Tag Archives: caregiving

It’s time to appreciate the nurses literally and figuratively

During eight years of caregiving for a wife with ovarian cancer, there were many times when nurses served to help us get through the challenges of treatment, surgeries, chemotherapy and in the end, palliative care. I wrote the following essay about the value of nurses for the caregiving group that formed around us. Later it was published in The Right Kind of Pride, the book I wrote about our journey and for which this blog is named. 

With nurses doing so much work on the front lines and as first responders during the Coronavirus and Covid-19 epidemic, this bit of testimony is meant to encourage nurses everywhere, and to urge people to appreciate their training and work

Nurses, literally and figuratively

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Tuesday, December 20, 2011, 5:30 PM

Two days after my wife’s surgery I woke early to head west and pick up our dog to go home and check on the house. Stepping onto the elevator I encountered two tired-looking nurses leaning on the back wall.

“Shift over?” I asked. “Yes,” one of them breathed, trying not to look too relieved.

“Well, I admire your work,” I told them. “Patients can be a pain in the butt, I’m sure.”

“You said it, not me!” one of them replied as they headed out the elevator and down the hallway, exchanging knowing glances.

No easy gig

Nursing is no easy gig, of course. Nothing in the medical profession really is.

They see so much, both literally and figuratively. Nursing is the most intimate of all professions. Even more so than being a doctor, in some ways. From inserting catheters to administering shots to washing patients who can’t wash, nurses see humanity up close and personal.

There are also broader dimensions. Families in crisis. Human frailty laid bare. The human condition. On those dynamics rest hopes of healing. That is why medicine exists, and nurses carry it out to the best of their abilities.

Of course, nurses deal with varied results and varied perceptions of their profession. Not having worked in the medical field, I do not entirely know what the environment is like. But some nurses I’ve met speak of doctors that do not treat them well, or show respect. Maybe the pecking order at some hospitals is harsh. Yet the good hospitals seem to celebrate every role from orderly to surgeons. And there really are some great hospitals in the area where we live. We can be grateful for that. And this is no paid testimonial.

But I’ll reiterate: When we think about who provides a great amount of care and recovery in medicine, we should never forget to thank the nurses, both men, and women. There was Allan, and Silvia, Rafaela, and Kathy. the list goes on. All with attributes that add up to good care.

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Professional caregiving

Because nursing is basically professional caregiving, it is something to observe when you’ve been placed in the role of caregiver yourself.

The challenging part is that the tools have advanced but the needs have not changed. The records have gone digital. The ability to monitor patients is so sophisticated. Yet it is still the human responsibility of nurses to read those signs and pass them back along the chain for the doctors and surgeons to study. Front line. First responders. In tune. In touch. That’s the role of nurses.

It is a cosmopolitan profession. The nursing professionals in the four or five hospitals with which we have had experience are quite racially diverse. Hospitals seem to hire nurses to match the culture and backgrounds of their constituent populations. But not always.

Language is another important aspect of nursing. For example, at the network hospital where Linda had her surgery, the primary phone greeting is given in several Eastern European languages. Diversity is not some casual thing at a hospital. It really can mean life or death.

Communication

Style of communication is also important in nursing. Some nurses excel in this category, with a gift for compassion that is comforting and encouraging. Others are more business-like, and their attributes can be of tremendous value in many circumstances. Linda’s chemo nurse this time around was a focused woman whose competency and the organization was of great assurance. Success in chemotherapy treatment can depend on the nurse’s ability not only to administer the medicine but also to track and monitor patient response in real-time (daily response to treatment, blood counts and side effects and over the course of treatments (chemo tolerance and patient affect) these attenuations add up. Literally and figuratively.

Racing for life

Getting chemo really is like running a marathon; checking your vitals along the way, taking aid at the proper points and pacing your effort so you don’t falter. Chemo is a marathon.

But surgery is a sprint of sorts. Our surgeons fixed a hernia, did a colon resection and removed a 31mm cancer tumor in about 2.5 hours. That’s fast and brilliant work. You can worship athletes all you want. Medical doctors like these deserve real accolades.

It is the nurses however who are the trainers that get you back into shape after the taxing sprint of surgery or the exhausting marathon of chemo. With cancer sometimes you need both to be successful. Fast-twitch and slow twitch.

The range of human foible

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That and a sense of perspective and humor helps. I was really glad the people at the nursing station had a sense of humor when after the first night at the hospital I trundled out of Lin- da’s room at 5:00 a.m. to visit the bathroom down the hall. No one looks dignified at that hour, and I felt a little like a college freshman in a “walk of shame” down the dormitory hall after an all-nighter. But no one said a word. They see weirder things every day. Lucky for me, a bald man seldom has bad hair days.

Nurses see it all, of course, the whole range of human foible. Being able to encourage patients with an occasional jest about the difficulties of recovery can break the ice and open channels in working through pain or other humbling issues such as finding ways to go to the bathroom when it is far from easy and convenient for the patient. All this basic stuff,. They have to know when and how to be light about it, and when not.

Startups and bending over backward

Nurses are the professionals who get it all going for people again, over and over. Week after week. Year after year. Think of all the focus and dedication it takes to be a nurse for 5, 10 or 25 years. And people do it.

The nurse who checked Linda out of the hospital has been working in the same phase of nursing for 25 years. She was immensely practical and detail-oriented, dispensing instructions so that we would know how to care for the surgical wounds and tend to bathroom matters the right way. That nurse fit her job.

A young nurse named Rafaela checked on Linda regularly during her week in the hospital. She seemed to appear like magic from around the curtain whenever there was a need in the room. That nurse excelled in care.

The first night after surgery, Linda’s nurse was a soft-spoken woman who struck up a conversation starting with a compliment about the fact that I was staying overnight with my wife. Perhaps it is not so common for people to stay over. The new Planetree model for health care offers a more humanistic approach to medicine and facilities, especially hospitals. Hospitals now provide comfortable couches that convert into beds so that family or supportive friends can stay overnight with a patient.

I can tell you that’s a huge improvement from the night spent next to her bed back in 2007 when the only available place to sleep next to her was something like a Medieval torture device. The vinyl recliner on which I slept formed a pronounced hump approximately the curve of a mature dolphin in mid-jump. It was not the most comfortable night of sleep in my life, punctuated as well by beeps and whistles and the bustle of nurses hustling in and out for blood pressure checks and temperature readings. They were just doing their job, yet I felt like it was a torturous night of sleep deprivation in a black site somewhere in Eastern Europe. I exaggerate, but when you’re tired the mind works overtime.

To her everlasting credit, my mother-in-law, who had done overnight duty on the dolphin chair the previous evening tried giving me fair warning without scaring me off completely. But let us say that it was one of the 3 worst nights of sleep in my life. The top 2 were surviving a bad bout of the flu and one very long night in the late 1980s with a prostate infection that made my lower abdomen feel like I’d swallowed an angry serpent. I don’t really want to list a Top 10. The memories are too painful.

But the dolphin chair simply had to do in that instance. Such are the duties of caregivers at times. It’s like God wants to humble you into sympathy for the patient. So I thank God for Planetree now.

Patience and patients

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Still, as a caregiver, I lose patience in too many situations, grow irrationally embittered by circumstance or fall too quickly into self-pity or worse, anger or depression. What is the cure for those selfish emotions? Mostly, it’s gratitude. Step back and take a breath. Be a nurse to your own soul. Forgive your- self. Then get back to service.

Because it’s a miraculous little dynamic that when we fix our focus on serving others we wind up serving our own true best interests. That’s where we learn we are not alone in our challenges and our minds off our own problems.

People who through simple self-control and a modest demeanor exhibit such patience always amaze me. Admittedly I envy people like that, especially when failing to manage that level of self-control myself. Where do some people get such strength of character? Can it be learned? Are some people just natural caregivers?

Probably those questions cheapen the issue. It is, of course, a complex combination of things that makes people good caregivers, or nurses, or doctors. Or perhaps it is simplicity that makes it possible. Be content. Learn to give. Don’t make life harder than it needs to be.

When it comes to institutional compassion, that is a goal much harder to achieve in some respects. The hospital where Linda had her surgery communicates its compassionate values in many ways. If I recall correctly, one of the messages posted on the wall reads, “We welcome all to this place of healing.” There’s definitely room for a religious message in there, but not an exclusive one. As it turns out, our nation is actually formed on a similar, inclusive ambiguity. So uniquely Ameri- can. Yet people seem to miss the subtlety in that. Want to turn it into an ideology not in keeping with the Constitution which guarantees freedom of religion and freedom from religion.

We are all equal souls. Nurses probably know that better than most. There’s nothing special about any of our functions. We all poop and pee. We all have a heartbeat. Breathe. Think. Cry out in pain. Laugh. Worry. Hope. Heal if possible. All part of the process. Such is humanity.

You know that cynical phrase, “some people are more equal than others…” Well, a nurse cannot afford to think like that. People notice if that sort of thinking creeps in.

When it’s your wife or your husband, your son or daughter, a close friend or even co-worker, you want the hospital and doctors and nurses taking care of them to do their very best to help them get well. It simply cannot matter whether someone is one race or the other, speaks Russian instead of English, or has no money to pay for the care they need.

Grace and blessings

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I can tell you we have been the beneficiaries of such care, in ways that absolutely flabbergasted our ability to comprehend the many forces working behind the scenes to ensure our welfare. The least we can do in response to this grace and these blessings is what? Give back in any way we can. Pay attention to those taking care of us. Express our appreciation.

And guess what? Opportunities to reach outcome up more often than you might think. It is true that when you are in a position of most vulnerability, you are best able to share in the pain and challenges in other people’s lives.

Our nurse during Linda’s first night in recovery from surgery was so caring and attentive that conversation naturally flowed to the discussion of family and friends. It turns out our nurse was a single mom whose husband left her for another woman, leaving her to raise her two children alone. She was frustrated by how hard it was as a working mother–also attending graduate school–to meet someone, a man she could grow to love. She had nearly given up hope, she told us. Even the men on the Christian dating services turned out to be less than honorable.

It’s a story quite familiar to my wife who over the years has worked with dozens of families and single moms in her job as a preschool teacher. At one point after checking up on Linda, conversing while she worked, our nurse stopped and stood in the middle of the room, seeming to want to gather herself before moving on to other duties. We’d been talking about how she gave so much time to raise her kids, got them to rehearsals and practices and games. But how it was all worth it in the end because it keeps them busy even if it wears her out.

We talked of God and faith, too. She shared several of her favorite Bible passages with us. We told her we’d recently been in a bible course where we read the entire book in 90 days. “Oh, I don’t think I could do that,” she sighed.

“12 pages a day,” Linda assured her.

I admitted. “I didn’t keep up and had to hustle to finish.”

We encouraged her that all her work as a mom was worth it. That her children would turn out to be a blessing to her for her dedication. “Yes, I know,” she murmured. “But I have had to sacrifice a lot.”

Then she stood quietly in the middle of the room, seeming to contemplate her place in the universe. Standing in front of the privacy curtain and silhouetted by the light from the hallway behind her, our nurse stood and stared across the room, soaking up the relative stillness until she said quietly, “Well, God Bless you guys.”

It’s impossible to know the exact circumstances people face, or how they truly feel. Linda turned to me after our nurse had left and said, “She reminds me of so many single moms I’ve met, just “poured out” from having to do everything themselves. Wanting to be filled up spiritually.”

We met a veritable parade of nurses the following 5-6 days. All types of people and styles of care. Some were talkative. Others were focused and efficient. All played a brief yet important role in our lives. We can only hope that in some small way we give back to these people who daily give so much of themselves. Nurses literally and figuratively rule as far as we’re concerned.

From bitter to sweet memories on the 7th anniversary of my late wife’s passing

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Our early dating years.

Tomorrow marks seven years since my late wife Linda Cudworth died after eight years of survivorship through ovarian cancer. The diagnosis came as a shock, as did multiple episodes of recurrence. Each time we’d reel from the news, go back into treatment and compartmentalize the best we could by using the phrase, “It is what it is.”

Those last months during the winter and spring of 2013 were confusing because doctors treating her for seizures learned there was a tumor in her brain. I’ve never published photos of her during that last round of radiation treatment because while we made the best of it, snapping pics using my laptop Photo Booth and laughing as the absurdity of it all, it was a strange world we were about to enter, because ovarian cancer was not supposed to be able to pass through the blood-brain barrier. But it did.

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All dressed up and going somewhere.

We treated it with radiation and she started a regimen of steroids to contain the swelling and her personality became magnified. She lost native inhibitions about many things. On one hand, that was disorienting, as it ultimately became impossible for her to continue teaching at the preschool she loved. On the other hand, it proved to be liberating as she used those final bursts of steroid-fueled energy to buy a beautiful piece of art. She also stayed up late at night to research and buy a new car even though she abhorred going online. In sum she lived life to the fullest, however manic it might have been.

And that was bittersweet. Because when the steroids stopped, so did her energy. She passed away a few weeks later in the company of her husband and two children. Still, she never lost her sense of humor. After I’d arranged for palliative care in our home, we moved her from our master bedroom to the hospital bed in the living room where nurses and such could tend to her properly. The journey from bedroom to living room was awkward and difficult given her weakened state, but she looked up at me once she was tucked into the cover and smiled while saying, “I thought I wasn’t supposed to suffer.”

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On our honeymoon at Waterton-Glacier

Most of that was indignity, and my late wife was a person who believed and abided in dignity in all she did. It was part of her beauty as a person. She also respected propriety, which made it amusing to think back on the fact that I showed up a night early for our first date. “What are you doing here?” she asked. “Our date is tomorrow night!”

She agreed to go out for a short dinner before hosting her parent-teacher conferences at the high school where she taught special education. But before we parted that evening, I got a taste of her naturally biting humor in reminding me that I ought to call confirm a date.

We got to know each other a little that evening and followed up with a hike to Starved Rock State Park. Stopping on a high ledge for a picnic on a mild November day, she broke out a lunch of apple-walnut bread sandwiches, cheese and wine served from a leather-covered flask. That implement was a remnant of her high school hippie days.

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Enjoying our festive 4th of July traditions.

We dated four years and even survived a long-distance romance early on when I was transferred from Chicago to a marketing position in Philadelphia. She visited me on Thanksgiving that year despite her mother’s objections, and I moved back to the Midwest the following spring when the company decided to disband the entire marketing department due to misguidance by the Vice President.

That would be one of a few job upheavals experienced over the years, and we survived them all. Our children came along in our late 20s and early 30s. Soon our lives were immersed in preschool, elementary adventures, and all the way through high school performances in music and drama.

We also belonged to the highly conservative church synod in which she’d grown up. The pastor that married us at the time was, however, a grandly considerate and patently open-minded man that once gave a sermon titled, “Do-gooders and bleeding hearts : Jesus was the original liberal.”

Emmy in Garden

Our lives swirled with church activities as our children passed through Sunday School all the way to confirmation, where they roundly passed the tests despite having to choke down conservative ideology about evolution preached by the pastor that had long-since replaced our marriage counselor.

After 25 years we moved up the road to a more tolerant and progressive Lutheran church. It was gratifying to learn that our friends from the former church did not abandon us. In fact without their help and the guidance of one of Linda’s best friends, a woman named Linda Culley, we would not have had as much grace and good fortune in the face of the perpetual challenges served up by cancer survivorship.

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At 7 Mile Pinecrest

Now what I like to think about are the camping trips we took to the north woods while dating, and later, when we had small children, we’d spend a week each summer at a humble resort called 7 Mile Pinecrest thirteen miles east of Eagle River, Wisconsin.

Our children paddled around in the water and slipped off to Secret Places in the woods while their father fished in the early and late hours and went for runs half-naked in the pine woods north of the resort, swatting at deer flies the entire time.

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Linda and Evan reading together.

At the center of all that family joy and adventures was Linda, whipping up sandwiches and sitting with a glass of wine on the small beach overlooking the lake. That was the only time the Do Not Disturb sign seemed to rise on the Mom Flag.

And when we weren’t visiting or traveling or doing school activities, Linda was immersed in planning, purchasing and planting her garden every year. Her priorities were indeed God, Family, and Flowers.

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She was a really good person. That’s what so many friends have told me over the years. I was married to a really good person, and that makes me think of what a close friend told me when he first met her. “This is a good one, Cuddy. Don’t let her get away.”

It is bittersweet and sweet to think about all those years together. My daughter went through our stacks of photos to digitize the images and I’ve waited until today to open it up and pull some memories out to post with this blog. Holding people close to your heart is first and foremost the right kind of pride. I hope this writing inspires you to consider the importance of people in your lives.

And to realize as well that life does go on. She told our close friend Linda Culley that she knew, if she were to pass away from cancer, that I would meet someone again. And I have found love. But it does not mean the years with Linda Cudworth are forgotten. Far from it.

These memories can lift us up. Give us courage to go on. Cherish the life we had as well as the life we have. And that is the right kind of pride as well.

 

Six years on and beyond

Linda and Chris.jpgDuring eight years of cancer caregiving for my late wife Linda, who passed away six years ago this day on March 26, 2013, I grew to understand many things about other people. How some have such a heart for others. How giving they could be. How friends willingly took on chores too difficult to imagine. All of it done without judgment. These things came true in our lives.

There were also mysteries that were beyond explanation and should remain that way. During one period of time when I was out of work to take care of her needs, we sat together at our dining room table and added up the money needed to cover our bills. We’d already paid the $2000 COBRA monthly premium for health insurance. That was absolutely vital or we’d be broke in a minute from a running list of medical bills that came our way. These included chemotherapy treatments and surgeries that cost tens of thousands of dollars. In the days before the Affordable Care Act and protection from  pre-existing conditions, clinging to your health care was a life or death matter.

Somehow we made it week-to-week, month-to-month and year-to-year. But sometimes we just turned to prayer for help. So it was that we determined the need for $3500 to cover the rest of our bills. During periods when I had to be out of work to take care of her, I’d hustle up freelance work to cover our bills and more.

LInda and Chris.pngBut it was stressful. Sometimes we’d be pressed financially, and it was on one of those nights that we added up the bills, said our prayer and got her into bed to rest.

The next morning I came out to the kitchen to make her oatmeal and heard the front door mail slot creak open and shut. Whatever fell through the door made a solid thump on the floor. I walked out to check on the delivery because people were often bringing us food and other requests made through our caregiving website.

This package was different. The envelope was thick and bulging. I picked it up and opened the tab. Inside was a wad of money. $3700 worth.

I broke into quiet tears and stood there looking out the door. Whoever dropped off that envelope and collected that money was already gone. To this day I have inklings about who might have gathered that cash but in many respects prefer to leave it as a mystery. That’s what the folks who gave us the money apparently wanted. We used it wisely and gave a prayer of gratitude in response.

Yes, it’s been six years since my late wife passed away. But the kindness and grace of others that sustained us has never left my mind. I know it never left her mind either. In so many ways the support of others kept her alive during all those years in and out of remission after her initial diagnosis. We drew on that support for strength and hope during periods of both sickness and health. Our children felt that support, and in the ensuing years that remains an important part of our collective grieving process. Last year we held a memorial gathering in her honor. Rightfully so.

She and I met in 1981 and were married for twenty-eight years. Yet in many ways, we were also married to the world around us. It was that bond of vulnerability and hope that drew on the strength of others and became our main source of pride. The Right Kind of Pride. 

 

 

 

The art of dying

Losing a loved one is one of the hardest things to experience in life. All signs may indicate that the end of a life is near, yet it is so hard to accept them.

Most typically, people experience the death of parents late in life. There are exceptions of course. Tragic accidents or fatal diseases intervene with the normal cycles of life. For those experiences, the principle need is to focus on coping strategies. Helping people when the shock of death comes too early is a profound challenge. Every single circumstance is different.

But there are some commonalities we all share when it comes to aging parents or grandparents. We know they are not going to live forever. We sometimes see the decline, yet focus on the good signs and hope the bad things hold off as long as they can.

Triggers

Often there is some incident that triggers the process toward actual death. It may be some shift in health such as a heart issue or surgery. Yet something as simple as a fall can undermine a person’s health.

Recently that happened to a close associate of mine. His mother fell in the middle of the night and her equally aged husband did not notice. What followed was a series of stays in different hospital facilities and nursing homes.

There is a harsh reality afoot with people very aged and in a severe state of decline. Hospitals are chartered to help people get better. They reserve the right to determine if that is happening. There are broad patterns that affect these decisions. People experienced with the dying come to recognize whether the trend is toward better health or whether the symptoms of an accident or illness are likely insurmountable.

The protocols of this decision-making can seem confusing to family members or those chartered with caregiving. The legality of prescribing certain medications, for example, is often determined by the prognosis issued by the presiding physician.

Free radicals

Then there are the more radical decisions to consider. Will a surgery help mom or dad survive longer, or is it just a desperate attempt to extend their life?

Meanwhile, the patient sometimes vacillates between wanting all that rigamarole and perhaps not putting up with the intrusions. This can seem like they are giving up, or losing hope. But in truth, some people come to grips with their situation faster than their caregivers.

Yet that’s not often the case with people suffering pain. Their decision-making abilities are directly affected by their pain tolerance. That’s where it gets difficult for the hospital or other facilities to make decisions that please the family. Either the patient gets so doped up from painkillers and can’t converse, or they grow agitated from lack of treatment and just want the pain to end. Even death becomes a desirable option.

Opponents

There are relationship issues to confront as well. A temperamental parent can be a daunting opponent when it comes to end-of-life decision-making. If there are unresolved or dysfunctional relationship issues between parent and child or siblings, the end-of-life process can become complex and tense. Blame gets tossed around. Insinuations made. Guilt enters the picture. No one can find peace or balance. The parent becomes Ground Zero for family conflict.

Usually, there’s one sibling or one person that does most of the steering through an end of life journey for a parent or grandparent. Yet that leadership role can generate friction too. It can happen that parents will play one sibling off the other in order to gain sympathy or hedge the bets. When those parallel decisions work against the medical advice of the presiding doctor and the presiding sibling, things can get really confusing. Or angry.

Palliative care versus hospice

Sometimes medical staff will seek out the primary decision-maker(s) for discussions about palliative care or even hospice. Palliative care is defined as follows: a multidisciplinary approach to specialised medical care for people with serious illnesses. It focuses on providing patients with relief from the symptoms, pain, physical stress, and mental stress of a serious illness—whatever the diagnosis. The goal of such therapy is to improve quality of life for both the patient and the family.

But quite frequently, palliative care has the goal of keeping the patient comfortable leading up to the actual process of death. When death is likely imminent due to any number of signs related to disease or debilitation, a transition to actual hospice care occurs.

Hospice removes most life-giving supports and acknowledges that the patient is indeed dying. This can be an extremely challenging decision for families to make. But there are good reasons why hospice is entered as a care strategy.

Experience

Having worked with both my parents and my wife in both palliative and hospice care situations, I can assure you that the differences are not so distinct or profound as they might seem. I am fairly convinced that the only reason the terms differ is to ease the transition for family members. The term palliative is designed to help them come to terms with the fact that their loved one is indeed dying. When the wise female physician pulled me aside the day my wife was unable to move from the table where she lay, and counseled me that palliative care was likely the next step, I knew what she was saying.

In my mother’s case, she had been directed home from the hospital because there was, n the doctor’s words, “nothing else we can do for her.” In plain and simple terms, a hospital is medically defined as the place where people go to “get better.” When it is determined by the hospital that a mission of that order is not likely to be fulfilled, families are often asked to move their loved ones to another facility, or to simply take the patient home. Hospitals do not like it when people die under their care. It does not look good on the record sheets.

My mother was consigned to palliative care following an attempt at chemotherapy to treat her pancreatic cancer. The treatment was too hard for her to take. It put her in the hospital for a few days. Then the doctor came by and told me that they were done treating her. She was able to get home and we hired caregivers. All our family visited during a three-day period and she was happily able to see nearly all her loved ones.

But then she had a stroke on a Sunday evening, and by Monday morning, the case was clear. Her ability to swallow had been destroyed. The decision to enter hospice care was defined by that condition. Within a week of entering hospice, she passed away peacefully at home. Her husband and immediate family were there with her. And while it was sad to know that she was gone, there was great closure and peace that came from that.

Hospital business

Hospitals try to avoid keeping patients until they die. It’s simply bad for business. And hospitals are a business. That does not mean hospitals can necessarily avoid death in their patients. Plenty of people die in their hospital beds. Death is simply unavoidable when the human body and mind have had enough trouble dealing with pressure and failure.

Life comes to an end in one of three ways; natural, unnatural or somewhat assisted. A natural death is what we all seem to desire. That’s when people pass away of so-called natural causes. That would be heart failure in many cases, or other organs. There are many ways to die.

An unnatural death is typically the product of overtreatment. That would be too many surgeries in many cases, and not enough energy to recover. From what I’ve read, that process and occurrence is an all-too-frequent occurrence in the American health care system.

Perspectives 

I’ve watched my own family members anguish over the merits of yet another surgery for my father-in-law. Deep down I knew it was fruitless. But the patriarch of a family is not something people give away easily. Never mind that he’d already skirted death when he collapsed face first into a pile of sawdust while sawing wood in his own backyard. His wife woke him up that day. But from there, it turned into a series of heart operations, kidney problems, weight loss and finally death in the hospital. None of that was an easy choice for the family to make. It was deemed necessary as long as he was alive, to keep him alive. But whether it was absolutely necessary to keep him alive was the question everyone avoided.

Almost all families face that type of decision sooner or later. No one said dying is easy. But we tend to make it much harder than it should be.

Prayers for dad

My father passed away in a hospital bed six months ago.  He had fallen in the middle of the night and broken his hip. His caregiver called emergency for the umpteenth time and they carted my dad off to the hospital.

Everyone knows that a broken hip is a tough injury for any elderly person to sustain. My father already had an injured arm from a previous accident. But mostly he’d had a long time dealing with the effects of a stroke suffered back in 2003. He outlived my mother by ten years and we kept him in his own home with caregivers. The diagnosis to do surgery was his decision.

The diagnosis to do surgery for the broken hip was his decision. I let him make it because even though I was an executor of his estate with Power of Attorney for health care, he was still lucid and capable of deciding for himself whether to live with a repaired hip or die from the effects of the injury.

He lived another four days and saw all four of his sons during that week. Then he passed away quietly in that hospital bed. I arrived on a Saturday afternoon to a room with quiet music playing. His blanched figure with open mouth lay on the hospital bed. I kissed his forehead as I had done many times in fifteen years of taking care of him. Then I knelt and said a prayer next to him even though he was not necessarily a praying man.

I thanked him for his love over the years even though he lost his ability to say it. I said thanks to what I know of God for believing in my ability to take care of my father. It was tough as hell, and definitely worth it.

He was dead, but his memory just as surely came alive in the days that followed. There was nothing medically I could have done to change that outcome. There seldom really is. Death comes because it is meant to be. It gave me peace to know that he no longer had to live without his voice, and his golf clubs, and that wandering spirit squelched by his confinement to a wheelchair all those years. He dealt with it pretty well, and like an SOB at times.

The art of dying

But he dealt with it. And it was our job now to deal with his passing. It all took so long and happened so fast. That’s how death works, after all. And sometimes you should not fight it. That is the art of dying.

There’ll come a time when all your hopes are fading
When things that seemed so very plain
Become an awful pain
Searching for the truth among the lying
And answered when you’ve learned the art of dying

––George Harrison, The Art of Dying

 

As the crocus petals fall

A close friend has been at the hospital the last few days tending to his mother. She injured herself severely in a household fall by tripping on a braided rug that her husband has long refused to throw out in their bedroom.

Such are the vagaries of old age, and sentiment. Her broken ribs and swollen brain are being treated at the hospital, but she’s not sure it’s a good idea to go on. There is fear, and there is pain.

Her son is also in pain, of the emotional kind. There has been no more faithful a son than he. For two decades he has tended their garden. Mowed their lawn. Taken them to church when necessary. His own life is intertwined with that of his parents. Because he cares.

And because he cares, he is suffering now at the thought of his mother’s passing. She is alive, but barely. Sooner or later most of us go through this experience with a parent. A spouse. Or a friend.

I know people that have even lost children. Such abrupt dissolutions.

Crocus

As I entered the house today, I glanced down to notice that the crocus in the front garden are already starting to drop their petals. We wait all winter for the first signs of spring. Then spring comes and sheds these bright signs of life as if they did not matter at all.

I have watched my mother die. I was there when she passed away 10 years ago. Recently I watched my father die as well. We emptied their house this past week. Filled a three-yard dumpster with all their former belongings. Kept a few keepsakes and practical items for our own.

My brother said, “I’m going home to get rid of 25% of what I own. If this is what happens to us when we die, I don’t want that.”

Time passes

Three years ago this March 26 my wife passed away after an eight year go-round with cancer. She lived fully right to the moment she passed away. I have always said that I am proud of her for that. But life itself sheds its hold on us like petals on a crocus.

We are reminded of all this come Easter time. According to Christian tradition, even the Son of God shed those petals of life here on earth. The faith holds that our souls are borne into heaven if we have accepted the grace, and shed the brand of pride that prevents it.

Instead, we should hold pride in the mercies we can show others. I told that to my friend, the selfless man that has cared for his parents all these years. “You are in pain because your love is wrapped together with her life. That is pain your have earned through caring. God knows that we feel that pain, and it’s the knowledge that we are loved that sustains us through it.”

Walking right into the pain

Three years ago on Good Friday, I walked into the church I attend with tears barely concealed behind my eyes. My brother asked me why I attended the service so soon after the death of my wife, and I told him, “I’m walking right into the pain.”

That’s really the only thing we can do. You can’t escape it by walking around. It follows you like a shadow. And when I walked up to meet the pastor for a blessing that Friday evening, he was the one shedding tears in my family’s name. “You are in the right place,” he told me.

That does not cure it all. There is still the absence and the loss. The profound depression knowing that someone is gone, for good. That is grief. It must be reckoned with as well. But first we must acknowledge the pain. All else is folly. That can take time. It cannot be rushed. Yet neither can we dwell in the past, lest we forget there is life to be lived.

Preaching to the choir

I understand that church is not for everyone. I get that more deeply than you might think. My own father relinquished his churchgoing ways. He loved the camaraderie of the choir, but the words ultimately didn’t mean that much. It doesn’t mean he did not have a soul. And I do not worry for it. That is not the brand of faith to which I ascribe.

We are all flawed people, who need forgiveness for the things we do. And, we should do all the forgiving we can muster. Because the real purpose of those falling petals should be to let go the lies, and the hurts, the harsh words and the lost opportunities to say that we love someone.

That is the faith to which I ascribe. It is ultimately transcendent, even in all its fallen glory. It is not keeping the crocus past its time, but knowing that its coming and going is the real sign of hope, and of caring, and of things planted for the right purposes.

My father’s house

Back in October 2015 when my father passed away in his hospital bed, I was proud to think that we’d managed to keep him in his house in the ten years that passed after my mother died in 2005. As anyone with caregiving responsibilities can tell you, there are challenges to protecting the freedoms of the elderly. And when we love them, those challenges only increase when emotions and old relationship patterns cloud decision-making.

My father’s house was purchased in 1977 or so. It sits on a hill in St. Charles, Illinois where my brother and I used to chase grey partridge around the fields where hunters had released them as wild game.

Those birds are long gone, replaced by the suburban sprawl that created my dad’s place. The house is nothing special in any way. A split level with peach and apple trees planted in the back yard by my dad and mom years ago.

But my folks made it home for 30 years. Then my father had a stroke in the early 2000s and the home turned into a caregiving facility. In fact, caregivers lived in the home with my father all 10 years that he survived after my mother’s passing.

That’s all done now. And soon my brother will be coming out to Illinois to go through all the family archives left in the home. That includes albums both musical and photographic. My dad chopped up lots of pictures and pasted them into collections, so it’s a mixed bag. But it’s our bag, and I trust my brother of all people to handle that process.

Before leaving after a walk-through today I noticed a videotape on the shelf that took me back to the period when my dad had his stroke. He was out East on a reunion trip when the stroke hit. That threw our family into turmoil. It was my job back here in Illinois to keep the home safe and pay the bills.

The home itself has never had much sentimental value for me. But my father’s house instead was the symbol for caring and concern. We’ll be cleaning it out and selling it soon. But there’s no need to give up the former for the latter.

Understanding the Relationship Algorithm

What follows is a brand of simple, straightforward advice on how to have better relationships.

The Relationship Algorithm (RA) is a tool to help you open communications, build respect and sustain love through all the years of a relationship. The Relationship Algorithm is a formula one takes to either tear down or build up a relationship. It works like this:

Relationship Algorithm: Negative Direction

Relationships break down because they are subjected to a series of negative responses.

Complaint to or about a person is most often the catalyst that starts a chain reaction of negativity that can tear down a relationship. Complaint is a form of insult. Insult is a lack of respect. Lack of respect leads to lack of trust. A lack of trust undermines the ability to love. The inability to love reduces the will to communicate. When communication fails, the relationship is over.

Here’s the quick synopsis of that Negative Relationship Algorithm:

RA/N: Unhealthy or Constant Complaint >Form of Insult > Lack of Respect > Lack of Trust > Inability to Love > Unwillingness to Communicate. 

 

The Better option: Relationship Algorithm––Positive Direction

By contrast, a Positive Relationship Algorithm places communicate at the forefront. From there, a healthy chain reaction can occur that affirms the love in the relationship and builds on positive emotional feelings. Constructive emotions such as trust, respect and positive dialogue produce a relationship that is healthy and progressive in nature.

Here’s the quick synopsis on the Positive Relationship Algorithm.

Desire to Communicate > Ability to Love > Building Trust > Showing Respect > Complementing the Partner > No need for Complaint.  

Within this spectrum of constructive relationship tools, there are also tactics that can help you work within each component of the Relationship Algorithm to build positive dialogue.

Solving problems using positive direction

For example, imagine a couple has challenges discussing financial issues. A negative response is to complain about money issues or disrespectfully accuse the other person of mistakes or abuses. That insulting approach leads to reduced trust, lost love and reduced communication. That’s how fights over money begin and continue.

By contrast, a healthier way to engage in financial discussions is for both people in a relationship to separately write down their financial concerns. Then carve out a time where both parties can give full attention and communication to the subject. If necessary, get a babysitter for the kids if you have them. Turn off the cell phones and shut down the computer (unless you want to use a spreadsheet for discussion.)

Agree not to threaten, accuse or complain during the initial discussion.

Always show respect

Promise at all times to show respect on the issues at hand. If additional information is required to make a decision, make notes and agree on a timeframe for action or answers on each topic. Focus on establishing a consensus about each issue on the table. If that’s not possible, and you need to consult with advisors or professionals to organize or solve your financial (or other) problems, agree to make that appointment and engage in no complaint on the subject until that issue can be resolved.

Likewise, do not engage or impose the “silent treatment” on your partner following discussion of relationship (especially financial) problems. This is a form of silent complaint and a true lack of respect. In many ways saying nothing is far worse than having a fight.

Also, be especially aware of Passive/Aggressive behavior, in which one person baits the other with kindness or passivity to gain an advantage, and then turns on them with assertiveness or even violence to overwhelm or win a fight. That is obviously an unhealthy, unfair and unproductive way to relate.

It is always important to be aware of your own emotional intelligence in these categories.  Avoid using scare or manipulative tactics to get what you want. That is no way to resolution or healthy compromise where needed.

Patience, respect and positivity pay dividends

Some problems take more time than others to resolve. Again, if one person feels additional discussion might be necessary to clarify their position or provide updated information, be sure to begin from the communication side of the algorithm, not the complaint side. This prevents the negative feedback cycle from turning into a stress factor between two people.

As our financial illustration shows, a good relationship algorithm always begins with communication, not complaint. Even this simple guideline can be enough to control potentially negative feelings and get people working toward positive response to challenges and needs within a relationship.

The Relationship Algorithm can work wonders if you keep these positive goals in mind.

Christopher Cudworth is author of the book The Right Kind of Pride, a memoir about character, caregiving and community, the positive aspects of cancer survivorship and facing challenges in life. The book is available on Amazon.com. 

RightKindofPridecover
The Right Kind of Pride is a book by Christopher Cudworth about the importance of character, caregiving and community in this world. It is available on Amazon.com.