About Medicine: Be thoughtful, be thankful, be kind

Hospice and Home Health Month
October 26, 2016
Doug Peterson, Chaplain
Marcus Daly Hospice


Be thoughtful. Be thankful. Be kind.
Julianne had lived with her daughter, Muriel, for several years. Muriel and Dick had converted their master suite into a mother-in- law apartment for her, and she was comfortable there. Well into her eighties Julianne had stayed active. She used the community senior shuttle to take her to her weekly activities at the library and senior center. She was also active at her church. Living with Muriel meant that there was always someone there to check on her, get her to appointments, and keep her from being lonely or alone.

Every few months Julianne's son, Keith, would make the three hour drive to pick up his mom and take her back to stay with him and his wife, Georgene, for a week or so. It was a way to stay connected to his mom and to give his older sister a break from caregiving duties.

One Thanksgiving, during one of Julianne's stays with Keith, she had a stroke, fell, and broke her hip. Keith called 911, got his 86 year old mother to the local hospital, and called Muriel to let her know what had happened. This is when things started breaking down. Not only for Julianne and her health, but for Muriel and Keith.

With Julianne unable to articulate her own wishes, the doctors turned to Keith for decisions about how to treat Julianne. Keith, a loving son and strong personality, dutifully took on the decision-making responsibilities: authorizing tests, requesting specialists, and urging efforts to find out exactly what was wrong and how to treat it. When Muriel heard about these measures, she was beside herself.

She had been the one who "knew what Mom would have wanted." In Muriel's opinion, their mom would have wanted to be kept comfortable and well cared for, not be poked with needles and prodded with machines.

Julianne's condition worsened. After several weeks of tension and back and forth between sister and brother, they agreed to have Julianne transported to an assisted living facility near Muriel's home. It was almost Christmas. Family gathered at Muriel's house to celebrate the holidays and to say goodbye to my Grandma. Julianne Swenson died a month later. The last picture we have of her is one of her holding our infant daughter, her great-grand- daughter, Hannah.

Twenty years later, and I'm a hospice chaplain. I share this story about my grandma's last days in order to name and dispel a dangerous myth. You see, there is this Hollywood idea out there that, when a loved one is dying, family members all heroically set aside their petty differences in order to rally around to "be there" for each other and especially for "Mom." But the reality is that dying is incredibly stressful for the patient and the whole family. And under stress, people are generally LESS capable of putting aside their differences. In fact, stress tends to magnify and exacerbate conflict in families (not to mention communities and nations).

Muriel and Keith were always very close (and continue to be to this day). But in that crisis, when "Mom" was suddenly facing death, communication broke down and feelings were hurt. Nowadays, when I am working with anxious and grieving families in hospice, I urge three main practices: Be thoughtful. Be thankful. And be kind.

Being thoughtful simply means thinking ahead. If you have parents who are retired or nearing retirement, you ought to talk to them about things like advanced directives, living wills, and end-of- life decision making. Talk to your siblings as well, and with step-family members, too. You don't all have to be on the best of terms, but please have an open channel for communication about who is making decisions about health care and financial matters that you will someday have to consider. Write stuff down. Don't fight about it.

Second, I entreat people to be thankful to the ones who take on the primary caregiving and decision-making responsibilities. I've had too many conversations with exhausted caregivers whose out of town siblings are unwilling to offer help but more than eager to threaten lawsuits against them for "using up their inheritance" on caring for Dad. My mom and uncle did this part well-Keith always acknowledged Muriel's commitment and sacrifice. Mom always kept her brother "in the loop." The times Julianne stayed with Keith's family were invaluable breaks for Muriel and Dick. This holiday season take the time to say thank you to caregivers for their labor of love: family members, paid caregivers, nursing home staff, doctors and nurses, neighbors, church members, and friends.

And finally, I urge you to be kind. Be kind to each other. Be kind to yourself. Everybody's doing the best they can. Mistakes happen. Feelings get hurt. Toes get stepped on. Stop beating up yourself and others. Get over it. Set it aside for now. This is not the time to try to fix an issue fifty years in the making. Exercise compassion. Say please and thank you. Think before you speak. Don't react to the stupid thing they said to you. Don't pick a fight, and don't get pulled into one, either.

Be thoughtful. Be thankful. Be kind. These are lessons my family learned the hard way. Facing death is never easy. May your family find ways to navigate safely through grief's stormy waters.

Questions and or comments regarding this week's health column please contact, Doug Peterson, Chaplain at Marcus Daly Hospice Center and Services, a service of Marcus Daly Memorial Hospital, 1200 Westwood Drive, Hamilton, MT 59840. Working together to build a healthier community!
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