The Dangerous Necessity of Hope

I had a request from one of the facilities we serve to visit one of their residents. This man had some tremendous losses in the past year. His wife, who had dementia, had died rather suddenly some months ago. He also had a stroke which affected his speech and mobility, requiring him to move in to the facility as well. I spoke with his daughter  before visiting and she spoke of how concerned she was for him, saying he had talked with his physical therapists about how depressed he was. Continue reading

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The Political Chaplain

An image from the Arbor Day foundation: “A rotten inner core … can cause a split trunk. The wounds are too large to ever mend.”

I have a game at home called “We Didn’t Playtest This At All”. It’s a really fun game (to some at least) based on unique cards that people play during the game that change the rules of the game as it’s played. For example, one card simply says “You Win” and when you play that card, you win (but only if you’re a girl in one case). Unless someone has the card that allows them to make someone lose whenever that person just won (but they also lose). My favorite card though is called “Politics”. When you play that card you are told to say “everything is ruined!”, then all players turn in all their cards and pick new ones. Because, as we know, politics ruins everything. Continue reading

There’s No Wisdom to Share: Thoughts on the Pittsburgh Synagogue Shooting

BRENDAN SMIALOWSKI/AFP/Getty Images

Just over a week ago the calm of a quiet Jewish neighborhood on the fringe of Pittsburgh preparing for Shabbat was shattered by a gunman who entered a synagogue, shot eleven people, and wounded several others. I live in the northern suburbs of Pittsburgh, but when I heard the location of the shooting I went into a panic. Tree of Life synagogue, which had been attacked, is where my CPSP chapter routinely meets. Three members of our chapter are closely tied to that community in one way or another, and one is the Rabbinical leader of New Light Congregation which was beginning services at Tree of Life when the shooting started. Three members of his congregation were killed. Another member of our group, also a Rabbi, was shot as well. It took over a day to find out he had survived but was in critical condition. Continue reading

Moving Beyond Helplessness: An Update

I recently wrote a post about the difficulties of overcoming helplessness in grief and grieving. Since then I wanted to give a bit of an update not only on the case but on my CPSP group’s reaction to it when I presented it to them for feedback.

I had written about a woman who recently lost her husband and since then had become very depressed. She felt that everything good was gone in her life and that nothing could make it better. The only thing that could make things better was for her husband to come back, and she knew that wasn’t going to happen. She often told me that there was nothing I, or anyone else, could do for her. I described talking to her as feeling like I was putting the needle back into the groove of a skipping record. After several discussions, visits, and referrals for her I brought the case up to my CPSP group for feedback and at least a listening ear.

The first response I got after detailing the situation surprised me: “so how long are you going to do this?” Continue reading

Moving Beyond Helplessness

In my working with individuals who are struggling with their grief, one of the most difficult obstacles I’ve had is the sense of helplessness that sometimes accompanies grief. I made a call the other day to the wife of a past patient the other day, and she expressed her feelings this way: “You can’t help me.” She went on to talk about how she and her husband did absolutely everything together and how they planned on growing old together. Life without him was unimaginable. Now, two years after his death, every day feels worse than the day before. She has no picture of a future without him, feels unmoored and purposeless, and lacks a sense of her own identity. She has panic attacks and is very depressed most of the time. Worst of all though is her feeling that there’s nothing I or anyone else could do to help her. Continue reading

Self-Disclosure: How Much is Too Much?

A reader asked me a while ago about the appropriate use of self-disclosure and I thought that was a great topic to write about more in depth. It can be a touchy subject, as I expect we have all met those who engage in too much self-disclosure with those we support. To completely avoid self-disclosure though is to not use our most valuable and powerful tool, our own story. Continue reading

528 Hertz

“You know that the universe vibrates at 528 Hz, right?”

This was only part of the first conversation I had with Neil*, who had just come on hospice and was living at home with with his mother. It was my initial assessment with him, and it was already off to an interesting start. When I arrived for our meeting time he wasn’t available. The neighbors in his apartment building who were sitting outside said that he had just gone out to the local Rite-Aid with his girlfriend. So I waited on the patio until he arrived.

Neil right off the bat struck me as an interesting guy. He was in his mid-50’s, and his long white hair, thin build, pale Hawaiian shirt and straw fedora made him look like a wandering beachcomber. He carried a portable oxygen concentrator, the only visible indicator of his end-stage lung cancer. “Hey man! Sorry I’m late. I had to go get my meds and some toothpaste.” He introduced me to his girlfriend who was with him and neighbors and then escorted me inside, chatting the whole time. Continue reading

NPR Show Discusses Hospice and “Comfort Care”, Advance Directives

Joshua Johnson, host of NPR’s 1A

The NPR show and podcast 1A recently held a discussion with former radio personality Diane Rehm and medical experts, prompted by the news that former First Lady Barbara Bush had chosen “comfort care” in the last days of her life. Continue reading

Countering Hospice Myths: A Response to John Neihof and the American Family Association

A recent article by Dr. John Neihof on the American Family Association website caught my attention recently. I find that I’m often at odds with the AFA, and try to counter some of their more off-base proclamations (the biblical mandate for border walls for example) in their comments section. It’s been a fool’s errand I think, and this fool has run his final errand with the AFA. Continue reading

CPE Verbatim: Avoiding the Unavoidable

I revisited an older verbatim that I wrote back in 2011. It’s interesting to go back and review older visits and interactions with the lens of history and experience. I don’t remember this particular case, but it reminds me of several other cases. I do remember that it was rather frustrating for me, which will be evident in the interaction. Continue reading