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 fath...

 

comic

 

      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 hospi...

 

paper butterflies

 

      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...

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

       The woman had been non-communicative and sleeping long hours for several days when one of my hospice’s volunteers, Janet, came to vis...

Baby Deer Fawn in Ohio



       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 

     A little boy went to the cemetery with his dad on Memorial Day to visit his grandpa’s grave. His grandpa had been killed in combat. The...

grave, boy


     A little boy went to the cemetery with his dad on Memorial Day to visit his grandpa’s grave. His grandpa had been killed in combat. There was a flag next to the headstone. “Is this the only day we take time to remember the people who died while in the military?” he asked his dad. 


     “Every day is Memorial Day for us who lost family.” His dad replied.


     Any hospice organization has had veterans of combat on service. Most of these veterans have never been able to leave the trauma of combat behind. It is not by choice that the memories have stayed with them their entire life. And so it is with the surviving family and friends back home of someone who was killed in combat. The feeling of loss has stayed with many of them their entire life, as well. 


     Most hospice’s offer a grief service that is opened to anyone who has suffered a loss; particularly someone who has suffered a loss that they are told  they should “be over it” by now.


     Memorial Day was established to honor those who have died while serving in the United States military. It might also be a day that maybe we, who have not had a close family member die in combat, call someone who has. Where do soldier, marine, airmen, sailor, and Coast Guard combat casualties come from? They come from families. The survivors of someone being remembered on Memorial Day may carry the war with them for the rest of their lives, just as surviving combat veterans do.


     If you know of someone who lost a person during military service, call them and mentioned the deceased by name. Let them know that their loved one is remembered, and not just on Memorial Day.

 

Author Rick Schneider 

       It took a long time for me to realize the significance of Memorial Day. All through childhood and into midlife, Memorial Day consiste...

 

parade

     It took a long time for me to realize the significance of Memorial Day. All through childhood and into midlife, Memorial Day consisted of a small parade from downtown to the veterans section of the cemetery. Then, a little while later, there was the distant boom of a 21 gun salute. And by noon it was the Indy 500 and a big cookout. But over the years as I’ve learned so much from the veterans we have on service at FAIRHOPE Hospice my way of “celebrating” Memorial Day has changed. 

     I wonder how the families who lost someone in the military, especially combat, feel about Memorial Day. It truly takes a family to defend a nation because those in the military come from families. I saved an article that was in a special issue of Newsweek magazine featuring an interview with a Vietnam veteran, who was 21 year old when the described firefight occurred. In it, he described his experience as to how combat in Vietnam occurred. It follows:

     “We were brought into La Drang on a Huey helicopter, and I had a few minutes to stand around and look at the area, which was just like every other operation in Vietnam. It was jungle. I was an assistant machine gunner that day with my friend Russ [ . . . ]. We traded off manning the weapon every other day. We barely had time to get our bearings when we came under heavy fire. And when the firing started, it wasn’t like a sniper shot or anything. It was bullets and bombs and grenades and everything going off simultaneously”.

     “And all at once, everyone around me is getting shot. My friend [ . . . ]was right in front of me and he got machine-gunned across the stomach. He dropped at my feet and was screaming for his mom. It was like something in a movie. You just can’t believe your eyes or your ears. And there were other guys just lying there dead, still in firing positions. So that scared the hell out of me. At that moment, my instincts and adrenaline just took over. I just ran, following Russ Adams, who was heading for the mountains with the machine gun. Since I had all the ammo, and the only weapon I had on me was my .45, It seemed like the place to go.”

     A friend of mine is a Civil War buff and he told me of letters he’s seen from soldiers of that war describing combat in much the same way as describe by the Vietnam veteran. Even though a mission might have been initiated exactly as scheduled, with a goal and a distinct plan of how to achieve it, once the battle erupted it was pure mayhem.

     Some of the aging spouses, and children, of those killed in combat are not able to get to the cemetery. Some may be having a difficult emotional time visiting the grave site. Maybe this year, before the cookout, feel free to thank a person who gave everything by going out to any cemetery. Find a veteran’s gravestone, or plaque, and clean around the site. That’s all.

      Such a simple gesture may have a profound effect on the surviving family, should they find out. And it may help you in that you aren’t saying, “Thanks for your service, I like tomato on my hamburger. “ but actually showing your gratitude. True gratitude is an action word.

    Every holiday has its meal for family and friends to gather around. For this Memorial Day, I’m not saying to give up the grill. I am suggesting considering making the cookout something for the end of the day, not the purpose of the day.    
 
Author Rick Schneider 

     


       There are a lot of articles written about the hospice philosophy, hospice care, who is eligible for hospice care, etc. But not many a...

 

two happy elderly women spending time with each other at home


     There are a lot of articles written about the hospice philosophy, hospice care, who is eligible for hospice care, etc. But not many articles are written about humor, or laughter, in the hospice setting.  Having been a hospice patient care volunteer for over 20 years and a paid employee for over 11 years, I know that hospice is serious business. I also know that hospice, especially the one where I volunteer, celebrates life. And life may involve laughter, but hospice is no laughing matter, is it?

     Of course, we’ve all heard the overworked phrase, “Laughter is the best medicine.” It may be an overworked phrase, but it is also a well documented truth. Laughter is just as necessary in life as are tears. A friend of mine told me that laughter may be the best medicine, but if you are really sick, maybe you should call a doctor. Good advice.

     It is important to know that used correctly, humor does not disrespect the situation nor diminish its gravity. It can allow what is happening to begin to be discussed. Humor may open the door to acceptance and healing. It is up to those involved to find the humor is any given situation.

    Humor may be in the form of a funny situation or a joke. In my case I can never remember a joke so years ago I began writing them down after I heard one that I liked. I’ve kept those jokes in a binder. After I get to know a patient and it seems like the right thing to do (sometimes it is not), I will bring that binder with me when I visit them. I’ll ask the patient and family if they’d mind if I read from my binder. It has never failed when I bring the joke binder we all have a great time. They invariably tell me that they haven’t had a good laugh like that in quite a while.

     There was a particular family I visited as a patient care volunteer who requested what they called, a “groaner-type” joke when I arrived for my weekly visit. A groaner-type joke would be for example, “Why did the cowboy buy a Dachshund?” Answer, “Because he wanted to get a ‘long little doggy’” (groan). 

     When I would arrive to visit, his wife would answer the door and ask,” Do you know any groaners?” I would answer, “Yes. Did you hear about the man who was reading a book on antigravity? He just couldn’t put it down.” She’d laugh and ask me, ”Did you hear about the Siamese twins who moved to England…so the other one could drive?” Then we’d go back to the patient’s room and he couldn’t wait to hear the jokes. He’d always have one ready. For example, “The waiter asked the teddy bear, after his dinner, if he wanted dessert. ‘No thanks, I’m stuffed.’ The teddy bear replied.” The whole situation was fun to me. I remember thinking that I never thought that I would have so much fun visiting a patient. 

     Exchanging bad jokes was fun and it made the patient, his wife, and I think of a silly joke before my weekly visit. There is no doubt that he and his wife were having fun too. Yes, the patient and spouse knew he was terminally ill but we had fun in spite of it. 

     One of my hospice chaplains, Karl, tells the story of a terminally ill patient who is lying in his bed at home and smells the aroma of cookies wafting through the house.

     “Honey,” he calls out, “Those cookies smell so good, may I have one?”
     “Certainly not,” she replies, “Those are for your wake!”

     In one study of humor in the hospice setting it was determined that humor helped to maintain a sense of belonging. It helped patients to relax. It offered a feeling of warmth, lightheartedness, and delight. Humor was a life-enricher and a life enhancer. 

          A study done on nurse-based home visits found that humor was present in 85% of 132 observed home hospice visits. Of these visits, hospice patients initiated humor 70% of the time. In this study, and others as well, humor was spontaneous and frequent.

     A while back, I was accompanying one of my hospice’s nurses while she visited a patient in their home. The family pet was a cockatiel (a bird similar to a parrot). The family would leave the bird cage door open so that the bird could get out and stretch if it wanted to. While our nurse was sitting next to the patient the bird flew over and landed on the nurse’s shoulder. Without hesitation the nurse put her hand over her eye and said, “Aye, matey.” as if she were a pirate. Everyone had a good laugh.

     Instances of humorous interactions between hospice personnel and patients can be a prevalent part of everyday care giving work. According to the researcher in the study mentioned above, “Our research suggests that nurses and other healthcare professionals don’t need to suppress humor. They should trust their instincts about when it is appropriate.” 

     Humor shows the human side of hospice’s staff. It is also an important aspect of communication. Patients will observe the nurse or aide for a response to humor. An open accepting response to humor signals understanding. While a negative or no response may serve to isolate the patient.

     The hospice where I volunteer helps people to celebrate life. One way to celebrate life is to enjoy the moment, regardless of the circumstance. Laughter is a very effective way to do that. I’m often asked, “How can you work in hospice? Isn’t it sad?” It’s hard to believe that not only is it very rewarding to volunteer with hospice, but sometimes it can also be fun. Yes, laughing matters.
 
Author Rick Schneider