Life, Death, and Everything in Between

This post is in honor of National Hospice and Palliative Care Month, which ends today.

I wasn't always passionate about palliative care, hospice, and end-of-life issues. In fact, I distinctly remember a time when I was very much on the "do whatever necessary to keep someone alive" bandwagon. When I was in high school or college, my maternal grandmother told me about her "living will" and desire to not be resuscitated if she stopped breathing. I was horrified. She was in her late 70s and in fairly good shape for a woman her age, but she did have a heart condition. In my youthful arrogance, I imagined myself ignoring her wishes, doing CPR anyway, and having her thank me when she woke up because...why, I don't know.
My views on that subject began to be more flexible when I went to seminary, which tends to be a time of examination and reformation of values, anyway. As I formally studied ethics for the first time, I began to become a little more open-minded. During my final semester of seminary, the Terri Schiavo case was front and center in the news, and there was a lot of discussion in our community around that issue.

However, it wasn't until the summer after I graduated from seminary that my current passion for end-of-life care was kindled. As part of my requirements for ordination, I did a unit of Clinical Pastoral Education at a local hospice. (In case you're not familiar with Clinical Pastoral Education, or CPE, it's basically supervised chaplaincy work, reflection in groups and one-on-one with a supervisor, and teaching seminars.) Over the next ten weeks, I learned so much about intentional living and dying, quality of life vs quantity of life, and the courage it takes to stop curative treatment, accept the end of your life is near, and do whatever possible to die on your terms. I was able to walk with several patients and families on that journey. One of my favorite memories was spending time with Charlotte, a patient with terminal cancer, the day before she died. We had gotten to know each other fairly well, and it was both painful and rewarding to pray with her and tell her goodbye, knowing that the next time I saw her would be in heaven. She died on her terms; surrounded by family in the inpatient hospice unit.

The phrase "dying with dignity" is often tossed around by those of us in "the business", but it's really a misnomer. Dying, in and of itself, is completely undignifying. After all, by the end you lose control of most things and are totally dependent on other people. I think a better phrase is "dying with as much dignity as possible", but I guess that doesn't sound as pretty.

The fact is, one of two things are going to occur: either Jesus will come to us (i.e. the Second Coming) or we will go to Him (i.e. death. I'm not preaching universal salvation; I'm simply saying that I believe we will all have our five minutes with Jesus before going to our final destination). Unless Jesus returns in our lifetimes, WE ARE GOING TO DIE. Moreover, we don't know how or when that will occur. I may be only 34 years old, in good health, and live a low-risk life, but I could die tomorrow or I could live another 60 years. Or, something could happen and I could receive devastating physical and/or mental injuries. I don't know the future, and neither do you. Only God knows the future.

Therefore, it makes complete sense to me to make some preparation and do some reflection on the future, and I encourage everyone else to do the same. First, everyone over 18 should have an Advance Directive (click on the link for more information and a way to download one that meets your state's guidelines). If Terri Schiavo had had one, then the whole fiasco over the feeding tube probably wouldn't have happened. Second, you should discuss with your family (parents, siblings, spouse, or children depending on your place in life) what your wishes are in regards to artificial life support, organ donation, and the like. That way, if you can't communicate your wishes, your family and Advance Directive can do it for you. Third, think about what gives your life the most meaning, and what you might be willing to give up in order to prolong your life. For example, my mother had to "back away" from some things she's been doing for years and LOVES, because of the time commitment and side effects of her chemotherapy. However, for right now, she feels that it's worth it to give those things up in order to have a fighting chance to have more years with her family (not that it's my decision to make, but I agree).  Finally, if you're over 60 or have a major health condition, I would also have a funeral home picked out and (if you're not a part of a local faith community), have an idea of who you would like to do your funeral. There have been so. many. times. when I have worked with a family whose loved one is dying/unable to communicate/just died and they are lost as to what to do, what the person would have wanted, what funeral home to call, etc. Advance planning, as difficult emotionally and logistically as it is, can make things so much easier when the moment comes.

And if you can afford it, get life insurance for yourself each member of your family. It's not uncommon for funeral expenses to run past $10K, so I would recommend at least that much, if not also enough to pay for outstanding medical bills, joint debts (if you're married), and any other transitional expenses.

My grandmother died in July of 2009 as a result of her heart condition and injuries resulting from a fall a few months prior. She simply went into cardiac arrest, and since she was a DNR (Do Not Resuscitate), that was that. I was not with her when she died, but if I had been, I simply would have held her hand, told her I loved her, and let her go*. Because it was what she wanted, and it was the best way for her to die with SOME dignity.

*Not that it would have been my decision. She had actually made my cousin Mike her power of attorney, so he would have made the decision. But you get my drift.

I'm jumping off my soapbox now. I could write another several paragraphs, but your eyes are probably already glazing over. (: However, if you ever have any questions or comments, leave them in the comments section below or e-mail me, and I'll be happy to either answer them or point you in the right direction. I'm not an expert by any means, but fairly well-informed and very passionate on this subject.

Quick Takes, Sick Baby Edition

1. Sheesh, I'm tired, and I'm on call tonight and then on Monday night.

2. The reason I'm tired is a certain little boy named Gregory James who is sick. The sickest I've ever seen him, actually. Last night he really didn't sleep, except for a two-hour period. Today he had a fever (101 and higher), a bad cough, and for several hours was exceedingly fussy. He seemed to feel better after his afternoon nap, but he still didn't want much to eat, so I'm worried about dehydration.

3. We put up our Christmas tree today. It's not decorated, but probably will be in the next day or so. I've never been a huge fan of putting up the tree so early (Advent and all), but last year we couldn't find any lights TWO WEEKS before Christmas (we save the lights every year, but some always don't work the next year). So, this year we're putting it up early.

4. Being a PRN (as-needed) chaplain is either feast or famine. A few weeks ago I was in the middle of "feast" mode: lots of extra on-call shifts, one regular day shift, and plenty of pages while on-call. Right now, I'm in the middle of "famine" mode: I've had about eight on-call shifts in the past three weeks, but only one of them has netted an actual page (I get paid $1.50/hr for carrying the pager, and then my regular hourly rate plus a "shift differential" whenever I answer a page), so my last paycheck was fairly small. However, that's going to change. I have three daytime shifts scheduled for December in addition to my regular twice-weekly on-call duties.

5. I bought Susanna the Candyland game at Target this afternoon because it was only $4 and I thought she'd like it. The first time, she was more interested in the pretty game board and the cards than the actual game and rules. However, the second game (which she played with James) was a little bit more fruitful. We shall see. Of course, now she'll be asking me to play Candyland every five minutes, but that's what parenthood is about, isn't it?

6. My traffic has really not picked up very much, and I was hoping it would as a result of my posting (almost) every day this month. I'm thinking of doing NaBloPoMo again in December (it's actually an ongoing thing you can sign up for now, not just a once-a-year deal) and actually making it all the way through this time. Maybe then I'll get more traffic...we shall see. Any suggestions?

7. Remember my de-lurking post from a week or so ago? I've done what I said I was going to do; I've left comments on just about every blog I've been "lurking" on and have begun "following" some new bloggers on Twitter. I feel good about that, and it will be interesting to see if any new Internet friendships come out of it.

Greg is crying! Bye!

Seven Quick Takes, Sunday Afternoon Edition

1. I totally skipped blogging the past three days because I'm trying to get the house somewhat clean. Emphasis is on "trying." It's not working. I'm horrible at housework and incredibly envious of those women who can have two (or more) children underfoot and still keep a reasonably clean house.

2. Greg is getting baptized next Sunday. We're very excited. He will be wearing the Heirloom Baptismal Gown that his great-great-grandfather wore in 1869? 1879? Anywho, a long time ago. Susanna wore it when she got baptized...at ten weeks of age. Because of all the craziness of this spring and summer, I didn't feel like having Greg baptized right away. So, Greg will be nine months when he gets baptized (Methodist theology does not associate baptism with regenerating grace, so unbaptized babies still go to heaven). It will take a little maneuvering for the gown to fit him, but we're making it work. It's all about TRADITION, darn it. And not wanting to fork over the $$ for a new baptismal gown.

3. I've begun applying for full-time chaplain positions. I love staying at home (most days), but I need to be ordained by 2015 or begin the whole process over again. I need two more years of full-time ministry before I am eligible for ordination. I don't really feel that going back to the local church is an option right now. Therefore, I am looking for chaplain jobs. I applied for three this week, but the job market is fairly competitive in this field, so I'm not sure what to expect.

4. We got a new stove on Thursday. Our old one was original to the house (1994), and while it worked, the thermostat was funky and so things would sometimes take too long to cook or get burned because they cooked too quickly. The new stove is AWESOME. It is a double gas oven, self-cleaning, and BLACK. I love black appliances.

5. We also got a new, over-the-range, microwave. It is also black, to match the stove, of course. Now all our kitchen appliances are black! Woohoo!!

6. I have to  want to buy myself a new winter coat. My current winter coat is "wearable", but I bought it when I was DATING James and we've been married for nine years. There are a few holes in the lining, too. I think a new winter coat every ten years is a reasonable purchase, right?

7. On that topic, I'm deciding whether to buy a traditional, wool coat that will keep me warm even if the temperature goes down into the teens OR buy something lighter that will keep me warm as long as it's above freezing. Here in Hampton Roads, it's pretty rare that it gets REALLY cold and most of my time is spent indoors or in the car. So, I'm leaning towards the latter, especially because that sort of coat will be cheaper. And I can always keep my old coat in case we do get Arctic temperatures.

There you go! Happy Sunday afternoon!