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Archive for February, 2017

crossing-over

Crossing Over

Between two worlds you
linger, waiting for freedom.
Choice is everything.

I feel compelled to write about the conversations and work we did with my mother-in-law Dorothy during her recent illness, choices that were designed to offer her freedom.

In a world that has sometimes become sterile, devoid of the important intimate conversations of living and dying, it is easy to let things slide. We believe we cannot speak of what’s next or talk opening about death. It has however, been my learning that these are not only important conversations, they are life-giving.

Certainly, as a family none of us wanted to see Dorothy leave us; she is loved and certainly a formidable matriarch and presence in our lives. Yet as she was fading, we also spoke openly about the possibility of her leaving and that all we wanted was to support her choice, to allow her the freedom to leave or stay.

During her sickest days, each of us spoke gently with her, reassuring her that we would support whatever decision she made. I personally spent time with her massaging her back and legs, offering comfort, and holding the intention for ‘highest good’. I understood that highest good for her may not seem so for me.

The other choice we offered mom was ‘energy work’, something called IET or Integrated Energy Therapy. This technique is designed to communicate at the spiritual level and when you are as ill as Dorothy was, the spiritual gate is wide open. Our therapist, Genevieve, is gifted, gentle, mindful and truly tuned in. Working with this technique offered mom the additional energy she required to pursue freedom in whatever form she chose.

I believe that the combination of the family support we offered Dorothy, the honesty and the energy work, gave her a conduit in which to fully understand the choices available to her. She was embraced by love and respect. There was no drama, just a family united. And I believe this has made the difference in her recovery as she is alive again, in a way she was not even before she became sick.

Living is dying and dying is living. It serves no one to steer away from this reality and in fact allows us to be more whole as human beings. Dorothy chose life, for now, and in this choice I am observing a new zest for life.

My lesson in all of this is that we simply need to offer one another the freedom of choice, to know that living or dying is a personal choice that we get to make for ourselves. Giving permission to others to make this choice , to unselfishly let them go if we must, is the greatest gift we can offer another.

FREEDOM!

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I swear my mother-in-law Dorothy is like a cat; it is evident that she has nine lives. My only concern is that by my count she has lived at least seven of them. Two week’s ago she was clearly on a downhill trajectory, unable to recover from a severe gastrointestinal flu and complaining a terrible stomach pain. Multiple ER visits were leading us nowhere (more on that later). any attempt to receive additional care services were in vain. we were in that no man’s land where families often arrive. Even with three health care professionals in the family, we were at a loss as to how to support her.

I reached out to her former surgeon and a friend of mine who immediately referred her to Palliative Care and the physician who leads the community program. The first thing she did was totally clean up the medication Dorothy was consuming daily. It seemed radical, but several on the meds have known GI side effects. That was six days ago. This morning on the physician’s follow-up visit, Dorothy was a new woman. She is eating again and enjoying her food. Her mobility is improving. Her mood is light. She is BACK!

Polypharmacy, yes this is a diagnosis, is common in the elderly. Drugs get added and rarely removed. I am finding that drugs are not being reviewed on a regular basis by family physicians, which is by the way, part of their role. Family physicians are the gate keepers for their older patients. They need to be informed as to the side effects of medications and they need to monitor the possible drug interactions.

Secondly frequent ER visits by an elderly patient should be a red flag for those attending to her care. Several of my physician colleagues were dismayed to hear that no one connected the dots for Dorothy and no one referred her for follow-up care post hospital stay. I assume that those who discharged her thought she lived in a nursing home which is not the case.

Finally, we have a home care system which, at least from my experience to date, is not working. They have been contacted three times in the last two weeks, by myself, the residence where Dorothy lives, and the palliative care physician. to date they have not made a visit.

Let me be clear – I am over the moon grateful for her recovery! Fortunately she has more resilience than most women her age and an amazing network of family support. Without this she would no longer be here.

And I have learned that having a health care advocate is essential. My message to those of you reading this is to stand up for and speak out for the care of your elderly parents. Without my interventions and the help of my colleague, Dorothy would not have been referred to Palliative Care.

I now understand that we as a family needed to be more clear on insisting that she relieve a referral to home care follow-up before being discharged. My advice to you – don’t assume anything.

Finally be a bad ass – a squeaky wheel if you have to. I plan to follow-up with home care today to find out what is going on.

As we all age in our Third Act, we will need to advocate for ourselves as well. While we need to be reasonable in our requests, we need to speak up when we are not being heard, to stand for our own well-being, and to expect the health care we pay for in our taxes. I personally am not a big health care user at the same time I am currently awaiting an appointment to the Joint Assessment Clinic. It took my family physician five weeks to make the referral after we discussed it. Is this reasonable – I don’t honestly know. Is she busy – yes. The thing is, stay with your requests.

Okay, this is my RANT for today. The Canadian health care system is amazing as we all know. We need only yo look to our southern neighbors to realize that we are fortunate. And the system has its flaws which we can all work on to correct. Let’s work together on this, be grateful, show appreciation for our health care workers and advocate for ourselves and others.

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