Cal's All-Star Angel Foundation

A friend let me know about an awesome promotion through Cal's All-Star Angel Foundation, an organization that grants wishes and provides financial assistance to children fighting cancer and their families. They are partnering with my beloved Chicago White Sox! The game Sunday August 23 at 1:05 pm is dedicated to Cal's and almost a full 50% of every ticket purchased will go directly to the foundation. A lucky raffle ticket winner will get to go on the field for batting practice and recieve an autographed Jim Thome game jersey- how amazing is that? If you live in the Chicago area and are interested in attending the game/supporting this organization, here's the ticket order form. Ticket orders must be received by Cal's by August 1. Please pass this information on!

Young@Heart

I've been waiting for Young@Heart to move up on my Netflix queue and it came last week. As I was on-call for most of today (but did manage to watch my town's infamous 4th of July parade!), I finally watched it tonight. The Young@Heart chorus is a group of Massachusetts senior citizens who have toured all over, showcasing their unique covers of rock songs. Led by Bob Cilman, the chorus members gamely try their hands at The Clash, James Brown, and Bob Dylan. The documentary follows the group as they rehearse for their show "Alive and Well." Anyone who works with the 70 + crowd will not be surprised by the array of spunky personalities and the affirmation that life does not end once you get your Medicare card. Director Stephen Walker does an excellent job of giving us a behind-the-scenes look at just what goes in to their tour and the issues they face, from their own mortality, the loss of 2 members, but also their various involvements and the perks of aging gracefully. Sprinkled throughout are hillarious music videos. You'll never listen to "I Wanna Be Sedated" in the same way after viewing it through the eyes of nursing home resident. My only complaint would be a wish that Walker had added the performer's names in caption so as to better acquaint names with faces.

It may be cliched to say that I laughed and cried but it's true. One of the most moving scenes occurred during a performance at a jail. The group had just learned of the death of one of their members, Bob, and barely had time to process this before the show began. The last number was "Forever Young" which proved to be a beautiful tribute to Bob, as well as evoking a touching response from the inmates. Equally moving is Fred's rendition of Coldplay's "Fix You," originally a duet with Bob (The embedding was disabled but here's the YouTube link.) Later in the movie various Young@Hearters affirm that they want the show to go on when they die. One woman went as far as to say she hopes she dies while on stage and that they just drag her off and keep on singing! It's easy to see how much this group means to them- not only for the activity of singing but for the friendships that have been formed. I cannot recommend this movie enough and hope that you'll move it to the top of your list. Check out the Young@Heart website for their story, tour dates, and CD information.

Dream Foundation

You may remember that a couple of months ago I was looking for a wish granting organization to help one of my patient's get back to Arizona one last time before he dies. Fairygodmother Foundation is no more so I went through the Dream Foundation. I am happy to announce that DF is granting this wish! The application process was very smooth and I heard back from them within a few weeks of mailing it off. Definitely a resource we should all be taking advantage of! We're working on the medical authorizations right now and hopefully they'll be able to start planning the trip soon! The patient and his wife are quite anxious to go, especially as he is starting to further decline. I'll be sure to keep you all updated on how this dream is realized.

Brianna's Battle

I got to visit with Brianna yesterday and her mom gave me permission to share this video, a recent news story on WCIU that aired Friday June 26. It's very moving, FYI. The family's hope is to raise awareness of DIPG (diffuse intrinsic pontine glioma) and promote fundraising until we find a cure. Click here if you would like to donate to Brianna's medical fund.

The video is having some difficulty embedding so here is a direct link just in case: Brianna's Battle.

A New Kind of Hospital Chaplain

I was absolutely fascinated this morning to read about a new Buddhist chaplaincy program, the New York Zen Center for Contemplative Care. It started last year and is accredited by the Association for Clinical Pastoral Education. While I personally do not agree with the Buddhist faith, I do agree that complementary or alternative treatments are worth looking at.

"Instead of relying on drugs and hospitalization, the Zen center encourages stress and pain relief through meditation, breathing exercises or conversation. Even if such methods cannot provide a cure, they can help make patients more comfortable. And the Zen chaplains are able to spend more time with patients, time that busy doctors and nurses often cannot spare."

Of course, Buddhist chaplains are not the only ones that can assist patients with meditation, breathing exercises, or conversation. Those activities are generally a function of most chaplains and social workers. The article quotes the co-founder of the Zen Center as stating, "There is one rabbi and two Catholic priests. They're great people, but the rabbi sees Jewish patients. The Catholics anoint the sick. Then there's everybody else." Maybe we do things differently in the Midwest but that statement is the opposite of how our chaplains opperate! Yes, Catholic patients will often request Catholic chaplains and so on and so forth. The beauty of our chaplains (we have 2 Catholic chaplains and 2 Protestant chaplains) is that they can meet with anyone regardless of their faith background. From what I understand, that is a tenet of chaplaincy, to help people access their own spiritual beliefs without imposing your own. I can, however, see how patients without a faith background or who are no longer affiliated with a church might be more open to meeting with a Buddhist priest than anyone else.

What I liked most about the article came at the beginning. Chodo decided to share his own battle with alcoholism with a medically compromised patient who would not discuss hospice or signing a DNR. His hope in sharing his own story was that it would spur conversation that would help the patient explore his reticence, ease his mental anguish, and prepare him for what was to come. There is so much talk about if or when to disclose personal information to patients, boundaries, etc. And it is wise that we examine these issues. But I also think that we can lose focus on what will best help the patient. I've disclosed personal information after careful consideration: examining my goal in sharing it, and discerning how this information could assist the patient or family member in their journey. Should you share this information with everyone? Definitely not. However, Chodo illustrated this technique very well.

IL Budget Crisis

It is a tough time to live in Illinois these days. Just when you think our legislators can't get any more ridiculous, this happens. On May 31, 2009, the Illinois General Assembly passed a partial budget which created a $9.2 billion funding gap leading to huge cuts in fundamental state services. Severe cuts in the State human services budget will have serious adverse consequences for local governments, healthcare organizations, public safety agencies, the courts and corrections. Slashing funding for mental health services, addiction prevention and treatment programs, and youth services will result in less prevention, more crime, and higher detention and incarceration rates. A budget that cuts human services and other vital programs by 50% or more will also result in significant job losses, perhaps as high as several hundred thousand jobs across Illinois.

I cannot even begin to imagine how these cuts will affect my patients. Several in my caseload barely make ends meet each month, even with food stamps, Circuit Breaker, and assistance from DORS, along with many other community resources. There are also patients on my caseload that are on Medicaid to cover medical care and often long-term care facility placement. Without these and other services, our patients would be lost and their quality of life greatly affected during an already stressful time. I cannot believe that cutting social services is the only way to resolve our state budget.

NASW for IL is spearheading a campaign to protect these vital services. Rallies are being held all over the state. Phone calls, emails, and letters are being sent to our representatives. If you live in IL, please click here to send a message to your representatives (you don't have to be a social worker to use this resource.) NASW-IL will continue to post updates on the budget crisis.

New challenge

Today a 28 year old woman was admitted to hospice from the palliative care program. When I listened to the admission report, my first response was that this would be way too close to home. I did not feel comfortable being the social worker and, given the family dynamics, I wasn't sure how the family would feel about having a social worker who is just a little older than their daughter. I was initally saved from further pondering as the palliative care social worker was going to keep the patient. Then my supervisor called me this afternoon and said the family did not want the PC social worker to stay involved. And given that this patient is firmly in my territory, the ball was back in my court. After further conversation with my supervisor and a lot of prayer, I agreed to take on this patient. There's a chance she will die over the weekend. And there's a chance that, come Monday, the family won't want further social work involvement. Or it could be that my youth will be to my advantage and will be a good fit for this family. Only time will tell. And at least I have a weekend to come to grips with providing care to someone close to my age. It at least made me realize that it's time to schedule some routine MD visits for myself- how's that for a reality check?

Simple Pleasures

I was visiting with a man in his 50s this afternoon. He's on some intense pain medications due to a fractured right leg which will never fully heal due to bone mets. Consequently he was a little sleepy when I arrived but he gamely engaged in conversation before falling asleep midsentence. Last week the same thing happened so I just sat there for about 5 minutes until he woke back up. He apologized for falling asleep- no matter how often I tell him that it's OK if he needs to rest for awhile, he always feels badly. He asked if we could go into his backyard since it was a nice day. He wanted to show his caregiver what needs to be done in the garden. I accompanied him (plus his walker) outside, trying to match my gait to his. He showed me some of his favorite plants and discussed the flower and fruit trees on his property. It felt nice to be in the sun! He can walk fairly well with his walker; his left leg has bowed out to compensate for his right leg. We chatted about nonconsequential things as we walked along. As we came around to the front of the house, he commented that it felt good to walk outside. And then he thanked me for walking with him. I of course told him he was welcome but was a little surprised that a simple walk was worthy of thankfulness. But as I thought more about this man's circumstances, I realized that he does not get much interaction from other people. His caregiver is Polish but speaks decent English. However, I don't think they talk a whole lot, mostly because this patient was initially very resistant to having any caregiver in the home. It also sounds like he wasn't around too much while his kids were growing up. To their credit, the kids are involved but they have families of their own. I got the impression that his family and friends tend to rush their visits or talk about doing things with him but don't follow through. And then along comes the hospice team. Along with goalwork, I provide a good distraction for this man once a week. A walk doesn't seem like a big deal to me but to this patient it seems to mean so much more. I was honored to bring something good to his day.