Posted in A Mother's Grief, Bereavement, Chronic Pain, Death, Hospice, OI Treatment, Palliative Care, Terminal Illness

“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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Posted in Angels, Bereavement, Death, Grief, Terminal Illness, Vicky Bruce

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.

 

Posted in A Mother's Grief, Angels, Bereavement, Death of a child, Grief, Vicky Bruce

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.


Posted in A Mother's Grief, Bereavement, Death, Death of a child, Grief

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

 

Posted in A Mother's Grief, Bereavement, Death, Death of a child, Grief, Vicky Bruce

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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Posted in A Mother's Grief, Angels, Bereavement, Death of a child, Grief, Vicky Bruce

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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Posted in Humour, Uncategorized

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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Posted in A Mother's Grief, Angels, Death, Death of a child, Grief, Terminal Illness, Vicky Bruce

From the diary of my precious child…


I found these words in Vic’s diary. It was an entry towards the end of her life. I believe it is a message from my precious angel child – not only to me but to her friends and family.

I found a web source when I did the plagiarism check. The poem was written by Karen Vervaet. Vic changed some words by never finished writing what she started.

These are the words my beautiful child wanted to share with her friends and family…

Goodbye
I turn my head and look towards death now.
Feeling my way through the tunnel with the space of
emptiness and quiet.
The shimmering silence that awaits me.
This is my direction now; inward to the green pastures…
The cares of the world concern me no longer.
I have completed this life. My work is done, my 
children grown.

My loved ones are well on their hero’s journey. (original text – My husband is well on his…)
I have loved much and well…
Those I leave behind, I love.
I hope I will remain in their hearts as they will
in mine…
Thank you for taking such good care of me…
And all of you who have been my friends, thank you
for teaching me about love.

Karen Vervaet

Posted in A Mother's Grief, Angels, Death, Death of a child, Grief, Terminal Illness, Vicky Bruce

I am Vic’s mother!


Child-loss is a black hole of grief and sorrow in which every emotion is compressed and compounded.   It is an inescapable vortex.  

Vic was the centre of my emotional cosmos. My world revolved around my precious child. Vic was my past, my present and my future. When she died it felt as if my life ended.


For the first time in 38 years I cried. I truly cried and called to the heavens. It was as if 38 years of pent up fear, anguish and stress was released. I screamed, I sobbed, I wept… Did you know that there is a difference between weeping and sobbing? I clung to my child. I stroked her hair. I washed her little body and dressed her in her favourite pyjamas. I sprayed her favourite perfume on her.

Grief is a strange journey.

When I embarked on the Journey of Mourning it was a strange road. I had lost people I love dearly before. My mom, my dad, BFF’s, colleagues and family had died. Of course grandparents too… But I had never lost a child. This is a road I had never travelled before. I did not only lose my precious child but I also lost the person I was.

Within a millisecond I ceased to be a mother. Wait – I became a “bereaved mother.” The hope I had clung to for 36.5 years was lost! The fight in me was gone.

The second my child’s soul left her body my heart shattered into a million pieces.

The hardest thing I had to do in my life was say goodbye to my child; listening to her breathing getting weaker and weaker…. knowing that her last breath was so close.


Then I thought nothing would match my pain watching my precious baby leave our home for the last time in a plastic sheet on a gurney until I had to stand and watch the hearse drive away with my precious, precious child lying in a cold hard coffin – her destination a crematorium!

No matter how prepared I thought I was for Vic’s death – I wasn’t! People seem to think I should be grateful Vic is dead. Just as people did not want to listen to me talking about Vic’s terrible suffering they now don’t want me to talk about Vic after she died. They ask you how you are doing hoping you won’t be honest and answer…

It is almost surreal to see that the world has carried on with its business; that the heavens are unchanged; that life has continued. I look at myself and I think that people that don’t know me would never guess that my life ended 6 months ago… People pat me on the back and say “You are so strong…”

We are nearing Vic’s 6 month anniversary and I have learnt to breathe again. I have learnt to stay strong for the boys. My life will and must mirror Vic’s strength and courage. Her dream of a Hospice will continue to live on in me…Her goodness will continue to spread to the community and the world!

I raised Vic to be strong, courageous, and brave. Vic taught her sons that she is their mother not their excuse…


I am Vic’s mother – she is my reason; not my excuse!


Posted in A Mother's Grief, Angels, Death, Death of a child, Grief, Terminal Illness, Vicky Bruce

Always the lady


Exactly one year ago Vic had a Brazilian Blow-dry. This is what I posted then…

Today I took Vic to the hairdresser and she had a Brazilian blow-dry treatment.  Now, for those of you who are as ignorant as I was, this is a “hair straightening” process.  Four hours!!

Shame Vic was sleeping in the chair…poor baby!  She is exhausted but it will make her life so much easier for many months ahead.  Vic will not wash and leave her hair – it has to be sleek…Now with this Brazilian blow-dry thing we can wash her hair and leave it!  Bliss!!

I never saw my late Mom not immaculately dressed with her hair beautifully done.  No matter how ill she was, Mom went to the hairdresser three times a week.  Her nails were always immaculate and Mom would get very annoyed with me if I wasn’t wearing make-up and had my hair in a ponytail.  “Always the lady” was her motto.  As it is Vic’s.  I find it absolutely amazing that she insists on getting dressed most days.  Well, certainly before the boys get home from school.  She does not want the boys to see her in pyjamas. When we wash her hair it must be blow dried…She will not scrunch it or put it up in a ponytail, plait or pin…Vic’s hair has to be sleek…No matter how ill she is.

Her little body is so swollen from the cortisone.  Her face looks like a little chipmunk’s!  It happens from time to time.  What is worrying is that Vic’s blood pressure is steadily increasing.  Addison’s symptoms include low blood pressure…so why is Vic all of a sudden developing high blood pressure?  And Madam will not see a doctor!  What to do?

Vic does look so beautiful after her hairdressing marathon.  She is passed out and I know it will take her a week to recover from this outing.  But, it is well worth it!

These are the words Jared wrote for Vic’s funeral letter….

Dear Mommy…

Words could never explain what you mean to me…

It always meant so much to me that no matter how bad you felt or how sick you were, you always went out of your way to do anything and everything you could for us… Always going out of your way to make everyone’s life easier especially mine…

You were always my hero… No matter how sick you were every morning you woke up and got dressed. Even if you didn’t do anything you always looked your best…

I love you so much mommy… You made such an impact on everyone’s life that you will never be forgotten…you will forever live in our memories as the bravest woman and best Mommy of all time…

No one will ever be able to replace you…


Jared

Jared and his Mommy 1.1.2013

Always the lady…

Posted in A Mother's Grief, Bereavement, Chronic Pain, Death, Grief

Different types of depression


Clinical depression goes by many names — depression, “the blues,” biological depression, major depression. But it all refers to the same thing: feeling sad and depressed for weeks or months on end (not just a passing blue mood).

Depression (mood) as defined by Wikipedia

From Wikipedia, the free encyclopedia

“Dejection” and “despair” redirect here. For the poem, see Dejection: An Ode. For other uses of despair, see despair (disambiguation).



Melencolia I (ca. 1514), by Albrecht Dürer

Depression is a state of low mood and aversion to activity that can affect a person’s thoughts, behavior, feelings and sense of well-being.[1] Depressed people may feel sad, anxious, empty, hopeless, worried, helpless, worthless, guilty, irritable, hurt, or restless. They may lose interest in activities that once were pleasurable, experience loss of appetite or overeating, have problems concentrating, remembering details, or making decisions, and may contemplate or attempt suicideInsomniaexcessive sleepingfatigue, loss of energy, or aches, pains, or digestive problems that are resistant to treatment may also be present.[2]

Depressed mood is not necessarily a psychiatric disorder. It may be a normal reaction to certain life events, a symptom of some medical conditions, or a side effect of some drugs or medical treatments. Depressed mood is also a primary or associated feature of certain psychiatric syndromes such as clinical depression.


Are you depressed?

If you identify with several of the following signs and symptoms, and they just won’t go away, you may be suffering from clinical depression.

  • Feelings of helplessness and hopelessness. A bleak outlook—nothing will ever get better and there’s nothing you can do to improve your situation.
  • Loss of interest in daily activities. No interest in former hobbies, pastimes, social activities, or sex. You’ve lost your ability to feel joy and pleasure.
  • Appetite or weight changes. Significant weight loss or weight gain—a change of more than 5% of body weight in a month.
  • Sleep changes. Either insomnia, especially waking in the early hours of the morning, or oversleeping (also known as hypersomnia).
  • Anger or irritability. Feeling agitated, restless, or even violent. Your tolerance level is low, your temper short, and everything and everyone gets on your nerves.
  • Loss of energy. Feeling fatigued, sluggish, and physically drained. Your whole body may feel heavy, and even small tasks are exhausting or take longer to complete.
  • Self-loathing. Strong feelings of worthlessness or guilt. You harshly criticize yourself for perceived faults and mistakes.
  • Reckless behaviour. You engage in escapist behaviour such as substance abuse, compulsive gambling, reckless driving, or dangerous sports.
  • Concentration problems. Trouble focusing, making decisions, or remembering things.
  • Unexplained aches and pains. An increase in physical complaints such as headaches, back pain, aching muscles, and stomach pain.
  • Negative thoughts. You can’t control your negative thoughts, no matter how much you try
  • Suicidal thoughts. You have thoughts that life is not worth living (seek help immediately if this is the case)

There are many on-line depression tests. These tests should not replace or substitute a visit to a physician. It is only an indicator. http://www.depressedtest.com A physician will have to rule out other serious medical conditions that may cause similar symptoms.

The main types of depression include:

  • Major depression — to be diagnosed with major depression, you must have five or more of the symptoms listed above for at least 2 weeks. Major depression tends to continue for at least 6 months if not treated. (You are said to have minor depression if you have less than five depression symptoms for at least 2 weeks. Minor depression is similar to major depression except it only has two to four symptoms.)
  • Atypical depression — occurs in about a third of patients with depression. Symptoms include overeating and oversleeping. You may feel like you are weighed down and get very upset by rejection.
  • Dysthymia — a milder form of depression that can last for years, if not treated.
  • Postpartum depression — many women feel somewhat down after having a baby, but true postpartum depression is more severe and includes the symptoms of major depression.
  • Premenstrual dysphoric disorder (PMDD) — symptoms of depression occur 1 week before your menstrual period and disappear after you menstruate.
  • Seasonal affective disorder (SAD) — occurs most often during the fall-winter season and disappears during the spring-summer season. It is most likely due to a lack of sunlight.
  • Manic Depression may also alternate with mania (known as manic depression or bipolar disorder).

Factors that can may cause depression include:

  • Alcohol or drug abuse
  • Medical conditions and treatments, such as:
    • Certain types of cancer (pancreas, prostate, breast)
    • Long-term pain
    • Sleeping problems
    • Steroid medications – Corticosteroid medications such as prednisone, which people take for diseases such as rheumatoid arthritis or asthma
    • Underactive thyroid (hypothyroidism)
    • Illegal steroids
    • Amphetamines
    • Over the counter appetite suppressants
  • Stressful life events, such as:
    • Abuse or neglect
    • Breaking up with a boyfriend or girlfriend
    • Certain types of cancer
    • Death of a relative or friend
    • Divorce, including a parent’s divorce
    • Failing a class
    • Illness in the family
    • Job loss
    • Long-term pain
    • Social isolation (common cause of depression in the elderly)
  • Many central nervous system illnesses and injuries can also lead to depression.
    • head trauma
    • multiple sclerosis
    • stroke
    • syphilis

Sources:

http://psychcentral.com/disorders/depression/

http://www.helpguide.org/mental/depression_signs_types_diagnosis_treatment.htm

http://www.nytimes.com/2013/04/07/opinion/sunday/wars-on-drugs.html?_r=0

http://health.nytimes.com/health/guides/symptoms/depression/overview.html

http://psychcentral.com/disorders/depression/

http://www.webmd.com/depression/guide/depression-types

 

Posted in A Mother's Grief, Angels, Family, Family Life, Vicky Bruce

I wish you peace…


Peace is not the absence of trouble; it is the presence of God



You are strong… when you take your grief and teach it to smile.






You are brave… when you overcome your fear and help others to do the same.






You are happy… when you see a flower and are thankful for the blessing.





You love… when your own pain does not blind you to the pain of others.






You are wise… when you know the limits of your wisdom.






You are true… when you admit there are times you fool yourself.





You are alive… when tomorrows hope means more to you than yesterday’s mistake.






You are growing… when you know that you are but not what you are becoming.






You are free… when you are in control of yourself but do not wish to control others.







You are honourable… when you find your honour is to honour others.





You are generous… when you can give as sweetly as you take.






You are humble… when you do not know how humble you are.






You are beautiful… when you don’t need a mirror to tell you.






You are rich… when you never need more than you have.







You are you… when you are at peace with who you are not.





I wish you peace, today, tomorrow and forever


Posted in A Mother's Grief, Bereavement, Death, Death of a child, Grief, Terminal Illness, Vicky Bruce

A lifetime of sadness


2010
13.2.2011

I am so tired of being sad.  I am so terribly tired of missing my child.  I miss our easy friendship, our laughter.

I miss laughing!

I miss being happy.

I miss looking forward to tomorrow…

The pain is just too much.  I cannot bear the longing any more.

The sad thing is that I have a lifetime of sadness ahead of me.

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Posted in Death, Family, Grief, Hospice, Palliative Care, Terminal Illness, Vicky Bruce

What do Alzheimer Patients Die from?


After my post https://tersiaburger.com/2013/06/16/what-is-the-difference-between-alzheimers-and-dementia/
I received a couple of emails and comments that I kept private and did not approve for publication. I decided to do this post at the time. Alzheimers is a terminal disease. Alzheimers has no survivors. The harsh truth is that there is no cure. There is no treatment.

Alzheimer’s disease is not just memory loss – Alzheimer’s kills.

• In 2010, 83,494 Americans died of Alzheimer’s disease – the 6th leading cause of death in the United States overall and the 5th leading cause of death for those aged 65 and older.

• Among 70-year-olds with Alzheimer’s, 61 percent are expected to die within a decade. Among 70-year-olds without Alzheimer’s, only 30 percent will die within a decade.

Deaths from Alzheimer’s increased 68 percent between 2000 and 2010, while deaths from other major diseases, including the number one cause of death (heart disease), decreased.

Change in Number of Deaths
between 2000 and 2010


• Alzheimer’s is the only cause of death among the top 10 in America without a way to prevent it, cure it or even slow its progression.

Dementia is the second largest contributor to death among older Americans, second only to heart failure.

Alzheimer’s disease is the 6th

Today, there are no survivors of Alzheimer’s. If you do not die from it, you die with it.

• One in every three seniors dies with Alzheimer’s or another dementia.

• In 2013, an estimated 450,000 people in the United States will die with Alzheimer’s, meaning they will die after developing the disease.

• Today, over 5 million Americans are living with Alzheimer’s disease, including an estimated 200,000 under the age of 65. By 2050, up to 16 million will have the disease.

• Of Americans aged 65 and over, 1 in 9 has Alzheimer’s, and 1 in 3 people aged 85 and older has the disease.

• Another American develops Alzheimer’s disease every 68 seconds. In 2050, an American will develop the disease every 33 seconds.

Alzheimer’s takes a devastating toll not just on those with the disease – but also on their caregivers. http://www.alz.org/documents_custom/2013_facts_figures_fact_sheet.pdf

Statistics can be extremely misleading. Alzheimer’s disease cannot be definitely diagnosed until after death, when the brain can be closely examined for certain microscopic changes caused by the disease. However, through thorough testing and a “process of elimination,” doctors today can diagnose what they refer to as probable Alzheimer’s disease with almost 90% accuracy.

My father’s death certificate stated “Natural Causes“… In South Africa and most countries, the law requires that a death investigation, or autopsy, be performed when someone dies under mysterious circumstances. Autopsies are usually done if the death was caused by injury, poisoning, infectious complications, foul play (homicide), or when someone dies without an attending physician. If any one of these criteria is present, the local coroner or medical examiner will perform an autopsy to determine the cause of death.

So what do Alzheimers Patients die from?

Stroke is a major cause of death in Alzheimer’s patients

Falling. Slower reaction time, difficulty recognizing changes in the height or depth of a step, can lead to tripping and falling. Changes in balance and coordination combined with poor memory can make it difficult for a person with Alzheimer’s to get from one place to another and avoid hazardous objects at the same time. He may miss a step while looking for a door or trying to listen to someone’s conversation.

Pulmonary aspiration.  Aspiration is the entry of secretions or foreign material into the trachea and lungs.  Alzheimer’s patients forget how to eat and/or swallow and might start choking on their food. The food basically goes down the wrong pipe. A tell-tale sign is when they start coughing whilst eating. This can lead to infection and pneumonia.

Pneumonia is a major cause of death in Alzheimer’s and dementia patients. Decreased mobility and pulmonary aspiration are major causes of pneumonia…

Urinary Tract Infection (UTI). An unidentified UTI can lead to sepsis which can in turn result in organ failure…

Dad in the ambulance en-route to hospital 1

On the 9th of May 2011 my dad had a bad fall. He was taken to hospital by ambulance and admitted to ICU as he required 24/7 care.  On the 10th I met with the medical team.  My Dad appeared to be in a coma.  The Physician said that Dad had pneumonia.  The Neurologist confirmed that Dad was in the Severe advanced stage of Alzheimers.  The Specialist Surgeon wanted to operate on my Dad’s aneurysm….

I made the heart wrenching decision that there would be no aggressive treatment of the pneumonia.  There would be no operation.  The Physician agreed with my decision.

On the 14th of May I took my Dad home.  Hospice evaluated Dad and accepted him as a case.  Hospice started administering Morphine, Dormicum and Serenace subcutaneously and my beautiful dad was comfortable. My Dad battled to swallow and I was pretty distressed about his liquid and food intake.  Dad’s core body temp had dropped to 34.5 degrees C.  Hospice said that Dad’s body had started shutting down and not to worry about his food or liquid intake.  On the 17th my beautiful father cried during a lucid moment because he could not articulate his thoughts and he was mumbling …

Twenty three days after his first fall my Dad lost his battle against Alzheimers when he forgot how to breathe.

Did he die from Alzheimers or pneumonia? Maybe it was the fall or even the aneurysm? His death certificate read “Natural Causes” – my Dad is not an Alzheimer statistic…


Posted in Grief, Hospice, Palliative Care, Terminal Illness, Vicky Bruce

Hospice – friend or foe?


Hospice – friend or foe?

A blogger friend, Terry, is preparing for her beloved brother Al, to move home from an Assisted Living Facility. Al suffers from Parkinson’s disease and his general health condition is extremely precarious. Terry blogged: “I finally heard nothing from the phone. I had done everything I could find to do trying not to have to make the dreaded call to Hospice. I decided not to use the Hospice here in our county. I was very disappointed in them with the lack of care they gave to my father.” http://terry1954.wordpress.com/2013/06/17/al-and-hospice-meet/

Vic wrote this on her Face Book page on the 15th of May 2011… “Today Hospice came to access my Grandfather… They dripped him & made him comfortable. He has lost his swallowing reflex, sleeps most of the day, is completely bedridden & can barely talk… The suddenness of his deterioration is very difficult to comprehend. Could you all say a big prayer for my Gramps and especially my Mom, who lost her best friend of 25 yrs., age 51 to a heart attack last Tuesday. My Mother is one of the strongest, bravest people I know… How do we say goodbye, how do I take my Boys to say their Goodbyes tomorrow, how do we accept that this incredible man has such little time left regardless of the fact that we all know that its best for him. How can I be strong for my babies when my heart breaks all over again, every day when I see him…? Especially my Eunice Friends will all remember how desperately my Gramps and Gran loved and spoilt me and how VERY MUCH they meant to me… I don’t want to live without him even though I realise that that is extremely selfish, but I love my Grandfather so desperately, it’s not fair… All I ask for is compassion… Compassion for Gramps and my Mother… Thank you to everyone for all your love & support through everything… Love Vic…”

I am a great believer in the services that Hospices offer – worldwide. Hospice cared for my Dad in the last week of his life and for Vic the last 5.5 months of her life. My experience was positive.

The hospice movement was started in the 1950’s in London by Dame Cicely Saunders, and the first hospice facility opened in London in 1967. Seven years later the United States opened their first hospice facility in 1974. In America the hospice movement has blossomed and hospice now serves 44.6% of patient deaths. Unfortunately, the median length of service for hospice patients is only 19.1 days, which means many patients did not receive the benefit of hospice care until the end of a difficult illness. In my country only 5% of the dying actually have access to Hospice services.

The original idea of hospice is that once curative treatments are no longer effective, a patient enrols in hospice to receive comfort care. In our culture of “fighting” death illness that should be addressed through ongoing decisions about the risk and benefit of interventions gets turned into a battle that should be won or lost. No one wants to be a loser, so the patient is reluctant to quit curative care until there is absolutely no hope. Many physicians are geared the same way, and their desire to give hope and “beat” disease results in a reluctance to call in hospice even when they know the situation is bleak.

Hospice care is for a terminally ill person who’s expected to have six months or less to live. This doesn’t mean that hospice care will be provided only for six months, however. Hospice care can be provided as long as the person’s doctor and hospice care team certify that the condition remains life-limiting.

The benefits of hospice and palliative care

Research published in the Journal of Pain and Symptom Management found that terminally-ill patients who received hospice care lived on average 29 days longer than those who did not opt for hospice near the end of life.

Source: National Hospice and Palliative Care Organization

Hospice care providers offer specialized knowledge and support at the end of life just as obstetricians and midwives lend support and expertise at the start of life. Hospice can reduce anxiety in both the terminally ill patient and his or her family by helping them make the most of the time remaining and achieve some level of acceptance.

When terminally ill patients, who are often already in a weakened physical and mental state, make the decision to receive hospice and palliative care instead of continued curative treatment, they avoid the dangers of over-treatment. In-home care from a hospice team often means the patient receives greater monitoring than he or she would in a hospital. In addition to focusing on the physical health and comfort of a patient, hospice care also focuses on the emotional needs and spiritual well-being of the terminally ill and their loved ones.

The above is all well documented facts. Yet, when a family is faced with that terrible decision to call in Hospice, it is a deeply emotional decision. The phone call is a terrifying telephone call. This is evident from Vic and Terry’s posts…..

It made me realise what a massive challenge lies ahead of us in Stepping Stone Hospice.  We need to educate the community.  We need to dispel the fear of and for Hospice.

stepping_stones_of_memory_by_nwwes-d3krg59