Tuesday, April 21, 2009

They call me the Dog Whisperer

I have become dear friends with a patient's dog, Murphy. He is one of the sweetest dogs I've encountered in awhile (but of course, no dog compares to my mom's dog Tucker!) I've visited this patient 3 times now and every time without fail Murphy has shown his affection for me. Within seconds of sitting down on the couch, Murphy will jump up on the couch and curl up next to me or sprawl out across my lap. His owners apparently have never seen him do this with anyone! I don't think I treat dogs differently than anyone else so I'm surprised by my affect on Murphy too.

I'm starting to provide some respite for Murphy's owners while the wife is at work. They have some financial troubles and while we wait for the DORS referral to go through, the hospice team is filling in for some respite along with volunteers through their church. I headed out there this morning for a few hours. The patient was watching a movie on TV- Eraser- and we both chuckled about how Schwarzenegger is a governor now. Then we thought we shouldn't laugh too much because of the sad state of affairs concerning our former governors. The morning passed by easily enough, with one exception. Since the movie was on TV, we had to deal with commercials and there was one in particular that made things a little awkward. Ever seen those KY Intrigue or Yours and Mine commercials? Then just imagine being a 29 year old female sitting with a 58 year old male while not one but three commercials were played. I think we both pretended like we didn't notice!

Monday, April 20, 2009

No limits for Alzheimers

I thought early-onset Alzheimers was bad enough. Apparently, there's something worse: a pediatric version of Alzheimers known as Neiman Pick Type C. Watch the video to find out more.

Saturday, April 18, 2009

Final Breaths

I'm on-call for most of this weekend and have made 3 visits today so far. Not exactly how I wanted to spend my Saturday. At the same time, I know I was able to help these families so that makes it worth it.

"Betsy" was actively dying and the family was a little anxious about her comfort level and what to expect. The nurses were all busy so Sam, our triage RN, sent me out. The family was amazing! They told me wonderful stories about Betsy- she was quite the dynamo up until this past month. She traveled all over the world, sang in European cathedrals and for Mayor Richard Daley, and raised her 5 children in a former mobster's home. This is a very musical family and they took their talent in an unusual, tender direction. Betsy's breathing was erratic when I arrived. At times her respirations were relaxed and regular, a few minutes later she would have apnea. Back and forth. If someone new came into the room, her breathing became regular. Then she'd go back to the apnea before snapping out of that. Her son joked that this was her 20th rally. At one point, Betsy's exhaling breath made a sound that had a harmonic tone to it. Her daughter, a music therapist, picked up on this right away. She and her sister started harmonizing to Betsy's exhalations. Soon enough, their brother joined in creating a perfect 4-part harmony. It was incredibly moving! I told them that I've never witnessed anything like it but I was sure their mom appreciated this musical gift. I stayed with the family for about an hour and a half. The family knew that Betsy was ready to go and that whatever happened next was between her and God. I left to go on my next visit. Forty-five minutes later Sam called to let me know that Betsy had died. I imagine she's singing in heaven.

Monday, April 13, 2009

Pediatric hospice

I just found out that I'm going to be the social worker for a 13 yo cancer patient being admitted to our program this afternoon. I originally wanted to work with pediatric oncology patients when I decided to become a social worker. Then when I started working in hospice, I thought I might specialize in pediatric hospice, if given the opportunity. While I was doing my fieldwork placement I had a 19 yo former gangbanger with HIV but that is the youngest patient I've ever worked with. Less than 1% of all terminally ill children come on to hospice and my hospice does not actively seek pediatric cases. Even though the interest in working with children has never gone away (and hence the reason for my heavy involvement with our child and teen bereavement program), I figured it wasn't meant to be. Already the on-call nurses are asking me for resources and advice; tension is high over caring for someone so young. I can only hope that I'm ready for the task at hand.

Wednesday, April 08, 2009

The Future of Homecare

I recently received an email from my executive director regarding Obama's proposed $13.4 billion Medicare home health benefit cut (over 5 years). I haven't had time to research this further and I rarely send out information that I have not double checked for myself but so far this does appear to be true. I love the premise of extending health care coverage to all Americans but I don't think it should come at the expense of those needing home healthcare. If people are unable to acess home health or hospice services, we will be doing them a great disservice and ourselves as well.

"The President's FY 10 budget proposes to cut home health services by $13 billion over five years to help finance health care reform. This proposal would lead to the loss of home health services by over a million beneficiaries as it will result in the closure of nearly two-thirds of all home health providers. The likely outcome for these patients is more expensive institutional care. Home health care is a proven cost saver for the Medicare program. It enables beneficiaries to live with independence and dignity in their homes and communities with their families and friends." -National Association for Home Care and Hospice

You can click here to send a letter of concern to your elected officials. HelpUsChooseHome.com has good statistics on how home care and hospice saves money while helping people achieve greater quality of life. It also has other tips on how you can take action.

Thursday, April 02, 2009

Palliative Care Grand Rounds link

I've been remiss in posting the links for the last 2 Palliative Care rounds hosted by other bloggers but luckily, I'm on top of things this month! Jessica has compiled great articles, blogs, videos, and more. Be sure to check it out when you get a chance!

Wednesday, April 01, 2009

Go White Sox!

White Sox Home Opener is this Monday and I can't wait! In the meantime, you might enjoy this 2008 radio ad featuring my favorite player Jermaine Dye. A few friends have said that this ad reminds them of me but I'm pretty sure I'd have plenty to say if I ever met JD in the flesh. There aren't direct links to the 2009 commercials but I love the theme: "There are traditions. And there are White Sox traditions."

Another Sean story

This Friday I'll meet with Sharon to start bereavement counseling with her. They don't typically let hospice social workers provide bereavement care. Once a patient dies, their family is followed by the bereavement department for a year, through letters, phone calls, and counseling or support groups as needed. Every once in awhile it makes more sense for the social worker to continue with the bereaved party based on the strength of the connection made while their loved one was on hospice, instead of turning them over to someone else. Our most excellent bereavement coordinator Peter agreed that I could stick with Sharon. While we won't be able to continue our weekly coffee meetings, we'll probably meet once or twice a month. I know she's really glad that I can stay involved with her in this way, especially as so many of her routines are changing now that Sean is gone.

Sean's funeral service was over the weekend and I was not able to go as I was visiting my best friend in Nashville. I was disappointed that I missed out on an opportunity to celebrate Sean's life. I don't go to too many wakes or funerals for my patients (not enough time generally) but I had definitely wanted to be there for Sean's family and for myself. I wouldn't have traded my time in Nashville for anything though! Instead I called Sharon on Monday to check in and set up a time for our first bereavement visit. After chatting for awhile, she shared a cool story. She had gone to the cemetery that morning to hang a shepherd's hook and windchime. The cemetery is privately-owned so families are able to be more creative about what they put up at the grave. Sean always had a thing about hawks. Whenever Sharon would take him anywhere after he was diagnosed, he always saw a hawk. There was even one hawk in particular that Sean designated as HIS hawk because of how frequently he would spy it watching over him. Sharon said that she put the shepherd's hook in the ground and when she turned around to hang the windchime on it, there were 2 hawks sitting on top of the hook! She could not believe it! In her typical humor, she greeted the hawk saying, "Hi Sean. So you found a new girlfriend already?" Sharon was immensely comforted by this connection and I was pretty amazed myself.