Posts Tagged 'Hospice'

We Miss You, Kochi-Dog

We were one of the families that adopted a dog just after 9/11. Matt and I were just starting our life together. We had planned to visit my family in India, around our one year anniversary. Instead, like many Americans, we sat in front of the TV in shock. Our trip was no longer possible.  Then we saw a funny looking mutt named Snoopy flash on our TV screen during a public service announcement.

the former snoopyWeeks later, we took Snoopy home from the Humane Society. We renamed him Kochi, after the place in India that we were no longer able to visit. Instead, we experienced our first lessons in parenting.  The dog (like us) was one year old. He was hyper and endlessly curious. At obedience class, we learned that we had to be consistent in our messaging, or all hell would break loose.

Gradually the dog fell into familiar patterns, and so did we. There was something deeply comforting about daily routines revolving around our new (slightly freakish) family member.

Inside the house Kochi displayed the affection of a kitty cat. He rubbed up against your leg, sat at your feet, straddled any part of you he could get close to. After a dog-sitting stint, my mother said she had never before known a dog to wake her up in the morning by rubbing against her bed.

relaxed, but ready to pounceOutside, the dog lost all loyalties. Life in the outdoors was totally governed by scent. Kochi’s MO was find-and-conquer.  (This may go back to his hardscrabble days living on a farm, before we adopted him, and his mixed Husky heritage.) Walking with us downtown, Kochi always sniffed out the chicken bones and pizza crusts hidden under the bushes. The fleeting scent, sight, and sound of a deer running through the park or neighborhood set him off at a fast pace. And always at the most inopportune times, he found and attempted to kill skunks. He must have been sprayed at least 7 times. The most embarrassing tale involved bringing him to a nature preserve and him immediately clobbering a duck (who survived).  Then again, there was also the time he jumped out of the half-open car window (while I was driving) to catch a squirrel; another uncomfortable memory I immediately repressed.

Given the dog’s unpredictability, we wondered how he’d be with a baby in the house. We followed everyone’s advice; Matt brought the baby hat back from the hospital, which he sniffed readily. When baby came home, he licked her face. The baby then became a child who pulled at his tail, teased, and dropped lots of delicious food crumbs. With her, Kochi was cautious, but affectionate. In 6 years only once did he bark at her; when she accidentally jumped on his foot doing gymnastics. The rest of the time Kochi was a gentle friend and brother, utterly patient and forgiving. L became his primary playmate and caretaker, whistling for him to come, letting him outside, and planning his birthday parties.

feeding kochiFast-forward to Kochi-dog’s thirteenth birthday. He ambled up the stairs, after the line of treats carefully set out for him. That year he almost missed the bone at the end of the path of treats. And getting up the stairs wasn’t easy. I started to refer to him as the elder in our house. We compared him to Great-Gramps, the other elder in our family whom my daughter loved dearly. Both were a bit lazy. They moved slower. They had little aches and pains. Both were near the end of their lives. We talked about making sure to give them lots of love before they go.

Around that time, our daughter set up a “salon” in the corner of the living room. Next to the hairbrush and the spray bottle was a pile of rawhide bones. All types of salon customers were welcome, and all went away happy.

Six months lakochi learns to stayter our dear pup no longer lived for food, companionship, and exercise. He walked with pain, barely ate, and slept for longer and longer periods. As my mother-in-law said, “Kochi is only 10% here.” This was a shocking reality, coming from the dog who seemingly had a million lives; he always bounced back. But a non-wagging tail raised questions about his quality of life. And when he stopped eating for good we knew we needed to call his vet.

Kochi’s vet did something extraordinary. She came to the house to help Kochi die peacefully. This decision was and still is especially hard for me. As a hospice volunteer, I help to make human lives comfortable during the dying process. But I never end a life. I was prepared to continue giving comfort care to our dog Kochi. But what was the point, if a few days of pain and suffering could be avoided?

Comfort care at the end of Kochi’s life looked like this: Matt and I peacefully saying goodbye (petting aby the fireplacend consoling), as he relaxed in his favorite bed in the living room, by the fireplace. I say relaxed, because the vet made sure he was drowsy with sedative. But even with his eyes closed, his nose was still sniffing away, sensing that someone new and interesting was in the room. While renal failure and arthritis slowed him down, dear Kochi never lost his curious spirit.

As I write this, I think I hear a deep sigh coming from the living room, by the fireplace. Smacking teeth and deep sighs have for years been part of my writing process, I now realize. During my working at home days, when Kochi relaxed, I did too, and vice versa. And that’s how it was in the end too.

That first night he was gone, we put on headlamps and tramped out into the dark and snowy backyard to find the holes he had dug the summer before. Each hole got decorated with his favorite bones. Later we joked about the squirrels having a field day. Inside, we hung his dogtag on a nail by the door. We lit a candle, and we looked at pictures and reminisced.

For anyonkochi and his devoted parentse who has lost a beloved pet/family member, you know how hard it is. I still want to feed Kochi the leftover scrambled eggs and Matt still wants to let him out at night.  Three weeks later, we persevere, but there is a huge hole in our lives. We talk about missing him; that’s all we can do.

Of course there is comfort in a life well-lived and the gifts he gave. And relief. Today, thunderstorms are in the forecast, and I am relieved that Kochi will never again have to endure that trauma.

Image

Thank you Mom and Rani, Karen, and Anh – Aunties to Kochi – for the fantastic pictures and memories. I will always treasure these.

If you have a favorite memory of Kochi to share, or a story about saying goodbye to a pet or a loved one, all are welcome here, as usual.

By the way, in case there are questions, it seems appropriate to me that my 100th post on this blog about aging with dignity and quality of life should be about our beloved pet. This blog has been a space for me to grieve and celebrate the cycle of life. Writing is one way I process such things. Thank you for sharing in this process with me, dear, loyal readers.

With love, Meika

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My Summer as Doula for the Dying

imagesA friend described the situation perfectly. “You are pretty much a stranger, walking into a home situation that can be so personal and vulnerable.”

This is what I, as a home hospice volunteer do. And hopefully, in that context of stress and sadness and pain, I can offer some solace through listening and just being a consistent presence.

My personal project this summer was to deepen my understanding of death and dying, and by association, living. As a medical sociologist and social gerontologist, I had taught the courses, but did I really know anything about dying, from reading books and grieving my own losses? And what could one learn about living, through comforting those in the end stages of their lives? This wasn’t a formal research project. This was just me, going deeper.

As the summer comes to a close, I have no idea how to sum up this experience. I have rubbed feet, held hands, recorded memories, and mostly just sat and listened, to everything from changes in breathing, to tearful stories of parents lost, gratitude for a life lived, or frustration for not having answers.

Being a hospice volunteer enables me to work at being present with myself and with others. To value human connection and vulnerability. And, of course, hospice is about life transitions, for all involved. (In many ways, my research on how people cope with retirement as a life transition is not so different from coping with the unknown at the end of life.)

Us volunteers are trained to be present with those who are dying. To become more comfortable with death, we write our own obituaries, and participate in an extended meditation on our own death. We learn how to help a patient transition from couch to chair, how to work an oxygen tank, how to think through ethical dilemmas (like gifting). But the real training is in the doing. Because dying is as complex as living.

The wife of a dying man told me she tried so hard to “lick it” – his terminal disease. That was her training, she said, to work hard and focus on the problem, and you can solve it. But it didn’t, and now she must accept this, and wait for the end.

A dying woman only spoke to me in Romanian, I in English and rudimentary Spanish. I think we managed to connect.

A man slept in a hospital bed, positioned in former dining room of his home. “I will shop and he will sleep the whole time,” his wife said. “He is at the very end stages.” But minutes after the garage door closed, he came alive, reaching for something elusive above his head, mumbling to himself, and then he slept again.

Another hospice patient sat watching the Food Network, munching on spice drops. “This is my only addiction,” she admitted. Later, her husband and caretaker reminisced about their travels, and wondered if he would ever travel again.

My role during the 2-3 hour shift is to sit with folks. But the hospice team involves many, including chaplains who talk to patients of any background, helping them to forgive, to right past wrongs, to let go (one even performed an informal divorce ceremony at a patient’s bedside!); social workers who get to know extended families, life stories, and bucket lists; and nurses and doctors and psychologists trained in grief support, pain management, and comfort care.

An ongoing life lesson for me is accepting the unknown. I feel like I learn this over and over as a parent, and now as a doula for the dying.

My summer project is really a life project. So I will continue doing hospice work, and see where it takes me.

Hospice in Rural Kenya

This is a guest blog post from Colgate University student Michelle Van Veen, who
has spent the last 4 months in Kenya (through the MSID study abroad program), where she worked with a hospice team. I am thrilled that she has taken this opportunity to reflect on her experiences.

The Hospice TeamHow does one begin to talk about working at a hospice in rural Kenya? When Professor Loe asked me to write a blog post for her, I struggled with this question. So, I decided to share an experience that has affected and taught me the most: a story that brings together a wide range of topics I encountered including family, spirituality, poverty, illness, mental well being, hospice care, and cultural sensitivity.

First, I feel that I must start off by giving some background information. I am a double major in Psychology and Women’s Studies at Colgate University. I went to Kenya last semester for my study abroad experience and was given the opportunity to work at the hospice while I was there. A hospice provides palliative (holistic) care that addresses the physical, spiritual, social, and psychological needs of people living with terminal illnesses. I was assigned to the hospice so that I could learn about the psychological aspect of living with cancer in rural Kenya.

On a typical day, I would accompany a nurse on a home visit. We would conduct these home visits to dispense medication, provide psychological counseling to the patient and their families, assist with any other medial needs, pray for the patient’s wellbeing, and offer social or legal advice. Each patient and their family had their own story and even though all of the patients I saw were unified under the label “cancer patient,” they all lived with different realities.

On this particular day we went to visit a patient who lived in absolute poverty. His wife had died, his children abandoned him (for unknown reasons), his house was falling apart, and he was bed ridden with esophagus cancer.  A neighbor came to cook him food once a day, but otherwise this man was alone and helpless. However, while we were there, things started to look better (in my eyes). His sister had come to convince her brother to live with her and her family in another town where she could take care of him. But, much to my amazement, the man refused. The nurse later explained to me why this man was being stubborn and refusing the care of his sister. Apparently when the patient’s sister got married, a dowry wasn’t given. This man believed that he would be cursed if he went to live with his married sister because it would be seen as if he were the dowry price (if I understood the nurse correctly). Thus, the fear of being cursed was stronger than his fear of living his last few months alone. When I heard about this, I was initially shocked which turned into frustration because I couldn’t even begin to understand his reasoning. But, the nurse reminded me that we have to respect the patient’s wishes because psychological pain can rival physical pain in many instances of those living with terminal illnesses. I agreed, but still didn’t understand.

The next day I learned that after we had left, the sister had successfully convinced her brother to come live with her. However, on the way to his sister’s house, the patient took a turn for the worse and instead they took him to the hospital. Later that night, he passed away. When I heard about this, my jaw literally dropped and I couldn’t believe it. To some it may look as if he was in fact cursed. But, what I learned from the experience was the importance of culturally sensitive psychology and respecting people’s wishes. Do I think he would have died on the particular day if his sister or we hadn’t visited him? Probably not. He was sick, but I thought he still had a few months left in him.

michelle van veen

This man’s story made me realize that while symptom management needs to be the first thing addressed and taken care of, mental health is equally important. Morphine can take away the physical pain in most instances, but we don’t have a miracle drug that can take care of the psychological pain of the patient or their family. Thus, we will never know what would have happened if the man had stayed home rather than gone with this sister. But, learning from his story, I do know that we need to continue placing an emphasis on mental health that accounts for all our differences (including cultural): a lesson that applies to not only Kenya, but the United States as well.

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Amazing Elders

ImageDear readers,

My deepest apologies for the three-month hiatus. In this second year since AOW was published, I have been speaking with fantastic groups of students and elders (including design students at SU), teaching Sociology of the Life Course, and training to be a hospice volunteer. These experiences have me thinking quite a lot about living, and living well.  A recent highlight was meeting the Colgate class of 1943, all of whom are male nonagenarians (because Colgate was an all-male school at that time). The pic is Noel Rubinton, Class of 1943 President, and myself. This spunky group of six elders (all of whom traveled to Hamilton, NY for reunion weekend) reminded me how full and rich a life can be in one’s nineties. A recent story about a Martha’s Vineyard elder who makes her voice heard, reminded me of the members of this group, who can teach us how to be socially engaged in various ways. I continue to be inspired by these lives.

This blog will live on as a site in which to post updates on my own thinking about healthy aging, inspirational elders, and death and dying. I have also invited a few of my students to tell their stories, including one who has completed a semester doing hospice work in Kenya, and another currently training to be a Certified Nursing Assistant (CNA). I look forward to featuring their stories here! Finally, I have been working on a new blog on feminist parenting, which will launch sometime this summer. Exciting prospects. Thanks all for your ongoing support!

-Meika

Update on Ann: “Her Journey has Begun”

You may remember Ann, the husky-voiced red-haired elder who loves to walk, from my book, Aging Our Way. She yearned to be published sometime in her life, and by writing the postscript to the book, she made her dreams come true. (Here I am reading Ann her published words for the first time!)

Ann volunteered for thirty years at her local nursing facility. She’d push people in wheelchairs who would always ask her “Are your teeth real?” She got a kick out of that. That same nursing home is where she lived from 2010 up until this week, when she passed away at the age of 96.

Here is an update on Ann, from her daughter Mary (posted with permission), from just a few days before her death. She reports that even on hospice Ann was very much in control.

Hi Meika,
Our mom has taken quite a dramatic turn of ill health. On 4/4 and
until 4/8 she was in St Peter’s for congestive heart failure and a
very painful compression fracture in her spine. She is now 96 3/4
years old. So we believe her journey has begun. We’ve called for
Community Hospice Services for palliative care and she’ll receive all
services at Good Samaritan Nursing Home, where she volunteered from
1980 until her broken hip and shoulder in July 2010, then as a
resident thereafter. Please know that she and I were instrumental in
securing that St Peter’s knew her end of life wishes, DNR in place.
She is now comfortable and sleeping much of most days. When awake she insists on being dressed and sitting upright in her wheelchair and has
continued (as tolerated) outings in the wheelchair van the family has
purchased, On outings and until the last couple of weeks she has
enjoyed her glass of wine at Gideon Putnam, and the vodka and juice
that my brother brings for her in the evening at the nursing home.
Recently, she awoke and asked “why is that oxygen in here”, referring
to the tank in a corner…..still independent, still in control. She
is choosing to eat less and less, but the family takes comfort in her
ongoing independent attitude.
I so enjoyed hearing you on Joe Donohue’s show this am….had to update you.
Many thanks for mentioning mom….she would have loved her mention in
regard to volunteering!
Mary Donohue Smith

Dearest Ann – it has been such a gift to know you these past years. And your devoted family has given you the ultimate gift; the ability to die as you would have wanted, in comfort and surrounded by loved ones.

As you described to me, your kids also enabled you to truly LIVE, by purchasing a used handicapped accessible van so that they could take you out of the nursing facility and away for weekend at Lake George, a place you have always loved.

I’ll never forget how, in your 90s, you proudly attended President Barack Obama’s inauguration, and rode on the DC subway for the first time.

With great admiration for a life well-lived, and your adventurous spirit,

Meika

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The Author

Meika Loe

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