Mary's Archive

What I don’t like about hospice work

Thursday, July 24th, 2008


Izzy, in a nursing home yesterday visiting a hospice patient,  always gets the girls

  July 24, 2008 – What I don’t like about hospice is when I show up at a house or a nursing home, and the patient is gone. Sometimes there are people standing around, a gathering that suggests death. Sometimes, as happened Friday it’s an empty bed and a nurse shaking her head,  telling me somebody I have connected with on the edge of life is gone, or has been rushed to the hospital. This bothers me more than sickness or death, and I can’t say I really know why. 
  Mary is not officially in hospice. We met her at a nursing home while visiting a hospice patient. I’m not sure I ever saw anybody connect with me or with Izzy so quickly. She grew up on a farm, from an old farm family, and especially loved and remembered her border collies. She was an Alzheimer’s patient, and was confused, repeating some words and phrases, but she was not confused about Izzy. But she has the broadest smile and the most beautiful and penetrating blue eyes.
   Mary glowed at the sight of Izzy, taking his head in her hands – and saying “what a wonderful dog,” and telling me how much she loved him, how much she wanted to give him a treat. Izzy drinks up this kind of attention, and returned it with interest and the two of them just lit up the room flirting with one another, loving each other, hugging.
 Izzy can really turn it on when somebody loves him. She turned to me and clasped my hand, and she was so gracious and generous, and said. “why, how can I thank you for coming to see me and bringing this wonderful dog and reminding me of my border collie, so long ago?” And I was overwhelmed a bit by that, and then she looked at me a bit vacantly, and then turned to Izzy and stroked his head.
  And I told her I would be back, and I meant it, and today I stopped to get some flowers and brought them to her room at the nursing home, and when I came in the room I knew instantly that something was wrong, as almost all of Mary’s things were gone, and I put the flowers down, and Izzy looked all around the room and then we walked quickly out into the hallway and found a nurse, and asked where Mary was, and I know that look by now, and she shrugged and said she had just been taken to the hospital, and she didn’t know when she would be back or if she would be back.
  So Izzy and I visited our hospice patient, who was also glad to see him, and then we drove to Glens Falls Hospital, where we were told that Mary was not able to receive visitors, and perhaps we could come back tomorrow. I hope we get to see her.
   Mary got to me, and I connected with the warm and love in her spirit, and so did Izzy, for sure.
  I took photos of Mary and she and her daughter both gave me permission to use them (one partial photo is above) and I have debating all week whether or not to use them, but her daughter is comfortable with it and I actually think it’s important to bring some fuller identities to the people we meet when possible. It makes them more real.
  But I will wait to see.
  It’s odd, really, because I have seen illness, some suffering and death in hospice work, and I am okay with it. But I don’t like showing up to see people we know and finding their rooms and beds empty. Volunteers are not, and shouldn’t be, the first people called when somebody is sick or dying. People have other things to worry about. But I’ll never get used to it.
  I may post a photo of Mary over the weekend, but I want to see how she is first, and whether or not we can visit her.

Mary’s joke

Thursday, July 17th, 2008

July 17, 2008 – I was much affected by my visit to the Alzheimer’s dementia ward at a nursing home in Argyle, N.Y. yesterday, and today went back again to see Mary, a hospice patient. She had been uncommunicative, even hostile to visitors and volunteers, but in her second meeting with Izzy today – I want to go several days in a row to encourage her recognition and Izzy’s work with dementia patients – she said, “well, Izzy,” when we arrived, and then patted him several times, before telling me an hour’s worth of stories about her grandfather, her dogs, and the horses she used to ride and care for.
  “How long have you known this dog?” she asked me, and when I told her, she asked me again, and then once more. She even started to tell me a joke about a horse she once had, but couldn’t quite finish it. The nurse was amazed that Mary was telling a joke.
  Izzy was swarmed with people in the ward who wanted to touch him, be near him and it was very different from our first visit. The nurses said Mary was calmer than before, and much more talkative.
  I felt much more comfortable there, and so did Izzy. Her zeroed in on Mary, and then we visited several other patients who were not in hospice, but are dog lovers.
  I’m learning to be much more “up” in my conversations with these patients. To speak clearly, slowly, directly. To act certain that they understand, because I am already learning, that sometimes they really do.
  And there are many sweet spirits in this forgotten little world. It has caught my imagination, and I want to focus on it. And Izzy is really, really good in there. And I can see he is doing good.
  This weekend, Izzy and I are hosting a little party in the ward. We will bring some flowers and cookies over the weekend, and maybe give Lenore a chance to brighten some corners as well.
  This is a genuine outpost on the edge of life, and the nurses tell me that even therapy dogs usually bypass this unit. Made me appreciate Izzy all the more.

Alzheimer’s and the power of love

Wednesday, July 16th, 2008

Izzy, getting a hug from Mary, and a big smile

July 16, 2008 – When I began hospice work, I confess I was drawn to comfortable notions of death and dying, gentle conversations in well-kept homes with articulate people and loving families. It wasn’t easy, but it was familiar, and I suppose, comfortable.
As my work as a Washington County, N.Y., hospice volunteer has advanced, I find myself more and more in situations I could not imagine being a year ago, and which make me intensely comfortable sometimes, and challenge my own ideas about courage and love. We go into adult homes with deformed and disabled people, and lately, and most powerfully, Izzy and I are spending time in the nursing home wards with people suffering from Alzheimer’s, and dementia.
It is an alien world, and Izzy and I have much to learn, and we are just beginning to understand it and get comfortable, more confident, walking into these spaces with people who seem lost, talking in tongues, shouting, crying, staring vacantly into space, walking in circles, gesturing. Izzy didn’t know what to make of it at first, and neither did I. I suspect I will never be comfortable in those spaces – protected by locked doors and security codes. It is another world, and like most people, I never saw it because I didn’t want to see it. But it is our world, too, part of our life, and I always think, they were once me, once us.
It was the hospice staff and the nurses who showed me the power of love and patience, and, of course Izzy, who has a genius for connections. These workers are loving, patient, clear, gentle. Eventually, it seems, they get through.
There is a way of speaking to people with Alzheimer’s, a way of communicating, of getting there. I am just beginning to learn it. You have to believe there is a spirit there, and talk to it, even if you can’t see it or hear it always.
I am determined to learn more, to do what the nurses can do. It is quite extraordinary, even magical, when there is that spark of recognition, that smile, that connection, when you know that you have broken through and made contact, affirmed humanity, and also the power of animals in our lives.
Mary was sitting alone in her wheelchair, napping when Izzy and I came in. A nurse woke her up, and she looked disoriented, almost angry, and then after a few minutes, her hand settled on Izzy and he pressed forward, and she smiled, and said, “my, my,” and remembered her dog, a “grumpy little mutt,” and then retreated into her own time and space, and was lost to us. We sat with her (Keith Mann of hospice joined us) for nearly an hour, and she talked about this and that and sometimes looked at Izzy and reached out her hand to him.
Then, we we were done I patted her hand and said goodbye. “We’ll be back,” I said, but she didn’t answer.
Then we asked the nurse for the security codes, walked past a half dozen patients sitting in chairs, talking, looking away from us, and we punched our way out, washed or hands as volunteers are required to do, and left.
I have to say I am increasingly drawn to this world, fascinated by it, determined to enter it somehow, and with Izzy’s help, I just might. We will be back, and often. Mary lit me up.