Allow Natural Death

Archive for January, 2014

How do I begin to forgive institutions?

I feel that some forgiving is in order. The kind that means I must find some forgiveness to extend to another.  But I need to forgive institutions. No individual persons need be included…. though I can make out some faces, in the murky soup of “this is how we have always done it” leaders. I need to forgive a system that has become far more powerful than the sum of their dangerously complex parts. One that I watch cause increasing amounts of suffering, while it purports to be alleviating it.

I feel I must forgive the transgressions of a system of care that dictates how we care for frail elders in most American institutions. I am sure other institutions could be held under a similar microscope, but it is health care that I have known the best and loved the most. I describe myself as a systems thinker with a front line focus. I have thrived on the crazy-making environments where activity levels are dangerously high for those on the front line, and that includes those receiving, as well as providing, care.  That activity swirls around all manner of suffering that is met with every possible medical intervention to stop it. But so often it is just not possible to make it stop. And that’s when I found myself needing to lie. To explain to patients, their loved ones and the concerned staff members struggling to provide the care they felt their patients deserved…I had to  lie. I had to pretend to believe that institutions and those who led them were truly most concerned with conditions on the front lines of care. And not so much the monies generated there. On these not so fine points, I could go on and on.

As you may already know…the book is coming. But I feel this forgiveness must come first. Let the anger at the institutions be the initial impetus for writing, but let the forgiveness inform my writing so that what I share is full of love and hope for a better end of life for frail elders. I am praying on it.luv cats stool aqua trays 032



I am afraid.

??????????????????????????????? The truth is I’m afraid. Just as scared as everyone else I suppose. But maybe even more so for having witnessed the experience of frail elders as I worked to bring comfort and kindness to those in my care.

I know that my love and patience showed in my practice at the bedside. I know it was evident in my efforts to make change happen in institutions that meted out care to elders as though it were a punishment for their belief in the lie that we could fix their ailments of old age and make life last. My concern for the insensitive and sometimes cruel treatment of elders caused me to “rock the boat” that wanted stay the course and just do the job, follow the orders and maintain the appearance that all is well. I grew to question accepted practice and to ask polite but pointed questions of those in charge. My most frequently asked question was always “why are we doing this?”

“Please explain to me why we are causing pain as we stick needles and tubes into places they do not naturally belong. Please help me understand why we are tying this person down so they can’t remove those tubes. Please tell me why we are not honoring the hours days and weeks that are left by providing an environment that offers interesting sights and sounds and the company of caring others and all that is required to stave off boredom and loneliness. Please tell me why the monies must all be spent to prolong life rather than to enrich it. And most of all please tell me why we are not listening to the ones who say…I am ready to go now.”

And it is all this and more that strikes true terror into my heart as I fear the control that others may take of me at the end. The possibility of those tubes and those needles and the boredom and the loneliness and the angry hurried hands that will touch me as my body is cleaned in places I do not wish to have touched at all.

I fear it. All of it. Because I know what is possible and I know that there is only one way I can be certain of avoiding it.