“Being prepared to die is one of the greatest secrets of living.” George Lincoln Rockwell


It is strange the number of Stepping Stone Hospice referrals we have received over the past two weeks.  The patients have controlled pain and symptoms.  Many caregivers are also looking for a dumping ground.

Pain at the end of life is inescapably interwoven with, and often amplified by, multiple levels of emotional and spiritual angst as the inevitability of death looms. Fear, a potent pain magnifier, is the dominant emotion – fear of pain, fear of death, fear of the unknown…..

It is a fact that people at the end of life fear pain even more than they fear death. Sadly, for many dying patients, pain seems like the ultimate torment, and death is its cure. It does not have to be this way, and if you or a loved one is facing death, you have every right to ask that your final days not be consumed by pain.

It is estimated that a maximum of 5% of people who die from terminal illnesses in South Africa have access to adequate palliative care. Even in hospitals, treatment is far from ideal, because doctors and nurses have seldom had training in palliative care and have little idea of what to do with the patients.

Dying patients are often prey to a host of anxieties about the state of their affairs, about the fate of those who will grieve their loss, and about how their behaviour will be seen, and possibly judged, during their final hours. And of course, there are often deep spiritual and religious questions to address. Did my life have meaning? Will my soul survive my body? Am I at peace with myself, my family, and my friends?

Not least of all these concerns, people at the end of life worry about how their pain will be managed. Will they be under medicated and have to ask, or even beg for relief? Will they be over-medicated and lose consciousness during their precious waning days and hours?

They may even be afraid to complain. If they do, will they be seen as whiners or quitters? If they ask for narcotics, will they be judged by their doctors as drug seeking, drug addicts or even cowardly? Or will their medical care be relegated to comfort measures only, while all efforts to cure their illness are suspended?

I read the post of an amazing woman who is suffering from congenital heart failure.  She is in so much pain.  I cried when I read her post.  http://thedrsays.org/2012/11/08/  She replied to a question whether better pain control was possible…..  “there is nothing that will let me participate in life and have relief. so at this point i am going for being lucid over some so-so pain relief. who knows how long before i cave. when the time comes i plan to take advantage of whatever is available to me. just my personal choice right now.”

I thank God that we are able to make a difference!

“Being prepared to die is one of the greatest secrets of living.” George Lincoln Rockwell

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Vic and Nelson Mandela meet


It was a horrible time of our lives when Vic started going to the Pain Clinic.  Her pain was out of control – or so I thought.  It was actually just “preparation school” for what was yet to come….  I was mortified that she was on 600 mg of morphine, a week…. When Hospice accepted Vic onto the program in 2013, a mere 9 years later, she was already on 600mg of morphine, twice per day.

I digress.

Vic needed to consult with an anaesthetist, specialising in pain control, on a monthly basis.  He would examine her and re-evaluated her pain medication. We need an original prescription for morphine. It was one of those dreadful experimental phases of her life.  But, bad things lead to great things…

The Pain Clinic was situated in an élite part of our city.  It was a mission to get to it and took many hours out of a day.

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“If you wish to remember me, do it with a kind deed or word to someone who needs you. If you do what I have asked, I will live forever.”

This particular day Vic was in terrible pain, and it was difficult moving her from the car into the wheelchair.  Her beautiful eyes were dark from pain and filled with tears. I remember thinking “How tiny and sad she looks”…

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We stood waiting for the elevator. It felt like a lifetime.  All I wanted to do was get Vic into the consulting rooms so she could get a booster shot of morphine. I was getting quite impatient, with the delay of the lift, when it started moving down.  I noticed quite a build-up of people on the outer periphery but did not pay too much attention to them. I was totally focussed on my child’s pain and discomfort.

The door opened.  Two tall men, wearing sunglasses, walked out.  There was an audible gasp in the hall.  The greatest statesman in the world, Nelson Rolihlahla Mandela, stood behind them.  He was so tall! In total awe I moved Vic’s wheelchair back clearing the way for this amazing man.

He walked out of the lift and walked towards us.  He stood in front of Vic. He stooped down, stuck out his hand, and said “Hello my dear.  How are you?”

“I am fine thank you Mr President,” Vic said

“I hope you feel better soon,” he said in his beautiful, raspy yet gentle voice.

He greeted me, still holding her little hand.  I will never forget his gentle eyes.  He had an aura of greatness.

Vicky and Nelson Mandela – Two great warriors locked in a moment of kinship.

“Goodbye” he said and walked away.

I know that Vic and Nelson Mandela will meet, again, in Heaven…  I believe that the two brave souls will recognise one another.  This time there will be enough time for them to linger and chat.  The people they are it will be about their loved ones, the grace they experienced in their lives… I know they will not discuss the hardship, pain or suffering they lived…

Two incredible people… Nelson Rohihlahla Mandela and Vicky Bruce.  Heroes of many… two people who made a difference, through their suffering; their bravery and inner strength.

 

Badge of honour


It is the silly season. The season of madness. It’s the time for holiday merriment with its relentlessly upbeat expectations, sometimes forced, especially for those of us grieving the loss of a loved one.

No matter where I or what I am doing, there is always one thought that is in the forefront of my mind: “My child is dead”. That thought can never be erased. It has become a part of my soul.

I sense an impatience in some people for me to “get over it”, “put it in the past”, “stop dwelling on your loss”, or “move forward”

Yes, I have moved forward, but I can never forget. There is an aching in my soul and a hole in my heart. There is always a part of me that is always aware that “my child is dead.” I will never be complete again. Nothing or no one can fill the place my child had in my life and heart!

Like a drowning person I am grabbing onto symbolic things – an angel garden, burning candles, a memorial light in a tree of remembrance, a Hospice….. These symbolic things simultaneously provides solace, searing pain and anger.

On Friday night the Tree of Remembrance was lit at the premises where our Hospice building is. I was filled with such immense sadness that I was unable to contain my tears. I know that I was not the only one moved by the lighting of the tree. I was flanked by a dear friend who lost her husband nine months ago and a colleague who lost her mother a year ago. Gentle tears ran down their cheeks. Jared, my eldest grandson who stood behind me, put his arms around me and whispered “I miss Mommy too…”


Many bereaved people will pretend this is just another holiday season. It isn’t. I refuse to pretend that it is.

This will be my first birthday, our first Christmas, Jared’s 17th birthday and New Year without Vic. My birthday I hope to ignore. Christmas Eve we will spend at Lani’s house with a lot of people we don’t know. I know there will be no room for thought. There will be a lot of food, gifts, talking, laughing…. Christmas Day I will go to a squatter camp with Reuben and the children in his church. We will provide the poor with a meal. Jared’s birthday – we will all make a huge effort to make special… New Year’s I will remember knowing last year that Vic was dying. That it was her last New Year.

Dick Lumaghi, bereavement coordinator for Hospice of Ukiah says “The depth of a grief is exactly proportional to the depth of attachment; from one perspective, a deep grief is a badge of honour, a big love between two people.”

I do wear my grief as a badge of honour. My precious child was gentle, kind, compassionate, beautiful, loyal and loving. She earned every tear I have ever shed. She earned ever tear I will ever shed. I wish people would understand that it’s total impossible for me to “get over it”, “put this in the past”, “stop dwelling on your loss”, or “move forward”.

I love my child. I miss my child. I want my child home with me.


Grief Intelligence: A Primer


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For the past 25 years, I have worked with thousands of grievers. I have sat with widows and widowers, the young and the old. I have offered tissues to bereaved parents in their inconsolable grief. I have normalized, educated, listened to and championed those grievers who, through tremendous pain, still engaged with life.

In the decades since my book Transcending Loss was published, the grieving process has not changed. As I interact with grievers from around the world, I am reminded of the universality of grief. And though each person has their own journey, still they share many common experiences.

Yet, still, I see and hear so much misinformation and confusion around grief. Principally, this comes from the widely-held myths that grief should be easy, that grief should be short, that grief has closure, that people should get on with their lives unchanged and that ongoing connection with the deceased is somehow pathological.

So, in trying to set the record straight, I’m offering seven principles in this primer on grief intelligence.

Most people don’t learn these lessons until life thrusts them onto the roller coaster of major loss. However, if we can get the word out, then perhaps a new generation of individuals will feel more supported and understood when it is their time to grieve.

1. Grief is a normal reaction — Grief is the natural emotional and physical response to the death of a loved one. Although our society desperately wants to avoid the messiness of deep sorrow, there is no way out except through the pain. Typical numbing techniques such as medications, alcohol and food are only temporary distractions to dull the pain.

Letting oneself grieve by going directly into the pain — in manageable doses over a long period of time — is healing. Avoiding the pain simply forces it to go deep into the heart where it subtly affects emotional and physical health.

2. Grief is hard work — Grief isn’t easy and it isn’t pretty. It involves tears, sleepless nights, pain, sorrow and a heartache that knocks you to your knees. It can be hard to concentrate, hard to think clearly, hard to read and easy to forget all the details of life that everyone else seems to remember. Grievers frequently feel that they’re going crazy and they sometimes wish to die. This doesn’t mean that they’re actively suicidal, it just means that they’re grieving.

3. Grief doesn’t offer closure — Closure is an idea that we like because we want to tie up our emotional messes with a bow and put them in the back of a closet. But grief refuses to play this game. Grief tends towards healing not closure. The funeral can be healing, visiting a gravesite can be healing, performing rituals, writing in journals and making pilgrimages can be personally meaningful and healing. But they will not bring closure. Closure is relevant to business deals but not to the human heart.

4. Grief is lifelong — Although we all want quick fixes and short-term solutions, grief won’t accommodate us. Many people want grief to be over in a few weeks or a few months and certainly within a year. And yet, many grievers know that the second year is actually harder than the first. Why Because the shock has worn off and the reality of the pain has truly sunk in.

I let grievers know that the impact of grief is lifelong just as the influence of love is also lifelong. No matter how many years go by, there will be occasional days when grief bursts through with a certain rawness. There will be days, even decades later, when sadness crosses over like a storm cloud. And likely, every day going forward will involve some memory, some connection to missing the beloved.

5. Grievers need to stay connected to the deceased — While some might find it odd or uncomfortable to keep talking about a loved one after they have passed, or find it disconcerting to see photographs of those who have died, it is healthy to keep the connection alive. My heart goes out to a generation or more of grievers who were told to cut their ties to their deceased loved ones, to move on, almost as if they had never existed. Such unwitting cruelty! It is important to honor the birthdays and departure days of deceased loved ones. Their physical presence may be gone, but they remain in relationship to the griever in a new way beyond form, a way based in spirit and love.

6. Grievers are changed forever — Those who expect grievers to eventually get back to their old selves, will be quite disappointed. Grief, like all major life experiences, changes a person irrevocably. People don’t remain unchanged after getting an education, getting married, having a baby, getting divorced or changing careers. Grief, too, adds to the compost mixture of life, creating rich and fertile soil. It teaches about living and dying, about pain and love and about impermanence. While some people are changed by grief in a way that makes them bitter and shut down, it is also possible to use grief as a springboard for compassion, wisdom, and open-heartedness.

7. Grievers can choose transcendence — Transcendence has to do with gaining perspective, seeing in a new way and holding pain in a larger context. Seeing one’s grief from a larger perspective allows it to be bearable and gives it meaning. For one, transcendence might mean reaching out to those who suffer. For another, it might mean giving to a cause that will benefit others. Grievers who choose transcendence recognize that they are not alone, that they share a common human condition, and that they are amongst so many who have experienced love and loss. They use their pain in a way that touches others. The pain is still there, of course, but it is transformed.

So I invite you to reflect on these grief principles, how they might be true for you and how they might be true for someone you know and love. Share and share again so that we might spread grief intelligence far and wide. Perhaps we can effect a change so widespread that grievers will know what to expect. Hopefully, we all can be comforted, in small ways, by that knowledge

Reblogged from http://www.huffingtonpost.com/ashley-davis-bush/dealing-with-grief_b_3716013.html

 

What am I doing?


This is one of the most heart wrenching posts I have read in a long time.  I read a lot of blogs written by grieving mothers.  Why did this post affect me to this extent?   I don’t know.  Maybe because this mother’s grief feels as real as my own grief.  Maybe it is because I am doing the same.  Writing and desperately trying to keep my Vic alive…hugs and tears Gatito.

My Bright Shining Star

What am I doing Kaitlyn? What am I trying to do by my endless blogs about you, the photo albums, the posts on Facebook, the printed out version of my blog, the printed out comments by your friends after you died on your Facebook, in my private messages and by email, the posts I made on Student Doctor Network warning them of what could so easily happen if they don’t heed the warning within them of depression, for posting about you In the off topic sections of forums I belong to that are about motorcycles, RVing, and cats. Posting on suicide survivor forums. Posting every video and song that remotely has to do with what you were and I am going through. Making DVD slides of you. Going through all you music CDs, going through all your recent things, old things, things I put up long ago, things that are…

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When a child dies…


“When you are sorrowful look again in your heart, and you shall see that in truth you are weeping for which has been your delight”. ~ Kahlil Gibran.

At times the pain and feelings of desolate loss is overwhelming.  I know it is because I loved Vic so much.  I am grieving because I miss my child, the mother of my grandchildren, my friend.  I miss drinking endless cups of tea…. sometimes laughing and sometimes weeping.

I have grown used to not constantly checking my text messages when I sit in meetings.  I have actually forgotten my phone at home on two occasions.  I miss the countless phonecalls, finding little notes everywhere…. a soft kiss on the forehead.

When a parent dies, you lose your past; when a child dies, you lose your future. – Anonymous

 

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Aging….


I am so grateful that I am no longer young. I received this in an email and thought I should share it!!As I’ve aged, I’ve become kinder to myself, and less critical of myself.

I’ve become my own friend.


I have seen too many dear friends leave this world, too soon; before they understood the great freedom that comes with aging.


Whose business is it, if I choose to read, or play, on the computer, until 4 AM, or sleep until noon? I will dance with myself to those wonderful tunes of the 50, 60 &70 ‘s, and if I, at the same time, wish to weep over a lost love, I will.


I will walk the beach, in a swim suit that is stretched over a bulging body, and will dive into the waves, with abandon, if I choose to, despite the pitying glances from the jet set. They, too, will get old.


I know I am sometimes forgetful. But there again, some of life is just as well forgotten. And, I eventually remember the important things.


Sure, over the years, my heart has been broken. How can your heart not break, when you lose a loved one, or when a child suffers, or even when somebody’s beloved pet gets hit by a car? But, broken hearts are what give us strength, and understanding, and compassion. A heart never broken, is pristine, and sterile, and will never know the joy of being imperfect.

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I am so blessed to have lived long enough to have my hair turning grey, and to have my youthful laughs be forever etched into deep grooves on my face. So many have never laughed, and so many have died before their hair could turn silver. As you get older, it is easier to be positive. You care less about what other people think. I don’t question myself anymore. I’ve even earned the right to be wrong. So, to answer your question, I like being old. It has set me free. I like the person I have become. I am not going to live forever, but while I am still here, I will not waste time lamenting what could have been, or worrying about what will be. And I shall eat dessert every single day (if I feel like it). 

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