compassion

Those in hospice need additional care

Published in Picayune Item by Leah McEwen

Those who are in hospice care often have many needs, but don’t always have access to the assistance required.

One of my grandmothers developed Alzheimer’s about ten years ago and lived with it for several years. She was in her 60s when she received the diagnosis. While the onset of the illness was slow, when it worsened, it became unmanageable.

She forgot who we were, disappeared from her home several times and eventually became a danger to herself. As her condition worsened, she also developed several other illnesses, which made taking care of her impossible for my grandfather. Thankfully, my family was able to pay for outside help to provide the care she needed until she passed away.

Unfortunately, this isn’t the case for everyone. Many elderly adults don’t have family to care for them, and do not have the funds to pay for outside help such as a nursing facility or in-house nurse.

Many hospice services fill this gap by providing care that is paid for through donations, or government programs like Medicare and Medicaid. There are also non-profit organizations that can provide everyday necessities like groceries.

I recently met a man in his early nineties who had saved enough money to pay for his livelihood until he reached 85-years-old. He said he hadn’t expected to live past that point, but when he did, he found himself penniless and with no one to turn to.

With the help of local volunteers and nonprofit organizations who discovered his need, he was relocated to a better home, his utilities were paid and he was provided with groceries and medical coverage.

Organizations that help elderly adults and hospice patients in need improve the quality of life for patients and their families.

 

 

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Healthcare services, policies for end of life misunderstood says hospice leader

Reform burdensome Medicare regulations to improve end-of-life care

Published in The Hill By Norman McRae, opinion contributor – The views expressed by contributors are their own and not the view of The Hill

Research shows that more than a quarter of Americans have given little to no thought about how they want to die – or how they prefer to be cared for in their final days. As a hospice care provider for more than 32 years, sadly, this is not a surprise to me.

What too many don’t realize is that with heartfelt consideration and careful planning, death can be a profound, peaceful and personal journey. That is why it is so important that patients and their families have timely access to high-quality hospice care.

Given how warily our culture approaches death and dying, health care services and policies surrounding the end of life are often misunderstood. At the expense of comfort, precious time and countless dollars are spent chasing an elusive cure rather than approaching an end of life illness with peace and reflection.

Hospice care provides a holistic experience that focuses on the wishes and needs of the individual. The hospice model involves an interdisciplinary, team-oriented approach to treatment that includes expert medical care and comprehensive pain management but also includes emotional and spiritual support for the patient AND their family. It’s this philosophy that drew me to this field and what I and our team at Caris continue to practice and uphold today.

For more than 35 years, the Medicare Hospice Benefit has ensured older Americans at the end of life could access this philosophy of care. As Medicare’s original coordinated care model, hospice is a program that works.

While those in the hospice community have grown and adapted to meet the needs of those we serve these last 30-plus years, many of the regulations imposed on the Medicare Hospice Benefit are still outdated relics of the 1980s. Thankfully, members of Congress recognize the need to modernize and changes are on the horizon. We welcome updates to burdensome regulations that will improve the delivery of patient care, including the reduction of existing requirements that create needless and time-consuming administrative work for hospice programs. One positive example of this recently discussed on Capitol Hill is the Center for Medicare & Medicaid Services’ (CMS) proposed rule to give more flexibility to physician assistants to re-certify patients who have been in hospice care for more than 180 days – a change broadly supported by the hospice community. We applaud efforts underway in Congress – including the Ways and Means Committee’s efforts to address and cut red tape in the Medicare program.

Policymakers should also consider reforms to make palliative care more widely available and hospice care available in a more timely fashion. This means that they must ensure that any proposed payment reforms do not threaten the integrity of the Medicare Hospice Benefit and the principles on which hospice care was founded.

During my tenure, I’ve seen plenty of change, and I imagine I’ll see more, maybe even policy changes to the Medicare Hospice Benefit. What all involved must remember is that any changes must compassionately consider protecting timely access to care while making sure that regulations are less rigid, duplicative and costly. Failure to implement commonsense reforms could unintentionally disrupt or delay patients’ access to high-quality end of life hospice care. Any new policies must continue to support the basic human right of quality end of life care and protect the values of hospice, the right of patient choice and the integrity of our care philosophy.

Norman McRae is on the board of the National Hospice and Palliative Care Organization (NHPCO), chair of the Hospice Action Network (HAN) and the founder of Caris Healthcare in Knoxville, Tenn.

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‘They Deserve It’: In Foster Homes, Veterans Are Cared For Like Family

By Patricia Kime for Kaiser Health News

With the motto “Where Heroes Meet Angels,” a small Veterans Affairs effort pairs vets in need of nursing home care with caregivers willing to share their homes.

Ralph Stepney’s home on a quiet street in north Baltimore has a welcoming front porch and large rooms, with plenty of space for his comfortable recliner and vast collection of action movies. The house is owned by Joann West, a licensed caregiver who shares it with Stepney and his fellow Vietnam War veteran Frank Hundt.

“There is no place that I’d rather be. … I love the quiet of living here, the help we get. I thank the Lord every year that I am here,” Stepney, 73, said.

Caregiver Joann West calls taking care of veterans Ralph Stepney (left) and Frank Hundt at her home in Baltimore a “joy.” “They deserve it,” she says. (Lynne Shallcross/KHN)

It’s a far cry from a decade ago, when Stepney was homeless and “didn’t care about anything.” His diabetes went unchecked and he had suffered a stroke — a medical event that landed him at the Baltimore Veterans Affairs Medical Center.

After having part of his foot amputated, Stepney moved into long-term nursing home care at a VA medical facility, where he thought he’d remain — until he became a candidate for a small VA effort that puts aging veterans in private homes: the Medical Foster Home program.

The $20.7 million-per-year program provides housing and care for more than 1,000 veterans in 42 states and Puerto Rico, serving as an alternative to nursing home care for those who cannot live safely on their own. Veterans pay their caregivers $1,500 to $3,000 a month, depending on location, saving the government about $10,000 a month in nursing home care. It has been difficult to scale up, though, because the VA accepts only foster homes that meet strict qualifications.

Read full story

 

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How do you celebrate your calling during National Nurses Week?

Published in Nurse.com by Jennifer Mensik, PhD, RN, FAAN

Make a Nurses Week resolution to recognize each other every day.

One of my favorite sayings about nursing is our ordinary is actually extraordinary. We provide an amazing service to the public, whether in hospitals, clinics, long-term care or in the community.

Being a nurse is not something we turn off completely at any time. It doesn’t stop at the end of our shift like many other professions.

We are there to help at a moment’s notice because we care. That perspective of caring is always with us and we believe we are doing what any other person might do in the same situation — that it was our job.

We have become so accustomed to the caring we do and the miracles we assist with daily, that what we and our colleagues do “daily feels” as if it is our job. As nurses, we also don’t like to take credit as we should for the healing that we assist with. Absent our caring, people would not heal and get well, and that is special.

Enter Nurse’s Day and Nurses Week. Celebrated since 1965, the original intent was to raise awareness of the important role of nursing, which mark our contributions to society. Nurses Week was first unofficially observed in October 1954, the 100th anniversary of Florence Nightingale’s mission to Crimea.

It was later changed to May 6 and officially recognized by President Ronald Reagan in 1982. The American Nurses Association expanded the holiday into National Nurses Week, celebrated from May 6 to May 12, in 1990. Over time, this week became the one time of year we as nurses truly expect we should receive external recognition for our contributions.

Organizations may do a variety of things to recognize nurses, ranging from giveaways to receptions. But does this serve the original intent of this week?

Have we all moved away from recognizing the important role in nursing that the outcome of our caring results in one week of food or tchotchkes a year? I am speaking here for administration and all nurses alike.

Let’s make a Nurses Week resolution to recognize each other more than once a year

What if each week throughout the year, you, your unit, department or organization decided to recognize yourselves? What if we recognized each other and ourselves daily? How do we give our gratitude to other nurses? How do we show our caring to others? How might this type of recognition look?

I asked many of my nursing friends how they should celebrate themselves and each other and here are some ideas:

Nursing retreats designed just for nurses by nurses. My colleagues and friends at the Arizona Nurses Association have organized this retreat for four years straight!

The DAISY recognition program is a formal program healthcare organizations can participate in to recognize the work of nurses. This program exists in all 50 states and 18 countries!

In our daily manager and administrative huddles at Oregon Health and Science University we discuss staff who deserve recognition. Clinical and non-clinical staff and managers know to escalate stories so individuals are recognized. There always are several staff members mentioned daily during these huddles.

Celebrate little victories, such as when a patient finds solace in music or speaks for the first time after visiting with a therapy dog. This might be just part of your routine day, but it is yours to celebrate. Take a moment to reflect on how your caring was part of this patient’s victory.

Write a letter to the editor in a non-nursing-related newspaper or magazine that reflects positively on the nursing profession.

Have a nursing school reunion.

Attend your state nursing association conference.

When we do not stop to recognize ourselves and others, we are not supporting ourselves or each other. When we don’t support each other, individually we can burn out and experience compassion fatigue, which makes it harder to provide a healing environment for those in our care.

Patients and families can tell when we don’t or can’t care any longer. Worse yet is we start to exhibit bullying behavior to others, instead of compassion and caring our colleagues and fellow nurses need just as much.

Nurses Week shouldn’t and can’t be just the only time we recognize, celebrate and demonstrate the importance of nursing. Each of us need to commit to a Nurses Week resolution to celebrate our profession, ourselves and each other each day!

Jennifer Mensik, PhD, RN, NEA-BC, FAAN, is division director of care management at Oregon Health and Science University and instructor for Arizona State University College of Nursing and Health Innovation DNP program. She also is treasurer for the American Nurses Association. Formerly, Mensik was vice president of CE programming for Nurse.com published by OnCourse Learning. A second-edition book she authored, “The Nurse Manager’s Guide to Innovative Staffing,” won third place in the leadership category for the American Journal of Nursing Book of the Year Awards 2017.

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Help Your Employees Deal with Grief

Published in MultiBriefs By Lisa Mulcahy

It’s a common scenario, unfortunately. One of the best members of your team suffers the loss of a spouse, parent, sibling or child. Corporations, of course, allow for some bereavement time, but experts say the process of working through the initial stages of grief can last on average between six months and a year, and in some cases even longer.

How do you handle it if this employee breaks down in tears in a meeting? What if his work is temporarily not up to par? How can you best encourage your staff to show compassion and support for her at this difficult time?

Here are five compassionate strategies for helping your workers cope emotionally as they navigate their duties as productively as possible through a profoundly difficult time.

  1. Send condolences

First, it’s a must to send appropriate condolences to your employee in the early days of her initial bereavement. This means a heartfelt sympathy card and flowers sent on behalf of your entire staff. Your employees should also be allowed and encouraged to express their individual sympathy as well.

If a wake and/or funeral is open to the public, attending these services is a strong and supportive gesture you and your employees can also make to show care and respect.

  1. Have a productive face-to-face

The day your employee returns to work, ask him to sit down with you in your office. Express your condolences with sensitivity, and express your sincere desire to support him as he re-acclimates to the workplace.

Ask him directly what he needs. Is it a gradual re-entry into his responsibilities? If so, delegate some of his project work temporarily. Is it more time off? Work with him to see if personal days or vacation time could be used for this purpose.

Listen to what he tells you, and let him know you are here to make things as easy as possible. The Society For Human Resource Management has published some helpful information regarding respite time for grieving workers.

  1. Implement a kindness policy

Encourage your staff to show compassion and offer assistance openly to this employee — and let everyone know this policy will apply to anyone dealing with a loss in the future as well. Grieving professionals repeatedly report in studies that compassion shown by co-workers has a powerful effect on their psyche as they heal, and lets them feel supported so they are as productive as possible. Two interesting pieces of research touch on this concept.

Your employee may become emotional at times during her workday, maybe even crying openly because she can’t help herself. Never judge this understandable behavior — instead, let her know it’s perfectly fine to excuse herself for a short time whenever she needs to. Encourage her co-workers to lend her a hand with supportive words whenever they think she’s struggling, too.

  1. Double-check without judgment

Take the time to follow up on your employee’s work to make sure there are no major mistakes (there will probably be minor ones), but don’t make a big deal out of doing so. If bigger mistakes happen, reassure your employee that you understand this is a temporary situation, and assign a second worker or workers to kindly help him with tasks. This technique can quickly get him back on track without any awkwardness.

  1. Praise her strength

Grieving people can use all the positive feedback you can provide. Don’t hold back on a compliment as to how well she handled a presentation — this will give her confidence as she tackles her next task. At the same time, don’t overdo your praise — your employee doesn’t want to feel singled out as “the griever” in your office who needs to be handled with kid gloves.

Treat her kindly but normally. You’ll be helping her feel more like herself, so she can concentrate well, accomplish more and continue to feel better.

Lisa Mulcahy is an internationally established health writer whose credits include the Los Angeles Times. Redbook, Glamour, Elle, Cosmopolitan, Health, Good Housekeeping, Parde and Seventeen.

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The Other Side of the Conversation

Author: Christopher M. Thompson, MD, HMDC

This article originally was published in Winter 2017 NewsLine.

In this post, a physician connects his personal and professional caregiver roles.

As palliative care providers, we spend our careers talking about end-of-life care and helping families make difficult choices about life and death. Have you ever been on the other side of the conversation, answering questions and making decisions for your own loved ones? I have cared for thousands of patients at the end of life, but recently I’ve been on the other side of that conversation – twice.

My first conversation began with “Momma,” my wife’s 91-year-old paternal grandmother. Her decline started with a kidney stone, which then led to urinary tract infections and tremendous pain. Momma made the decision to have lithotripsy. During the procedure, she had respiratory distress and required intubation. Her heart was not strong enough to tolerate this “routine” procedure. She developed right-sided heart failure and pulmonary edema. Doctors were able to extubate her; however, she continued to have more respiratory distress. She was not doing well. They placed her on Bi-pap but she did not tolerate this. She was in the hospital, agitated, dyspneic, and did not want to be re-intubated.

So now what? Our family had to begin those difficult discussions. Do we continue to push aggressive care? Momma told the family she was tired and ready to die. It was hard for our family to acknowledge what this meant even knowing her wishes. Added to that, it was two weeks before Christmas and my family lived six hours away from Momma. We decided my wife and our three-year-old daughter would travel to Georgia while I stayed home to work. I wanted my wife to be there for the conversation in person and to see her grandmother, as I knew this might be her final days on earth. After discussing options, the family agreed to inpatient hospice care.

I was too involved with work and like many times before chose work over family. My wife was at Momma’s bedside for less than 24 hours when she called me telling me that Momma was asking for me, “The Doctor.” I pulled myself away from work in the middle of the day and headed to Georgia.

I was now being asked medical questions as well as “what about Christmas?”, “what do we tell the great-grandchildren?”, and “is this the right thing to do?” I did not have answers. I had memories and emotions for this woman I loved; I did not want to think, “Momma is dying.”

All the signs were there; it was her time to die. The family began the journey with Momma. I have worked in three different inpatient hospice facilities. It’s easier for me to study the staff, their workflow, their EMR, their census, their medical director – this is what I know. My wife reminded me that this time, I was there for Momma and our family. I was not “The Doctor” now; I was family.

Staff managed Momma’s symptoms quickly and she had two good days talking and interacting. We had made the right choice, albeit not an easy one. Long days and nights at the hospice home wear a family down. Hospice staff participate in these experiences daily. We think how hard it must be for the patients and families. When you are on the other side, you feel the sorrow and you learn a lot about the value of hospice care.

Momma died peacefully four days later. We returned home to North Carolina, only to receive a phone call that “Granny” was in the hospital. Granny was my wife’s 78-year-old maternal grandmother. She had Alzheimer’s disease, had fallen at home, and had developed altered mental status. She was not eating, she had a UTI, and a CT scan showed a small hemorrhage in the frontal lobe. Granny was agitated, not eating, and declining. So now what?

Just three weeks earlier we had lost Momma. Now our family was deciding on inpatient hospice for Granny.
My wife, daughter, and I packed the car and headed for Florida. I took the time from work, but I was still on call and was on the phone, giving orders the entire trip. Once again, it was easier for me to do my work as a hospice physician than confront what I had no control over. We were losing both our grandmothers within three weeks.

As we arrived in the middle of the night, we received a call letting us know Granny died. She had declined quickly. That was truly a blessing. After all the heartbreak and tears, we went to Granny’s house and celebrated her life. This is what she would have wanted.

Those two experiences remind me how hard end-of-life conversations are for families. We as palliative care providers need to remember it is different when there are memories and emotions involved. No matter how informed our families are, these decisions are not easy. And, it’s hard being on the other side. We are no longer medical professionals, we are family. All our medical training leaves our mind and we become an emotional basket case. We find it hard to think straight or make rational decisions. It’s difficult living with the decisions and through those choices.

I’m 40 years old, my parents are approaching retirement, and my grandparents are dying. I have friends who are struggling with acute and chronic illnesses. All of this has made me a better hospice and palliative care physician and I’m glad I can reflect on my training and life experiences to help my patients and families. I make the conversations personal and emotional. I have more empathy during family meetings. I think this adds a new dimension to the work I do, the work I’m proud to do.

These two experiences brought our family closer together and I’m grateful I could help in the decision-making process. My family saw firsthand how our jobs as hospice and palliative care providers are intensely emotional. We all need to realize the impact we have on the families we care for, how a well-trained hospice and palliative care staff can have an impact on a family.

During our trip home from Florida, my wife looked at me and asked, “How do you do this day after day? I am proud of you and now understand your job even more and how rewarding it must be.”

———–

Christopher M. Thompson, MD, HMDC, assisted in developing the palliative medicine programs at two hospitals prior to joining Transitions LifeCare as Medical Director for Transitions Kids, Transitions LifeCare’s pediatric hospice program. Dr. Thompson is board certified in Family Medicine. After completing his Fellowship, Dr. Thompson became board certified in Hospice and Palliative Medicine with the added qualification of Hospice Medical Director Certification.
 

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March Celebrates Social Work

Professionals who care. Helping improve people’s lives is at the heart of social work

In honor of National Social Work Month in March, below are facts about social workers from the National Association of Social Workers:

About Social Workers

Social workers seek to improve the lives of others.

Social work is a profession for those with a strong desire to help improve people’s lives. Social workers assist people by helping them cope with issues in their everyday lives, deal with their relationships, and solve personal and family problems.

According to the Bureau of Labor Statistics, there were almost 650,000 social workers in the United States in 2014. With an expected growth in jobs of 12 percent by 2024, social work is one of the fastest growing professions in the United States.

Who are social workers?

Social work is a profession for those with a strong desire to help improve people’s lives. Social workers assist people by helping them cope with issues in their everyday lives, deal with their relationships, and solve personal and family problems.

Some social workers help clients who face a disability or a life-threatening disease or a social problem, such as inadequate housing, unemployment, or substance abuse. Social workers also assist families that have serious domestic conflicts, sometimes involving child or spousal abuse.

Some social workers conduct research, advocate for improved services, engage in systems design or are involved in planning or policy development. Many social workers specialize in serving a particular population or working in a specific setting.

What do social workers do?

Who employs social workers?

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The Road to Healing Takes Time

Originally Published in Pocketful of Chelles Blog

By Michelle Kohlhof / February 19, 2018

Last week was tough. The world witnessed a tragedy that has become all too familiar, another school shooting. A day that was supposed to be about love and peace, turned dark and cold for so many. On the day after, when I dropped my little dude, Jason, off at his school, he dashed into his classroom shoving his backpack into his cubby, and my heart just broke into pieces for the families of the victims in Parkland, FL.

How could one person take seventeen beautiful souls, most of them being children? We ask ourselves why did this have to happen, we say prayers for the families who now have to learn how to move on without their child, and we call on congress for change, yet again. It’s hard to imagine how you go on after such a devastating tragedy. Simple things like going back to work, seem like mountains to climb. While we look for answers, one thing is for sure; time doesn’t stand still for the ones who need it to the most. Instead, you learn how to compromise with time, and make the most of what he gives you. We find ourselves pleading for time to just stand still, to have just five more minutes with the ones we love. But you see, time doesn’t wait for no one, and this is why there is more to life than the nine-to-five grind.

We find our humanity—our will to live and our ability to love—in our connections to one another.― Sheryl Sandberg, Option B: Facing Adversity, Building Resilience, and Finding Joy

As I mentioned at the beginning of this post, last week was tough. Sometimes you don’t get a “do over”. What you do get is a chance to put things in perspective, and not take the life you’ve been blessed with for granted. So on a whim, my husband, Travis, says to me, “you know, we can take a road trip, South, and hang out with your parents”. So, we took advantage of the long weekend (President’s Day), loaded up the truck, and off we went! And as you can imagine with a nine hour drive, I had time to reflect, time to think, and time to write…

All this time got me thinking, how can employers and HR support employees through grief and loss? Are bereavement leave policies enough? I started to research this and one article from SHRM stood out. Click here to read more. In a time of unspeakable loss, what are some big things that HR can do to support their employees and organization?

1) It’s more than policy – It’s about having a plan:

To my fellow HR professionals, let’s work together with management and executives to create a plan to support employees in their time of need. We should do more than just contact the employee and share information about our organization’s bereavement policy. One great example is what Ernst & Young did last year. They provided dedicated HR support to the family of one of their employees who was critically hurt in the Las Vegas mass shooting tragedy. Thankfully, this EY employee survived, and her story showed us that having a plan can lessen the burden on the employee and her family. It shows us that an employer can really champion for their employees when they need us to the most.

2) It’s time to lead the way:

What can we do to prepare fellow employees for a grieving employee’s return to work?  There are a lot of emotions that the employee will still be dealing with upon his return. There will be lack of focus, and difficulty with concentrating, even on the simplest of tasks. We as HR professionals have to partner with management on creating a smooth path for the grieving employee as they return to the workplace. We need to lead the way in helping the grieving employee navigate back into the environment. It is vital for his success.

3) Give some space – It takes time:

I think the single most important thing we can do to help a grieving employee return to work is to give space. What if we created a private place where the grieving employee can go to take a break when she is feeling overwhelmed with emotions? These emotions will come in waves and it is important to give space.

Some “Chelles” find their way to shore, while some live in the sea for eternity. ― Michelle Kohlhof

My closing thought, take the time to set eyes on the ones you love, and are blessed to still have in your life. It’s another chance to fill your pocket full of “Chelles”.

 

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Share These Helpful Resources For Grief & Loss

Helpful Resources for Grief & Loss
grief and loss

 

 

 

 

 

Taking Care of Yourself Includes Accessing Support

Grief may be experienced in response to physical losses, such as death, or in response to symbolic or social losses such as divorce or loss of a job.  The grief experience can be affected by one’s history and support system. Taking care of yourself and accessing the support of friends and family can help you cope with your grief experience.

There is no right way to grieve. It is an individual process and a natural part of life. Life won’t be the same after a loss, but experiencing your grief will allow you to adjust to life after loss.

Grief lasts as long as it takes to adjust to the changes in your life after your loss. It can be for months, or even years. Grief has no timetable; thoughts, emotions, behaviors and other responses may come and go.

Helpful Resources

Supporting Someone Who is Grieving [PDF]
There is no Wrong or Right Way to Grieve After a Loss [PDF]

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The Man in Overalls

Overalls

The volunteer called and said she would not be able to make her regular shift at the reception desk. As the Volunteer Coordinator, it fell to me to sit at the desk that afternoon. It happened to be a very busy day. Four patients were admitted in just two hours. I was frantically trying to keep up when a man clad in bib overalls came in the front door. He looked around slowly and approached the desk. He told me his wife was coming to the Hospice from M.D. Anderson Cancer Center that afternoon. He wanted to know what room she would be in. I gave him the information, offered him a cup of coffee and invited him to make himself comfortable while he waited for the ambulance to bring his wife.

After he got his coffee, I expected him to go into the family room or go to his wife’s room to wait. Instead, he just stood there, looking at me with woefully sad eyes. The silence was heavy. I didn’t really know what to say; lots of things were racing through my mind. I was searching for something brilliant, meaningful, perhaps even profound, to say to make him feel better. I was coming up with nothing when I remembered volunteer training. Maybe this was one of those times when silence was the best choice.

So, I stopped what I was doing, looked at him and smiled, just a little. With a heavy sigh, he put his callused hands up on the ledge and began to talk, very slowly. He talked of his wife’s cancer, of her pain and of his pain, as a result of hers. He talked about his daughter and how she helped so much. He talked about his wife wanting to stay with her sister if she stabilized enough to leave here. He said he really didn’t like staying anywhere except home but right now his wishes didn’t matter much. He said all he wanted was for her not to hurt, be as happy as she could be and make the most of the time she had left. He was willing to do whatever it took, even sleep in a strange bed, if that is what she wanted.

He looked off in the distance, shook his head and told me about the many people he and his wife had helped over the years. These same people were nowhere to be found now that they could use some friendly support. His eyes became teary as he shared how the parking lot attendant at M.D. Anderson had only charged him for one day’s parking after he lost his ticket and told her he had been there for at least three days.

He marveled at how a complete stranger could be so kind when lifelong friends didn’t even call. His voice cracked as he wondered out loud why these people couldn’t just say it was too hard to visit and see his wife so sick. Instead, they said nothing and their silence really hurt. He hung his head, wiped a tear from his cheek and asked where he could smoke. After I told him, he turned slowly and left, without another word.

I sat there quietly thinking about what had just occurred. I felt so privileged to have been allowed to listen as this gentle man poured out his hurts, to me, a stranger. I don’t know why he chose me, except maybe he took the silence that I wrestled with as an invitation to say what had probably been on his mind and in his heart for a very long time. I hope he felt better after he talked. I know listening to him was a gift for me. I learned valuable lessons from that man in bib overalls. I learned never to put off calling a hurting friend, even if I don’t know what to say. I know and I care says it all.

By the way, I also learned not to judge men in bib overalls!

-Patsy Piner, Houston Hospice Volunteer Coordinator

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