of love and memories. Boys inherently follow their dad’s example, not their advice. And what a profound example this was for the grandson.

Although losing a husband, a Dad, a Grandpa is sad, the family had good memories of his last day. FAIRHOPE allows families to do what they feel is necessary to complete their life, and will try to assist if needed. Hospice doesn’t change what is going to happen but it changes how it is going to happen.

It is never too late to take your dad fishing, or to help him enjoy his favorite hobby.

 

 

Nursing is one of those careers that has steadily evolved. As the field expands and adds more responsibilities, what the career actually entails seems to be getting less clear-cut. I think the simplest definition of a nurse is, “A person trained to care for the sick and infirmed”. On the other side of the coin, The American Nursing Association states, “Nursing is the protection, promotion, and optimization of health and abilities, prevention of illness and injury, alleviation of suffering through diagnosis and treatment of human response, and advocacy in the care of individuals, families, communities, and populations.”

Not too long ago the hospice where I work received a thank you card from a man whose wife had died on our service. In the card, the man thanked, “ the nurse who sat on the floor at (my wife’s) bedside with us when she had expired. (Our nurse) Tammy waited patiently and lifted our spirits while waiting for the funeral director to arrive to retrieve the body.”

The man’s wife had died at home in her bedroom. Since no one wanted to leave her alone, they sat on the floor. Tammy knew the family needed comfort, so she, too, sat on the floor with them. I’ve heard it said, ”People don’t care how much you know until they know how much you care. ”Tammy cared enough to take to take as long as was necessary to wait for the funeral director’s arrival. That simple gesture meant so much to the deceased’s family.

Absolutely, there is a need for advanced degree nurses, nursing professors, directors, leaders, etc. But at the end of life, the only need is for “a person trained to care for the sick and the infirmed”; a hospice nurse.




— American Nurses Association[36] (36) ANA Considering Nursing…Retrieved Dec 2018
(ANA website 2015) …found at acadamia.edu on 7/17/2020 and in wikepedia

Fairfield Today

Your Hometown Connection
In this week's episode, Paul is joined by former Fairhope Hospice Today host Rick Schneider. He talks about his newest book, "Simple Human Compassion," which will be available shortly.

Full Video with Rick Schneider

https://www.rickschneiderauthor.com/
 

 

 

      I have a five frame comic strip, “For Better For Worse” taped on the shelf over my desk. The first  frame of the comic show a father and his adult son leaning on a porch railing, at night, looking thoughtfully at the stars. In the second frame the dad says, “I’m proud of you son. You’re doing a good job” In the third frame the son replies, “Thanks, Dad.” In the last frame both of them have a thought bubble over their head with the same thought, “Who says men can’t have profound, personal conversations.”

     That little comic strip, like much of the communication by men, said a whole lot to me with just a few words. Men don’t talk as much to express feelings as they talk to share information. Truthfully, a lot of our communication doesn’t just mean talking.

     Not long ago a man on hospice service was being transferred from his home to the hospice’s inpatient facility for end of life care, meaning he was going there to die. At the patient’s home, as they were preparing to place the patient into the ambulance to transfer him, his son asked if they could stop by him and his dad’s favorite lake to go fishing. The hospice nurse, Tammy, immediately agreed.  She instinctively knew that the purpose was not to go fishing one last time. Tammy knew that this would be the way for the son to say thank you to his dad for all of the happy memories, and to say, “I love you.”
  
     When I was going through my training to be a hospice volunteer, I went through a communication class. Some of the important aspects of communicating that we discussed in that class were to be opened minded when dealing with people (don’t prejudge), to listen (not just wait my turn to talk) and to observe their mannerisms and body language. Seems strange, but talking was not discussed in that class nearly as much as the prejudging, body language and listening.

     As an example of non-judgmental, non-verbal communication, a family that I was involved with a few years ago comes to mind. The assignment was that of a man roughly my age. Clearly, he was too young to be in this situation. He had oral cancer and consequently could not talk.

     My first visit was on a dreary, cold, Good Friday evening. I am always apprehensive on my first visit because I don’t know what to expect as to the patient’s personality, the family dynamics, the type and condition of the living quarters, etc. Since I am entering another family’s inner sanctum I must be accepting of their way of living. At this stage I make a conscious effort to be completely open minded. If I’m not, any of my body language or facial expressions may signal disapproval. Non-verbal communication plays an even larger role in our lives that verbal communication.

     The apartment that I was entering is where this man had lived for years and it was in this apartment that he chose to complete his life. His room was filled with display cases of swords, daggers, battle-axes and various other types of weapons. Many more similar items were mounted on the walls. Even the man on service was covered with tattoos of daggers and swords. His hair was combed back in the classic duck-tail style of the 1950’s. My first impression was that he must’ve been a “pretty tough customer” at one time.

     As mentioned, he could not speak so during this first visit I learned in a hurry how he conveyed when he needed his mouth moistened or the TV channel changed. About a half an hour into the visit his 9 year old granddaughter arrived, she was a “spittin image” of the girl who played the middle daughter on the 80’s sitcom, “Full House”. This little girl had the same hair style, same voice, and the same looks as the character Stephanie.

  After her arrival she took off her coat then come over to her Grandpa’s bedside. She pulled over a chair, stood up on it, gently raised his head off the pillow, and brushed his hair. She pulled down his blanket and sheet then brought them back up and tucked them under his chin.

     Next she moistened his lips with a toothette (a small sponge on a stick), wiped his face with a warm wash cloth, changed the TV channel to his favorite show and finally sat down on the chair next to his bed. She tenderly put her hand through the bed railing placing it on the mattress near his waist.

     I thought the patient had been asleep because his eyes had been closed and he was passive through all of her activity. He slowly moved his hand off his abdomen and onto her hand. As their fingers entwined, I felt a tear form. I was profoundly touched by what I had just witnessed. After a minute, she looked at me and said, “This is how he tells me that he loves me.”

     Sometimes there are no words to express what is being felt. What I witnessed was love in its purest form. She communicated love to him without saying a word, and he as well. One half hour earlier I had entered a somewhat dingy apartment filled with the acrid smell of stale cigarette smoke. I had entered the room of a gruff appearing patient. It was a room that was filled with articles of violence. In very short order, in a very quiet way, I had learned about love, tenderness, and communication.

     It’s easy to get wrapped up in the surface drama of a situation and overlook the silent connection of the eyes or the tender affection of two hands touching. This little girl taught me that to truly communicate all you need is a hand to hold and a heart to understand. I haven’t had a hospice family yet who hasn’t taught me in some little way that communicating doesn’t just mean talking.

 

Author Rick Schneider