“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  

 

 

      When I speak to a group about the goodness of hospice care, the first thing I do is ask if there are any questions regarding hospice. Sometimes I will be asked what palliative care is; what is its purpose? And along that line someone may ask if a hospice offers two different types of care. That is, are hospice and palliative care different from each other?

In a nutshell, the difference between the two being palliative care offers symptom relief while allowing the ill person to continue to receive aggressive treatment whereas, hospice focuses on comfort. 

Any chronic illness is appropriate for palliative care with cancer being high on the list. Palliative care addresses the side effects of chemotherapy, radiation and the recovery process after surgery. To demonstrate its scope, palliative care may include treatments for depression or anxiety. Tools to help family members plan for the future are also made available. 

The two types of care are similar in that both are generally administered in the patient’s home. One man told me he wished he’d known that choosing palliative care, as the illness continued, did not mean giving up. He talked about how stress grew as his family dealt with the continuance of care for his brother. Once called, the palliative care team provided physical, emotional and spiritual support. 

“Once we tried palliative care my brother’s comfort and his attitude improved. And to be honest,” he added, “so did ours.” The man mentioned that his brother received palliative care from hospice for over a year.

When someone in your family is suffering from a chronic illness, consider discussing with your tending medical care provider the option of palliative care. And who knows, just as the man mentioned above, your emotional comfort and attitude may improve.

 

Author Rick Schneider 

This is a brilliant, heart-warming, and insightful book full of stories from his experiences as a Hospice Volunteer and as a Hospice Patient-Contact Volunteer, as well as from memories that were shared with him by family members that had a loved one that was cared for in Hospice. This book highlights the care and compassion that Hospice offers to the dying and their family members.

 
Maureen P. Keeley, Ph.D.

Professor of Communication
Texas State University

https://www.rickschneiderauthor.com/Simple-Human-Compassion.html

       The woman had been non-communicative and sleeping long hours for several days when one of my hospice’s volunteers, Janet, came to visit her at the hospice house. The weather was perfect so Janet helped the hospice house aide bring her out to the back patio, in her hospital bed, to enjoy the weather.  

     As Janet closed the hospice facility’s patio door she noticed a deer and her fawn observing everything from the edge of the woods fifty feet away. Janet softly told the woman that a mother deer and her fawn want to visit. The woman very slowly moved her hand through the bedrail. Janet thought that she did this possibly to let her arm dangle in order to better feel the gentle breeze.

     Janet noticed that the mother and fawn were slowly approaching. The little one continued onto the patio while the mother stayed back. The fawn, leaning against the bedrail, walked the length of the woman’s bed gently letting the woman’s hand glide along its head. Janet noticed the sleeping woman faintly smile. The fawn then scampered back to its mother. Janet stood transfixed. A moment later the woman took a deep breath, as if giving a sigh of relief, then died.

     My hospice’s facility is not on a busy street. In my heart I believe that the location was Divine Intervention so that all of His creation, even a little fawn, could help comfort not only those on our hospice service, but also their families, our staff and volunteers.    

 

Author Rick Schneider