Celebrating 50 years of nursing!

2018 is Joyce Story’s professional golden anniversary.  She has been a nurse for fifty years!Joyce Story w patient

Graduating in 1968 from Wichita General Hospital School of Nursing, a three year diploma program at the hospital in Wichita Falls, Texas, Joyce lived in the nurses’ dormitory under the close supervision of a house mother.  She remembers white caps, sharpening needles, sterilizing syringes to use over and over again.

Joyce’s first nursing job was in pediatrics, and now, fifty years later, she reflects that she has come “full circle”, working in end-of –life care as a Field Mentor and Home Care nurse for Hospice of East Texas.

In the years in-between Joyce has done med-surg nursing, been a house supervisor, and an assistant director of nursing.  She served as director of nursing in a hospital for twenty one years.

Ten years ago, she joined the staff of Hospice of East Texas.

As a Home Care nurse, Joyce spends her days visiting her hospice patients in their homes, in nursing homes and in assisted living facilities.  She treasures the close relationships and friendships she develops with patients and their families.  “I always tell them, ‘I’m not a boss.  I’m part of a team that will help you in your final days.  I promise to be here for you and to do anything I can to make these days as comfortable and joyful as possible.’”  For Joyce, this work, these relationships, are a privilege, one she’s not ready to give up just yet.

“I love this work,” Joyce asserts, though she acknowledges that it can be difficult, mentally, physically and emotionally.  “I put 2400 miles on my car every month, traveling to see my patients.  The time behind that windshield is actually good for me.  I think.  I pray.  I recharge so that I can be my best for the next family I visit.”

“My rule is to treat people the way I want to be treated,” Joyce says.  “Death will come for all of us.  It doesn’t matter how much money we have or what we have accomplished in life.  I hope there will be someone there for me when my time comes.”

For Joyce, there are so many memories from her years as a hospice nurse, but one stands out in particular.  Her patient was a hoarder, in a horrible living situation.  “Of course, all of us – nurses, social workers, physicians, volunteers – we all wanted to ‘fix it’, move the patient to someplace better, but that was her home and that’s where she wanted to stay.  She died peacefully in her home, just as she wanted.  She died with dignity.  Every human being deserves that.”

If Joyce could change one thing about her work, it would be that families call for hospice care sooner.  “There are so many misconceptions about hospice,” she says.  “We do NOT hasten death!  Our team can bring so much peace and comfort to patients and to their families, but we need time to do that.”

Advertisements

Definition…?

Red autumn and fishing pierWalk with me down to the edge of the water.  Step with me onto the wooden pier that connects the shoreline of seemingly solid stability to a world of liquid uncertainty.  As we make our way along the planks, notice the smell… it’s fresh, it’s muddy, it’s fishy, it’s exciting, it’s familiar.  We come to a spot where we find a small boat tide off to a metal cleat.  Let’s jump in gingerly, let’s untie the rope carefully, let’s stay as steady as we can and let’s push off.  We are going to float for a moment on the sea of memory.

Memory is a word that can be packed with emotion, especially if you have experienced loss in your life.   It could be the loss of a relationship; companionship; independence; financial stability or any number of other things you cherish.  In fact, whatever the loss, if your loss carries with it an element of love and value, you will react or respond to that loss.  It’s called…Grieving…  If you are grieving, your memory is probably connected to that which you have lost. However, while we are in the boat today, I would like to ask you to remember not only the loss but also something else.  Remember school?

Yep, that’s what I said, school.  Remember when you were in school?  Remember your teachers and your classrooms and those quirky desks you once called “home”?  Remember when your teacher would give you an assignment or a test and you would have to provide a “Definition” to a word or a term?  If you are like me, you did not always look forward to multiple trips to the glossary located at the back of the book. Looking back, it’s an amazing thing, the more definitions you learned, the more you begin to recognize the importance of the definitions. In fact, definitions provide clarity and stability and insight to the world around us and they often serve as keys that unlock the doors that lead us to further understanding and discovery.

Each of us has a “definition” attached to our lives.  It’s how we are perceived, how we are viewed, how we are accepted (or rejected), it is how we are identified by the people…including ourselves.  When we lose those that we love… dare we say it…when someone we care about and are attached to dies, it has a tendency to mess with our definition.  Everything was one way, now everything is a different way.  The definition of the word “spouse” used to be so clear… now, not so much.  The definition of son or daughter that was without question now seems to somehow demand an asterisk.  The definition of grandmother, grandfather, mother, father, aunt, uncle, friend… they all become shadowy reflections of a life before the loss.

Gradually you begin to comprehend that life, your life, is defined by “Redefinition”, and redefinition is not always easy and it’s not always pain free or guilt free.  It is, however, always a normal part of the grieving process.

Wes Bynum, Direct of Care Support Services

So much sadness… and so much kindness

Everyone who worksantas sleighs at Hospice of East Texas, staff and volunteers alike, has heard this comment… “I don’t know how you do it.  It must be so sad.”

The truth is, yes, there are many sad moments, but there are also moments of such sweetness and even moments of unspeakable joy.  Our work here is like itself, a mixture of pain and sadness, balanced by moments of joy and even celebration.

Two days before Christmas, we admitted a young woman to hospice care, too young to be dying of terminal cancer, too young to be leaving a two year old daughter.  Adding to that unimaginable tragedy were her family’s circumstances, a disabled husband, desperate poverty, a home that was more a shed than a house fit for people, cold weather, no coats, her little girl without a pair of shoes that fit. Certainly, there was no Christmas either, nor even the thought of one.

But then, as they always do, the people of Hospice of East Texas went into action. They called their coworkers, their friends and neighbors.  They dug deep into their own pockets.   The necessities, food and cash and shoes and coats, started piling up, and so did the fun things, stuffed animals, candy, silly little girl treasures.  Already on a tight holiday schedule, with lots of work and their own families to take care of, people stayed late, worked the phones, went out of their way to pick up donations.  A Hospice of East Texas medical equipment van became Santa’s sleigh, delivering comfort and joy to a family who had no expectation of either.

Yes, there is sadness and tragedy in the work we do at Hospice, no doubt about it. There is nothing good about this young woman’s situation, and she and her family have a rough journey ahead.  But the people of Hospice of East Texas will be there for them, not just at Christmas but in the months to follow, working to smooth and balance their tragedy with comfort and kindness and generosity.

We can do that because of your support.  For thirty five years, generous friends in our communities have upheld our mission, making sure that Hospice of East Texas was here to help families like this and thousands of others.  Because of you, we can provide our unique brand of extraordinary end-of-life care to everyone who needs it.  And because of you, we can go above and beyond when circumstances call for it, creating a little joy to balance the sadness, sharing some good to smooth the bad.

Sliding down a slide

Have you ever slid down a slide? slide 1

I think back on clear autumn days and trips to the park.  The air is clean, clear and cool.  The leaves on the trees are beginning to turn different shades of gold and red and orange.  A few float lazily to the ground. As I take in the beauty and my heart begins to warm with thoughts of days gone by, my ears hear the squeals and laughter children playing. My attention turns to the playground and I find myself transported in time, back to earlier, simpler days.  There are swing sets standing ready to take me on a gliding trip up and down.  There is a merry-go-round ready to take me ‘round and ’round.  There is a castle or a fort or a ship or a tree house or an airplane… a magical structure that I can pretend in, as I climb on and around and over.  Oh, to be a child again…

Somewhere amidst all this fun and excitement and imagination stands the slide.  I remember how tall the ladder seemed to me when I was just a little tot.  I remember cautiously making the climb to the top of the platform, my trembling tender hands gripping tightly to the cool metal rail.  I remember the lump in my throat and the knot in my stomach as I got to the top.  The view was amazing.  It seemed I was on the top of a high mountain.  Then I would look down.  The slide would be shining in the sunshine and I would hesitate for a moment as I thought about the adventure that was just ahead.  A moment of fear, a moment of question, a moment of apprehension…should I try to turn around and climb down the ladder or go for it?   All I had to do was to let go of the sides and enjoy to trip. I take a deep breath and…  Whoosh!  The thrill of the slide down the slide!

As you walk through the world of grief, you might find yourself facing situations that cause you hesitation.  Moments in life when you pause and try to decide whether or not you really want to let go and experience the “slide”.  Especially during the Holiday Season, you are surrounded by laughter and smiles.  It seems like all the stories have a happy ending and everyone is getting what they wish for.  All the while your heart aches from the loss of the one you love.  With so much “cheer” around, you may feel grumpy, awkward, frustrated, sad, or even a little bitter or jealous.  These feelings, as well as countless others, are all normal pieces of your individual grief puzzle.  Instinctively you know that you can’t go back down the ladder.  However, sitting on the top of the slide will not make the feelings disappear.  The fact is, the longer you sit there the more intense the feelings could get.  My suggestion… accept your feelings, understand that where you are can be a scary place and that it will require some courage to let go.  But remember, as difficult it has been for you to get to where you are and as intimidating the next step may be, there is still a special thrill in store when you choose to let go and slide down that slide. Whoosh!

Have you ever slid down a slide?

Later…Wes

Choosing a Hospice: 16 Questions to Ask

Good information provided by the American Hospice Foundation…Crape Myrtle flowers on campus July2,2012 006

Hospice is a set of services that we all may need someday – if not for ourselves, for our parents. While death is not an option for any of us, we do have choices about the services we use at the end of life. Hospice is undoubtedly the best option in the last months of life because it offers a whole variety of benefits, not only to those of us who are dying, but also to those we leave behind.

How do you find the most appropriate hospice? Until hospice quality data is readily and easily available to all of us, the experts at American Hospice Foundation have pulled together some tips for choosing the most appropriate hospice. Answers to these questions will give you clues about quality of care and help you make an informed assessment.

What do others say about this hospice? Get references both from people you know and from people in the field – e.g., local hospitals, nursing homes, clinicians. Ask anyone that you have connections to if they have had experience with the hospice and what their impressions are. Geriatric care managers can be a particularly good resource, as they often make referrals to hospices and hear from families about the care that was provided. Anecdote and word of mouth won’t paint a full picture but they are still valuable data points.

How long has the hospice been in operation? If it has been around for a while, that’s an indication of stability.

Is the hospice Medicare-certified? Medicare certification is essential if the patient is a Medicare beneficiary to permit reimbursement.

Is the hospice accredited, and if required, state-licensed? Accreditation (JCAHO or CHAP) is not required and not having it doesn’t mean a hospice isn’t good, but if the hospice has it, then you know a third party has looked at the hospice’s operations and determined they come up to a reasonable standard of care.

What is the expectation about the family’s role in caregiving? See if what the hospice expects from family members is consistent with what the family is able to do.

Are there limits on treatment currently being received? Is there anything currently being done for the patient that a hospice under consideration would not be able to do?

Can the hospice meet your specific needs? Mention any concerns the family or patient have about care and ask the hospice staff how they will address those concerns
.
Does the hospice offer extra services beyond those required? Some services fall in a gray area. They are not required by Medicare but may be helpful to improve the comfort of a patient. An example is radiation and/or chemotherapy for a cancer patient to reduce the size of a tumor and ameliorate pain. Some hospices would not be able to afford to do this but others with deeper pockets could.

How rapid is crisis response? If the family needs someone to come to the home at 3AM on a Saturday, where would that person come from? What is their average response time?

What are the options for inpatient care? Patients being cared for at home may need to go to an inpatient unit for management of complicated symptoms or to give their family respite. Facilities can vary from the hospice having its own private inpatient unit to leased beds in a hospital or nursing home. Visit the facilities to ensure that they are conveniently located and that you are comfortable with what they offer.

If the family caregiver gets really exhausted can we get respite care? Caring for someone with a serious illness can be exhausting and, at times, challenging. In addition to home hospice care and inpatient care when symptoms prove unmanageable at home, hospices also offer “respite” care (periodic breaks for the caregiver of up to 5 days during which the patient is moved to an inpatient bed) and “continuous” nursing care at home for brief periods at the patient’s home when family caregivers are unable to manage on their own. Ask the hospice under what conditions the hospice provides these types of care.

Are their MDs/RNs certified in palliative care? Not having it doesn’t mean the staff is not competent as experience counts for a lot but having this credential is an indication of specialized study in palliative medicine/nursing.

How are patient/family concerns handled? Is there a clear process for sharing concerns with appropriate hospice staff and making sure they are addressed, including a process for escalation if the concern is not adequately addressed at lower levels?

How does the hospice measure and track quality? You are not looking for a lot of technical detail, just a response that indicates that the hospice evaluates its own performance in order to improve it.

What are your general impressions at initial contact? What is your reaction to the people you talk to?

What kind of bereavement services does the hospice offer? Types of grief support can vary widely and may include individual counseling, support groups, educational materials and outreach letters.

Choosing a Hospice: 16 Questions to Ask by Naomi Naierman and Marsha Nelson was originally published on the website of the American Hospice Foundation. © American Hospice Foundation. All rights reserved.

In life…

hospiceA5[1]In life, death is inevitable.  We don’t like the idea.  We don’t want to think about the idea.  We don’t want to accept the idea.  We would rather focus on something else… maybe anything else… something that doesn’t make us feel so helpless an

 

 

 

 

d sad and out of control.  However, sooner or later we come back to it…In life, death is inevitable.

When death or loss occurs, we respond.  We respond in ways that we recognize, and we respond in ways that we may not recognize.  You have probably heard that “no two people grieve the same way” or “there is no right way or wrong way to grieve”.  These are tried and true statements and there is a reason why they are tried and true, it because…well…they are tried and they are true.

You are individual.  You are unique.  You are you, and you will respond

 

to your loss in your own special way.  That being said, as you walk this path of loss, you may find that there are a few common landmarks along the way.

Listed below, in no particular order, is a list of some of the different ways that loss can affect you.  This is NOT a list of requirements in order to grieve “appropriately”.  This is NOT a complete list of the potential ways that loss can touch our lives.  It IS a list that is offered to you in order to broaden your awareness of how impactful death can be.

Responses to Death or loss may include:

 

 

Restlessness, difficulty concentrating, disrupted sleep patterns, frequent dreams of your loved one, loss of interest in social interaction, altered eating habits, loss of interest in personal appearance, denial of the loss, blaming others for the loss, feeling shaky, increased heartbeat, tightness in the chest or throat.

 

You could experience:

Anger, Guilt, Frustration, Anxiety, Confusion, Fear, Despair… Relief, Comfort, Peace, and/or Hope.

 

You might:

Cry unexpectedly, Feel you are burden to others, Find yourself wandering aimlessly around the house, Forgetting to finish things you have started, or that you are simply “Going Crazy”.

The list could continue, but hopefully you are beginning to get the idea.  When it comes to Death and Loss and your response, it can be a multidimensional experience.  The key is it is your experience.  Embrace it, lean into it, and allow yourself the privilege to walk this special pathway you now find yourself walking on.  If the bereavement staff at Hospice of East Texas can help, please reach out to us.

Later… Wes

“Life” by Wes Bynum

sunrise picThe shadows lengthen.  The sun moves slowly, and steadily makes its journey to lands far away.  The orange red glow begins to melt into shadows and shades of grey.  A soft breeze is blowing and the leaves are dancing to its gentle rhythm.

Life

Somehow, in some way, and without clear definition, the light of day is no longer and the darkness of night is now.  Why did it have to come?  How did it get here?  How long will it last?  Does anybody notice?  What will happen next?  Some questions have logical, scientific, absolute answers.  Some questions defy our ability to come to any kind of answer at all.

Life

Darkness prevails. It is a time for contemplation and reflection.  Truth is hard to accept at times. At some point, thoughts and experiences become memories.  Tomorrow holds new hope.  Sleep deeply. Rest peacefully.  Dream sweetly…

Life

Now open your eyes!  Your heart is beating.  A sense of anticipation and excitement is in the air.  Light has returned.  Darkness has gone.  The sun is brilliant.  The sky is blue. The sweet fragrance of morning is carried along on the wings of the wind.  Soft, happy songs of busy birds gently touch the ear.  The soul of man rejoices.

Life.

Martha Jo Price, Friend!

Martha Jo PriceMartha Jo Price loved Nacogdoches, Texas, with all her heart.

Though she lived abroad in early adulthood, “Jo”, as she was affectionately known to her close friends and family, returned to Nacogdoches for most of her adult life.  She enjoyed everything about life in her community.  There was time to paint prodigiously in her home studio.  The local golf courses allowed her to perfect her game and to compete often and fiercely.  Most of all, she loved the company of her decades-long friendships.

It was her friends who introduced Ms. Price to the mission of Hospice of East Texas.  She played golf with Jessica Henderson, Hospice’s Director of Operations in Nacogdoches, and Leah Brasher, RN and their husbands.  Her friend, Sara Pennington, volunteered at the Hospice of East Texas Shop in Nacogdoches and shared stories about the shop and the mission of Hospice that the shop supported.  Ms. Price liked what she heard and became a regular and generous annual donor to Hospice of East Texas.

When Ms. Price became ill, it was a privilege for Hospice of East Texas to care for her in her final days, returning to her the same extraordinary care and support her contributions as a donor had made possible for others.  “We would not have chosen anyone but Hospice of East Texas to care for Jo,” said Pattie DeLamar, her close friend, golfing partner and executor of her estate.  “We already knew them.  We loved and trusted Jessica and Leah and knew Hospice of East Texas would provide the very best care.  And they did!”

After her passing in 2015, Ms. Price’s love for her home town bloomed into life with the granting of six transformational gifts to local nonprofits from her estate.  Hospice of East Texas was blessed to be among the recipients of Ms. Price’s ultimate generosity.

“Jo was an extraordinary woman,” said Mrs. DeLamar, “smart, accomplished and so much fun. She was not one for fanfare or fuss.  She would never have wanted to see her name up in lights, but she did really love the Nacogdoches community.  The gifts she made through her will are evidence of  just how much she cared about her home town and its people, and how much good she wanted to do.”

About Peanut Butter

He’s a small white and tan cat, and he belongs to Hospice of East Texas.

He chospeanut-butter-paintinge us, appearing in the back garden behind HomePlace one day, hanging around like he wanted to make friends.  A little shy at first, he roamed the edge of the woods, timidly crossing the lawn on occasion to sit in the sun by the gazebo.  Staff and patient families spoke to him as he sauntered by, and slowly he let us know that he had found his home.

One day, LaStasha named him:  Peanut Butter.

The nurses started putting out little bowls of food and water on the patio.  Courtney bought him a cat house and a bed.  Lisa bought cat toys.  Courtney bought him a second cat house and a climbing tree.  Brittnee Cagle from “Spay Neuter NOW” heard about Peanut Butter and  arranged for him to get his vaccinations, had him neutered and fitted with a microchip, free of charge.  A family member of a patient painted his portrait.   When the weather was cold, he cuddled in his house by the glass door and watched the traffic inside.  People in the hallways.  People on the phones at the nurses’ station.   When the weather turned warm again, Peanut Butter sunned on the lawn furniture, chased the birds at the feeders, acted the way some cats act, like he owned the place.

Over these months, Peanut Butter has not only found a home, he has found a mission.  In the gardens around HomePlace, families watch and wait, seeking solace in nature’s beauty, and as an outside cat, Peanut Butter seems to know who needs attention.   He slides up next to a lady sitting on a garden bench, rests by her leg, lets her know he’s there.  He walks back and forth in front of a gentleman who’s pacing the grounds, keeping him company.  He charms little children, filling the air with their squeals and giggles, but he’s too quick
for them to catch.  When patients can go outside, sometimes in wheelchairs, sometimes in their hospital beds, Peanut Butter is especially watchful.  He seems to know that those days, with the last touch of the sun on their faces, are precious and sacred.

There are many things that make the experience at HomePlace special.  Extraordinary care and medical attention.  Complimentary meals provided by a caring community.  A play room for the children.  The gentle touch and listening ear of volunteers.  To that list of special things about HomePlace, we can now add one more:  Peanut Butter.  For many families, his is that “extra touch” of comfort, offered with no words, just a caring presence, wrapped in white and tan fur.