Thank you Liz. The community work of care staff and volunteers in home care and the ethical dilemmas that are faced as we honor the dignity and autonomy of the patients and their families are often beyond the understanding or experience of the man on the street. We pray for discernment and often times can only provide the net for a controlled crisis. I never saw this as supporting a bad situation, but as softening the blow. Retired now, as I provide emotional support to family members newly introduced to home care, I remind them that home care staff don’t do magic they look at the way a family system functions and try to figure out, using their professional training and compassion, how they can foster the positive and minimize the impact of the negative. Remembering my own sleepless prayer filled nights I keep you caregivers in my prayers.

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It also happens in the hospital. Abandonment. Health directives ignored. Unneeded procedures for a loved one to keep them alive so they do not die on a holiday or anniversary. Over medication to keep someone from calling out. Sometimes nurses are caring more about a person than their loved ones/relatives.
The ego takes over and it becomes about them, and not the care of the one in need. “Why are you doing this to me.” “You can’t die at Christmas, it will ruin the holidays for the family.”
The patient that is admitted to the hospital so the family can take a vacation and abandons them there because “they can’t handle it.”
A hundred years ago most individuals died at home with their families. Now most die in hospital settings. Family is on the internet and not in person. There are people in hospitals that will sit with patients so that they do not die alone. That was something my mother in law was afraid of. Not dying, just dying alone. We promised that she would not, and she did not. We held her hands all the time until she let go of this world and travelled on.
In our families, there has always been talk of the circle of life. What is born to this world will eventually leave. There is no other way. Some, like my mother in law, are more dignified about it. Others live in ignorance and denial. Our societies have become more materialistic and ignored spiritual knowledge. And we our poorer for it.
Namaste
(Liz, you drew a marvelous mandala. Beautifully deep in richness, yet emptiness in the dark blue. If it were an eye, I would say I see two fish caught between a torment of encirclement, going ‘round and ‘round, in the reflective iris.)

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Hi Sherry, I appreciate your helpful insights, the wisdom gleaned from your work & life experiences as well as your kindness and prayers. Thank you!

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Thank you for your poignant insights, Jolyon. It is true that most people would prefer to be at home in the final days and hours, yet only about 25% really do. Part of the dilemma is families never having the conversation about what they would want at the end of their life. These conversations have been too uncomfortable but there is a grassroots movement to help normalize thinking about and talking about our end of life wishes while we are well.
The lack of mental health services and the increasing difficulties that people face is a disturbing trend in healthcare as well as the lack of funding for in home caregivers who can assist with activities of daily living. Insurance does not pay for this but it is really what people need most and a little help could go a long way in preventing unnecessary re-hospitalizations.
Thanks too for thoughts on the mandala…

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