Transition

Another active day at the Hospice last night. I had to leave 15 minutes earlier than the scheduled time last night as I had promised by neighbor who had left on vacation to feed their pet pig sharp at 8 a.m. and 8 p.m. as my duty time is 5 p.m. to 8 p.m. every Saturday.

5 deaths - 1 transfer - 4 new admissions - 1 patient who got admitted at the age of 108 last week is still in the Hospice care center. There was a retired doctor (relative of the patient) who visited this patient several times. Among the volunteers, the patient in Room #16 got special attention from them as she was extraordinary sweet to everyone who was looking after her. She was only 57 years old but there was no sign of any stress in her face about transition even though she is marked Level 4 in the chart.

When I entered the Hospice, two young visitors probably in late teens or early 20s were unloading a lot of things from the car. After I parked the car, I went directly to them and asked whether I could help them carry a few items inside. They were very surprised by my offer and politely said, "Thanks, We got it" and reluctantly agreed to give a bag to me after I insisted.

5 visitors came for Room #1 and after I guided them to the room, one of them came back and asked why the patient is unconscious. We were puzzled and I walked up to the room to find the patient not responding to the visitors calling her repeatedly. Then, I went to the Nursing Station and asked the nurse what was going on with that patient in Room #1. She came to the room and politely responded directly to the visitors that they had given her Morphine to reduce her pain and she would be awake soon. Later, the visitors when they were about to leave, I asked them whether she talked and they smiled and answered she was able to converse with them.

1 new patient came when we were on duty completely unconscious. Those two Ambulance guys who brought her in were very nice and systematically helped to move her to the bed like handling a flower. I told them to pick up some cookies and coffee and they responded that they would leave the stretcher in the ambulance and come back for it with a smile in their faces. There is so much to learn from these guys motivation to do it day in and day out with a smile.

Only one patient was a major concern to all volunteers throughout our stay in the Hospice. She was constantly shouting at someone to get out and screaming non-stop. When we approached the nurse, she said, "the patient is in delirium and probably recalling some of her past happenings". The door was shut but I was very concerned that her shouting may make other patients nervous. The nurse clearly explained that they couldn't do anything to stop her screaming as she was given the maximum dosage for pain management.

Each one of their volunteers had their own life stories and let me get to it another time.

Viswa

 

Dear Smt. Jayasala:

I wondered what would be the mindset of 108 year old when he was admitted to the Hospice? By divine grace, you answered my question through your response. The doctor who visited him was himself walking with the help of a walker but was very frustrated about his need to visit his elderly relative. It showed up in his interaction with us. However, we are all trained to be patient in all situations. We are all not saints but at the same time do everything possible to avoid any unnecessary friction as our focus is to pay attention to those who transition and the visitors who come to see them. Their demeanor is irrelevant.

Viswa

 

Slowly, I am beginning to learn it is a privilege to be of help to the Hospice and the patients who are transitioning in the Hospice. It was not very active day last evening with only 14 patients and most are on medication for pain reduction. 4 deaths in the last 24 hours and 2 transfers. 1 Patient came in when I was on duty. My co-volunteer has been volunteering for the past 17 years and really a very experienced volunteer. He has a lot of health issues but volunteers at least 2-3 days a week. He lives alone and has no family.

He shared a transition experience that happened on Monday with me. He was asked to be near a transitioning patient and he noticed the patient was unconscious. Suddenly, she started lifting her left arm up and took a deep breath and didn't breath for good 3 minutes. Before, he could rush for help, she started breathing again and lifted her right arm again and took a deep breath and didn't breath for another 3 minutes. This time, he called for a nurse. When he was calling the nurse, she lifted both her hands and took another deep breath and stopped breathing. This volunteer believes that someone took hold of her in her transitioning. Hearing this made me understand how hard it is for every life to disconnect with the world and sometimes may need external assistance.

Viswa

 

Saturday - January 26th, 2019

19 patients - 4 new admissions - 6 deaths in the last 24 hours (some are <60 years old). The care center at the Hospice had so much of activities last evening. One patient got admitted at 4:45 p.m. just before I joined duty at 5 p.m. had 20 visitors in an hour. I didn't know who the patient was. However, I had a chance to sit with a patient until the drip ends as only volunteers or nurses could take responsibility for that and not visitors. Nurse was busy with so many patients in and particularly, she asked me to notify if the patient was gasping for breath or wakes up. He was suffering from Alzheimer is what I learned from the visitors as his records was not updated as he was a new admission. To my surprise, he woke up soon and I promptly notified the nurse. She thanked me and discharged me from my duty of watching the patient.

A few minutes passed and the nurse came running calling for me. I thought something worst happened. As soon as I walked into the patient's room, he held my hand and said, "Thank you" for my services. Tears dripped from my eyes to watch a person not recognizing his own kith and kin caring to thank a total stranger.

All 20 visitors were very patient waiting outside the room to take turn to visit them. They were sure that he was not going to recognize them. But they were visiting him out of love and bring closure for themselves. I came to know later that he wouldn't make it to the next day as per medical team but who can predict it accurately?

A gentleman came as a visitor and asked me to guide him to his dad's room. Instead of showing direction and I accompanied him to the room. He thanked me profusely and when he left the Hospice he said, "Let me prepare myself as I expect my dad to leave tonight". I said, "I am so sad to hear that but we are here to let you know if something happens before you return". He ran to his car and came back to say, "Thank you for your service".

Another lady came to visit a relative. I looked at the senses book and noticed that she could be visited only with a gown and face mask. I told her about that and took her to the door of the patient's room. I told her to clean her hands, gave her a gown and face mask. Unusually, the door was open as it is general practice to keep the door of those patients with infectious disease closed. I notified the nurse and she said it was kept open intentionally as she need to do paper work and rush back to the patient.

 

A few years back, someone explained the rational for being a vegetarian. Human beings being the most advanced with discrimination should use very little in the food chain and help as much as possible to other species to balance the nature. Keeping that in mind, I felt the human beings have help from others but not an animal who is entirely relying on me for the timely meal. Moreover, his unconditional love welcoming me with his usual grunting and tail wagging makes me feel very connected with him. Please read my Oliver & I

There is a senses book made available for the use of volunteers. This is exclusively patients data and hence we need to handle confidentially. If we carry the book with us, we need to have them secured. If we use in a patient room, we need to cover it in a fashion data is not visible to anyone. Senses data is prepared everyday and all the information provided above are changes in the last 24 hours. This information gives you the magnitude of how many deaths are happening in the Hospice.

Like you, I am inquisitive about this as well and hence I am trying to experience it watching them. I feel those who know in advance that they were going to die and it is a question of when, they reconcile their mind to be prepared for eventual departure. May be they systematically shut down their connection to the world and wait for their turn. If mind is focused on how to handle death, then, all of the energy is on single subject. If you read a comment I have made about a person leaving after lifting both her hands, it gives me the impression that even dead people help living people transition smoothly.

The man and woman were very young and they could have done themselves. I know they were visiting probably a mid-aged relative of them and I wanted to make their experience better in the Hospice. That is all. I will watch my back.

Kindly read this thread regularly and I will keep sharing those experiences as well. Veterans, loved ones benefiting from the Hospice care, spiritual experience, considering healthcare volunteering is the best way to give back to the community, etc. are primary reasons. Some of them have been treated for cancer and experienced remission. One volunteer works for Department of Correction and face a lot of Felony criminals and Juvenile facing trial. Unfortunately, her son is in the system for illegal possession of drug going through rehab. She lost her husband in the Hospice. Despite all those sufferings in her life, her volunteering for the Hospice makes me wonder what a determination she has to give back to the institution that took care of her husband. Some have other health issues with no family but still volunteer instead of staying back at home. There is so much to learn from them.

 

Saturday - February 2, 2019

As usual reported at 5 p.m. for 3 hour shift. In the training, the most important lesson I learned is not to get agitated by the happenings around but to focus on the duty and keep ourselves in cheerful mood. I see that in all the nurses working for the Hospice.

The senses data indicated there were 17 patients out of 20 beds and 1 patient to come during our duty. 2 patients came in during the earlier duty period for the day. 5 deaths within the last 24 hours. Finally, I got an opportunity to volunteer by the bedside of a patient who was restless. He was a new patient and hence I couldn't find details of his disease. However, there was a marking against his name that he is categorized as "Level 4".

As soon as I walked in, other volunteers informed me that the duty nurses was looking for me. I rushed to that room and both nurses were happy to see me. They explained that the patient is very restless and trying to remove the catheter despite tying his hands with a cushion like pad. They asked me to watch him until he goes to sleep as they have already administered pain killer to him.

He was moving around for good 5 minutes. I started reciting a few Mantras silently in my mind to ease his tension for my own sense of fulfillment. The pain killer worked like a dream and within 20 minutes he was fast asleep with stable breathing with no body moments. The nurse came in and told me that I can go and take care of other duties.

A new patient came in at around 7:20 p.m. and I showed the room to the ambulance staff. They were dressed in white and always smiling. They took a candy from the jar kept in front of the reception desk and when I asked them to help themselves with cookies and coffee, they gently refused.

Sharp 5 p.m., I heard that one of the patients passed away and I came to know about it later because the Pastor came in to conduct a ceremony in the hall where the family members assembled. They hugged each other and cried. I walked by and distributed tissues to each one of them and some gently thanked me through their eyes while others focused their attention on the service. This service happened after I finished my duty with a patient who needed my attention in his room. Later I came to know that the Pastor wasn't pleasant to the family members and the volunteers. Perhaps, he had a bad day before the service. He wrote the patient name wrong in the register and rushed the entire service. I

While other volunteers expressed their interest to report to the coordinator, I told them to let it go and leave it to the family to determine further course of action. The family members stopped and thanked all of us before they left the premises. Generally, most visitors are very kind and considerate. We always accompany them after finding the rooms of their loved ones in the register.