Before I get to the heart of this blog, I would like to clarify something from my last blog. My decision now would be to give Bob oral antibiotics if he needed them for an infection.  On the papers for our living wills where it asks if we want antibiotics, I put a big question mark.  If Bob was worse, and I felt he was near death, I would opt not to give antibiotics.  But right now he is in a grey area, in limbo so to speak.  He is still enjoying his food, and is very responsive to me and other people, although he cannot say who we are or carry on any conversation. (For those of you who knew Bob, this is significant...)  Thanks for asking about this, Duane Hallock.
He is becoming more immobile, although he fell out of bed the other night.  I don't know how that could happen as the hospice bed has big foam bolsters all along the edges.  He was not injured, as the bed also lowers to the floor.  Hospice has brought in a lift as he is becoming very hard to transfer, and I am afraid someone will hurt their back.  It is not a Hoyer lift that I am used to and is not ideal either, but this one uses a jacket that is put on him and then the lift hooks on to hooks on the jacket.  I am afraid this is not being used as much as it should be, as it is quite cumbersome, and time consuming.  The CRNAs at The Piper were talking to the hospice bath aide the other day when I was there.  The lift is manual and they had gotten Bob stuck up in the air and couldn't get him down.  They said they were laughing and Bob was laughing!  He must have thought he was on a carnival ride.  They have figured out you have to manually push it down as well!
I would like to address in this blog something I am very concerned about.  I cannot worry about it, as there is nothing I can do about it, so it wouldn't do any good to worry.  I don't think I am a "voice crying in the wilderness" either.  I am speaking from what I observe in this area; I welcome comments on my blog if you observe something different in your area.  THERE IS A SHORTAGE OF HEALTHCARE WORKERS OUT THERE FOLKS!!  The new facilities that are opening up in this area are HUGE, and there is a new one opening all the time.  I visited someone in one the other day, and they cannot open all the wings, as there is no staff to do it.  The turnover in all facilities is phenomenal; when another facility opens up and the pay is 50 cents more an hour, everyone flocks there.  Facilities, including hospitals, use agency nurses and pay them much more than their regular staff, which is demoralizing to the loyal employees.  And this is nothing new, but the problem seems to be increasing.  Some nurses are traveling nurses--they travel to warmer climes like Florida, California, and Arizona in the winter and like snowbirds fly home in the summer, and still work for the travel agency and get their housing (in their own home) paid for.  But I have observed the downside to this.  One traveling nurse I knew traveled to Texas.  She was put in charge the first night on a unit as she was the only one that could speak English and there had to be someone there to answer the phone if a doctor called.  That is really scary; they don't know the doctors' preferences or hospital policies.  A lot of places are staffed with nurses from foreign countries. When I worked at a hospital near Washington D.C., a lot of the staff was from India or the Philippines.  They were hard working, dedicated and competent nurses, but could only work as nurse techs, because they didn't speak English well enough to pass boards.  Another business that is booming is hospice.  There are new ones opening at a dizzying pace.  They are funded by Medicare, and the government is going to wake up to that soon.  I also want to mention VA hospitals.  Our veterans deserve the best they can get, but I am afraid that is not the case in a lot of places, with the news of the long waiting lists to get treatment.  In our area, the reports vary about the care.  I think it is pretty good here, and for that I am thankful.  I know several wonderful ED doctors from Shawnee Mission Medical Center left to go to the VA hospital where they could work for 20 more years and retire with a great pension.  Can you blame them?!  I am so thankful for the healthcare workers that are willing to do that kind of work that is so demanding both physically and emotionally.
Now people that are living in these facilities are wondering if they are going to get the tax breaks for living in them that they have in the past. There are several continuum of care facilities that you get a tax break when you live there as you pay for your health care to the end of life in the package deal.  I think I can deduct Bob's care this year, but we will have to wait and see what happens in the future.
Bottom line, I would like to die in my sleep, so I would not have to go to ANY facility.  But as we all know, we don't get a choice!
I have been making pillows for friends who have lost their spouses from the shirts and sweaters of their loved ones.  As I see them grieve, I grieve with them.  It reminds me of the grief cycle of Elisabeth Kubler-Ross.  The five stages are denial, anger, bargaining, depression and acceptance.  But they are not stops on some linear timeline in grief.  I would much prefer to leave you with this quote:
"Grief never ends.  But, it changes.  It's a passage, not a place to stay.  Grief is not a sign of weakness, nor lack of faith...It's the price of love."  from Random Thoughts n' Lotsa Coffee with J.V. Manning.  Thank you Jackie Moranville for sharing the quote.
May your cup of coffee (or tea) be bottomless and your tax return be more than you expected,
Until next time,
Betty