Tea with T.

A matter of life and death.

2012-01-25T08:26:44-08:00

A hospital setting is an awful place to have conversations. Small talk usually isn’t anywhere to be had on the menu. Topics range from the body’s input and output (yes, even the guests pitched in on this one. Especially the over-70 crowd, oddly obsessed as they are with bodily functions); the disease history of one’s family (those half-siblings you half ignore do count, you know); whether the fact that the majority of medical terms are in Italian could be part of some great conspiracy (these being the after midnight/after Ambien chats) and Advance Health Care Directives.

Ouch.

Seems like people would rather natter on about the frequency of their BM’s over a cafeteria lunch tray of Salisbury Steak than broach the touchy subject of an Advance Directive. Some people delay discussing it all together, until it is too late. Or, nearly so.

Five years ago I was called upon to carry out the Advance Directives of someone who was terminally ill and wished to have no heroic measures taken and I followed his wishes to a “T.” (it is, after all, who I am). This task was met with some pretty ugly opposition by one of the man’s family members, who disagreed with his very firm wishes and called me “cruel and heartless” along with some other unsavory titles. Still – I stood firm and did what was asked of me, even if some of the choices were at odds with what I believed.

Now, after having spent over a week in the hospital and nearing an age that is a half a dozen keys shy of a grand piano, the Grande Dame that is my Maternal Unit has to face the daunting task of making life choices of her own. She has not yet put pen to paper, but is very vocal about what she wants in the matters of health care. “Boy, if something ever happens to me, you’d better make sure they use every possible lifesaving device there is! I want all the bells and whistles the medical field has to offer!”

This is a woman who has spent her entire life in the eye of the storm, watching as chaos ensues all around her, as people and projects spin madly out of control. It makes an awful lot of sense that she wants to make sure all of the cosmic plates keep spinning, no matter what. I have assured her that not only will all bells and whistles be employed, I will make stuff up if I have to (should there not be enough action for her), and hook up car batteries to klieg lights and roll her into the center of a Las Vegas casino. These are not concurrent with my views, but it is not about me, it is about whatever she wants – I will do whatever she requests. The thing is: it must be verbalized, written out and attended to by an attorney.

It is interesting to me that people of a certain generation have different ideas about life and death. Being statistically smack in the middle of my own life, my views about death may change – but for now, they’re wildly different than the adults I grew up with. My mother-in-law couldn’t even use the “C” word, even after having been diagnosed herself. Cancer was almost as verboten a topic as s-e-x wass and it irritated her that because of pancreatic cancer we needed to discuss burial plans, wills and Advance Health Care Directives. My peers are much more candid about all of the above (and sometimes a little bit TMI about the s-e-x), but even they are somewhat squeamish about Living Wills.

Life and death. Not a typical topic to bring up over tea and scones, but critically important nonetheless. Illness is not reserved for the elderly and it has struck every corner of my existence and the people I know, young and old. Cancer, diabetes, Multiple Sclerosis, aneurysms, car accidents – a long laundry list of life-changing events, bringing the subject of “What will we/I do in the event of?…"

So, one of my resolutions for this year is to encourage everyone I know to sit down with a strong pot of tea (or beverage of your choice) and make some decisions, while you are of sound mind and body, about what you would want in the event that your body and mind defy you, making it necessary for someone to speak and act on your behalf.

In most states, Five Wishes is a legal document (once signed and notarized) that you can procure to help you.

Wish 1: The Person I Want to Make Care Decisions for Me When I Can’t.

Wish 2: The Kind of Medical Treatment I Want or Don’t Want.

Wish 3: How Comfortable I Want to Be.

Wish 4: How I Want People to Treat Me.

Wish 5: What I Want My Loved Ones to Know.

It is my wish, that each and every one of us will have such a document put away, in the event of…

My greater wish is for continued health and happiness as the year progresses. [Well, that and that my peers never get fully comfortable discussing their BMs. Except with medical professionals. Just sayin’.]

Patience for patients. Caregiving 101.

2012-01-20T14:57:39-08:00

Nobody really likes being in a hospital, not the visitors, not the staff (and I’m going by facial expressions alone, here) and especially not the patients. Even if they’re being attended to with the greatest of care and compassion, patients are a surly lot. Why wouldn’t they be? They’re not comfortable, they’re not sleeping well and they’re basically not themselves. Come to think of it, that probably applies to the hospital staff and visitors, too. For over a week, I stayed at the hospital with someone I love very much, watching over her at night as she fitfully slept and spent her days in full-on fret mode. In general, this woman can be a bit prickly, but as a hospital patient -- she was more than simply porcupine-like. Incarcerated, medicated and violated (they mean well, but honestly, those 5am lab people are still vampires), she became more like one of those fish that, when they feel threatened, release venomous neurotoxins… wiping out whoever else is swimming in the tank.

This woman I speak of, who has played the role of “mother” for me since I was knee-high to a very short grasshopper, is neither my biological nor adopted maternal unit, but I couldn’t love her more than if she were related by love or law. I’ve always said that I care for her enough to give her one of my kidneys should she need it, but I didn’t really think that she’d be admitted to the hospital for that very same organ. Uh, hulloh? Note to self: Be careful what you joke about. Because, after a week of sleepless nights and some very tense and constantly-questioning/judgement-passing/you’re-doing-that-all-wrong days, I’m not gonna lie, I found myself seriously reconsidering whether one really could procure vital organs, if it came down to it, from Craigslist and an appointment in a dark downtown alley. You see, it is one thing to cavalierly offer your body parts to someone you love when they’re healthy and happy and a whole other ball of beans when you find yourself in the role of caregiver to the cranky. The Krav Maga* of Self-Preservation kicks in and you’re just doing what you can to remain vertical.

Caregiving is one of the hardest jobs in the world. I know of what I speak, because once upon a time I was the primary caregiver to my mother-in-law. She was a brassy redhead with a sassy personality to match and when she was diagnosed with a particularly horrible illness, she was angry, hurt, frightened, depressed, defensive and oh, so much more. It was a very long list of understandably and appropriately nasty emotions that perfectly matched what she was going through. Sickness is for the birds and any illness, large or small, takes over more than your body – it consumes your thoughts, strangles your emotions and tortures your soul. To be the caregiver for someone who is ill, is to stand in direct contact of the often intense nuclear emotional fallout and I can tell you from experience, you can and will get hurt.

As the odometer of life hits the middle mark, many of us find ourselves wedged between the task of taking care of the young and old all at once, but to become a caregiver in times of illness is a huge undertaking, both physically and emotionally and can leave you feeling depleted and powerless, but with the right tools caregivers can stand in a position of strength, with a satisfied heart.

10 Tips for Caregivers

Remember that caregiving is a job (a really, really BIG job) and respite/rest is your earned right and the thing you should reward yourself with. Often. Even if you feel guilty, you must take time to recharge your batteries in order to go back and do your job to the best of your ability.
Be on the lookout for signs of depression and get counseling when you need it and quickly. It is a slippery slope once you’re on the path to being depressed and the sooner you get help, the better you will feel.
When and if people offer to help, don’t be a martyr. Go ahead and accept their offer(s) and don’t be shy about being incredibly specific about what you need them to do.
Educate yourself about whatever illness “your patient” is dealing with. It can help you to communicate effectively with doctors and provide the best care possible.
Trust your gut. Your instincts will usually lead you in the right direction.
Watch your back. No, really. Watch your back, as in your spine. As caregiver you are often called upon to do a whole lotta lifting, pushing, and pulling.
Don’t get hung up on doing everything as caregiver. Understand that there are technologies, ideas and tools “your patient” can and should use.
You can plan, but don’t plan the outcome. When you are the primary caregiver you need to know that you have to mourn losses of your own (time, vacations, hobbies) and give yourself permission to delay certain dreams or dream new ones.
Seek support from other caregivers. Knowing you are not alone is a great source of not only power and strength, but gives you a sense of community and peace.
Stand up for your rights as a caregiver and a citizen.

While the Maternal Unit I adore is now out of the hospital and on the mend, I know that we may, at some point, come to this crossroads again and I will be called upon to don my Caregiver Cap (and epaulets, darn it – I’ve earned them). When I do, I know there will be difficult days, but as complex and challenging as it will be -- I also know there will be incredibly rewarding and delicious days, too. It is my sincere desire that during times of medical crisis I can be of assistance to those I care for: helping to tame their wild thoughts, deal with their rollercoaster emotions and soothe their ravaged souls. Caregiving is one of those strange and interesting gifts of love that life presents to us, because while I initially give because I care – when all is said and done… I find that ultimately I care, because I gave.

For More Information on Caregiving

http://www.webmd.com/balance/tc/caregiver-tips-caregiver-tip-number-1-take-care-of-yourself-first

“The best way to find yourself is to lose yourself in the service of others.” -- Mahatma Ghandi

“Caring for our seniors is perhaps the greatest responsibility we have. Those who walked before us have given so much and made possible the life we all enjoy.” – John Hoeven

“I attribute my success to this – I never gave or took any excuse.” -- Florence Nightingale

*Krav Maga – a martial arts philosophy emphasizing threat neutralization, simultaneous defensive and offensive maneuvers, and aggression.

No rest for the wicked

2012-01-13T08:59:17-08:00

There is no sleep to be had in a hospital, no matter how good you feel or are. The woman starring in the role of "Mother" in the play that is my life is not well, so I've had to check into Motel Sicks this week, sleeping on the cot of the incarcerated. Plastic pillow and all.

The patients have been...interesting, since we've been here. One fella hollered so much last night, he required four security officers, restraints and Haldol. I begged the staff to give me five minutes with him. I was tired and in no mood to put up with his mouth and I am not positive, but I am p r e t t y sure I could have provided him with a Come to Cheeses moment, but that might've ended up with me in restraints so I stayed put.

My maternal unit has always been one of the craziest players on my stage, but this place, a regular hospital with some highly irregular characters, is giving her a run for her money.

So, one more week where circumstances have sucked away my life and time. The good news is, I get to observe the medical field as they deal with the "what" as they attempt to determine the "why" of this health mystery. There is a reason they still call it "Practicing" medicine. But, they should know -- I also get to report it.

I warn you, this may get snarky. Seeing it as I will through bleary eyes and all. Who can sleep through this? Night or day, they leave the light on.