Knocking On Unknown Doors

With each new client there is a new world upon which I enter. I start each visit with an address, phone number, name, and diagnosis. Each new client is a challenge, an unknown that I must face as I walk up to unfamiliar doors. Questions race through my mind as I wonder who will be waiting for me. Should I knock or walk in? Should I say the word 'dying'? Should I leave my shoes at the door? Will this be a well kept home? Will this be a 'dysfunctional' family?

Behind my uniform and name badge is someone who feels she doesn't quite know what she's doing. "All I do is rub their feet" I say. "How hard is that?" I remind myself that half the challenge, is the attempt at doing it. The willingness to go into a home filled with grief and attempt to do something that is frightening to most everyone. Massage with hospice patients is not difficult in terms of technique. It is the simplest form of massage. Much of what is difficult is the intent behind the motion. The putting your fears aside to alleviate the fears of others. To look family in the eye and say "If C is with us next week, I will be back" and not feel embarrassed about pointing out that I might not be back. To touch someone who is dying. To give to them what their family possibly cannot.

I do this each week with trepidation. I wonder will this be the last week I can face this, and by the end I say "No, it will not". I started this to challenge myself and beliefs and I'm not finished yet.

*****

The trepidation on the job is matched by a over-assurance off the job. When I am around others not involved in hospice, I feel like I am the keeper of sacred knowledge. My ego is kept in check with every hospice visit that follows and by my mother. My mother is sweet and unassuming in nature. She has been working with the elderly either in nursing homes or hospice for 35 years. My experience with this is nothing in comparison. I imagine that the novelty of newly acquired knowledge will temper itself and then I will see this all with less fear and cockiness and hopefully a higher level of understanding about life.

The days when ... are gone.

Today I went to see my client in the Long Term Care Facility (a.k.a. Nursing Home) where she has lived for several years. As I was waiting for the elevator I noticed a board that listed the residents and what rooms they were in. It was a very nice wooden frame with each name printed on a golden plate. It looked very elegant, except for the half a dozen white print outs placed in their for the newer residents. I wondered, did they give up on having the names printed on the shiney metal plate, or are they just waiting for the order to come in and the white ones are just place holders. I wondered how long it took to get a name plate, and did people pass away before they arrived. Before I could ponder any more the elevator came and I was on my way to my visit.

After the visit, I bumped into one of the hospice nurses who was there to see a different client of ours that had denied massage therapy services. This client wasn't doing well, in fact, should could die tonight, if not tomorrow. I remembered her name was one of the names on the white strips of paper.

The elevator opened for my return to the main floor and it was filled with staff from another floor. They were talking work business and I followed the conversation only on the basic level. As they were exiting the elevator on the floor before my stop, I heard, "...the days when people are here for 15 years are gone. Now it's just rehabs and short terms..." and then doors closed. At first I thought she was talking about employees working for 15 years or more at the same place, but quickly realized she was talking about the residents. She sounded a little wistful for the old days. I imagined she missed getting to know residents and their families over a long period of time.

As I exited the elevator I pondered why this was happening to the nursing homes, and it didn't take long for me to cite hospice programs as a reason. Of course hospice had an influence! Hopsice programs were making it possible for families to care for their loved ones at home for as long as possible. They weren't shipped off at the first sign of trouble, instead we were helping them until their illnesses required the care of a 24 hour nursing solution. To me this meant more families are taking care of each other and more people were dying at home among their families and comforting surroundings.

Maybe hospice can't take all the credit or blame, as it may be, but we can hope that we are doing some good and that it is starting show up in the larger picture.