Hospice+grief+letting go

This week I am supposed to blog about "a good death." As I'm told this, I'm thinking, "seriously? Could there be a more depressing topic? *sarcasm*"So what does a good death mean to me? I think that a good death is when you have come to terms about what you've done or haven't done, about the life you lived and what may or may not await you. Ideally when it is my time I would like to have forgiven those who I still hold grudges against and forgive myself for choices that I've made. I want to feel ready. I want B to be all grown up and not need me anymore. I want to know that she'll be ok when I'm gone.

I didn't really know what hospice was before this assignment. We talked about myths of hospice care last week in class. I thought a lot of those "myths" were true. After our discussion I decided to look a little deaper. Hospicenet.org has a wealth of information for patients, children and caregivers. It has information on how to handle grief and how to talk to children about death. Here is a portion of the hospice concept that really stuck out to me,

"Hospice affirms life and regards dying as a normal process. Hospice neither hastens nor postpones death. Hospice provides personalized services and a caring community so that patients and families can attain the necessary preparation for a death that is satisfactory to them.

Those involved in the process of dying have a variety of physical, spiritual, emotional and social needs. The nature of dying is so unique that the goal of the hospice team is to be sensitive and responsive to the special requirements of each individual and family."

Hospice is so much more than I thought that it was. I think that someone choose hospice either b/c they know that their is no treatment left or that they don't want to fight the disease at all or anymore. I think people who choose hospice are at peace with death.

I think that the best activity for someone who is dying is to make a scrapbook of their achievements or what they want their legacy to be. What do they want people to remember about them? Or maybe even a video of them telling their life story or showing off their talents. Something concrete that can be left behind, something more than memories.

Someone once told me that you never get over the grief of losing someone, you learn to deal with it. About 5-years-ago my mom's friend died. Her daughter was in 5th grade and her son was in 2nd grade. About the time she was given a year to live she began to write letters. She wrote them a letter everyday addressing any possible issue that may come up. She talked to her daughter about getting her period and how to buy a bra and how to apply make-up. She wrote to both of them about how it was ok for their dad to find someone new and it was ok for them to like her. She told them that it was ok for them to be mad at her for dieing. I think that this is a great way to handle grief on both ends.

When do you push someone to do more and when do you "let go?" I was thinking about this out on FW last week. My pt. is almost 94-years-old. He has been refusing to transfer and would rather sleep than do anything else. I understand the justification for services but at the same time, he is really old. Can someone at his age still be independent? Certainly. Could he still live another 5 years? Sure. My thoughts are just that if he doesn't want therapy, then who am I to make him? Also, there was a pt. that I saw out on FW who was a member of one of my peer's churches. She was a tough pt. What I heard from the OT and the CNA was that she refused to eat, threw her food at people, pulled hair, swatted her hands around and bit. The CNAs would give her meds. to calm her which ended up knocking her out so when I saw her she was pretty much asleep for the whole session. Well, I saw her on a Tuesday, she died a few days later. I hate that she spent her last days in a place that she hated with people trying to get her to do things that she didn't want to do. I think that is another reason why I struggle in this FW. It seems to me like it is time to "let go" when the pt. decides that it is time to let go.