End of Life Issues

Father’s Day

Father’s Day

Daddy is already dressed when I get to the nursing home. He wakes easily when I say, “Hi, Daddy.”  He grabs my hand and holds it to his cheek and says, “Oh, my sweet daughter.  I love you!”

I say, “I love you, too. Wanna get up and go have a snack?”

“Do I want to have a snack,” he repeats (because he repeats just about everything I say to him). “Yes, let’s go have a snack.”

I take him to the bathroom first, because he always has to pee. It’s amazing to me that this man, who has forgotten just about everything in his life, is still continent. He may not remember much, but he knows when he needs to go.

I show him where the sink is so he can wash his hands and hand him a paper towel to dry them. He tosses it in the corner wastebasket—also an amazing feat for someone who is legally blind.

I put him in his wheelchair and say, “Here, I’ll give you a free ride.”

“You’re going to give me a free ride? Aren’t you something!  You’re so special.”

“You’re special, too, Daddy,” I say.

I wheel him to the day room and park him at a table. I know where the stash of fig bars is kept, so I get him one and a glass of apple juice.

“Oh, good old cold apple juice,” he says. “Hits the spot.”

He gobbles up his fig bar and drinks two more glasses (which I don’t mind since he struggles with constipation and apple juice just might help him go).

His gaze turns to the window and he looks at the world outside the nursing home, which he rarely sees anymore. His expression is pensive as he stares out the window.

“What’s on your mind, Daddy?”

“Gosh at the traffic,” he says.

“Daddy, are you healthy and happy?” This is the question I ask on every visit.

“Healthy and happy,” he repeats. “Yes, I’m healthy and happy.”

He continues to look outside, humming his happy tune.

“Gosh at the traffic.”

I realize, once again, that my dad lives only in the present. He doesn’t worry about the future. He knows he’ll be fed.  He knows someone will take him to the bathroom. He knows he has a “good ole bed” to sleep in (and puts it to good use, since sleeping is his favorite activity).  He doesn’t know where it is or how to get there, but he knows someone will get him there eventually.

He sits there, humming a happy tune (the same one he’s been humming for almost two years), and looking outside at the traffic.

I wonder if he’s not more fortunate than we realize. He’s healthy and happy, kind to his visitors, enjoys the simple pleasures of the sunlight on the passing traffic outside, and sings his happy tune. Doesn’t worry about a thing.

I think we could take a lesson from my sweet father, so afflicted with dementia that he’s able to recognize hardly anyone these days, couldn’t troubleshoot anything to save his life, can’t dress himself without help, remembers almost nothing about his past, and most of the time admits that his mind is a complete blank. He doesn’t know where he is. He doesn’t know how old he is. He doesn’t know how pitiful his once brilliant mind is now. But he knows he’s going to be taken care of and he’s happy just knowing that.

Why can’t I be more like my father? I know I’ll be taken care of, too. My heavenly Father will provide for all my needs.  Daddy wants for nothing. That’s how I should be. Satisfied with what the Father gives to me so graciously.

My father has been my hero for all my life. And now, as I become a member of the senior set myself, I recognize that he’s still teaching me important stuff about life.

Happy Father’s Day, Daddy.

Posted by Deborah Howard in Days of My Life, Dementia, End of Life Issues, Grief, Musings and Meditations, 2 comments

For John

My brother, John David Koon, died ten years ago on February 27. Ten long years. Ten short years. It depends on how I look at it. In one way, it seems like yesterday.

Telling him goodbye for the last time on this earth, we held each other and all that would come out of my mouth was, “Oh, my dear!” That being spoken with such emotion. I’ve never called him “my dear” before. Don’t know why it came out like that. But clinging to him, tears flowing, I didn’t want to let go. I suspected I’d never see him again. Yet, I did see him again. He was in a coma that time. I snuggled next to him and cried, patting his frail hand, and telling him that if he needed to go on, it was okay. Yes, as tears flow now with the memory it seems like ten short years ago.

My little brother, John, was not perfect. But he was exceptional. Even as a little kid, his sweetness was evident. From early on he seemed to have a devotion to Christ that I didn’t share back then. No, he was touched by God in a way I wasn’t. One of my sweetest memories of him was playing Roy Rogers and Dale Evans. I’ve always been the loud one, the bossy one, the assertive one. So I insisted on being Roy and made him be Dale. Hahaha. Oh, what a sweet boy he was.

We didn’t become absolute best friends until I was around fifteen years old. I don’t know if that was because that’s when he was suddenly bigger than me, or because that’s when I was saved. But I became a nicer, more loving person then and John and I were joined at the hip. We went to the same school. We had some of the same teachers. We both played trumpet in the band. We had the same friends. We truly enjoyed each other’s company more than other people.

One summer, while we were at band camp, we were both going steady and our “steadies” weren’t there. So John and I hung out a lot that year. We entered a twist contest and if memory serves me right, I think we won. Also, we were write-ins for cutest couple. Haha. That was fun.

Our adult years were often marked by separation. I left home when I went away to college. Then got married. Then he left to move to Texas, then California and back to Texas. Then he moved back home to the Little Rock area. Later, he got married and moved to Cabot, Arkansas—about an hour away.

Through it all, we maintained our relationship. When we were together it was as if no time had passed. We didn’t do “shallow” very well, so our conversations were always at a heart level. But he was also one of the funniest people I ever knew. So we were either laughing or deeply involved in conversation—or sometimes both.

When he was diagnosed with cancer, our relationship was kicked to the next level. We were all heart-broken. His wife and little girls tried to care for him to the best of their ability. My mother was devastated. And me? Well, it was the saddest thing I’ve ever experienced, so far in my life, to watch my dear, smart, funny, adorable brother suffer the indignities of cancer. We all felt so sorry for the toll it took on him.

But he didn’t. No, he rose to the occasion. Always content to be in the shadows, he suddenly thrust himself into the spotlight with a message that inspired and touched everyone he shared it with. The message was about how gracious and good God is—even in adversity, or especially in adversity, perhaps. He spoke before churches, schools, civic groups, in waiting rooms, in restaurants. Whenever the opportunity opened up for him to speak, he was there to joyfully proclaim God’s goodness. He said he’d never known such peace and internal joy as he had through those last years of his life. It certainly showed. Every conversation centered on spiritual things. It was like he existed on a higher spiritual plane; he understood things that had eluded him before; he saw God’s hand in everything. He faced death with courage and anticipation for a better world where he would be united with his Lord and Savior, Who had just become his new best Friend. And then he died. Ten years ago.

When I think of all that has transpired in our lives since then, ten years seems like a long time ago. Since then, I’ve had six books published; we’ve added a new daughter-in-law and four grandchildren. My boys have achieved so much; and John’s daughters have grown into beautiful young women—one in nursing school, and another with two babies of her own. John’s grandchildren. Oh, what joys we’ve had over ten long years without him. And then there have been the sorrows—but the joys have been much more abundant by the grace of God.

Ten long, short years ago my brother died. I promised him once that I’d always love him and never stop missing him. I’m keeping my promise. My dear. This is for you.

Posted by Deborah Howard, 2 comments

Double Grief

People talk to me about grief. I spent over 20 years in hospice, so they know I’ve seen my share of pain and sorrow. I’ve always tried to be approachable whenever someone needs to talk about their loved one.

Recently, a sweet young woman approached me with a question regarding her mother, who has been told there is nothing else they can do for her. First, let me reiterate what I’ve written in a couple of my books—there may be nothing more that can be done medically for a patient, but there’s never a time when nothing more can be done to improve their comfort and quality of life. That’s one reason I love hospice as much as I do.

Losing a mother is hard. As my mom is fond of saying, “No one loves you like your mama.” I think that’s true. A mother’s love for her child is special, and unique. And no one else could love you that way. But the same is true of you. Who you are when you’re with your mom is probably different from who you are with other people—even your spouse or other family.

My mom and I share so much. We have our own language—one made from all our little private jokes and shared experiences. And I know I relate differently to her than to anyone else. Thankfully, I still have my mom. We still talk and laugh and have fun together. But if/when I lose her, I will also lose that part of me I am with only her.

That’s not true just with mothers. I think we adjust to the various close people in our lives—incorporating little differences that only the two of us share. That’s why anytime we grieve the loss of someone we love, we lose a little of ourselves. In this way, our grief is doubled. That’s why we can be grateful when we know our loved ones are in Heaven, but still so sad at their loss—because when they died, they took that part of us that belonged only to them.  We miss them. And we miss who we are with them.

Fortunately, that’s not the end of the story. We will not grieve for eternity. Yes, time erases some of the intensity of our grief, but it never stops us from loving and missing that person. Yet, the Bible speaks of death as a temporary parting. One day there will be a reunion for believers in Jesus Christ—a glorious day surrounded by more love than our keenest imagination can invent. Oh, what a day that will be!

Posted by Deborah Howard in Cancer, Counseling, Days of My Life, End of Life Issues, Grief, Musings and Meditations, 1 comment

Aging Jars of Clay

Some people are uncomfortable around old folks. I have rather an affinity for them. My work in hospice placed me in close, intimate proximity to the elderly—as the majority of my patients were older.

Even before that, I remember observing old people I encountered through my life. I’d especially study their eyes—trying to see the intelligence, humor, personality, and experience reflected there. For some reason, I’ve always been able to see them as older versions of myself—with skills, energy, physical stamina, their own kind of beauty, passion, and interesting experiences. My imagination allows me the freedom to recreate them into the way they must have looked in their youth. The common tendency in our society is just to see them as old, and all that comes with that–including their disposability.

Standing recently on the beach, I looked across the water, which has always been a spiritual experience for me. The beauty, the power of the water, the gentle breeze blowing softly through my hair, the sounds of the gulls overhead, the feel of the sun upon my skin, the smell of the salt in the air—all of it welling up within me, filling me up to overflowing with awe for a God so great that He could hold that immensity as but a drop in His hand.

It paints a pretty picture to imagine a beautiful 20-something flat-belly with cornflower eyes and long flaxen hair staring out across the ocean, her smooth, soft skin shimmering in the sunlight, her long, lithe, strong legs supporting her with the water lapping around her exquisite ankles.

Haha. I was kind of that girl once, about a million years ago. I may be forty years older and 100# heavier, but I’m the same person, and on the inside I still feel like I did when I was in my 20’s. When people see me now, do they see that girl of long ago? Or do they only see a fat, old lady with thinning hair taking up space on the beach? Perhaps they don’t even realize I’m looking out through the same eyes, feeling the same passion for life and waves and God as I did when I was young and fine. It’s not as pretty a picture, but it’s just as poignant to me.

Let me encourage you young people to try an experiment next time you find yourself sitting next to an elderly person. Instead of looking upon them as just taking up space in a world meant for the young, try to see them as a repository of rich stories, of relationships gone wrong—or right. These people were young once, too. They had dreams and hopes and aspirations. Some realized those dreams—others didn’t. But try to open the lid to see what’s inside. Remember, when they look into your face, they’re looking through the same eyes they had when they were young and fine. You just might be surprised what you find in their depths.

Posted by Deborah Howard in Counseling, Days of My Life, End of Life Issues, Musings and Meditations, 0 comments

Look to the Hills!

We’ve been covering some of the Psalms of Ascent in our Sunday School class. The Psalms of Ascent are Ps 120-134. Though we’re not told what this tiny subscript under each heading of these psalms means, it is generally understood that these are psalms sung as travelers made their way up to Jerusalem.

One of the commonalities is the theme of trust in the Lord. I’ve written a lot about trust and that subject has been on my mind lately. In his book, Longing for HOME: A Journey through the Psalms of Ascent, J. Stephen Yuille says, “to trust in God is to rest in who he is,” (pg 66). I believe that’s a fitting bottom line.

Our trust in Him doesn’t depend on our ability to hold on. If it did, we would fail every time. We trust imperfectly. Yet we are to continue striving for complete trust in Him. Spurgeon wrote that the sovereignty of God is the pillow on which we rest our heads. The better we comprehend His character and attributes, the more fully we can rest in who He is.

Instead of our faith and security depending on our tentative hold on our Savior, we can “rest” knowing that He holds us instead. Psalm 63:8 says, “My soul clings to you; your right hand upholds me.” Therefore, the reason we can rest in our security in Him, no matter what our earthly circumstances may be, is because His righteous right hand holds onto us!! That grip will never falter.

Let me close by quoting my favorite of these Psalms of Ascents. Psalm 121:

“I lift up my eyes to the hills.

From where does my help come?

My help comes from the LORD,

Who made heaven and earth.

He will not let your foot be moved;

He who keeps you will not slumber.

Behold, he who keeps Israel

Will neither slumber nor sleep.

The LORD is your keeper;

The LORD is your shade on your right hand.

The sun shall not strike you by day, nor the moon by night.

The LORD will keep you from all evil; he will keep your life.

The LORD will keep your going out and your coming in

from this time forth and forevermore.”

 

So, regarding my own heart, I cry out, “Lord, equip me with the kind of faith and belief and trust in You which will allow me to rest in Your perfect sovereignty. When my head hits the pillow at night, let me close my eyes in the peace that comes from loving You.”

Posted by Deborah Howard in Counseling, Days of My Life, End of Life Issues, Grief, Musings and Meditations, 1 comment

Against All Odds

My grandmother once told me that the hardest part about getting older was losing everyone who shared a memory with her. We might all know the stories, but we weren’t there at the time, she said. She was 84 when she died. By then she’d outlived most of her friends and all of her sisters and brother.

In a week, my father will turn 84 years old. He’s outlived most of his friends, too. That’s astonishing considering that no one expected my father to live beyond 33. That’s how old he was when he was found to have two brain tumors. We were told their location was so complex the only doctor who would have any chance of successfully removing them was in St. Louis—Dr. Henry Schwartz, at Barnes Hospital. Dr. Schwartz gently told my mother that there was a high probability Daddy would not survive the surgery, and that, if he did, he might need to be institutionalized for the remainder of his life. Yet, it was a certainty that he would die without the surgery.

He survived. He did not require institutionalization. He was severely impaired, at first, and needed a lot of care, which my mother selflessly provided. But then he began to improve. No, he was never the man he was before the surgery, but he was able to return to his life and career as a band director on a limited basis.

My parents had lots of friends. I believe most of them suspected Daddy wouldn’t be with us long—that, as fragile as he was, there was no way he’d survive long-term. They felt sorry for my mom who valiantly rose to the occasion, taking care of Daddy for the next 50 years.

Ironically, most of those friends have died by now. And my mother’s health is failing. But Daddy’s doing fine. He’s healthy and happy. He’s outlived almost all of them.

The surgeries took their toll on him, mentally, though. That once bright mind began slipping. For the last twenty years, he’s drifted away from us in a slow downward spiral. He’s retained his sweetness and charm through it all, but now he’s a mere shell of who he once was.

I still see glimpses. That smile. Those beautiful, soft hands. The kindness. The Southern politeness and propriety. I still get to hold his hand and tell him what’s going on in the family—even though he may not remember who they are.

My father never felt sorry for himself. He counts himself blessed and never complains. Since he requires 24/7 supervision he lives in a nearby nursing home. The other day I took my mom for a visit. They sat together in the day room holding hands.

She asked, “Joe, do you know where you are?” “Yes, I know where I am,” he replied. “Where are you?” she asked. Daddy looked around (and doesn’t really have a clue where he is), but he beamed at her, “I’m somewhere sweet.”

That’s all that counts.

Posted by Deborah Howard in Days of My Life, Dementia, End of Life Issues, Musings and Meditations, 3 comments

Death by Suicide

Wrapping your mind around suicide. How can one do that? It’s senseless. Selfish. Cruel. Needless. A permanent solution to a temporary problem. So many words and phrases come to mind when trying to understand the mind and motives of a friend or loved one who commits such an unbelievable act.

I’m reeling from the news that a dear friend died in such a way a couple of months ago. I’m just now hearing this, so my grief is fresh and pierces my heart with sorrow—and yes, some anger, as well.

He’s been on antidepressants for years. Lately he started drinking more and more heavily. Alcohol + antidepressants is a terrible combination and the literature clearly states that if you’re on an antidepressant, you must avoid alcohol. Too few people read the literature, though. Too few know what a dangerous combination this is.

My friend was so drunk one night that his anger and emotion tangled with his ability to think rationally, and he took his life in a moment of time when he could think of no other way out of his pain and fear. I truly don’t think he could have/would have done this when in his right mind.

When he pulled that trigger, he set into play a cascade of consequences—none of them good. His family, his friends—so many friends—were plunged into grief that has no words, only disbelief and pain too intense to describe.

Another consequence is the “if only” syndrome. If only I’d known he was so disturbed. If only he had called me, had given me the chance to talk to him. If only I’d stayed in closer touch with him. If only . . . 

In my book, Sunsets: Reflections for Life’s Final Journey, I quoted Erwin Lutzer, who wrote, “Let me encourage you to take those ‘if onlys’ and draw a circle around them. Then label the circle, ‘The providence of God.’ The Christian believes that God is greater than our ‘if onlys.’ His providential hand encompasses the whole of our lives, not just the good days, but the ‘bad’ days too. We have the word accident in our vocabulary; He does not.”

In the chapter on death, I wrote about suicide. “A moment of thoughtlessness leaves loved ones struggling with anguish, confusion, guilt, and pain. Suicide is the ultimate selfishness.” I still believe that.

I know some people suffer unbelievable pain—physical or emotional—that I cannot truly fathom. But, if you are toying with suicidal thinking, please talk to someone—anyone!! Call a pastor, trusted friend, or suicide prevention hotline (800-273-8255).

Whatever you’re dealing with can be resolved. Tomorrow things may change! A month from now the whole problem could be a thing of the past! A year from now, you may not even remember today’s dilemmas. There are always better options than suicide.

Please, choose life!

Posted by Deborah Howard in Counseling, Days of My Life, End of Life Issues, Grief, Musings and Meditations, 0 comments

God Puts Us Where He Wants Us

God puts us where He wants us.

As an RN, I round for a brilliant gastroenterolist one weekend per month. It’s amazing how many times I know why God put me there in that hospital on that day. Perhaps He put me there for one person—perhaps for more. But as I drive home, my heart is so full of gratitude when I know He’s used me to make a difference in other peoples’ lives.

After all, don’t we all pray that God would use us as a vessel? Don’t we want Him to use us to bless others?

But I didn’t want to work this weekend. Last Tuesday I injured my knee playing tennis and hobbled on it painfully for days. I tried to get someone else to cover this weekend. Everyone was busy. So God blessed me by a) healing my knee well enough for me to work on it, and b) using me to make a difference in one family’s life.

Back when I was an on-call nurse for hospice I sometimes resented my pager going off—especially if I had to leave church to respond to a call. Sometimes I fumed all the way to the patient’s house.

But something happened once I actually got there. I’d walk in to see pain and distress, the situation in chaos. And, because of my training and experience, I was in a position to bring them comfort. I knew what to do. When I left that house, I realized that I’m the one who received the blessing that day. No, I didn’t get to finish the worship service, but I did something else. I tended His flock.

You simply can’t out-give God. Even on the occasions when my utmost desire is to serve others, He finds a way to bless me by the experience, to leave me breathless with gratitude. It’s thrilling when God uses you to help someone else.

So this weekend, an elderly patient got some very bad news. Terminal cancer that had already spread. He and his family were still coming to grips with it. I was there to help at a moment when they needed just that! I won’t share the details but suffice it to say there was some rejoicing in God’s sovereignty. This man knew he wouldn’t die a moment before he was supposed to and told me he was ready any time the Lord called him home. They tearfully thanked me for my visit. I don’t know if they noticed the tears in my eyes, as well. No, I didn’t know them, but it’s amazing how we, as believers, are part of the same family in times like these.

My knee was really angry about me working this weekend. But I told it to stop its whining. I knew why I was supposed to be there. And that was far more important.

God put me where He wanted me. That’s enough for me.

 

Posted by Deborah Howard in Counseling, Days of My Life, End of Life Issues, Grief, Musings and Meditations, 1 comment