Much closer to home

I had mentioned in an earlier post that my grandmother was dying and that she was admitted to hospice. This was about a year ago, and she pulled though and was doing great, until a month ago. She is back in hospice, with an even short life expectancy than before.

I went to see her on Sunday with my father and we chatted and cleaned her house for her and visited with the other relatives that were there. I gave her a back and leg massage in her chair and she really enjoyed it. I felt good about being able to do something besides just sit there and be the granddaughter amongst the hubbub of visitors.

Kneeling down by her chair, rubbing her legs, my grandmother started talking to me as an adult, something she rarely does, even though I'm 32 years old. She normally tells me to 'go ask your daddy' things, instead of asking me what I think. This day she told me that she "wasn't faking this, as some of them think" and I let her talk. I did what I always did working with hospice patients, I let it be their time and let them have what they needed.

I left feeling drained and depressed. This is much different. Providing care for your own grandmother, and not someone elses. When I worked in Hopsice there is that magic thing called "boundries" and the knowledge that your responsibilites lasted the hour a week you were in the home. With this I took home much more information that I wanted about my aunts and uncles, about my cousins, about who is being nice, and who is being mean. I just don't want to know.

I rode home with my father, an hour drive, in a pseudo silence. A silence about what we had just expierenced. He is greatful for my help with the massage and my calm demenor during the visit. There is enough arguing and crying and flitting about these days.

Lessons Learned

It's been almost a month since I've left the hospice program. 

I still scan the obituaries to see who has passed away, and whether or not I knew them. This last week one of my clients that I had been seeing for over six months finally passed away. I was surprised at first, but in the end I was glad that she is finally at rest.

A few weeks before I left, I had a new client who was recently diagnosed with terminal cancer. We bonded right away and I was able to give her her first massage ever. She was very excited about it and couldn't wait to brag to her daughters about her massages. I've heard through the rumor mill that she really misses me and the massages I gave her.  It was when I heard that she missed me that I had the first pang of loss about leaving my clients. I wanted to say, I'll see her anyway! I'll go over there on my own! But I can't do that. With all the laws and ethics and liability I can't just go over and give this woman what she needs... though in doing it, it would be giving me somthing that I need, too.  

I went into the job hoping to squash my fear of death and the unknown. That didn't happen exactly.  I learned to face towards death and not close my eyes, but the fear is still there. I learned more about love and families than I ever thought I would. I learned to tell people how you feel and to let go of material things because they aren't worth fight over in the end. I learned about the letting go, but I haven't learned how to achieve it yet, and there is still fear.

 I believe this is still progress and I hope that it will help me in my next challenge-- deal with the death of my grandmother who collapsed today and left the hospital with a prognosis of three weeks to live. 


 

Anticipation

Tomorrow is my last day of hospice. 

It will be a good day. 

The two people I see are the most recent clients, and they are great clients.  Both had never received massage before and one took a little convincing, but they both really enjoy it.

Hopefully, all will go as planned... but as I've said before... don't count on your day going as planned in Hospice, they never do.

The First Day of School

I am feeling the anxiety pains of leaving a job I helped to create. 

I knew that when I left they would have trouble replacing me because of the qualifications required for the job. It's not that I'm extra qualified in the world of massage therapy. It's more that for this region I have the papers that say I know stuff. Hospitals like papers that say you know stuff. There are a few of us over here in the sticks, but not many. And of us, there are fewer who are up for the challenge of working with the terminally ill. 

I helped start and develop the MT portion of the hospice program here and I am worried that it will suffer with my absence. Part of the reason I needed to leave was the amount of work it took to start this program and grow my private practice at the same time.  It takes constant attention outside of the actual massages I give.   I needed to be there continually educated my coworkers and clients and remind everyone what I needed to happen to make this program work. This is fine if you can dedicate all your time to this process.  I was doing this very thing for my private practice and being a constant representative for two causes can be overwhelming. 

I am worried that when they find my replacement it will be months after my last day and the momentum of what I helped start will have waned. I worry. I feel like a mother sending her child to preschool. Will it be okay alone for a while, without me to nurture it? 

I have to have faith that it will survive and grow to be a better program.  I am of course sad that it wasn't me to make it great, but I did help get the thing off the ground. 

I can't forget my other child, the business that I started and is in desparate need of my attention. There are something there that I have neglected and need attending before they go awry.  

Time to let go... 

Enormous Guilt

I heard a phrase last week and it all became clear. Compassion fatigue.

I had a fantastic experience visiting Chicago taking a class on improving my clinical outcome with head and neck pain. It was fun, educational, and it reminded me how much I love practicing massage therapy. I like working with people and making their lives a little better. I like seeing the improvement in their range of motion and out look on their day.

In order attend this class, I had to take two days off of work. When I returned one of my clients had passed away. I was crushed. I felt enormously guilty for not being able to see him one more time before he passed. I took a deep breath and let the guilt pass and then turned in my resignation.

It seems I'm not able to seperate this emotions from this job from affecting my life outside of the job. There are enough things that make us feel bad and decided four years ago when I began this career path that I was never going to feel bad about going to work again. I am not the right person for this job, and for this I am sad, but not devastated as I thought I would be.

I have learned a tremendous amount about the value of positive touch and the dying process. I will never regret taking this job, but I do not believe I will regret leaving it either. I do not ever want to have my passion become a burden, the minute it does, I will have to stop doing it because I am of no value to my clients if I do not love what I am doing.

I am hopeful that the therapist that replaces me will have this passion and bring what is needed to this position. I am excited about the chance I know have to dedicate more time to my private practice. To be reinvigorated by my recent educational travels and channel that energy and excitement to benefit my clients.

I think I may keep this blog going for a little while as I still have a month left of the job and I am sure with the stress of the job off, I will possibly come to some more conclusions about this experience.

I encourage all massage therapist with intrest in hospice massage to explore the possibilities in your area. It is definitely worth your time. A life lesson to say the least.

Two Years Already?

It seems like I was just making posts last week about how I've been doing massage for hospice clients for a year, and now it's almost to the two year mark.

I expected this job to be more than a job in a lot of ways. When you sign up to bring comfort to the dying, you think to yourself "This is going be a an amazing, scary, fullfilling, life changing job". You pat yourself on the back for having the cahoonies to take the job in the first place. You feel good about the recognition you recieve from your peers, friends, and community. In a lot of ways the job is like how I expected to be. Some of the most common things I hear are "I could never do this", "It's so great that YOU are doing this for people who really need this", etc...

It didn't go to my head too much though, because I still had my mother, who is a hospice nurse, to give me some doses of reality. My sister said something to the effect "This is the last job I would expect YOU to take" and she was right, this position was a bit of stretch for my personality. The reality of the position, is while you are helping people while on visits, the times you are in the office are very much like any other job. There are co workers who don't shut up while you are trying to document your visits, nurses who still don't write a referral for MT correctly, state inspectors you have to perform for, and paperwork that boggles the mind.

The funny thing is, I have a much less glamorous job as a Chiropractic Assistant that seems less like a job than this one does. That was not what I expected when I signed up to "change peoples lives"

I've come to conclusion that this is a very worthwhile, fulfilling, giving thing to do as a massage therapist. It is definetely something that we need to see more of in hospice programs across the nation. When I graduated from massage school, I was asked to give the speech for my class during the ceremony. I gave a nervous speech on Passion for what we do... I felt that passion that day and I feel it for my private practice, but I don't feel it doing thing work for hospice anymore. People in hospice deserve that passion. I see it in the nurses and aides that work with them, I see it in the clergy and social worker that visit them, but I don't feel it in me and I think that is wrong.

I am thinking about leaving hospice, but I want the person who replaces me to be committed and passionate about what they are taking on. This has been a difficult realization for me to accept. It's nice to be thought of as an amazing person for working with dying people, but that's not the reason to do it.

I imagine it will take me several months to go through with this in the end. There are logistics and of course the aformentioned 'cahoonies' to give up in the middle of something that is going so well for the other people involved.

The First Has Left

Today the first hospice client I ever treated was discharged from hospice. She had stabilized and even gained a pound of weight, so it was determined she no longer was in need of hospice services.

I have been wondering for so long what it would be like when I wouldn't have her on my schedule anymore. I have been seeing her once a week for two years. I honestly didn't think it would be because she was discharged, and it is almost a relief. I got out of having to deal with my first client pass away.

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I've come to notice that a lot of people who are referred to hospice see it as the first step in a death sentence... and I guess I could see how they would feel that way, most of the time it is. Instead of taking advantage of hospice right away, they wait until the last minute when there is little time left for help to be given.

I guess I would be the same way. I would like to think that I'm enlightened and would face death without fear, but I know that isn't true. If there is one thing that this job has taught me, it's that watching other people die doesn't solve my issues. It's not the death of others that I fear, it is my own. That is something I still need to face on my own.