Lenore's Archive

For the dogs, a painful challenge

Friday, June 27th, 2008

Team Hospice at the Pleasant Valley Nursing Home

Team Hospice at the Pleasant Valley Nursing Home
June 27, 2008 – Izzy and Lenore went with me this afternoon to the Pleasant Valley Nursing Home in Argyle, N.Y., and there, was saw two Hospice patients, Edith and Diana. Lenore is coming of age, calm, appropriate, friendly and increasingly focused.
But izzy did some of the best work of his hospice career, especially with Edith, who suffers from dementia, (Diana has an advanced brain tumor) and can no longer communicate easily or directly with people. These are dfficult environments for dogs, filled with machines, wheelchairs, and people who do not act the way dogs expect people to act, often shouting out in pain, confusion or alarm.
Edith at first refused to acknowledge me, Izzy, or Keith Mann, a hospice official. Keith and I have worked with izzy for more than a year now, and we have learned to wait, and give Izzy a chance to find a way to connect. Edith was turning her wheelchair in circles, saying she has things to do, waving us away, ignoring us. Izzy had to manuever quickly to get out of the way of the wheelchair, which was turning in all sorts of directions. He approached from one direction, then the other, while Keith and I tried to connect with Edith. Finally, she put her hand out and Izzy rushed forward and put his head under it, and Edith froze, smiled, then reached down and patted Izzy on the head. One of the nurses said she was ready to cry, as she had never seen Edith be that responsive.
For five minutes, Edith turned away again, then came back to pet Izzy, then let Lenore come up and lick her hand. Keith and I looked at each other when we saw this connection being made, and it was a powerful experience, reaching through the screen of that disease, and connecting with the spirit there. I love this week. We didn’t do as well with Diana,  unfortunately, who was in too much pain and confusion to focus on Izzy or Lenore.
We tried, then left.
But we were both impressed once more by Izzy’s remarkable gift for finding ways to make contact with people, even on the edge of life.

Grief Observed: Warren, Organizing the rest of your life

Sunday, June 22nd, 2008

Warren got a double-barreled love dose from the Hospice dogs today. Lotsa love.
Warren got a double-barreled love dose from the Hospice dogs today. Lotsa love.

June 21, 2008 – Cool, dry. Storms passed. No damage. Warren says one of the things he wasn’t prepared for was the question of how he will make decisions about the rest of his life. He was so used to making decisions for and with Helen that he simply doesn’t know yet how to make them for his life without her. He is thinking of a new car, but, he wonders, is there a point to that? How long will he be driving it? Should he bother to replace the trees knocked down by the recent storm? Does it matter one way or the other?
At first, this seemed like depression to me, but I realize that it is something more than that. With death, a whole system of living changes, and the survivor has to find a new way to rationalize and conceive of life.
“I am not saying I don’t wish to live,” he said. “I do, and I have things I want to do. It’s just that I’m no longer sure of how to make decisions about organizing my life.”
For 60 years, he discussed every decision with Helen, and she with him. Now, she is not there. I asked him if he wanted to join a Hospice bereavement support group, or see a counselor, and he said no, not yet. He said he felt he was nearing the end of one phase of grief, entering another. He is, he said, preparing to return to the world a bit.
He and Helen were so close, so connected, that he has not yet, I see, envisioned a life without her. But he is working on it. He faces a number of medical decisions, as well as other life choices, and he seems confident, purposeful and resourceful. I told him I was concerned that he was bottling up a lot of grief and pain, and that I couldn’t imagine what he was feeling, which I can’t, not really. I said I just wanted him to know there was help if he needed it.
He said it was important to talk with me about it, and he wouldn’t hesitate to get help if he needed it, and would ask for it. I left it there. He knows himself, and these are his decisions. Warren talks about a lot of different things when we meet, and he is gracious and interesting, as always, but I always make sure to bring the conversation around to Helen, and his loss, and he is ready for that. Active listening, and more active listening. No one can tell anyone else how to grieve, or knows, for that matter.
Warren says that at his age, one can’t help thinking about death, and he is eager to rejoin Helen in the hereafter, but nothing, he said, really prepared him for the space in between.
Izzy and Lenore continue to have a pronounced emotional impact on Warren, as they did on Helen. When we pull up, Warren is at the door, smiling and calling to them, and they come bounding down the walkway to the door and rush into the house. Warren is instantly laughing and talking to both dogs, throwing dogs, giving them treats.
I am pleased with Lenore’s great progress in Hospice work, beyond what I expected. Lenore, interestingly, seems acutely aware of Warren’s painful legs, and never bumps into them or him, showing some of the intuition that makes Izzy so effective. An enthusiastic, even boisterous dog, she just seems to know.
In Hospice work, the dogs are often beyond control or command. You have to trust them sometimes. I completely trust Izzy. I am trusting Lenore more each visit.
They light him up, and the change in his mood is palpable. He is simply at ease around them, and opens up, lightens up. These dogs are doing important work, and all three of us are learning and growing all the time, and I am excited and fortunate to renew my commitment to it.

When you don’t want to go: Caleb’s passing

Monday, June 16th, 2008

June 16, 2008 – A social worker told me once that Hospice work is the most bounded kind of social work there is. There is only one outcome. This weekend Caleb, who had suffered a series of debilitating strokes, died in his home.
Izzy and Lenore and I had visited him weekly for several months, and I wrote about this patient recently, saying this was the most difficult patient we had visited, the only place we didn’t want to go. We were supposed to see him the day he died.
I did not know him well, or become attached to him. His family did not permit photos.
He loved Izzy, and loved seeing Lenore, yet neither dog reacted to him as intensely as they usually do to the people we visit. I was never comfortable in that house, for all sorts of reasons, and I was reminded by a Hospice official not to drift towards judgment. It didn’t matter what I thought of patients, their families, helpers or environments.
We were there to help people at the edge of life, and if people felt they might be criticized, they might be even more reluctant to seek out help from Hospice or other groups. Besides, when I see what these people are going through, I understand the last thing they need is my sense of what they ought to do or say.
If you don’t want to go, I was told, then that is probably the place you should go. That was good advice. It was always a tough visit, and I rarely felt good about going, yet we cheered Caleb up every time, and seeing his face light up when he saw Izzy and Lenore, and watching him beam as they cuddled  next to him in bed or in his wheelchair proved the point: our job is to bring light into darkness, and the dogs did it well. I could have done better, tried harder. I will next time.
In some ways, Caleb was the most important patient we visited, and I am grateful for that.
I wish him safe passage. It is never easy to lose someone we have been visiting, yet the social worker is right. It is never a surprise.

For Warren, and the Bride and Groom Tree

Sunday, June 15th, 2008

Generally, Hospice dogs are forbidden to take treats in a patient's home, but Warren has a jar of beef jerky and I can't stop him from giving some to Izzy and Lenore.
Generally, Hospice dogs are forbidden to take treats in a patient’s home, but Warren has a jar of beef jerky and I can’t stop him from giving some to Izzy and Lenore, who appreciate it, and I suppose, have earned it. But I’m careful. I don’t want the dogs begging in Hospice homes, or anywhere else.

June 15, 2008 – When Warren woke up Sunday, he saw that part of one of the two maple trees in the back yard had fallen into his yard. The other tree – both are 200 years old, and are called “Bride and Groom Trees” because they were planted when a new couple moved in – was blown down in the same lightning storm that hit my farm.
The symbolism, a month after Helen died, hit him powerfully, and hard. “I guess I feel useless sometimes, wondering exactly what I will be doing with my life. I believe in an afterlife, and so did Helen, and so I do have a sense of waiting.” Warren and I talked for a couple of hours about his life, and his plans for it. He wants to do genealogical research, and preservation work as well.
I gave  him no advice, other than telling him there is help available if he needs it, and it is perfectly normal for him to be feeling this way. There is no knowing when that feeling will ease. He is 81, and wondering how much time he has left, whether he should have the knee surgery his doctor has been urging. He wasn’t sure he wanted to take a couple of months and use it that way.
I said it was his decision, to be made in his own time.
I know this is an especially painful time for him. He has done most of the business related to Helen’s death – lawyers, insurance, credit cards. The calls and visits are slowing, and now, he is face to face with the new normal, life without Helen.  I can only imagine.
The tree seemed to open a deep vein of loss, and some grief, and this is also common, these triggers that bring up so much pain and sadness. I was grateful again for my Hospice training, even as I visit him more as a friend now than a volunteer, and we are close and comfortable with one another.
Warren is almost painfully reluctant to talk about himself, or his pain, and so we approach these issues glancingly, hopping back and forth to other things. I make sure to talk about my life, my farm, so he doesn’t feel self indulgent. And I listen.  Actively.
Izzy and Lenore bring great cheer, and Izzy and Warren are almost brothers.
I admire Warren, for his faithfulness to Helen, for his bravery, for his fierce independence. But it was a hard day, for him, and a challenging visit. It was a difficult day. There will be others. That is the truth of it. Before and after death, Hospice work is not about reassurance, not about cheering people up, or making them feel better. It is about being there, helping in any way people want or need. I have no idea if he should get that knee surgery or not, and I think, just a few months ago, I might have thought that I did know. Hospice is a great teacher.
So is pain and loss. They have their own life, their own path. I might wish I could ease it, but I know I can’t, not really.
Warren is an optimist by nature, and he also has many interests. My guess is that they will soon re-emerge.
“I want my life to be more than just waiting,” he said, “and I want to get my affairs in order so that my life isn’t a mess that falls on anybody else.” I asked if he might want to plant some new maple trees, a new Bride and Groom tree, in honor of Helen.
He said he might drive to the Historical Society meeting Monday night. I said it was up to him.

Izzy’s time: Hospice Journal at Gardenworks, Sunday, 2 p.m.

Monday, June 2nd, 2008

Izzy

June 2, 2008 – For more than a year now, Izzy, a border collie rescued from a farm not too far from mine, has led me on one of the greatest journeys of my life, Hospice work. We’ve traveled to the Adirondacks, to homes, trailers, villages, hospitals, crumbling houses, restored and working farms, nursing homes, tiny apartments and clapboard mill houses, to bring some comfort and attention to people on the edge of life. Izzy has entered one strange environment after another, coping with strangers, machines, cramped and dark spaces and people in intense stages of many emotions – love, despair, pain, grief, decline, death.
He has done a great job everywhere he has gone, and is loved by everyone who met him. He has always been welcome, and been to more funerals, memorial services and cemeteries than any dog I have ever known of. He has never harmed or frightened a patient, disturbed equipment, had an accident, or made himself in any way unwelcome.
He is an empath, an intuitive creature gifted with a wondrous ability to see into the souls of people, and connect with them.
He has been challenged by dogs, cats and unfamiliar circumstance, day after day. He has brought light into darkness, eased loneliness, opened emotions, brought comfort and even joy when it seemed almost impossible. As Keith Mann of Hospice said of Izzy tonight at a volunteer’s meeting, Izzy is the world’s greatest active listener, showing the rest of us how to hear and see.
Izzy has seen more than one person he loved die, and has almost visibly grieved. I see him suffer sometimes, confused and deflated. But not for long.
I do not know what goes on inside the spirit of this extraordinarily loving creature, but I am blessed to have brought him into my life. Lenore is not intuitive in the way Izzy is, but she is a powerful Ambassador of Love, a spreader of smiles and laughter and love. She is on her way to becoming a great Hospice dog.
Sunday, I honor Izzy and also Lenore, my two Hospice dogs, by bringing them to Gardenworks, Route 30 in Salem, N.Y. (518 854 3250) at 2 p.m. I will talk about my Hospice work with dogs. There will be some music, Maria Heinrich will show her quilts, Mary Kellogg will read from her new book, “My Place On Earth,” and Gardenworks will offer its rich menu of crafts, flowers, cheese, organic produce and pies, donuts and muffins.
Hospice officials will talk a bit about Hospice and photos from Hospice Journal will be shown publicly for the first time. There are lots of good reasons to come, but in my mind, the day belongs to Izzy, and honors him for his great and faithful heart, and proud service to the great tradition of dogs helping human beings.

Barb, and quiet time

Sunday, June 1st, 2008

June 1, 2008 – Our visits are shorter, now and quieter. Barb is tired, but asks to see the “puppies.” She loves to have Izzy on her lap, and laughs at Lenore, who she calls the “slurpy one.” We stayed away for a week because Barb seemed so tired, but she asked for the dogs, and we are resuming more frequent visits.
I’ve noticed a curious thing about Hospice work and the dogs. Almost always, the patients say they think the dog doesn’t really want to be there, or would like to get off, or is uncomfortable. This happened with Glen and Helen and others, and it speaks, I think, to a sense among the critically ill and dying that nobody really wants to be with them, given a choice.
This is, I think, part of the isolation of the dying process, a sense of being shunned, avoided, because something horrible is happening. In truth, visits with Barb are always fun, always pleasant. I want to be there, and the dogs are attached to her.
She is sharp, courteous and has great stories to tell – we are planning a poem for later this week – and the dogs are happy to be with her, not at all restless. She keeps her own schedule in her head, and knows when family, nurses or social workers are coming. Monday she was getting a bath, she said, so Tuesday morning would be a good time to visit.
Izzy didn’t have to stay on her lap, she said, he was probably getting warm or restless. No, I said, he seemed quite content to me.

Barb and the Hound of Love
Barb and the Hound of Love

Memorial Day Weekend: Stiff Upper Lip, Kid

Wednesday, May 21st, 2008

The Hospice dogs Izzy and Lenore bring a big smile to Warren
The Hospice dogs Izzy and Lenore bring a big smile to Warren.

May 21, 2008 – Cloudy, cool. The role of the photographer is as varied as the writer, but one mission, for me, is to capture moments, images and emotions worth remembering. I love stories in all forms, but I especially love photos that tell stories, as good ones do.  You can get so overwhelmed by the technical trappings of picture-taking that you sometimes forget the point – tell good stories.
Warren’s life is shaped, at the moment by two photos that tell stories, ones that are dear to him. One, on the mantle across from his new Med-Lift chair, shows Helen shortly before her death, lying in the hospital bed. She is smiling, in the way that Helen smiled, right up to her last day. I took that portrait.
The other, taken by Warren about 10 years ago on the couple’s beloved hill up behind the house, captures a healthier Helen,  in her 70′s, sitting in a field of BeeBalm, smiling.
Warren talks to the portrait that I took, because, he says, it is the most recent.  I tell her about my day, and I say “I love you, honey,” and I imagine she waves back and says quietly, ‘I love you, too.”
But he loves the other photo also, and looks at it all the time. “One shows Helen sick,” he says,”the other well.” He calls them the two Helens, and he loves both of them.
Warren had a rough day yesterday, perhaps the worst since Helen’s death, and the first time he called me to talk since she died, rather than wait for my visits. He spent several hours cleaning out her purse, the one she took on all their trips together, across the United States and overseas. “I can’t tell you how many times we would go into that bat – for passports, money, keys, phone listings. We called it the storehouse.” Cleaning it out of her keys, makeup, brushes and other personal affects, and then taking that and other of her belongings to the town dump was the toughest thing he has had to do, he said. “I just can’t tell you how awful that was.”
He and Helen often drove by a pond that had two swans living near it, and for years, the swans seem to have disappeared. Yesterday, he drove by the pond and saw one, and told himself he couldn’t wait to get home and tell Helen. Then he remembered, and felt a wave of sadness.
Warren is very conscious of not complaining, or being self-pitying, so much so that I urged him to permit himself the grief to which is entitled, and which he admits to feeling.
“I know you’re right,” he told me, “but when I feel down, or sad, I just tell myself ‘stiff upper lip, kid,’ and go on with my life. That’s what I was taught to do.”  He was, I am sure, like so many men of his generation.
I know from talking to bereavement counselors and reading about grief that this is common, this notion of a stiff upper lip, of not complaining, of getting on with life. Grief has a life of its own, I am told, and will have its own way. You couldn’t stop it if you wanted to, or bury it for long.
So I say little and I note that Warren looks better than he did yesterday, and is getting some rest and his aching knees have been helped by his Med-Lift chair, which moves upright and helps him get up without bending. And despite the grief, he has so much less work.
This will be his first holiday weekend alone, and he says he has plenty to do, that he intends to spend the holiday weekend cleaning up the house, sorting through Helen’s clothes and possessions, and plotting the historical and preservation work he hope to do in a few weeks.
I told  him I am going to New York City to visit my daughter, but would check in. We have plans to have dinner next week, Warren’s first social excursion outside.
It is hard to leave him for the weekend, but I sense that he is all right, as he puts it, as good as can be expected.
“Don’t worry,” he said, “I have two Helens to keep me company, and there is nobody I would rather be with.”