Do you want to kill my mother?

“Hello?” A man answered the phone. 

“Mr. Myers?” I asked. 

“Speaking,” he said, in a curt tone.  

“This is Doris, the social worker. I’d like to set up a care plan meeting so we can discuss your mother’s medical changes” 

“Again?” Mr. Myers queried in an explosive tone of voice. “I already got a phone call from a nurse telling me that my mother is getting worse, and that she needs to be on hospice. What’s the deal with you all? Haven’t you read her Advance Directives? This is unacceptable. Do you want to kill my mother? Is it what you all want?” Mr Myers screamed, as he hung up the phone. 

I was astonished. Not so much with his poor acceptance of his mother’s condition as I was with his questions. “Haven’t you read her Advance Directives?” echoed in my mind. 

To me, that was a bizarre question. An Advance Directive is the document that reflects one’s wishes concerning medical treatments at the end of life. Most of the Advance Directives I had read gave clear instruction of what medical procedures were to be “withheld.”   

What did I miss? I pondered.  

Mr. Myers’ mother, Daisy, was a resident, with a very poor medical prognosis. She needed total care. She was confined to a wheelchair. She was non-verbal. Her eyes were normally closed, even during meal time. She needed to be fed by the staff and only ate small bites with much encouragement.  

But now Daisy was not eating at all. She had become more lethargic. Her weight loss was significant. In an inter-disciplinary meeting, it was suggested that hospice would be on her best care choice. 

With Mr. Myers’ admonishment still ringing in my ears, I looked for Daisy’s medical chart immediately. I read her Advance Directives and living will carefully. It was a thick document brimming with legalese.  

“Oh my goodness!” I exclaimed. I hadn’t noticed the “not” word that changed the whole context of the living will: “..not  to be withheld.” 

The following day, Mr. Myers came to the facility and dropped a five-page letter to the nursing home administrator on the receptionist’s desk. It was a very hostile letter, questioning our phone calls and the interpretation of his mother’s Advance Directives. He had sent copy of the letter to state offices and other overseeing institutions.  

I panicked. My worries grew as I thought of the consequences of misreading the document and making the wrong phone call.  

But I also wondered why Mr. Myers had overreacted. He could have simply declined the option of hospice, and educated us about the content of her living will. 

Our corporate legal office followed with its own investigation and sent a response to Mr. Myers. In the meantime, Daisy continued getting worse, and had to be sent to the hospital. Sadly, Daisy spent her 87th birthday in the ICU where she remained for a couple of weeks, on a ventilator, tube fed and on IV fluids. 

Until the Lord had mercy and took her to heaven.  

Weeks later, a well-dressed and polite lady came to my office. She introduced herself as Lois, Daisy’s daughter. I was taken by surprise because I never knew about her. “I live out of State, and my brother didn’t let me get involved in any issues regarding our mother.” She said. “I know all about my brother causing trouble. My sister-in-law told me. I am really sorry for you all having to put up with my brother’s behavior.” 

Lois explained that her brother had lived in their mother’s home for many years. Daisy had set up a trust which provided that her assets were to be equally divided between the two children after her death. Somehow, Mr. Myers had convinced his mother to sign an Advance Directive with instructions to extend her life. A living will that appeared to merely reflect the son’s wishes. 

And certainly his greed. 

"Wow!" I mused, and sighed. 

I felt some peace of mind in learning the truth that fired Mr. Myers’ reaction to our concerns for his mother’s care. I hoped that someday he got on his knees and asked for forgiveness. 

And for the Lord to have mercy. 

Wisdom Sister Margaret taught me

“Doris, keep your composure!” Sister Margaret said to me.  She was my fourth grade teacher.  I was quite upset and argumentative that day, defending my idea of what the art group should have worked on to present at a local art festival.  I was outraged when the group rejected my idea.

I was a top student, earning high grades.  My family wouldn’t stop bragging about “how smart” and “what a good girl” I was.  But my pride stumbled that day. 

“The world doesn’t revolve around you,” Sister Margaret told me.

I sulked.  Sister Margaret’s words shook me.  I felt embarrassed.  I realized that my pride had grown into arrogance and poor self-control.  Sister Margaret gave me a stern scolding, and now, more than three decades later, her firm words still echo in my mind, reminding me to keep my composure.

Sister Margaret was trying to, and succeeded in, teaching me about reasonableness, patience, and self-confidence.  And I am thankful for it.  I’ve thought of her during a handful of events and incidents where I realized that keeping self-control and prudence had led to positive outcomes. 

One event that I recall involved a resident’s family member.  As I was ready to head to a care plan meeting, Mr L, whose father had recently been placed in the nursing home, showed up in my office, anxiously asking to talk with me.  

“Mr L, I only have a couple of minutes,” I told him.  “But I can meet with you after my meeting,” I offered.  

“No, it has to be right now” he demanded.  “Just come with me. I need to show you something,” he said. 

I followed him down the hall.  I could hear his heavy breathing.  I could see that his face was flush.  I sensed what he wanted to show me would be an unpleasant sight.  

We walked into his father’s room. Mr L opened the door to the bathroom.  He then asked me to step in.  He stood over the toilet, pointing toward the bowel, with a stern expression and arched eyebrow.  The toilet that was dirty. It clearly had been used and not flushed.  

“Do you see this #%!@? Mr L yelled at me while pointing to the toilet with his outstretched index finger.  He then brought his finger close to my face.  His glaring eyes reflected his rage.  It was almost as if burning embers had replaced his eyes.  

“I am tired of this @!#%” Mr L exclaimed. Then he started making all kinds of threats.  

Amazingly, I was not scared of him, but rather annoyed. I felt humiliated. I wondered why we put up with his uncouth behavior which was not new, coming from him.  But I remembered these incidents were to be handled professionally.

I looked at him.  I didn’t say a word.  I flushed the toilet.  Then I looked him in the eyes, 

shaking my head, and showing my understanding of his frustration.  His outrage was not diminished.  

“Don’t you see that you have to hold the handle down or it won’t flush?  he screamed. 

Mr L seemed to enjoy proving that there was something wrong with the toilet that would justify his hatefulness.  

“I will address this, Mr L,” I said, in a calm tone, even though I felt a growing turbulence inside me.  Mr L gave me a doubtful look.  I did my best to disregard it. 

We both left the room and headed off in different directions.  I reported the problem with the toilet to maintenance.  While walking the hall, I was immersed in my thoughts, reminding myself to keep my composure.  I remembered Sister Margaret. And I was grateful again because she taught me wisdom. 

After addressing the incident with some of my co-workers, the issue was resolved within a few hours. The toilet was actually replaced with a new one that worked properly.  

Surprisingly, Mr L came back to my office, with a grin on his face. 

“Thank you for taking care of the problem,” he whispered, and left.  

Mr L was well-known for being a difficult and demanding man who often laced his 

lashings with profanity.  Listening to his “thank you” was definitely a reward—even if it was just for that day. 

Yet my true reward was remembering the lesson Sister Margaret had the patience to teach me. A lifetime lesson that the world doesn’t revolve around me, but those that I am here to help.  Every day. 

Treasured people

“We’re in the dark,” my fellow worker Jane told me on the phone. 

“Come again? What happened?” I asked her, becoming anxious.  

“There was a power outage and we are running on a generator.” 

“Oh my God!” I exclaimed. 

It was a stormy day. I was away from the nursing home at a seminar. During a break, I had called to the facility to check on pending issues. The bad news only increased my worries. 

“The administrator is here doing his best. The maintenance guy is working hard to find the problem,” Jane stated. 

A nursing home without electric power on a summer day means no hot water for showers, no ice, no cooking, no television, no computers, no copy machines, no faxes, and, worse, no air conditioning. 

“Jane, that’s critical!” I replied, shaking my head. 

The generator only provided power to a few areas of the halls, and supplied electricity to the emergency outlets, mainly for oxygen concentrators.  

I worried about the residents and how they were coping with something new and unexpected in their day.  

After the seminar I stopped by at the facility. It was still raining and misty outside. The once well lit halls were filled with shadows and it was muggy inside. I started my rounds. 

I glanced at my residents. They looked worn out, but they were calm, and patient. They were hopeful things would return to normal soon. In the meantime, they savored ice cream that was brought in. 

Mr. Stephens, one of the residents, appeared in good humor.  “We’re okay; we’ll do what we used to do back in the days when we didn’t have electricity,” he joked. It was a blessing that someone could put on a smile during these hours of crisis.  

I observed the staff. They looked sweaty and tired, but I didn’t hear one complaint. I looked at the administrator. He moved fast throughout the facility, checking every resident room and station, giving instructions, making phone calls.  

Then I glanced at the maintenance man, Mr B. He remained—as usual— quite  serene despite he critical situation. He ran in and out of the building, checking the electric system, digging in the ground, running cables, plugging and unplugging machines. Although soaked and wet from the rain, he kept his focus at all times.  

Mr. B always amazed me with the way he handled the stress of his work.  

“You are always fixing problems,” I told Mr. B one day. “I don’t know how you hide the stress,” I observed.  

“I do get stressed!” he replied.  

“Really?” I grinned, doubting.  

“Of course! But I have to control myself. If I don’t control myself, how am I going to resolve the problems?”  

How clever! I mused, looking at Mr. B. 

I had previously learned that Mr. B, a tall man in his 50s, had served in the Army in his younger days. Although he rarely talked about his personal life, I surmised the discipline of the military trained him well and carried into his work ethic of tackling every problem with vigor.  

“Did you learn stress management in the Service?” I dared to ask.

“Definitely. If you don’t keep self-control, you can get killed. That’s how serious it is!” he asserted. 

Serious he was. Mr. B normally looked serious. Even when joking around. He was always polite and respectful. He kept busy, never wasting time, or slacking.  

“But Mr. B, you can’t tell me that you don’t feel anxious and nervous when you’re stressed!” I challenged him. 

“I do feel anxious and nervous,” he admitted. 

“So, how do you control those feelings?” 

“Breathing!” he pointed at his nose. “By knowing how to breathe.” 

Mr. B gave me a good lesson. Not only about the breathing technique to manage stress, but also by making me realize that everyone around us—people that we may easily overlook— have important jobs and lessons to teach us.  

  

The electric crisis was resolved after several hours successfully. No more darkness. No longer muggy. As the lights returned and brightened the whole place, and the cool air returned comfort to us all, I recognized that I was surrounded by many amazing people. Treasured people.  

How fortunate I am.

Angel dogs

“Can I bring my dog with me?” 

“No, Mrs. Johnson, pets are not allowed to live in the facility.” 

Mrs. Johnson’s health had significantly declined in the past year. She had tried very hard to stay at home. But multiple falls and her increasing need for daily assistance forced her to make the decision that no elderly person wants to make: moving into a nursing home.  

Mrs. Johnson was ready to give up the home she had rented for years. Although she cared about her furniture, clothing, books, photos, jewelry, and everything else that reminded her of her life, nothing would compare to her prized poodle, Gizzie.  

“I came into this world with nothing, I can leave this world the same way,” she commented. “But I just can’t abandon Gizzie. She is my baby,” She said, determined. 

Mrs. Johnson had been a widow for many years. She had no children or close family. “Gizzie is my family!” Mrs. Johnson exclaimed with tears in her eyes. “She has been my companion for fifteen years.” 

Dogs have played a special role in my experience as a nursing home social worker. I remember one woman who came to a facility where I worked, wanting to talk to the administrator. She told the administrator that her grandmother had recently died, and the family wanted to donate her dog to the nursing home.  

“She likes older people, and is really good to them.” the woman stated. "She is up-to-date on her vaccinations and is well trained." 

“I will be glad to take her,” the administrator replied. That very same day Koya, a beautiful black and white Collie, was brought to the facility.

An odd resident, I mused, grinning.

Koya was, indeed, a good dog. Calm, kind, obedient. She loved the residents and some began giving her dog treats. Soon Koya had established her daily route down the halls, collecting her treats from the residents she knew would have them. 

My son Ernie was a high school student and worked part time in the nursing home, helping in the kitchen. Ernie joined the club of Koya’s fans, petting her and handing her treats. Suddenly, Koya started to follow Ernie on his way home as we lived within walking distance of the facility. The next I knew, Koya was spending nights on our porch, and days later, she was comfortably sleeping in our house. She became our part-time pet. 

Koya alternated her time in between the nursing home during the day, and our house at night. She gave companionship and love to the residents. And to Ernie and I as well.  

Koya had been like an angel to her former owner, and her mission was not over after the elderly woman died.  

She is now our angel dog, I thought.    

After several months with us, Koya, who was already elderly herself, became very ill and had to be taken to a vet hospital. She spent a few days there and, sadly, had to be put to sleep. This information was handled with caution as we didn’t want the residents to get upset. But in my times of solitude, I shed several tears. 

“When will Koya be back?” Ernie had asked. “I don’t know,” was all I could say. 

I didn’t let Ernie know she was put to sleep until I was certain he was used to her being absent. For a while he continued thinking she was in the hospital. By the time I revealed the terrible truth, he seemed more prepared to handle it. Or perhaps I was more prepared to tell him. 

I understood why Mrs. Johnson was so heartbroken about giving up her dog, Gizzie.  

“I’m so sorry, Mrs. Johnson,” I sympathized. And I felt so helpless.  

But something wonderful happened.  A home health nurse that had assisted Mrs. Johnson for a long time, and who had bonded with her, offered to take care of Gizzie, and to bring her to the facility for frequent visits.  

“Thank you!, thank you!” Mrs. Johnson exclaimed with excitement, and tears rolling down her face.  

Thank you, God. I silently prayed.  

Mrs. Johnson transitioned well into her new living environment, and enjoyed Gizzie’s visits almost daily. Mrs. Johnson voiced no more worries. 

Months later, Mrs. Johnson’s health declined rapidly. In her final days, the administrator made an exception and allowed the dog to stay with her in her room. Gizzie watched over Mrs. Johnson with tenderness. She laid in bed with her at night, like in the old times, as Mrs. Johnson had mentioned.  

Mrs. Johnson’s angel dog, I mused.   

With her hand on Gizzie’s soft and warm body, Mrs. Johnson took her last breath. 

Peacefully. 

Broken wings, lost feathers

“Oh my God.  Poor bird!” I exclaimed as I saw a bird bounce off the windshield of the car heading toward me. I was driving to work that morning and had the misfortune of witnessing what, to me, was a quite disturbing scene. I vividly remember seeing multiple feathers being blown off the bird at the time of the violent impact. 

But amazingly, the bird had rolled off the windshield after the impact, leaving its flurry of feathers floating gracefully to the highway pavement, and continued flying. I was astonished. I saw it heading off toward a grassy field beside the road. The bird was struggling, flying in a very unbalanced way, but with evident tenacity to safely land. I turned my head back to the highway, and continued driving, with the image of the bird etched in my mind.  

Will it survive? Will its broken wing or wings heal? Will its lost feathers grow back?  

A few months later I received an unexpected phone call. The news was bad. Someone needed my help. I was astonished. I felt close to collapse. I had to make decisions, but couldn’t focus. I closed my office door, sat on my chair and breathed deeply. And I said a prayer, asking God for guidance. 

The image of the unfortunate bird came to my mind, even though several months had passed since that incident. Like the bird, I was in pain. Emotional pain. I felt as though my wings were broken, or worse, ripped apart. With no feathers left.  

But like the bird, I knew I had to do something right away. I had to continue moving and heading off to where I could find relief. A place with green pastures. Then I switched my course of thoughts with a more determined state of mind. I realized I still had my wings. I regained my strength, and made quick decisions. Successfully.  

Several weeks later, I found myself looking back in retrospect, thankful that everything was resolved. And life went back to normal.  

A recent event involving a nursing home resident made me think of the unfortunate bird again. Mrs. Williams’s niece came from out of town to visit. A rather unusual visit. Mrs. Williams’s sister had just died, and her niece came to bear the bad news. Mrs. Williams is a lady in her 90’s, with advanced dementia, and in a very declined condition. I was present when Mrs. Williams and the niece met. As a social worker, I like to be present when my residents receive bad news, in case of any crisis.  

“Aunt, I am Gloria, your niece, do you remember me?”  

Mrs. Williams perked up, and seemed to recognize her niece, despite her poor memory.  Hesitating, the niece told her about her sister’s death. Mrs. Williams had remained still for several seconds, then she opened her eyes widely.  

The impact against the windshield, I thought, recalling the bird incident, the shock and the realization of instant pain. 

Mrs. Williams started crying.  A few minutes later, she fell silent. She let her head lean forward, closed her eyes, and then looked as if she went to sleep. Due to her dementia it was not unusual for Mrs. Williams to look sleepy or lethargic.  

“Aunt, aunt,” the niece called quietly. Mrs. Williams tilted her head up toward her niece and opened her eyes. They shared a smile.  

“Aunt, are you okay? 

 “I’m fine,” Mrs. Williams answered. She started talking about the plants in the sunroom. The niece and I realized that Mrs. Williams had completely forgotten about the recent sad news. In less than five minutes.  

The niece didn’t broach the subject again. She had accomplished her mission of telling her aunt about her sister’s death. A painful moment for Mrs. Williams and her niece. Fortunately, a very brief moment for Mrs. Williams, who now continues her routine. And life went back to normal.  

Her wings were healed. Her feathers grew back, I mused.  

All within five minutes. 

On the right path?

“This is Doris,” I said, picking up the phone receiver with one hand as I continued typing on the computer keyboard with the other. It’s amazing how social workers learn, or are forced to become multi-tasking. There is never enough time to complete all that is required in a day’s work.  

“The social workers are here,” the receptionist announced. 

“Good!” I exclaimed. I’ll be there in a minute,” I replied, hanging up. 

Three social workers that had recently joined the medical department at a local hospital had arrived to meet me. They had expressed their desire to visit our facility and learn more about our services. I was quite excited to give them a tour. I am always eager to interact and network with colleagues.  

I met the three girls. They were in her twenties, dressed casual, and looked excited. I walked them through the facility, showing them all areas, and explained  the services provided. While walking the halls, I noticed them glancing at residents. Most of my residents were in wheelchairs, some in bed, and others ambulated with the assistance of a walker. I was proud of my residents. They looked clean, well groomed, and happy. Some of the residents greeted at the social workers. 

We paused at the rehabilitation gym, one of my favorite areas. I love to see the residents getting stronger, recuperating, and redeveloping their physical and mental capacities.  And I love even more when I see them leaving the facility, going back to their home.

One of the social workers expressed her approval as she observed residents in therapy,  working the machines with their frail and slender arms which, with work, would gain endurance and be worth all the muscle stiffness and pain. A truly amazing scene. 

Next, we headed to my second favorite place: the beauty shop. Several ladies were under hair dryers, getting glamorous hair styles. Others were being manicured. Anne, the beautician, is a very patient woman who enjoys making the nursing home ladies look pretty and stylish. I stopped for a good few minutes there, and gave the social workers a speech about self-esteem, femininity and dignity.   

“As you can see, most of the ladies in this facility take pride on their personal appearance,” I gladly noted.  

I walked to the door, heading back into the hall. When I turned and looked back, I noticed that the social workers had not followed me. They were still in the beauty shop. 

 Are they talking to the ladies? I wondered. They must have liked the place too, I mused, smiling. But then, after I glanced inside of the shop again, I noticed that one girl was wiping tears from her eyes, and the other two surrounded her, consoling her. 

“Are you okay?” I asked.  “I’m fine. Sorry,” the tearful woman replied with her soft voice cracking.  

We all headed into the hall, and I continued my tour, trying not to think of the social worker’s emotional episode.  

After I finished the tour I gave the girls some literature and my business card. They all seemed appreciative of the tour. 

After they left  I went back to my office and wondered what had happened. Did the facility or residents bring back sad memories? I was unsure what could have possibly triggered such a reaction. I sympathize with the girl, but I was also concerned about a social worker not being able to control her emotions in front of the population that actually needs her support.  

I later thought about the incident, hoping that the young woman would become emotionally stronger as she advanced down her career path. The more she interacts with patients and families in the hospital, the more self-confident she will become, I anticipated. 

A few months later, I was visiting some of my residents in the hospital. I came across one of the social workers that visited the facility. I was glad to see that she was assigned to one of my residents. I observed her working with self-confidence and pride. I was pleased. 

After we talked about my resident I drew closer to her. “How is the other girl doing, the one that was tearful that day?” I whispered.  

“She’s gone. She couldn’t handle the job” 

I was astonished but not surprised. 

I left the hospital immersed in thoughts about the young social worker that was gone. I wanted to believe that she had opted for another area of intervention more suitable to her aspirations and desires. 

I prayed that she had found the right path on her career. 

A note from Natoya

I love Jamaica was one of the stickers I glanced at the gift shop. It was as though my thoughts had been colorfully printed on that sticker. Definitely, our vacation in Jamaica was one of the best my husband and I can recall. The people were vibrant and friendly, and the island was a tropical beauty surrounded by its blue sea and inviting beaches. 

On our second day in Jamaica I visited the sports center wanting to get information on tours and schedules. Three girls were at the desk. They wore white and blue uniforms, looked very fashionable, and well groomed. One was on the phone. The other two spotted me as I approached the desk. 

“How can I help you?” one of the girls asked, in her gracious Jamaican accent. 

She provided me with the information I needed. 

“What are you reading?” the other girl--who I noticed was starring at a book I was holding in my hand-- asked.  

“It’s a novel, it has to do with mystery and murder,” I answered, showing her the book cover.  

“I see you’re almost finished!” she commented. Her keen eyes viewed the book, including where I had last left the bookmark, revealing that I was close to the end of the book.  

Does she want the book?, I wondered. 

Her eager eyes continue to view the book --my book. 

I can’t give it away, I thought.  

I glanced at the book --  "The Prairie Grass Murders" a signed copy that I had recently won on a blog contest. My blogging friend, Ann Best, gave away two copies signed by the author, Patricia Stoltey. The book was meaningful to me. I had actually emailed Patricia to let her know how excited I was at being one of the lucky winners.

And now, a Jamaican girl wanted to take away my book, I lamented . 

“Well, let me finish reading it, and I'll bring it to you tomorrow,” I promised.  

“What’s your name?” I asked her. 

“My name is Natoya” she proudly replied, while pointing at her name tag. I looked closely, and using my almost-always-successful mnemonic trick, I repeated in my mind: Natoya, Latoya Jackson...Natoya, Latoya -I'll remember! 

As I was whispering my mantra-like memory technique, I spotted something peculiar on Natoya’s arm. I noticed she had a huge scar on her left inner arm. It had no doubt it was a burn scar. What happened to her? I wondered. Was it an accident from her childhood? Did someone do that to her as a punishment? I shook my head, and blew off my unpleasant questions and impertinent thoughts. 

I’m just glad she is alive!, I mused, and sighed.  

Immersed in my thoughts about the book, I headed back to the beach where my husband was waiting for me. The humidity was high, and so was the speed of my thoughts. A pale idea of buying a book at the gift shop crossed my mind. I was sure Natoya would have appreciated a new book anyway.  

That’s cheating, I reprimanded myself. 

I returned the next day. My husband and I were waiting for the boat that would take us snorkeling. I looked for Natoya. She wasn’t at the desk. I sat in the shade, talking to my husband, and scanned the surroundings, hoping to see my Jamaican friend.  

“There she is!” I exclaimed. She was heading to her desk. She looked elegant again. Smiley. I noticed she held a notepad and a pen in her hand, walked strong and confident. 

“Natoya!” I called as I approached her. A beautiful smile blossomed on her face. “I brought you the book.” 

“Oh, you did!”, she exclaimed, with evident surprise.  

Did she sense my hesitant thoughts yesterday? I feared. Has Natoya’s precious heart been broken by false promises in the past?, I wondered.   

I was glad I kept my promise. 

“I got to tell you something, Natoya” I warned her. “This book was signed by the author” I opened the book on the page where Patricia had signed and showed it to her.  

“Oh, it’s a special book!”  Her eyes open widely.   

“Yes, it is,” I confirmed. I told Natoya that I communicated with Patricia over the internet, and in simply terms, I tried to explain about my blog. I think Natoya knew nothing about blogs, but she did have a vague idea about the internet. She seemed to understand that I could post public messages. Her eyes brightened as if it was an amazing discovery for her. 

And I gave Natoya the book.  

She thanked me, and told me she had to go back to work. I went back to sit in the shade where my husband was still waiting for our boat ride.  

A few minutes later, Natoya returned. She sat next to me. She told me that she was actually in training as she had recently started the job. Then she started writing on her notepad. I glazed at Natoya. She is precious, I thought, and took a picture of her. She grinned as if she had become a celebrity.  

She became my celebrity.  

Then she handed me a folded piece of paper, and told me she had to leave or she might get in trouble with her supervisor.  

While walking away on the beach, she paused, turned, and   waived goodbye, I unfolded Natoya’s note: