Imagine standing at the bedside of an 80 yr. old man who has been diagnosed with ALS (a progressive, debilitating disease that destroys nerves and weakens muscles until breathing is impossible without assistance while the mind remains clear). Despite his weakness, he makes the same repetitive movements with this hands, until one of his daughters asks, "Do you want to write something, Dad?" He nodded and his daughter held a clipboard and paper while he slowly and clearly wrote, "Let me die." This is John's story of the poverty that our medical professionals are capable of inflicting on those who need them the most and the anguish that accompanies those "professional" decisions and actions. That poverty was diminished by the love, faith, and determination of John's family.
"John" had been rushed to the hospital from a nursing home when he experienced difficulty breathing. All but the most important paperwork accompanied him. There was nothing that mentioned ALS! Soon it became essential to assist John's breathing and the physicians explained that he needed to be intubated in order to receive enough oxygen to sustain life. Despite his advance directive stating "Do NOT Resuscitate" John indicated his permission to intubate and to place him on a ventilator.
Those who were with John when he wrote his request to be allowed to die, immediately asked for a meeting with his primary ICU physician. The following morning, five of John's sons and daughters gathered with the physician and showed him the clearly written request. They inquired as to how the removal of life support would progress. "John is receiving a great deal of sedation; I can't simply remove the endotracheal tube. Just think how John had still been able to walk and push your mother in her wheelchair even the morning that his difficulty breathing began" (a paraphrase of the physician response).He indicated that he would have to ask John if removal of the tube and ventilator was what he REALLY wanted.
The physician and John's family re-grouped in John's room. Standing over John and nearly shouting his words, the physician began by asking John how he was doing; he blinked his eyes. " Do you want that breathing tube taken out? You know we have turned down the ventilator so that you are taking the breaths and the machine is providing the force to breathe out for you. It's possible that you can return to pushing your wife in her wheelchair and resume your activities at the nursing home if we give this treatment time to work. So, do you want us to remove the breathing tube?" "DO YOU WANT TO DIE?" John looked at him and shook his head "No." Back in the conference room, the physician told the family that John had made the decision that he was obliged to honor and that he would remain on the ventilator.
John developed pneumonia. The medical plan was to perform a tracheotomy and an insertion of of a feeding tube through his abdominal wall and which would remove the endotracheal tube and present feeding tube and be more comfortable for John. The morning that the procedures were scheduled, John spiked a fever which did not respond to medications. Early in the afternoon, when the family visited him, John was on a cooling pad (the length of his body). He was shivering and trying to move his legs off the pad. It was obvious that he was miserable. John's gestures were frantic; the look in his eyes was one of confusion as to what was happening to him.
Several days later, John's fever was under control, but his pneumonia had worsened. He appeared to be weaker and he slept more that he was awake. He continued to initiate breathing, with the ventilator assisting in expiration. Once again, the family asked to speak with the physician. He agreed that John might require the respirator for the rest of his life. His family asked if the nursing home would let him return on a respirator and he indicated that they would not. They inquired as to where there might be a facility nearby that would take John. There was a nursing facility that would take ventilator dependent individuals for rehab. The longest he could remain there was a month! What then?? Was there a facility for long term placement? The nearest nursing home able to care for someone on a ventilator was more than an hour's drive away. His wife would only be able to see him occasionally.
Once again the family gathered together to discuss the options for their father and husband. They approached the physician the next morning with their decision to have John gradually weaned from the ventilator and to let him die in peace. This time, as the physician spoke to John, he told them how serious his condition was and that there was a great probability that he would never be able to live without a respirator. The two possibilities that he explained to John were remaining on the respirator or keeping him comfortable while respirator assistance was gradually lessened and he died. John signaled that he understood and plans were made to begin the process within the hour.
As the gradual reduction in ventilator support began, a priest friend of his family had been asked to pray with them. Everyone was gathered around the bed and the image of a large group of people, each wearing white garments and gathered before God was recalled from the Revelation to St. John the Divine. When asked who these people were, an elder responded that they were the ones who had passed through the great tribulation. John was assured that he, too, would soon be one of that multitude standing before God who would say to him, "Well done, good and faithful servant." John's monitor indicated the slowing of his heart rate and the lowering of his blood pressure. Everyone present had the opportunity to hold John and tell him how they loved him. Peacefully and painlessly, John slipped into the open arms of God. As the monitor indicated cessation of life, the priest began, "Eternal Rest grant unto John O Lord....." and the prayers of the family began as John was held in their loving arms and committed to God's care.
The first question which the priest and the Levite asked was: "If I stop to help this man, what will happen to me?" But... the good Samaritan reversed the question: "If I do not stop to help this man, what will happen to him?" Martin Luther King, Jr.
John's family never asked the question of the priest and the Levite. Although it was not verbalized, I sense that this was a huge question for the physician. Had John's family not been attentive to his wishes, he would be in some nursing facility; away from family and friends. He would not be able to speak and would be totally dependent upon others and machinery to sustain "life." John has moved now from the poverty of illness, fear of lawsuits that often dictate medical decisions, and total dependence upon others to a new life in the Presence of God.
Monday, September 28, 2009
Monday, September 7, 2009
The Poor in Long Term Care
During the three months that I have served as a chaplain in long term care, I have identified more individuals who are poor for reasons other than lack of financial concerns. Most of these women and men are living on "memory care" units. (think Alzheimer's disease for many of them).
This particular facility has placed chaplaincy/spiritual care, within the Recreation department! I was aware from the first interview that this person wanted me to plan, preside and preach for three Sunday services as well as manage the music, encourage nursing staff to bring residents to the service, and have time in between to run to the next unit and repeat the process! I questioned the wisdom of this plan and asked if we might instead, spread the three services out during the week. "No, they must be on Sunday."
My second concern regarding worship services was the benefit to those on the two memory care units. I agree that worship is important to many people through all stages of life, but I questioned the formality of the service rather than a more relaxed worship where there might be both group activity as well as time for individual and personal interaction. "No, they must be as I have said."
When does the in depth human interaction happen for most of these residents? I've observed the nursing assistants pulling residents in wheelchairs backward where there is no hope of conversation between staff and resident. I have also observed staff members all sitting together at the desk while 30 residents sit in silence in the recreation area, in full view of those same staff members.
Of course, there are staff members who have grumbled because I question the decision to turn a dying woman on her side and facing the wall making it next to impossible for anyone to get near her, hold her hand, speak softly to her. They are the same staff members who don't seem to understand that one need not be left with drool and medication on their chin because they don't know it's there.
My heart and soul ache for these residents. In less than 90 days, I have shown that a resident who mostly vocalized sound and not words, spoke clearly to me when I patiently encouraged her to "use words." She now perks up in her wheelchair and breaks into a smile when she sees me; we wave and smile at each other now.
On these units especially, the sermon is in the presence of Christ visible and tangible through those of us who extend a hand, smile at, speak pleasantly, show consideration and love, to them as would Christ and St. Francis. It is so natural to me, and so confusing to those who make the "rules."
The poverty resulting from lack of individual attention and concern, screams out through the blank looks of some, the uncertainty of people who do attempt interaction, the tears of a woman who spends her day sitting on a bench outside the unit's elevators. "There but for the grace of God, go I" I think to myself. "I'm not budging on this requirement for three worship services on Sundays," the Recreation director insisted. Why can she not recognize that worship and the lessons from the Gospels are being lived through kind words, smiles, a brief time sitting on a couch with a lonely resident....and so many others.
What I have learned is that the push for Sunday worship as described here, is the fulfillment of recreational "activities" during those times. If I don't lead a group activity, "someone would have to be hired to fill those times in order to be compliant." "Yes, and........."
We share the wonder and the love of God with everyone we meet when we celebrate our connectedness and share our experiences and feelings in friendly one on one conversation, an arm around a lonely resident, a question about their day, a wave to everyone in the dining room, a "dance" with a woman in a wheelchair........ Spirituality is about connectedness and that is the starting point in reducing the poverty experienced by many human beings.
This particular facility has placed chaplaincy/spiritual care, within the Recreation department! I was aware from the first interview that this person wanted me to plan, preside and preach for three Sunday services as well as manage the music, encourage nursing staff to bring residents to the service, and have time in between to run to the next unit and repeat the process! I questioned the wisdom of this plan and asked if we might instead, spread the three services out during the week. "No, they must be on Sunday."
My second concern regarding worship services was the benefit to those on the two memory care units. I agree that worship is important to many people through all stages of life, but I questioned the formality of the service rather than a more relaxed worship where there might be both group activity as well as time for individual and personal interaction. "No, they must be as I have said."
When does the in depth human interaction happen for most of these residents? I've observed the nursing assistants pulling residents in wheelchairs backward where there is no hope of conversation between staff and resident. I have also observed staff members all sitting together at the desk while 30 residents sit in silence in the recreation area, in full view of those same staff members.
Of course, there are staff members who have grumbled because I question the decision to turn a dying woman on her side and facing the wall making it next to impossible for anyone to get near her, hold her hand, speak softly to her. They are the same staff members who don't seem to understand that one need not be left with drool and medication on their chin because they don't know it's there.
My heart and soul ache for these residents. In less than 90 days, I have shown that a resident who mostly vocalized sound and not words, spoke clearly to me when I patiently encouraged her to "use words." She now perks up in her wheelchair and breaks into a smile when she sees me; we wave and smile at each other now.
On these units especially, the sermon is in the presence of Christ visible and tangible through those of us who extend a hand, smile at, speak pleasantly, show consideration and love, to them as would Christ and St. Francis. It is so natural to me, and so confusing to those who make the "rules."
The poverty resulting from lack of individual attention and concern, screams out through the blank looks of some, the uncertainty of people who do attempt interaction, the tears of a woman who spends her day sitting on a bench outside the unit's elevators. "There but for the grace of God, go I" I think to myself. "I'm not budging on this requirement for three worship services on Sundays," the Recreation director insisted. Why can she not recognize that worship and the lessons from the Gospels are being lived through kind words, smiles, a brief time sitting on a couch with a lonely resident....and so many others.
What I have learned is that the push for Sunday worship as described here, is the fulfillment of recreational "activities" during those times. If I don't lead a group activity, "someone would have to be hired to fill those times in order to be compliant." "Yes, and........."
We share the wonder and the love of God with everyone we meet when we celebrate our connectedness and share our experiences and feelings in friendly one on one conversation, an arm around a lonely resident, a question about their day, a wave to everyone in the dining room, a "dance" with a woman in a wheelchair........ Spirituality is about connectedness and that is the starting point in reducing the poverty experienced by many human beings.
Monday, August 31, 2009
Preach the Gospel; Use Words if You Must
This morning, I officiated at the funeral of an 86 yr. old woman who had spent the last 14 years of her life in a long term care facility. As I drove to the funeral home, I began to think of just what I wanted to say in my homily. I had only visited this woman a few times before she was actively dying.
Suddenly, St. Francis' words came to my mind: "preach the gospel; use words if you must." I had an image of Janis (not her name) in either her wheelchair or her bed. She was unable to speak much and when she did her disease rendered the words garbled and not easily understood. Despite her inability to verbally communicate, Janis preached the gospel to all she met: She communicated with her eyes. There was a gentle calmness that I perceived as I looked into her eyes. I felt as if Janis accepted her need for help and the absolute necessity for patience with others who, like herself, could not articulate needs or thanks.
Here was a woman who struggled for each breath yet who relaxed when we prayed the rosary. One hand was set in a grasping position while the other gently grasped the hand of anyone sitting with her. Without words, there was an affirmation that sitting with a dying woman and holding her hand was a preaching of the gospel command to love one another. The longer I sat with Janis, the fewer words I uttered. Soon, we sat in silence; "tuned in" to God and one another.
There are some who ask me why I wear my Franciscan Habit in nursing facility. Contrary to what some believe, I wear it because it is a visual clue to those who do not easily comprehend spoken words, that I am a person who brings the Presence and Person of the Christ to them. Certainly this is not the only way this message is conveyed. I often greet residents on the memory units when they are in the day room. I go to each resident, speak to them, and give many hugs. Last week, I dropped into the dining room on one of these units, and the first resident I met hugged me and said, "Now, don't forget to go to everyone and give them a hug." She recognized the need that so many residents have for gentle, physical, caring, human contact.
This is the gospel at work in one of the most effective ways I have experienced it.
Suddenly, St. Francis' words came to my mind: "preach the gospel; use words if you must." I had an image of Janis (not her name) in either her wheelchair or her bed. She was unable to speak much and when she did her disease rendered the words garbled and not easily understood. Despite her inability to verbally communicate, Janis preached the gospel to all she met: She communicated with her eyes. There was a gentle calmness that I perceived as I looked into her eyes. I felt as if Janis accepted her need for help and the absolute necessity for patience with others who, like herself, could not articulate needs or thanks.
Here was a woman who struggled for each breath yet who relaxed when we prayed the rosary. One hand was set in a grasping position while the other gently grasped the hand of anyone sitting with her. Without words, there was an affirmation that sitting with a dying woman and holding her hand was a preaching of the gospel command to love one another. The longer I sat with Janis, the fewer words I uttered. Soon, we sat in silence; "tuned in" to God and one another.
There are some who ask me why I wear my Franciscan Habit in nursing facility. Contrary to what some believe, I wear it because it is a visual clue to those who do not easily comprehend spoken words, that I am a person who brings the Presence and Person of the Christ to them. Certainly this is not the only way this message is conveyed. I often greet residents on the memory units when they are in the day room. I go to each resident, speak to them, and give many hugs. Last week, I dropped into the dining room on one of these units, and the first resident I met hugged me and said, "Now, don't forget to go to everyone and give them a hug." She recognized the need that so many residents have for gentle, physical, caring, human contact.
This is the gospel at work in one of the most effective ways I have experienced it.
Monday, August 10, 2009
Grief, suicide and the poor
Can you imagine being a 29 yr. old male and a resident of a nursing facility? Add to your imagination, that person as gay and one who recently lost his life partner complications of AIDS. By the grace of God, Craig (not his real name) has been supported by his partner's family through these difficult several weeks. He was included in decision making regarding funeral planning, and his wish to have a small companion urn (containing a small amount of the cremains of his partner) was granted.
Craig has a history of depression. This past week, he received the companion urn and has had his partner's cremains at his bedside. He told staff members that he sat holding the urn to his heart and rocking back and forth as he poured out tears of loss, love, and grief.
Feeling unable to cope with his loss, Craig purposefully hiked up a dose of antidepressant medication with the intention of suicide, he became frightened and let staff members know of his actions and intentions. He was sent to the hospital and released later in the day.
Many in society today would respond to this story saying, "If he hurt so much why didn't he turn to his fag friends to hold his hand?" There are still so many places where lesbian and gay men cannot share what is in their hearts and souls and minds. "Safe" staff members knew what was going on with Craig, but they weren't always working. Because so many people didn't know how to respond, they left Craig alone or never mentioned his partner's death.
It seems to me that a large portion of human beings walk through life with blinders on; always looking directly ahead and trying to never meet the eyes of others. If we don't see, hear, or feel other's pain, depression, and confusion, we don't have to respond. If we can keep someone away by judging them unworthy of our attention, we use obstacles such as sexual orientation, race, political affiliation, socio-economic status and others, to alienate them.
Poverty is much more extensive than that which is experienced by those who lack adequate food and water, shelter, and income. Poverty is a part of loneliness, grief, loss, hopelessness. It often is the experiences of parishioners in our parishes, professionals, students, those struggling with decisions such as abortion, and many others who do not "wear the face of poverty" that we expect.
We live in such a disconnected world that we often simply don't take the time to look around us realizing that we are all children of God and called to care about and for one another. Thousands of people in Taiwan have lost their lives due to a typhoon. We acknowledge the loss, yet many of us barely give that loss of life another thought. The more we draw the shades and tighten the boundaries around us the more lacking is our spirituality. As Christians, we are called to embrace the other, to care about them, to comfort them, to do all that we can in a broken world.
If we can give only a passing prayer for thousands of people, how do we remember the individual prayers of the poor within our sight?
Craig has a history of depression. This past week, he received the companion urn and has had his partner's cremains at his bedside. He told staff members that he sat holding the urn to his heart and rocking back and forth as he poured out tears of loss, love, and grief.
Feeling unable to cope with his loss, Craig purposefully hiked up a dose of antidepressant medication with the intention of suicide, he became frightened and let staff members know of his actions and intentions. He was sent to the hospital and released later in the day.
Many in society today would respond to this story saying, "If he hurt so much why didn't he turn to his fag friends to hold his hand?" There are still so many places where lesbian and gay men cannot share what is in their hearts and souls and minds. "Safe" staff members knew what was going on with Craig, but they weren't always working. Because so many people didn't know how to respond, they left Craig alone or never mentioned his partner's death.
It seems to me that a large portion of human beings walk through life with blinders on; always looking directly ahead and trying to never meet the eyes of others. If we don't see, hear, or feel other's pain, depression, and confusion, we don't have to respond. If we can keep someone away by judging them unworthy of our attention, we use obstacles such as sexual orientation, race, political affiliation, socio-economic status and others, to alienate them.
Poverty is much more extensive than that which is experienced by those who lack adequate food and water, shelter, and income. Poverty is a part of loneliness, grief, loss, hopelessness. It often is the experiences of parishioners in our parishes, professionals, students, those struggling with decisions such as abortion, and many others who do not "wear the face of poverty" that we expect.
We live in such a disconnected world that we often simply don't take the time to look around us realizing that we are all children of God and called to care about and for one another. Thousands of people in Taiwan have lost their lives due to a typhoon. We acknowledge the loss, yet many of us barely give that loss of life another thought. The more we draw the shades and tighten the boundaries around us the more lacking is our spirituality. As Christians, we are called to embrace the other, to care about them, to comfort them, to do all that we can in a broken world.
If we can give only a passing prayer for thousands of people, how do we remember the individual prayers of the poor within our sight?
Saturday, August 8, 2009
Preach the Gospel; use words if you must
Preaching the gospel by example is much more difficult than doing so by using words. This morning, I stopped at the long term care center in order to finalize my service format for tomorrow's worship. I am never able to go directly to my office. As I exit the elevator, I turn toward the day room which is often filled with residents.
This morning, there were 23 residents all sitting with absolutely no stimulus except CNN news! There were three CNA's at a back table with one resident and none of them were speaking to the resident. None of them made a move during the 20 minutes that I was in the day room, to speak or interact in any manner with the residents.
I know that many of these residents are non-verbal and others are extremely confused. On the other hand, they always respond when I go to each of them individually and speak to them. Several of the residents anger the others in that they do not speak but rather, simply vocalize in a shrieking voice and another by loudly singing out the melody of songs! I have learned that the first woman is able to speak, but needs to be reminded and have limits set. When I do this, we are able to have a conversation. This is not always an easy time, but I am generally able to have some conversation with her. Once again, the CNA's in the dayroom, looked at me as if I was crazy trying to interact with any of the residents let alone with one who would rather yell than speak.
"Preach the Gospel; use words if you must." Not all those who need a hug and some encouragement are in long term care. I have observed drivers swerve around an obviously intoxicated individual and make no attempt to move that person to safety. I have called 911 for a patrol vehicle to move an obviously intoxicated individual to safety only to be asked if that person is "an Indian." We have all been in crowds so dense that we are nearly piled one upon the other and no one speaks or acknowledges the other in any manner.
Francis understood what the disciples of Jesus couldn't grasp. They became confused with the words of the Teacher and they missed the impact of his actions. Many of us are still confused disciples of the Christ. If we can't say or write what we think, we are immobilized by anxiety and concern that we will not make an impact.
The poor will always be with us. You and I as disciples of Jesus Christ, have an obligation to become one with them, rather than engage in a "them" and "us" recognition of one another. Let's try to speak fewer words and to increase our outward and visible actions to others as we spread the Good News.
This morning, there were 23 residents all sitting with absolutely no stimulus except CNN news! There were three CNA's at a back table with one resident and none of them were speaking to the resident. None of them made a move during the 20 minutes that I was in the day room, to speak or interact in any manner with the residents.
I know that many of these residents are non-verbal and others are extremely confused. On the other hand, they always respond when I go to each of them individually and speak to them. Several of the residents anger the others in that they do not speak but rather, simply vocalize in a shrieking voice and another by loudly singing out the melody of songs! I have learned that the first woman is able to speak, but needs to be reminded and have limits set. When I do this, we are able to have a conversation. This is not always an easy time, but I am generally able to have some conversation with her. Once again, the CNA's in the dayroom, looked at me as if I was crazy trying to interact with any of the residents let alone with one who would rather yell than speak.
"Preach the Gospel; use words if you must." Not all those who need a hug and some encouragement are in long term care. I have observed drivers swerve around an obviously intoxicated individual and make no attempt to move that person to safety. I have called 911 for a patrol vehicle to move an obviously intoxicated individual to safety only to be asked if that person is "an Indian." We have all been in crowds so dense that we are nearly piled one upon the other and no one speaks or acknowledges the other in any manner.
Francis understood what the disciples of Jesus couldn't grasp. They became confused with the words of the Teacher and they missed the impact of his actions. Many of us are still confused disciples of the Christ. If we can't say or write what we think, we are immobilized by anxiety and concern that we will not make an impact.
The poor will always be with us. You and I as disciples of Jesus Christ, have an obligation to become one with them, rather than engage in a "them" and "us" recognition of one another. Let's try to speak fewer words and to increase our outward and visible actions to others as we spread the Good News.
Tuesday, August 4, 2009
Poverty and those living in a Persistent Vegetative State
Two weeks ago, I met Jake (not a real name). He is a 30+ yr old man residing in a long term care facility and diagnosed as being in a persistent vegetative state. I first saw him in his room. The curtains were drawn (about 1 PM), there was no music or other sound in the room. Jake's eyes moved randomly and he allowed me to place my hand in his. He drooled constantly and made no obvious connection with his environment. I spoke to him and assured him that many of us care about him.
Last week, as I was about to begin a "chaplain's chat" group, Jake was brought into the day room. The CNA placed his wheelchair outside of our circle. I immediately moved Jake into the circle and placed him next to me. As I began the group, I took Jake's hand in mind and kept it there (as a means of connecting Jake to us) throughout the next 45 minutes. It was obvious that some of the residents were uncomfortable having Jake with us. Several shook their heads as if they could not believe that I would include Jake in anything, let along "their" group!
It is obvious that Jake makes many people uncomfortable. Because of that, staff respond to the majority who would rather keep him in his room and out of sight. Certainly, we don't know what Jake is experiencing: does he recognize people present near him or hear and understand voices?
Perhaps the need to keep Jake out of sight stems from the realization that anyone of us might be in a similar state at some time. We don't want to think of living without any realization or connection with others.
This approach to Jake certainly lacks a realization of connection of others with him. There is a poverty of spirit with no acknowledgement by many residents and staff that we are truly connected to and with Jake by virtue of our human experience. Jake is being denied the possibility of human interaction at the most basic level (simply being placed in the circle).
I'll admit that it isn't especially easy to speak to someone who shows absolutely no response or indication of connectedness. I don't remember Jesus or Francis having an expectation of response. I doubt that Jake would have been excluded from any one of the large crowds that followed Jesus. If someone had tried to exclude him, certainly Jesus would have used the occasion as a teaching moment.
I have made a commitment to Jake and that is to include him wherever I can and to add variety to his days by providing music of various types, group interactions, visitors, interaction with his family, and anything else that is an acknowledgement of his humanness. How, as a follower of the Christ and Francis can I do any less?
Last week, as I was about to begin a "chaplain's chat" group, Jake was brought into the day room. The CNA placed his wheelchair outside of our circle. I immediately moved Jake into the circle and placed him next to me. As I began the group, I took Jake's hand in mind and kept it there (as a means of connecting Jake to us) throughout the next 45 minutes. It was obvious that some of the residents were uncomfortable having Jake with us. Several shook their heads as if they could not believe that I would include Jake in anything, let along "their" group!
It is obvious that Jake makes many people uncomfortable. Because of that, staff respond to the majority who would rather keep him in his room and out of sight. Certainly, we don't know what Jake is experiencing: does he recognize people present near him or hear and understand voices?
Perhaps the need to keep Jake out of sight stems from the realization that anyone of us might be in a similar state at some time. We don't want to think of living without any realization or connection with others.
This approach to Jake certainly lacks a realization of connection of others with him. There is a poverty of spirit with no acknowledgement by many residents and staff that we are truly connected to and with Jake by virtue of our human experience. Jake is being denied the possibility of human interaction at the most basic level (simply being placed in the circle).
I'll admit that it isn't especially easy to speak to someone who shows absolutely no response or indication of connectedness. I don't remember Jesus or Francis having an expectation of response. I doubt that Jake would have been excluded from any one of the large crowds that followed Jesus. If someone had tried to exclude him, certainly Jesus would have used the occasion as a teaching moment.
I have made a commitment to Jake and that is to include him wherever I can and to add variety to his days by providing music of various types, group interactions, visitors, interaction with his family, and anything else that is an acknowledgement of his humanness. How, as a follower of the Christ and Francis can I do any less?
Tuesday, July 28, 2009
Long Term Care Residents (Part II)
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?
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?
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