I truly don't want this blog to become a nursing home care form, yet I cannot sit by and not speak in behalf of the poor in those facilities. The incident I will reveal is true while the names of people and facility are not.
Sunday, July 26th, my roommate and I returned home following a wonderful and uplifting week end at the Dubuque Franciscan (Sisters) Motherhouse in Iowa. Two hours into our unpacking and reorientation to the week's schedule ahead of us, my chaplains pager sounded. "Zeek J died a couple of hours ago." The nurse went on to relate that they had a major problem regarding the disposition of the body. There was no designation of funeral home on the admission page nor was there any mention of such throughout the chart.
The nurse mentioned the social worker believing that the body should be sent to a local funeral home while this lack of information regarding choice of a funeral home was sorted out. I asked about family and I was told that "some friend" said she would call the VA in the morning. I explained that the VA was fine for interment information but that the body needed to go to a funeral home. I called the social worker in order to explain that a funeral home needs the consent from the legal representative before a body can be transfered to them. I stated strongly that calling an unauthorized funeral home was both illegal and immoral, citing the "removal charges" that might be duplicated if the next of kin decided to not make arrangements at that funeral home.
Finally, I was able to reach the "friend or whoever" of the deceased. I asked what Joan's relationship was and she exclaimed, "I'm his wife." I could barely believe my ears! How could our staff not have asked about relationship?!!!! I identified myself as the chaplain (made no mention of being a licensed mortician) and explained that I had a great deal of experience in funeral law and practice. I further explained what the VA would provide and why a local funeral home was needed. She understood more as we visited and finally decided on a local funeral home. While we spoke, I found the phone number for her and directed her to call the funeral home and have them pick up her husband's remains yet that night.
Approximately 90 minutes from being paged, I sat at my desk and held my head as I asked myself how such a mess could have ever happened. It was later that I began to consider who the poor were in this situation.
1. Essential information re: funeral home was not obtained at the time of admission.
2. That lack of information was not addressed by social services, nursing or anyone else until
the resident died.
3. The Social Worker believed that it was undignified to cover the deceased and move his
remains (bed and all) into a private room until we found the solution to the situation at hand.
4. Furthermore, she had no idea what constitutes legal right to authorize a funeral home and
arrange for removal of the deceased.
5. No one took time to accurately determine the relationship of the person who was notified of
the death and who came to the nursing home.
Nurses, social workers, nursing assistants were all confused about how to handle a situation that never should have occurred. Admission professionals dropped the ball by not obtaining information regarding choice of funeral home, and I was not called to be with that person and assist in the process.
I believe that spirituality was greatly lacking because interconnectedness with one another and with the deceased and his family, did not exist. The deceased was pretty much "lost" during the several hours of questions, worry, passing the buck and so on. Initially, I believed this incident to be somewhat removed from my original intention for this blog, but I have reconsidered. We haven't solved the problems of the hungry, the financially poor, the homeless, the uneducated, the sick, the elderly, the mentally ill and others, because we have not truly connected with them so as to view them as equal in our sight as well as the sight of God. We have not found the human connectedness free of prejudice, superiority, pity, and preconceived notions.
If we cannot even take care of a deceased body and determine the relationship of the person who responds to a death call (whom we can see) how can we respond to one another (who we do see) and to God, in Whom we believe and put our trust?
Tuesday, July 28, 2009
Wednesday, July 22, 2009
Where does spirituality fit into this picture?
Spirituality has been defined and explained in many ways, most of which speak to interconnection of creation. As I read through my previous postings, I find this interconnection one of the missing pieces (that which at the heart of the poverty). Our spirituality is essential to our development of values and our understanding of the very meaning of life.
Each of the experiences of poverty about which I have written, exemplify my understanding of spirituality. As spiritual persons, we cannot walk through life with blinders keeping us from seeing those around us. Rather, we are keenly aware of others and we are disturbed when the other is marginalized, forgotten, neglected, disrespected.
Even as I write, my mind has focused on Henry Nouwen's book, WITH OPEN HANDS. Fr. Nouwen speaks to the necessity of opening our hands in order to receive others. As disciples, he tells us that our responsibility is to challenge society, to ask the difficult questions, to not accept the status quo.
It is not enough for me to lift up the poor as I write. I MUST act to change the society, the systems, the mindsets, the prejudices that cause others to be impoverished and marginalized. This is hardly an easy commitment. As spiritual persons, we must do everything in our power advocate for changes: help for the homeless, respectful areas in nursing homes and other places for those who are dying, outreach to all who reside in nursing homes (even the most cranky).
Saint Francis of Assisi recognized this interconnection with all of creation. He embraced people, animals, nature, the sun and moon, as his brothers and sisters. Francis treated the wealthy and the poor alike and gave to the poor what others refused to give-unconditional love, human loving interaction, kindness and compassion.
Each of the experiences of poverty about which I have written, exemplify my understanding of spirituality. As spiritual persons, we cannot walk through life with blinders keeping us from seeing those around us. Rather, we are keenly aware of others and we are disturbed when the other is marginalized, forgotten, neglected, disrespected.
Even as I write, my mind has focused on Henry Nouwen's book, WITH OPEN HANDS. Fr. Nouwen speaks to the necessity of opening our hands in order to receive others. As disciples, he tells us that our responsibility is to challenge society, to ask the difficult questions, to not accept the status quo.
It is not enough for me to lift up the poor as I write. I MUST act to change the society, the systems, the mindsets, the prejudices that cause others to be impoverished and marginalized. This is hardly an easy commitment. As spiritual persons, we must do everything in our power advocate for changes: help for the homeless, respectful areas in nursing homes and other places for those who are dying, outreach to all who reside in nursing homes (even the most cranky).
Saint Francis of Assisi recognized this interconnection with all of creation. He embraced people, animals, nature, the sun and moon, as his brothers and sisters. Francis treated the wealthy and the poor alike and gave to the poor what others refused to give-unconditional love, human loving interaction, kindness and compassion.
Monday, July 20, 2009
Are the Dying Poor?
Like most Americans living in the 1960's, I clearly recall the assination of President Kennedy. I shed tears as the announcement was made over the school PA system, as I watched thousands pass his casket in the rotunda, the procession to Arlington Cemetery and the mourners as the interrment ended and the rituals came to an end. Had anyone asked me why the tears, I would have responded, "He's dead." Dead meant no more interactions with family and friends, no celebrations of special events, no long awaited vacations, no playing in the snow (even for adults), no snuggling with those we love. That certainly seemed to poverty (at least on a subliminal level).
Our attitudes and understands of death have changed dramatically in the last 20+ years. An increasing number of family members now are very much engaged in the care of their dying parents and other family members. Hospice assists the dying person in "dying with dignity."
All of this created an uneasiness within me; maybe the dying aren't poor.
In 2007, USA TODAY reported that 1.8 million people in the United States resided in nursing facilities and receive a full range of care from simple monitoring for safety to hospice care when they are dying. With institutionalized nursing care, comes the poverty; reduction in decision making, rarely a choice of menu for daily meals, often no choice where one will be placed in the dining room, others deciding when it is time to bathe, shared room-diminished privacy, and the list continues.
For the last four years, I have worked part time as a hospice visit nurse. This generally meant visiting hospice clients who were residents in local nursing homes. I was appalled by what I witnessed in some locations. Residents near death were in darkened rooms, televisions were turned to CNN and blasted the news, there was resistance to hospice staff in some homes, there was no place for visitors to sit and be comfortable while visiting the resident....and the list continues.
I would take this a step further to say that often the dead are poor. I don't mean monetarily necessarily. An example of this is a 20+ yr old male who was convicted of murdering a mother and two adolescent children and a man and his adult daughter. The funeral director was angry with another director for accepting the death call. He told that director that there would be no one to assist with moving the body from the Medical Examiner, none to move the body from the cart to the embalming table, and none if there was difficulty with the embalming. The rationale was that this was a murderer, he didn't deserve any care. The reality is that the body was simply only a body. It was the body of someone whose family loved him despite the conviction and who grieved deeply for him. To have one's body cast aside as if it was the one who murdered is to be poor. To have professionals refuse to assist in the care of that body is (in my opinion) unforgivable.
If we are truly Christians, we must read and make ours the words of Jesus: words of compassion, care, concern, forgiveness rather than scorn, hatred, depersonalization, and sin. Jesus reminds us that we will always have the poor with us, even in death.
Our attitudes and understands of death have changed dramatically in the last 20+ years. An increasing number of family members now are very much engaged in the care of their dying parents and other family members. Hospice assists the dying person in "dying with dignity."
All of this created an uneasiness within me; maybe the dying aren't poor.
In 2007, USA TODAY reported that 1.8 million people in the United States resided in nursing facilities and receive a full range of care from simple monitoring for safety to hospice care when they are dying. With institutionalized nursing care, comes the poverty; reduction in decision making, rarely a choice of menu for daily meals, often no choice where one will be placed in the dining room, others deciding when it is time to bathe, shared room-diminished privacy, and the list continues.
For the last four years, I have worked part time as a hospice visit nurse. This generally meant visiting hospice clients who were residents in local nursing homes. I was appalled by what I witnessed in some locations. Residents near death were in darkened rooms, televisions were turned to CNN and blasted the news, there was resistance to hospice staff in some homes, there was no place for visitors to sit and be comfortable while visiting the resident....and the list continues.
I would take this a step further to say that often the dead are poor. I don't mean monetarily necessarily. An example of this is a 20+ yr old male who was convicted of murdering a mother and two adolescent children and a man and his adult daughter. The funeral director was angry with another director for accepting the death call. He told that director that there would be no one to assist with moving the body from the Medical Examiner, none to move the body from the cart to the embalming table, and none if there was difficulty with the embalming. The rationale was that this was a murderer, he didn't deserve any care. The reality is that the body was simply only a body. It was the body of someone whose family loved him despite the conviction and who grieved deeply for him. To have one's body cast aside as if it was the one who murdered is to be poor. To have professionals refuse to assist in the care of that body is (in my opinion) unforgivable.
If we are truly Christians, we must read and make ours the words of Jesus: words of compassion, care, concern, forgiveness rather than scorn, hatred, depersonalization, and sin. Jesus reminds us that we will always have the poor with us, even in death.
Sunday, July 19, 2009
African countries facing HIV/AIDS medication shorteage
God of our weary years, God of our silent tears, O Good and gracious God, you are the God of health and wholeness. In the plan of your creation, you call us to struggle in our sickness and to cling always to the cross of your Son. Father, we are your servants. Many of us are now suffering with HIV or AIDS. We come before you, and ask you, if it is your holy will, to take away this suffering from us, restore us to health and lead us to know you and your powerful healing, love of body and spirit. We ask you also to be with those of us who nurse your sick ones. We are the mothers, fathers, sisters, brothers, children, and friends of your suffering people. It is so hard for us to see those whom we love suffer. You know what it is to suffer. Help us to minister in loving care, support, and patience to your people who suffer with HIV and AIDS. Lead us to do whatever it will take to eradicate this illness from the lives of those who are touched by it, both directly and indirectly. Trusting in you and the strength of your Spirit, we pray these things in the name of Jesus. Amen.
-The African American AIDS Taskforce
------------------------------------------------------------------------
Here we are, nearly thirty years of known HIV/AIDS. It's been an uphill battle yet, once the reality that this is not simply a disease of the gay community, there has been a tremendous outreach here in the USA toward providing medical care, services, and support for all of those who are impacted by AIDS.
In stark contrast, is Africa. Stigma, living in rural areas, lack of adequate sanitation, and other conditions, have made possible the obliteration of families and communities. The news yesterday reported that funds for HIV medications are running out in Africa and that thousands of persons living with HIV/AIDS may be without medication; Africa has not run out of those living with HIV/AIDS.
Using a somewhat overused question, I ask, "What would Jesus do?" From this question, each of us must begin to ask, "How can I help?" "What can I do?" Certainly there is no immediate "cure" for the problems facing persons living with HIV/AIDS in Africa. We can pray for changes of heart that slow the process of relief for this infection: governments, churches, poor living conditions, lack of understanding and others.
In order to impact the HIV infection rate as well as the AIDS death rate in Africa, the Roman Catholic Church especially, must understand that encouraging the use of condoms is one of the most effective means to this end. We must move from an unbending understanding of moral behavior to a compassionate understanding that we don't have the time to change some behaviors, but we do have the ability to lessen the number of those becoming infected by HIV.
The people of Africa who are impacted by HIV/AIDS (which is basically all of Africa in one way or another) are the poor. I don't believe for a mili-second that Jesus would ever prohibit a product that would greatly lessen infection by a deadly virus. Along with allowing condoms, encouraging, education, and providing compassionate care, Jesus would educate and would encourage compassionate educators to begin a process of change leading to safer sexual practices, better hygeine, improvements in living conditions (cleaner water, better housing, and so on).
I fully believe that WE, the people of God are often responsible for keeping the poor in that condition! It's easier to have the government provide services for the poor and for us to feel good when we drop a handful of change into the hand of someone on the street. We don't have to know "those people" and we don't have to remember them.
Write unceasingly to your US congresspersons. Learn the facts regarding HIV infection in poor countries. Be attentive to the attitude of Jesus as presented in scripture, as he relates to the poor, the destitute, the unwanted, the misunderstood, the sick and wounded. You and I have the ability to make a difference. Most importantly, we have a responsibility as godly persons to do so.
Thursday, July 16, 2009
Our response to the poor in long term care facilities
Several weeks ago, I accepted a half time position as a nursing home chaplain. This facility has several hundred residents and only one chaplain (me). With that number of folks to visit, I have tried to focus on one nursing unit a day as well as to respond to requests for a visit and those who are dying and/or families of the deceased.
As I walk through the hallways, I am aware of residents in their rooms and make mental notes to visit each of them with some regularity. Early this week, I was ready to go home; there had been a death, a second resident near death, and several of the residents upset that they would not be leaving the transitional unit for home as they had anticipated, but they were rather, being moved into the skilled care rooms on another unit. As I neared my office, I saw a resident in her room and didn't even consider stopping. I stopped suddenly, as if someone was in my path urging me to turn around and check in on the resident I had elected to not see. There she was, with her wheel chair foot rest caught on her room mate's bed and she couldn't move back into her own area of the room. I recognized her as a woman with whom I had visited the day she was told she could not go home, but would be moving to long term care. She was inconsolable and we simply sat together as she began to mourn the loss of the life to which she was accustom.
As I entered the room, I asked if I might be of assistance. She responded that she didn't know what was keeping her from moving her wheel chair. I immediately realized that her wheel chair was caught on a bed frame, and after explaining what we needed to do to free her, I was able to move the bed and finally wheel this woman back into her own "room." She was most grateful and she thanked me for coming to visit her.
As I left the room and resumed the walk to my office, I realized how many of our residents must find themselves in similar circumstances much of the time. I was struck with the selfishness of my decision to pass by this woman but "see her another day." I also realized how we marginalize those who show no obvious need at the moment leading us to continue whatever we had been doing. This was a humbling realization and an even greater experience of the blindness that can so easily overcome everyone of us in relation to those we meet and pass by daily. I was reminded too, that the only thing upon which we can count is the moment. There is no assurance that either that resident or I would be here tomorrow. In not taking the time to stop, I would have refused a God given gift of myself to another and denied the other person the comfort and freedom of unrestricted movement in her room.
The bushel basket that so easily covers our light, is also responsible for our times of unawareness of and outreach to the marginalized and poor. Let us throw off that which dims to light and become bright and perpetual beacons in the world.
As I walk through the hallways, I am aware of residents in their rooms and make mental notes to visit each of them with some regularity. Early this week, I was ready to go home; there had been a death, a second resident near death, and several of the residents upset that they would not be leaving the transitional unit for home as they had anticipated, but they were rather, being moved into the skilled care rooms on another unit. As I neared my office, I saw a resident in her room and didn't even consider stopping. I stopped suddenly, as if someone was in my path urging me to turn around and check in on the resident I had elected to not see. There she was, with her wheel chair foot rest caught on her room mate's bed and she couldn't move back into her own area of the room. I recognized her as a woman with whom I had visited the day she was told she could not go home, but would be moving to long term care. She was inconsolable and we simply sat together as she began to mourn the loss of the life to which she was accustom.
As I entered the room, I asked if I might be of assistance. She responded that she didn't know what was keeping her from moving her wheel chair. I immediately realized that her wheel chair was caught on a bed frame, and after explaining what we needed to do to free her, I was able to move the bed and finally wheel this woman back into her own "room." She was most grateful and she thanked me for coming to visit her.
As I left the room and resumed the walk to my office, I realized how many of our residents must find themselves in similar circumstances much of the time. I was struck with the selfishness of my decision to pass by this woman but "see her another day." I also realized how we marginalize those who show no obvious need at the moment leading us to continue whatever we had been doing. This was a humbling realization and an even greater experience of the blindness that can so easily overcome everyone of us in relation to those we meet and pass by daily. I was reminded too, that the only thing upon which we can count is the moment. There is no assurance that either that resident or I would be here tomorrow. In not taking the time to stop, I would have refused a God given gift of myself to another and denied the other person the comfort and freedom of unrestricted movement in her room.
The bushel basket that so easily covers our light, is also responsible for our times of unawareness of and outreach to the marginalized and poor. Let us throw off that which dims to light and become bright and perpetual beacons in the world.
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