Thursday, March 29, 2007

Well, sad, sad

The two people I wrote about yesterday both died. I am glad for them, they didn't linger long. It was a blessing to have been able to work with them both. I feel sorry for anyone who doesn't believe in God or an afterlife, what a comfort it is to know they are beyond pain, that their prayers and the prayers of those around them were answered in such a quick, decisive manner. What a blessing to be taken from the world and ushered into a place of peace and rest, to be with God, to see him face to face. Bless the people who cared for these folks, they were loved and well taken care of.

Wednesday, March 28, 2007

life, death, and all that

So, I have been hospicing now for about 2 1/2 months. So far the job is going well. I am finding that it is difficult in some ways, that I have not encountered before. I enjoy the continuity I get with following a case load, although I also enjoyed the relative anonymity I enjoyed when I did home care as an on call nurse. Not to mention the variety. It is nice to go into a home however, knowing ahead of time what to expect. I have to live with my decisions, that can be a bit tough, I get to clean up the mess if things don't go well. That is a bit more stressful than before. I worry a bit more about the people I care for, when I am not working. I pray for them more too, because I know them better. So I guess it is good, I have to be more a grownup about my job, more accountable.

Everyone is different and I am finding out that everyone dies differently. You'd think this would be common sense, but our little brains so want to make sense of things, to find a common thread, a sense of stability in an everchanging world, even in death. What will it look like, how will people feel, what do I do for them? Every family comes with their own challenges and needs. I want people to look neat and tidy, and dying people don't always. They don't. I want them clean and dry, resting comfortably in a clean bed, not thrashing about and sweating, with dry cracked lips and rasping breaths. It does look scary, and what am I to do to help a family not be afraid when I am afraid? I am not afraid of death, but the whole dying thing, that is another matter.

One patient is a young man with a brain cancer. It is tough to watch him die. He is running fevers, has been confused all along. His parent is caring for him, but it is tough, a parent watching a kid die. They want to care for him but there is a fear too. They can't understand why he is taking so long to die. He is othewise young and healthy. He says he is a Christian, professes a faith in God. I am glad for that, it would be tragic if he were not. He is a kidder, a real smart ass, you can tell, even in his stupor. I don't know if it would have been a good thing to have known him healthy, smart asses piss me off, this way I can forgive the attitude. Anyway, it is hard to watch an otherwise healthy young man die. For all their saying they have said their goodbys and are ready, there is too much tragedy not yet expressed in that house.

Another person is an older woman, whom supposedly has dementia, although she seems more psych than confused. She is clear and answers questions readily, but is terrible fearful. I hear she has been fearful all her life, and I can see that. Her eyes are wide and darting, she never takes her eyes off you when you are with her. I move very slowly, and I tell her everything I am going to do, and I ask her permission first, I wait until she says yes. She allows me to care for her, and she allows me to pray for her. I pray that God will ease the anxiety. It is the main thing she is suffering from, and it is one thing we can't really medicate away. We tried giving her risperdal, it was working, she was allowing the caregiver to care for her, she was calm. But she stopped being able to swallow. We had to stop the medication. I guess we can go back to the lorazepam, but it isn't so much good for anxiety, it just makes you sleepy, and anxious. I know. I think that for her prayer is the best I can do.

One of the nurses gave me some books to read about hospice. One is very good, Final Gifts, and I would recommend it to anyone who is caring for a dying person or who just wants to know about dying. One is called How we Die. It is kind of a bummer. The author writes from an exclusively humanistic viewpoint, and I don't know about you, but there is nothing that sucks the life out like an atheist. Supposedly a person derives meaning from living their life the best they can because there is nothing else, and that is supposed to bo comforting. This author goes on about how we build up all these myths and layers to insulate us from the ultimate defeat of death, the nothingness that it entails, but we really need to face reality, death is ugly and final.

Well, gee, thanks Mr. Sunshine. I am sorry that he doe not have a personal relationship with his creator, I hope he gets one before he goes not-so-gently into that good night. I do, and I truly believe that the meaning and purpose of my life does not reside only in the physical life of my flesh, but my spirit is eternal, and the life I lead goes on from there. Death is a gateway, not a grave. I know this because God is eternal and he has allowed me to get to know him, both directly and through his written words. He tells me in his written word that we are made in his image and likeness, that there is a life after this one. Jesus talks about the poor man and the rich man who both die, and where they went. They were conscious after death, they knew where they were and where they were not. What absolute crap, and who is he to make himself an authority on what happens after death? He has watched a lot of people die. That is like saying you have sent a lot of people off on voyages, and because you have stood on the dock and watched them leave, you know something about where they went. Anyway, it is helpful in the sense that is helps me to understand the mechanics of what happens to our bodies when they die, but he oversteps it a bit with his attempts to philosophise. Stick to what you know. Anywho, that is my HUMBLE opinion.

Sunday, March 18, 2007

Spring flowers

Some of my spring surprises, we didn't know what had been planted at the house we bought, I am glad to see there were some pretties, all over the yard. I will get the tulips when they bloom.

Friday, March 09, 2007

Layers upon layers

Well, I was seeking further clarification about the trouble my daughter has been having with her scholastic endeavors, by the way she is now officially 14, yes, 14 years old, and boy is she proud, anyway, as I was saying, I was getting a second opinion about her assessments done by the schools last year to qualify her for special ed. She has a good verbal score on her WISC IV, which is an IQ test they use for assessment and screening purposes. Her other scores were all quite a bit lower. The tester(or is it testor?) attributed the lower scores on everything else to her not trying, non participation. They reported the scores cautiously, because of her level of engagement in the process. However, she had significant deficits in many areas, including perceptual reasoning, working memory, processing speed, and her WIAT scores were all on the lower end also, which shows a discrepancy between her ability, at least verbally, and her actual performance. Since they weren't going to say she had an actual LD, because they didn't think she was really trying, they got her ok'd because of emotional disturbance, and got her into a school for kids with emotional disturbances. While it has been helpful for her to get help in the area of behavior, they have taught her lots of great skills she did nto have before, they are not addressing her academic needs, she is still functioning well below grade level and is not improving. She still has trouble with work completion and says she doesn't feel like she is learning anything. She probably isn't.
On the one hand I am glad to hear that it isn't just about her emotional stuff. We knew about her ADD, but I never felt that emotional disturbance explained all her problems. I keep getting told that the ADD isn't a sufficient excuse to explain why she has such behavioral and attitude problems. I am told she is oppositional. I think she is, although I think that I would be too if I was faced with the hurdles I think she is faced with every day. I think I would be very crabby. I have blogged about her ADD in the past, and have gotten comments such as, you'll just medicate her to fix her, that sort of thing. It shows some ignorance, because the ADD is a biochemical problem, and is reasonable to medicate to correct. If she had Diabetes no one would gripe if she took metformin or insulin. Oh well.
Anyway, this Dr is taking her results at face value, her attitude is that kids don't try to do poorly and they really do care what people think, kids won't fail because they want to, they will make all sorts of excuses such as, it's boring, it's stupid, I don't feel like it, because they can't do what they are being asked to do. Taken at face value her tests show she has a nonverbal learning disability, her left brain is working ok in general with some specific deficits, in reading and writing, but her right brain is not working well, which affects her ability to do math and abstract reasoning, interpreting visual patterns, social cues and skills. She does struggle with many of these areas.
My job now is to get this info to the schools and get her IEP changed to reflect this. I don't know how it will go, they were pretty set in the idea she just wasn't trying and that all her problems are emotionsl, with a little bit of effect from the ADD. The good news is this info will help her get into the right school, we want her to go to Thomas Edison HS. It is one of the few high schools in the country which are specific for kids with learning disabilities. I have a lot to learn also, about how I can help her be the best she can be. It is so weird how different brains can be, how differently they work.
I have to admit, I have failed miserably over the years. I have been so angry with her, so frustrated, I have blamed her for not trying, I have accused her of acting stupid. I have compared her with her brother, and probably made her feel like an idiot. I am so sorry for that. I don't mean tobe that way, I don't want to be that way. I think sometimes, why me? I feel so ill equipped. I never struggled in these ways and I have no frame of reference. I have trouble believing her when she just doesn't get it. I trust that God knows what he is doing and that we are her parents for a reason, but I can't see what that is sometimes. I see people who have the kind of temperment that makes them calm and understanding, they don't get mad at their kids for struggling, failing. I don't say it is right, but it is what it is. I am not glad I feel that way but I recognize that I do feel that way. I have dealt with a lot of judgement over the years, if we just did this, if we just did that, parenting is a hard job, no one said it would be easy. Noone who has raised a special needs kid ought to say that, they should know better. Noone knows how hard it is unless they have done it. No one who has not gone through what we have can say how we ought to be, or feel or act. I have to learn how to just let her be her and not hold her up to the same uncompromising mirror I sometimes hold up to myself. Maybe being her parent is for my benefit more than hers. Maybe I am the one who has to learn from her. In that case, she could have done better, and I feel bad for her, she deserves better than I have been able to give her.

Sunday, March 04, 2007

Belknap Hot Springs

Our trip to the hot springs was great. I just wish I could have gotten more pictures, captured a few more of the beautiful things I saw. Oh well, it is what it is. I am still getting the hang of this camera, the different settings, etc.

A field near our campsite, steam from the hot spring pool kept wafting across.

Cougar Dam resevoir

And again, Cougar Resevior