Toni D. Helfrick, R.N.
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“A Memorable New Year’s Eve”
“I’M SORRY, MAMA”
“THE ELUSIVE STORM” (non-fiction short story)
“MOM’S COMING HOME!”
“AN IRISH SHORT STORY”
“The Tales O’ Thomas”
“AN ABSENCE OF FAMILY: A Hospice Short Story”
"In The Alzheimer's Dining Room"
"QUALITY FAMILY TIME"
“A Memorable New Year’s Eve”
This was a fine idea, as all of the others here know each other, and they are also interested in what ever would be happening. They are all friendly, and with the Christmas tree still in the room that we use for either for meetings and also, to pass along to others about anything they need to know.
About two weeks ago, it suddenly came to me the thoughts of all these patients who have been In a psychiatric unit. This group of patients, who we call by name, were all very curious about what it was we were going to do. These are patients who are about to move to either home, or the assist of a psychologist. These are lucid and not very ill.
“A New Year’s Eve? Is that right?” I assured them all that I would call them when we were going to have a meeting. Everyone is always in the meeting room, and also as a television room, and now, tonight, they will be told about this evening’s night.
I was in the locker room adjacent to the nurses station, I tried to put my coat in the closet. When I saw it, I didn’t really understand why there were cardboard hats, and also noise makers, for midnight. Some others of us found there were plastic champagne glasses, but they were actually made of plastic. I counted the amount that we needed, and yes, we did have enough.
That next idea I had was to give them punch with ginger ale, and also a mix with some juice. I also added some ice cubes from the kitchen and put them into the punch. Then I decided I will bake a sheet cake, and some cookies and a pie or two. Then I also added some liters of soda, for those who don’t like punch.
When I arrived the New Year’s Eve, I had all my things and some other decorations so they could have fun. Then, when I arrived, I got onto the speaker and I asked all patients to please come to a meeting, and it is an important one. I gave them the time they were to come, and as I then went with them to the meeting room, and we all had seated.
I asked if anyone had any problems at this time, and they said they were just fine. I then said to them that I wanted to have a New Year’s Eve Party, here on our Unit. They were all very pleased and there were all smiles.
Then, I explained to them all that I could not do all of this myself, but rather, we should all sign on the papers that I sent around, and those who wanted to help gave their names. I then explained to them that we might just like to have a Decoration Committee. Well, they just loved it.
Then I explained the group who were going to make the party merrily- they had hats for this Committee, and enough for all the others. This group then would decorate the sitting room where we have our meetings, but tonight, it will be until MIDNIGHT! They were all very excited, and they couldn’t wait for this.
I asked the girls if they could send all the food and beverages as I could not leave them alone. The girls, volunteers, brought the food and beverages and it was put into the locker room, so no one could see them.
It was a fine night, and they were in good spirits, and they seemed to be talking to others, which is a fine sign- they felt good, and I kept watching. I also described that I had a need for the food committee, and they also helped out, and there was another group, and that was, The Entertainment Committee. I told them they could sing, dance, or tell normal jokes, nothing that’s not correct. They all agreed.
And then, I asked them just one more thing- all of us are here, and any people who need to help us with the party all agreed that they wanted to help, too. I also told the decoration committee that they could wear their hat, for only the decoration committee, so they could feel good about what was to happen. It seemed that all the others wanted to put on make-up and also a new outfit. It was nice to see them happy.
At about 9:00 PM, we were busy cooking things, putting the potato chips and pretzels, and they all could have some cakes and cookies, and two men volunteered to turn on the coffee urn. I explained to the men that the coffee amount was done correctly, and so was the water. Then, one of the food committee asked me when I should put the plug in, and they both did so, and they also took out paper cups for the coffee, and also milk, cream and sugar or sweet and low.
Well, I think it has been working well, and the decorations looked great. They had crepe paper and streamers, and also balloons. The television was turned on at 10:00 PM, and we then had the decoration committee and they gave everyone a hat, and there was a large tray that was filled with noise makers.
The patients had done fine decorations, and others had brought out the punchbowl with plastic glasses, and they were very interested in the television for Times Square. The people in the meeting room was being watched via the television. I explained that “The Big Apple” was a red ball, that started from the top and in 60 seconds, it hit the bottom, and everyone wanted to see what was going on. As the Big Apple, the red apple started down and in 60 seconds, the audience was yelling, and jumping up and down.
One of the ladies said, “Hey, what are we supposed to do, Nurse?” Suddenly, I realized they had never seen the ball drop, and they had never seen Times Square, in New York. So I told the lady that when the Big Apple is down at the street, it means it’s NOW~ and the next year will be blinking with the 4 numbers of the new year. Then, as I told them, they should use their noise maker, or also talk to all of them and tell them “Happy New Year!”
They were all making noise, some sang, some of “Auld Lang Syne.” And later, they did sing and tell stories and jokes, and it was a great time. I think that’s as much to me, as it was to the patients. Yes, all the committees did their own jobs, and the meeting room was spotless.
It was a fine night, and at midnight, they had coffee/tea for drinking, and they also had some cake and cookies.
© Toni D. Helfrick
“I’M SORRY, MAMA”
A Heartwarming Short Story
I was at work a few evenings and four nights. I had cared for Mary, a woman who was very ill, and about to expire. She was not fully conscious, but she could take medicine, and needed a lot of care.
Many of her children and grandchildren had come from another state to say goodbye to her, and some lived in the local area and were there nearly all the time. They were so solicitous to her needs and the room became rather difficult for me to do my work, since there wasn’t enough space. Yet, I can understand that the family loves her very much, and she seemed to know they were there, and their presence calmed her. It also helped her family.
Many brought many children, and Mary seemed to move her hands, as she was a loving mother of many children, and she apparently loved little ones. Other relatives came by and told her all the news of the family, who was in high school, who got an “A”, and et cetera. Mary was unable to speak, but she could understand all that was being said to her. She had many kisses, many stroked her hair, and others held her hand and talked to her.
The last night, a person I had not seen had come to visit the patient. One of the nurses said, “Hey, this guy is drunk”. I decided that since he was her son, and if he behaved, he could certainly remain to visit his mother. I welcomed Bob, who was the oldest of the group of children. He was unmarried, and had no children of his own.
Bob came into the room, with large crocodile tears coming down his face, and he kept saying, “Oh, Mama, I don’t want you to die.” Bob was built like a linebacker and was very polite to me and everyone else. My only fear was that he might squeeze his mother’s hand too hard, because she was a tiny woman, and though she was unconscious, I stayed nearby to make sure she was alright. It seemed that it was so.
Meanwhile, about half of Mary’s kin had gone home for supper, and a few needed to nap, as they had not slept in two days. They quietly exited the room. Bob then looked at me, and said, “I’m the black sheep of the family.” I then told him that I had done some pranks as a child, and none of us are perfect. He ignored that and kept crying, having gone through a box of tissues. I asked him if he wanted some juice, or coffee, and he said, “No. I want to be here by my Mama.” Then, he said, “Mama, I’m sorry”. Mary could hear, but could not move or open her eyes. I wondered what he was sorry for, and he continued, “Mama, I’m a bad boy,” and he began to cry again. He kept on holding her hand, and her breathing relaxed some, as he was the only adult child who had not yet been there, and I think she was very pleased and comforted by his presence.
Some of the other patients seemed to be hearing this, and I closed the door. I not only think that those who mourn should be comforted, and I believe they should also have privacy. Bob calmed down a little bit, and I wondered why he said such self-deprecating remarks about himself. So I said, “Bob, why do you think you are the black sheep of the family?” He said, “Oh, I know I am. It’s always been that way. But my Mama always loved me, and she is the best Mama in the world,” and he then turned to Mary, his mother, and said, “Mama, I’m sorry I hurt you when I was in grammar school.” I asked him what was done that was so awful. “My Mama made us lunch at home, and I told her I didn’t like what she made for me. I hate peanut butter.” I told him all kids say things like that. Then he said, “I was mad at her for making peanut butter sandwiches, and I wanted bologna.” His face then changed, and he looked at me and said, “I told my Mama that she had a fat belly.” Then Bob began to cry again. I am sure this is due to the fact that he had a number of beers, and his thoughts weren’t what they would have been, if he were sober. Bob said, in a totally different tone, “Do you know what my Mama did?” Then he said, “Mama was very strict, and she made us do our chores, and our schoolwork.” I asked him if that was bad, and he said, “No.” My Mama was the best mother in the world. Bob began to cry again. I had to get him off this crying jag. So, I concentrated on his face, and looked at him, saying, “Well, you sure don’t look like you’re black. Bob said, “Heck, I ain’t that black!,” and we both laughed. Finally this man who thought little of himself, and felt as though his brothers and sisters didn’t like him, was now SMILING! Thank you, God.
Bob is kind of a big Teddy Bear, with a crying jag, because he lost his younger sister two years ago, and his father a few years back, and because he was intoxicated. I was reluctant to ask about his Dad, because I didn’t want to open another can of worms. He now is grieving over his inability to have his mother speak to him, and, he fears her death. I explained to Bob, that the one last thing that all people have is their hearing, and yes, this is true. I also told Bob that mothers are aware that their children love them, and I told Bob that I am sure she likes hearing it from him. He was pleased.
Soon, the rest of his siblings returned, and Bob said he was going out to get something to eat and rest. I asked him to come back anytime. In the place I was working, the family of a dying patient is always allowed at the bedside, unless they are loud, or cause any trouble. This was not the case. Bob was going to eat and rest. In the evening, Mary was not feeling well, as she was breathing with difficulty, as she did earlier. She felt very warm, and her temperature was 103 degrees, Fahrenheit, a definite high fever for an adult. I crushed two pills and mixed them in water, and put them into her mouth. I told her that this medicine would take her fever away. It had done so earlier, but this time it did not. Mary had some breathing problems, and I gave her a nebulizer treatment, and made sure her upper body was almost up to a sitting position. She had what is called, “air hunger”. It is not painful, but it is like being in a room with no air. Mary tried hard to get more air, and she was unable to get any, no matter how hard she tried. Her breathing became very rapid and noisy, and the look on her face was almost panicky.
I had someone watch her while I requested something to calm her, and the medication nurse brought it to her. There was a phone call for me, and the same person agreed to stay with Mary. After I hung up the phone, I returned to the room.
After I had hung up the phone, one of the nurses said, “The guy that is drunk is back again.” I went into the room, and Bob was sitting by his Mom, talking to her. “You are such a wonderful Mama, I am so happy you know that I love you, Mama. You’re the most beautiful Mama I’ve ever seen.” Bob asked me if that was true, and I assured him that yes, she is a loving mother, and she is very strong, and also, strong-willed. Bob was astonished, and asked me, ”How did you know about my mother?” I told him that what I had told him was correct. Most people who take care of patients can usually see the fine virtues of a mother’s love. Bob smiled and said to Mary, “You are such a wonderful mama, and I am so happy you know that I love you, Mom. You’re the most beautiful mama I’ve ever seen.” Bob was then smiling at Mary, and speaking to her.
Mary’s breathing became a normal rate, and with no noise. She seemed to be much calmer now, and Bob wasn’t crying any more, he just talked gently sat next to his mama, and Bob helped Mama to use the mask on, and her treatment. “I’m going to stay here with Mama tonight,” he said. I told him that was fine.
It was quite beautiful to see this “linebacker” son, seated next to his mother. Suddenly, Bob said that Mama wasn’t breathing. I checked her breathing, her pulse, blood pressure and her reflexes in her eyes. I sat down and talked with Bob, and he was very helpful to calm Mary, and to lift her up, and have her look well. She was a beautiful lady, and it was wonderful. After we had combed her hair, and bed linens, we then allowed others to stop by, to see this lovely lady.
As I was about to go home, I thanked Bob, and he began to cry. I attempted to comfort him, as I told him, his mother has no pain at this time, and she will be fine. Bob became the other relatives who he consoled. Bob came up to me and said, “This is not why I am crying.” Bob said. “When I was giving Mama the breathing treatment and holding her hand, at almost the end of the treatment, Mama squeezed my big ugly hand. This big Teddy Bear had tears coming down his cheeks, and he didn’t care that anyone saw.
Something very beautiful happened. The sisters and brothers were hugging Bob, and they realized they did love him. The Chaplain spent time with each, including Bob. Just before I left, I saw Bob, and I explained to him that he was the one person who actually got his mama to relax, and to feel comfortable. And so, I told Bob that he has a kind heart, which he has, and his mother will be smiling down at him right now, for the wonderful things he had done for her. The greatest gift for Mary, the mothers and relatives, were how she gave her family love, it is her love.
THIS IS A TRUE STORY, NAMES AND SOME INCIDENTS WERE CHANGED TO PROTECT PRIVACY.
© Toni D. Helfrick, R.N.
“THE ELUSIVE STORM”
(non-fiction short story)
© Toni D. Helfrick
It was a lovely day that carried my thoughts through the south pastures. As I wondered, it almost seemed that the trees, plants, bushes and flowers all knew of the impending storm. Rumblings in the distance could be easily heard, for about ten miles. High above the charcoal-dark gray stratocumulus clouds were there. The large cloud had become darker and moved much faster. I could see them coming toward the north pastures and the barn.
My camera in its case would have but a few seconds to snap this one, and I quickly took the picture and went inside to dry off. This was just a small amount of rain, but could be in the category of the monsoon. Neither birds nor insects were not to be found, but had sought shelter. The July and August rains always seem to begin with a serendipitous pattern, leaving those with umbrellas wondering why they had opened them at all! In July, they had what might be called a ‘sprinkle’, and then precipitation moves elsewhere.
In an August rain with high humidity and temperatures near 100 degrees Fahrenheit, the skies opened loudly with thunder and preceded multiple bolts of lightning. Similar to storms in this climate, share with us our need for rain and we are fearful of droughts, prior to lightning. “It”, the thunder and lightning, needs to be respected. Though I enjoy catching a picture, I normally do not walk upon the pastures. We’ve lived here for over twenty five years, and we have had many lightning strikes, torrential rains and yes, even tornadoes and heavy winds. Some have, by lightning strikes, the same stories we have told that we also have experienced.
My neighbors across the street, the Young’s, had a tree built in the middle of their house and their home was a very lovely one. At this time, during an electric storm, the tree across the street struck and hit the neighbor’s tree, and from there, we had a TV cable underground. The roots of their tree was near to the cable line, and when the lightning struck, the surge of the electricity hit the tree next to the roots, and it followed the electricity under the street to the TV cable of ours. Yes, it was a very loud crack of thunder when we had a ‘hit’.
Unfortunately, the surge from the cable sent under the street and across to our house. At the front porch, prior to the cable was all installed and we already had television. At the window of Al’s office, the half-bricks on the porch had been destroyed. It was a horribly loud noise and the half-bricks flew all over, as if it was a bomb. Along with this, our telephones were also of no use, and in the last ten years we had lightning, we also lost approximately seven phones and a computer and printer, both destroyed.
There are many strikes of lightning and electricity at one time. We know that we have also lost a new television, which we dearly loved, and also many, many other things. The most unusual of the strike which I was surprised about, had an innocuous, wooden fence in the south pasture. There was nothing that was too high, and trees were not in this strike, but suddenly, the lightning bolt hit the fence at about 4 feet and the wooden fence was literally in tiny pieces.
There was an unusual strike in another year. My husband bought a church organ, in New Jersey, when the pastor in New England was closing the church. My husband had purchased all the organ pipes, from other churches that could not support the church, and they combined two congregations into one, and they sold the other. This organ and pipes were in New Jersey, and when we moved to Florida, the moving company had moved with our furniture and we packed all the organ pipes, and this and other items were delivered fine, without any problems.
A few years ago after moving to Florida, we enjoyed the organ and the sound of a real church organ. Unfortunately, the organ was also struck by lightning. Many of the wires and other things needed to be replaced. I am happy that, though my husband Al spent much time for fixing the organ, and again, it sounds magnificently. One morning, I had overslept, and I heard Al playing Bach, and it was beautiful. This was Christmas Day.
In retrospect, I would not want to live in an area where the weather will cause it to be dangerous, or the losses of electric appliances. All the old stories about, “the highest thing that is at the top, that’s when the surge will hit someone.” NO, not so. Many of us are sometimes lucky, but in a flat area, like Florida, do find some mountains, or even some hills. The surges of the electricity in the air in the rain with winds and heat can conjure up an easy lightning storm. And, there is another place when one wants to move to another house. And they should be sure they are not near a stream or a lake. Flooding, also, is documented, and it could be seen by water lines in the basement, if you are looking for a new place to live.
“MOM’S COMING HOME!”
I was working as a Hospice nurse, and I was called by the hospital that my patient would be discharged to her home. They had given me a time when she would arrive by ambulance, and I would meet here at her home.
The patient, now from the hospital, was awaited by her large family, and their children. They were a loving family and close to one another. When I arrived, the Hospice admitting nurse was present, and gave me the report on the patient. It was a warm, lovely home and the family welcomed me. They had soft, soothing music playing, that the daughters had arranged, and the patient could hear this beautiful music even from the bedroom. It was the comfort and love in this home that had given even me, a stranger, the feeling of being needed. When I examined ‘Mom’, as they called her, she was very ill and in horrible pain.
The patient had a number of ailments that were literally, taking her life away. Knowing that she needed much care, I spend many minutes and sometimes hours, helping her adult children how to care for this very special mother. I did not tell them initially how ill she was. Whenever a patient returns from the hospital, the family and friends are all pleased, and are given a “boost” in knowing that, “she’s coming home!”
These adult children and their own small children came from afar, some were from local areas, and all of them had either driven or flown to get to see their mother. The patient’s husband had made a fine dinner with his daughters, and they planned a fine meal for them all. I then realized it was necessary to tell them that ‘Mom’ was critically ill, and I sat with the adult children and I explained anything that would help them understand.
I also assured them that I would be with their mother throughout the shift until midnight. The adult sons were at their mother’s bedside, and though she did speak at the beginning of my arrival, she now was sleepy. She was turned over to help her feel a little better, and I was at the bedside.
The patient, Mom, was resting and she did speak to me a few sentences. She was very happy to be at home. Sounds, smells of foods and persons with laughter- yes, this lady wanted very much to be at home. It did help her happiness, seeing and hearing all the family, and I think it helped her.
The patient was taking a small nap, and she had taken a medication to relax her, which was given to her via her MD’s order. It would seem that this patient literally wanted to be at home when Mom passed, or possibly wanted to tell them. The sons asked me if she was breathing. I told them that she was, but her breaths were shallow and it was difficult to hear. I could, however hear her breathing and her heartbeats with my stethoscope. Soon thereafter, the patient stopped breathing, and I told her sons of this. I then took her blood pressure and her heart rate. The blood pressure was very low, and her heart was beating erratically. At this time, I told the family that the patient stopped breathing, and they were to tell the adults. I took her blood pressure which was very low. I told the entire family that she had just passed. I also checked some neurologic signs and her pupils were not reacting to light. Her heart rate was erratic for about 30 seconds, and then it stopped. I then made sure that others, adults, would be able to let them know that she had passed. I asked one of the sons to go and get their wives and have someone watch the children.
I had placed the oxygen concentrator outside in the corridor, and I asked them all to leave the concentrator there, being on. I did not want any of the children to think she had passed. I had asked the son to leave the concentrator now, as it might alarm the children, if it isn’t on. The daughters and in-laws of her children, and her husband all came into the room, and I explained that she had passed, and I could tell you what happened, and answer any questions for you.
The family was horribly distraught. They were all so very happy that their mother was at home, and indeed, each of them had had time to talk with her at home. They were all shocked, thinking that “Mom is coming home, because she is all better.” The hospital did not explain the gravity of her condition to the family, but in such circumstances, it is possible that the patient wanted to be home when she died. This woman did suffer with her illness, and she knew of her impending death when she had arrived home. She spoke to them all, and I wondered how she ever had the strength to do so. This family had been so very happy to have their mother at home, and they must have thought that ‘things are as they used to be.’
Though, this woman had suffered, but now her painful fight was over. Each of them spent time with their mother, alone, and then, her husband asked me if I would come in also, and I told him I would. Her husband said he felt so very lost, as they had had a wonderful life together. They had been married for many years.
Yet, I somehow think that we all expect that life will go on, in the memories of the past. The end causes us to face reality. I had called the Chaplain, and before he had arrived, the patient’s husband told me of some of his fine memories. I think it helped him to be next to her, to hold her hand, and to tell someone about her. The chaplain soon arrived, and first spoke to the group, and then he visited privately with each family member, and in more than a few cases, the chaplain visited with even each of the children.
The family was most grateful for “Mom’s homecoming”, and for having received her wish to die at home. The patient wanted to be at home, one last time-where she could hear the echoes and voices of her family, down the corridor, and the giggling of small children, and, their footsteps. The patient, “Mom”, She could also smell the nice aroma of home, and hear the crackling fire on the hearth. Her children were all there, and Mom could discern their voices, even when she was in pain, knowing she would pass, and she told me of her happiness being at home. I explained all this to her children, all fine siblings, and they supported one another, as well as their Dad, in their sorrow and loss.
In glancing back, I cannot say it was a pleasant experience, but I do think, in some small way, I was able to comfort them in their grief. If I was able to help any of them, then I had done my job.
© Toni D. Helfrick, R.N., A.C.L.S
“AN IRISH SHORT STORY”
~With Seamus, Harry, Finbar and Thomas~
T’was the seventh o’ September. Ah, an’ a terrible day it was! Me buddies an me, wantin’ to play a bit o’ bridge on the train, we did. We di’ not know what was about to befall us…
Seamus had just dealt, an’ we wuz all about to sett’le back with a bit o’ Irish Whiskey. Ah, such a long day it wuz, in the city. Lucky we thought we was, that we din’na need to do any drivin’ of our own- just enjoy a quick game, a bit o’ ol’ Irish, an’ ride home to the missus. The day’s toil was behind us an’ I longed for me chair by the fire, an’ me pipe. We ne’er really noticed the others on the train, such as they wuz, just a sittin’ there, starin’ straight ahead they was, as though they was at a speech that bored ‘em silly!
All of a sudden, me buddies faces drained o’color! White as ghosts they was! Begorra, ye could hear the gasps o’ horror an’ screams from the lassies. The train wuz about to be headin’ fer Long Island, and home. Then, the train, it ne’er stopped at all, but it slowed down a wee bit, as we saw what was aside o’ the train. The saints preserve us!
Seamus cud’na believe it, nor I. Shocked, we was. Harry an’ ol Finbar ne’er even flinched. Sloshed t’the gills, ‘e was, an’ yet, still able t’ play the bridge! Ah, but surely there must be a bit o’ pity in ‘em, for this poor laddie, a layin’ by the roadside, his body split in two. The policeman, just starin’, not able to do his job, but lookin’ he wuz, at the train and the lad. A wee laddie, ‘e was, the boy on the ground, maybe only ten or so. Oh, what can the good Lord be a thinkin’, to let the likes of ‘im die like that? A cherub ‘e was, not to harm a soul, ne’er to get to ride the big train into the city, ne’er to come home to some hot Irish stew after a fine day o’ work, ne’er to know the likes of a fine lassie.
Lookin’ up the tracks, ‘e musta been, and never saw the train. In the blink of an eye, all this I saw afore the laddie- his past, ‘is present, and the future he will na’have. An’ Ol Finbar, just sittin’ there- a fine one, ‘e was! Ah, maybe too many deaths he’s seen, maybe the life’s pain has done him in, an’ he weeps no more. Kinda like, he’s already dead, ‘e is! Ah, a sad thing to hear it was, when ol’ Finbar just stared ahead at the card table, and Finbar just stared ahead an’ said, “TWO HEARTS.”
© Toni D. Helfrick
“The Tales O’ Thomas”
T’was the seventh o’ September. Ah, an’ a terrible day it was. Me buddies an me, wantin’ to play a bit o’ bridge on the on the train, we wuz. We di’ not know what was about to befall us. Seamus had just dealt, an’ we was all about to settle back with a bit o’ Irish Whiskey. Ah, such a long day it wuz, in the city. Lucky we thought we was, that we dinna need to drive any drivin’ of our own, just enjoy a quick game, a bit o’ ol’ Irish, an’ ride home to the missus. The day’s toil was behin’ us an’ I longed for me chair by the fire, an’ me pipe. We ne’er really noticed the others on the train, such as they wuz, just a sittin’ there, starin’ straight ahead they was, as though they was at a speech that bored ‘em silly!
All of a sudden, me buddies faces drained o’color- white as ghosts they was! Begorra, ye could hear the gasps o’ horror an’ screams from the lassies. The train wuz about to be headin’ fer Long Island, and home. Then, the train, she ne’er stopped at all, but she slowed down a wee bit, as we saw what was aside o’ her. The saints preserve us!
Seamus cud’na believe it, nor I. Shocked, we was. Harry an’ ol Finbar ne’er even flinched. Sloshed t’the gills, they was, an’ yet, still able t’ play the bridge! Ah, but surely there must be a bit o’ pity in ‘em, for this poor laddie, a layin’ by the roadside, his body split in two. The policeman, just starin’, not able to do his job but lookin’ he wuz, at the train and the lad. A wee laddie, ‘e was, the boy on the ground, maybe only ten or so. Oh, what can the good Lord be a thinkin’, to let the likes of ‘im die like that? A cherub ‘e was, not to harm a soul, ne’er to get to ride the big train into the city, ne’er to come home to some hot Irish stew after a fine day o’ work, ne’er to know the likes of a fine lassie.
Lookin’ up the tracks, ‘e musta been, and never saw the train. In the blink of an eye, all this I saw afore me,- his past, his present, and the future he will na’have. An’ Ol Finbar, just a sittin’ there- a fine one, ‘e was! Ah, maybe too many deaths he’s seen, maybe the life’s pain has done him in, an’ he weeps no more. Kinda like, he’s already dead, ‘e is. Ah, a sad thing to hear, it was when ol’ Finbar just stared ahead at the card table, and Finbar just stared ahead an’ said, “Two Hearts.”
© Toni D. Helfrick
AN ABSENCE OF FAMILY: A Hospice Short Story
~As a Hospice nurse, I see many families who are grateful for our presence
in their home. This story is about a lack of such persons. Situations and
names have been changed for privacy.
It was a lovely warm day, and I rang the doorbell. “Hello. My name is Toni and I’m a Hospice nurse,” I said. The woman did not smile. “This ain’t the door you’re supposed to come through!, she said. I apologized, and asked her to direct me to the door of the patient’s room… She sent another person, a young girl, to take me to the ‘proper door’.
I suppose I should have noticed all the clutter in the front yard, the lawn not having been mowed, and the hanging baskets, with dead flowers. As the daughter beckoned me inside, I saw an extremely cluttered living room, with papers, books, cups and everything imaginable. The patient was given his own room. ‘Almost like a sentence’, I thought. The man was never to get out of the bedroom/bathroom area. I was then told to, ‘Fix my father some supper. He’s hungry.’ I told them I needed to examine him, and check his blood pressure, and his heart sounds and lungs. ‘He don’t know that, he’s just hungry”, said one of the daughters. That remark I ignored. They pointed toward the kitchen, and said I could fix the patient some food in HIS kitchen, and they told me I HAD TO make this man his supper. The patient, who I will call Joseph, was very ill, and needed a lot of my time. So I thanked the family, and assured them that he would get nourishment at dinnertime.. “Hey, Lady, what the hell is nourishment?” I just smiled and said, ‘food to eat.’
I glanced over at the sink, and noticed several days of dirty dishes. The walls were stained, the bathroom dirty, and the patient’s room was horribly cluttered. I not only didn’t LIKE these people, who were very rude, initially- they wanted NOTHING to do with their father, and, they didn’t want to see him, either. In retrospect, I believe they were embarrassed at the way their home looked, but they didn’t have the energy, or the desire to clean it.
Luckily, I take my own ice chest and take all my food with me and eat it on my own plastic dishes. I assessed the patient, Joseph, and found him to be critically ill, and he was unable to walk. The patient, prior to getting lung cancer, was now unable to walk anywhere. This man, prior to getting lung cancer (the cancer has now spread to his bones and his brain) was very friendly, despite the gravity of his illness. I asked Joseph what he likes to eat for supper. He said he wanted a steak. I then went out to the kitchen freezer, and since Joseph had no teeth, I told him I was cooking his dinner. They had a microwave, and I cooked him some soup and a chicken pot pie. He was very pleased with his food, and he ate most of it, despite the inability on my part to find enough room to put all his food on the over-bed table. Finally, I just moved it all to a cardboard box that was empty, and I put it under his bed.
Joseph wanted to thank me for having cooked his dinner, and I told him I was happy he was hungry. He then shared with me that this was the first food he had had all day! I wasn’t sure if he was telling the truth, but he was emaciated. Joseph has lost his equilibrium, which is why he cannot walk to the bathroom any longer and he needs assistance, using a commode.. He also had a 30-foot piece of oxygen tubing, so that he could move about in the room, but he was unable to walk at this point. I then took the tubing, and told him it was ‘the wrong kind’ of tubing, and he did accept that. When he realized he couldn’t get up to use the bathroom, he was not thrilled, but annoyed. Joseph has been at home after radiation to his kidney tumor, and has also been through chemotherapy, which is fortunately completed, for now. Joseph has some delusional behaviors, and he speaks to other persons that he can see (a hallucination). He is somewhat confused, likely because he cannot get the air exchange into his lungs, that is needed for him to get the air exchange that he needs because of the lung tumor. One might say that Joseph is ‘an accident waiting to happen’. He needs a maid, a cook, and a nurse and the patient might fare better in a Nursing Care Facility for Hospice. I did notify this to the Hospice, and explained what they need for the patient. Thus, he will be bathed, given the correct medicines, and HE WILL ALSO BE GIVEN FOOD at mealtime.
When I went home that night, I was exhausted from trying to prevent Joseph from falling. Fortunately, he had one “nice daughter”, who said she would sleep on the couch in the living room, and she would give him his pills, as he needed them. WHAT PILLS? This patient has specially ordered medications and they either give the wrong things, or they don’t give him any. And, when the next nurse comes, Joseph is in terrible pain. I asked to keep the patient’s medicines, and I made a M.A.R., a sheet listing what the patient can have, and how much, and when it needs to be given to the patient.
I thought about the things that Joseph had said to me. He was one of seven children, he was the eldest, and he had six children of his own, and also grandchildren and three large dogs. Yep, they came into his room whenever they wanted to see him, and it made Joseph happy. I was worried that they might have fleas or ticks, but the others in the family summoned the dogs back to their part of their home.
I did not do the dishes, not because there were a few plates and cups to be washed. This man was being given a new dish each time he was fed, and that wasn’t often. Joseph had bags of candy, snacks, and whatever, in his room. I looked for ants, but did not see any. But, the sink, filled with water that had an indescribably ugly color and odor, I will not touch. I am here to care for this patient, despite the cries of the moochers who have lived off his “check” for years, and most of them only work part time, and none of it is ever done at home.
It did upset me that this poor man who was dying was being IGNORED. I recommended to Hospice that he might fare better in a Hospice Care Center. That way he will have been bathed daily, eaten three meals a day, not to be isolated to his bed, and would be in a clean place. I also worried about vermin, such as roaches, water bugs, et cetera. This occurs when a home or apartment is not cleaned regularly, it’s almost like sending out invitations to the bugs to ‘stop by and eat’. Fortunately, Joseph was placed in the care center, and he did well. I also found that the other siblings were very angry that they needed to pay bills on Joseph’s home. I believe I have found a better place for Joseph. I think when people take, and take, and never are able to give, somehow, someway, they might meet up with misfortune, themselves. I’m not suggesting it, and I’m not praying for it, (I only pray for positive things), but I’ve seen such things happen a few times too many. Joseph is not the only elderly person who is being exploited. There are several thousand, and that is only a conservative estimate.
Joseph has passed, but he did live out the last six months of his life in the Hospice Care Center and he was cared for, very well. I feel that I was able to help him live out of his last days much more comfortably.
This is, actually, the essence of Hospice.
©Toni D. Helfrick, R.N.
Motionless he sits
Mesmerized by the lovely music
He is in "sync" here.
We do not know him
Yet, with the orchestral sounds
We all understand.
We have known this mute, shy man
He is called "Harmony-"
"Man of the street, who loves music."
He's here again, Harmony, this man of the street, who unobtrusively and quietly walks to the front of the auditorium and sits in the center, front row. He comes each day and, he is never late and always enjoys the music, lugging his pack and plastic bag. This morning of first rehearsal, he sat quietly, enjoying the instruments. He always carries a notebook. No one bothers him, nor do we.
He is clean, with shoulder length hair, and is infatuated with classical music. He seems to watch the conductor lead. Harmony does not sit with others. Why he is here, how does he know? He's aware of rehearsal and dates also. He doesn't bother anyone, and is mute. It's puzzling that he does not work, but where does he sleep, bathe and eat? His hair is clean, and even his clothes. Thus, he must live with a kind caretaker. This man appears to have PTSD.
He has a passion for music, but doesn't talk. He is silent, and is not a beggar, and walks through the town of Meadville. His look appears to be that from the past: “living in the seventies" and Vietnam. His mannerisms are those of PTSD; survivors who fell through the cracks, yet Post Traumatic Stress Disorder has kept him well, without psychology.
Harmony should have his PTSD treatments. He wants to be in the time before Vietnam. He needs counseling, but does not get any. If he had treatments for him to re-assimilate, after the horrors of war, he left that to his past memories and socialization.
PTSD men have problems, they remain in a void with nightmares at night disallowing them to recall eating, and how to wash. The PTSD veterans often avoid others as they fear conversation and socialization.
Looking at him, I am happy he has a place to eat and sleep. Harmony, one of them, has a passion for music, and a fine place to hear it...
© Toni D. Helfrick, R.N
"In The Alzheimer's Dining Room"
"Who was this man?" his children wondered, as they spoke about "Dad," having trouble with his declining abilities, and the two siblings, Jim and Paula, were quite frightened, not knowing what was happening. They were wondering what they could do for Dad, but Dad could barely communicate. His son, Jim, said he noticed he just wanted to sit, and sometimes he had wanted to sleep, a good deal of the day. Paula, his daughter, made an appointment for a physician, and, though it was difficult to get him to go, Paula said she needed to see the doctor, also. Only after that, her father said he would go, too. Jim made the appointment for next Wednesday, and his father and Paula would go to see the doctor next week.
In the next two days, Paula and Jim observed "Dad," looking to see if he might see if he'd take a walk in the cold air, and those words made them flinch. Others might have to get him, or look for him, kind of like a toddler, said Jim. They discussed this with the doctor, who said, "There are many variables for you- you can have a nurses aide bathe him, or a family member could do that." The doctor also let them know that there will come a time when Dad will not allow anyone to bathe or dress him.
"How long will this whole process take?', Jim said.
The doctor told Paula and Jim that each person is at a same stage, and the process of his deterioration usually starts with sleep, disinterest with bathing or dressing one's self. "These are called A.D.L.'s," the doctor told them, and they also told them that they mean Activities of Daily Living, such as bathing, putting on clothing, using the bathroom, eating meals, and having interest in things.
Jim always looked forward, and he asked the doctor what could be done if his father became violent, or forgot to eat, or wanted to go for a long walk. All of these things literally terrified both Paula and Jim. The doctor also mentioned that what he appears to diagnosis is, very likely Alzheimer's Disease. The doctor told them that he is confused, but his health for now will tend to deteriorate, though the process varies with each one. Jim asked what that meant.
"Well, Jim," said the doctor, " I will give you a brochure which will help you with most of the questions, but, some may not be the same with other persons with Alzheimer's Disease. If your father becomes unable to dress, does not want to eat, will not bathe or cannot speak, the best place for your father, in that milieu, is an Alzheimer's Unit, either in a hospital or within a Nursing Home." The looks on their faces were quite disappointed, and they seemed to find this difficult for them. The doctor gave a prescription to Paula, and she kept it with the pamphlet, and also, the nurse gave them names of several places where they could visit, and find out which they liked. Paula was upset because the doctor had also said that people who have Alzheimer's disease seem to follow a path, meaning that his abilities will lessen, but there is no way to know what this patient will do. If he needs other things, such as a prescription, the doctor will help them with what their father needs.
They returned home, and everything was rather quiet. Dad asked why they aren't talking. Then, he started talking to Jim, but called him "George". Jim had tears in his eyes, and Paula wondered what was going to happen, and as they came into the driveway, they noted a familiar car. Paula and Jim had an uncle and aunt two doors down, and Uncle Harold and Aunt Edith were aware of his condition. There were a lot of hugs, as they loved their aunt and uncle. Paula thanked Aunt Edith for bringing a casserole. They had set the table, and Jim made a salad, and Paula helped Aunt Edith.
When they were all ready to eat, they didn't know where Dad was! Jim checked all the doors and windows, and they had not been tampered with. Dad was lying behind the sofa, and Jim saw his shoes! When they awakened Dad, he told them he was just a little cold, and he wanted to lie down next to the radiator. Jim and Harold helped him get to the table.
Aunt Edith made a delightful casserole of lasagna, and meatballs, and she also made a cake for them. Dad, who was now at the table, kept calling Jim "George", and everything seemed awful. Aunt Edith had a talk with Paula and Jim, as they have friends who have the same problems. "Thank you, Aunt Edith," said Jim. Both were upset and had tears in their eyes.
After Dad was put into his pajamas by Jim and Harold, they helped him to his bed. They came downstairs, but they told everyone to make sure he is in his room. The more things that happened, the more they thought that they wouldn't be able to keep him there, without total exhaustion. Edith and Harold did the dishes, and they both would either come by or call, if there are any problems. Jim and Paula thanked them both.
Paula had gone to bed and was asleep. Jim was in the next room to Dad. They kept hearing Dad mumbling, and as if he were talking to someone else. Jim spoke to Paula, and they were both concerned as to where he would go when they went to sleep.
As it happened, at 3:00 A.M., Jim heard footsteps, and he bumped into the bathroom door. Paula ran toward him, and he said, "Look, old lady, this is my place, and I'm going to sleep here." Jim heard what was said, and it must have hurt Paula.
In the morning, Jim called the doctor about what is going on. "Jim," said the doctor, "I think it will be almost chaos to keep him with you at home. It is more than a full time job, and you will be exhausted, every day." Doctor asked they told them to start looking, check out facilities given to Paula, so they could look around. Paula had just received a call from Aunt Edith, and she said, she and her husband would be there at Dad's home, so they could look at places that would fit. They Both hugged Aunt Edith, when she came, with her food, and Uncle Harold, also.
It took two days to find what Jim and Paula wanted, and it seemed that they both had narrowed it down to three places. Now, there were two that they liked very much, and then, they had to determine how the patients were fed, checking for cleanliness, and above all, they were very impressed about the friendly nurses, orderlies and aides, and how very much they watched for them. Paula told Jim that she was so happy to have found this place. It's not a huge place and wasn't impersonal, and she and Jim both agreed that we had better make our decision as soon as we could arrange a meeting with the director, and Dad's insurance, Social Security card, and any other things they needed. The director of the facility wanted to meet Jerry, the "Dad," who they would see tomorrow.
The next morning, Jim called the doctor, and told him that they had found a place for "Dad", who is Jerry, and that he will be brought to the Sunshine Village at 9:00 A.M. The doctor found a time for them both, and they doctor was pleased. As it happened, the doctor has a two hour time when he can call Sunshine and meet with the Director. When Dad did not want to get out of bed, Jim helped him, and explained to the orderlies that he needs assistance for walking and also standing up. Jim helped him into his clothing, and Paula then showered and dressed. Dad didn't want to go out this morning, but they wanted them to come and get into the car. There was an impasse, and Jerry would not talk, would not eat, and he insisted he wasn't going.
Then Jim said, "Hey, Dad, we were going to get you out for a breakfast at the diner." No one really knew whether he meant that or not, but they got into the car. The director greeted them all, and invited Jerry to come in and have a seat. She asked him if he would like something to drink, and he said orange juice. She called the kitchen and they brought it to him. He seemed to enjoy it. She was going to take Jerry to see the facility, and he didn't say much, but he did walk along with them. While they were on the tour, Paula accompanied them, and Jim went back to the Director's Office. He assisted the Director and then they asked questions, such as Insurance, and Social Security, And Medicare. They were asked if they wanted a single room or a double. Jim told them that he would prefer that he was in a double room, and that way, they could always talk to someone. Jim had given the information on his doctor, and the one medication he is taking. The Director asked if anyone has a problem, or need something, can we call you, doctor, or do we ask the nurses to call the doctor? They were there for about fifteen minutes, and then they went out to the diner, for some lunch. The Director and Jim both have papers for Jerry's nursing care, and also medicines, food, and the occupational therapy.
Jim seemed happy, and he said, "Dad, we're going to the Diner." Dad said he wanted some nice pancakes, and everyone laughed. Paula told the waitress that the older man has to only drink decaffeinated coffee, and she agreed. They seemed to enjoy their lunch, but it was hard for them to worry every night, that he might try to go outdoors.
Tomorrow, Aunt Edith and Uncle Harold will be coming with Paula and Jim, who are also bringing his clothing. They also bought a shaver, a bar of soap, comb and brush, and an extra pair of glasses. He also has toothpaste, toothbrush, and some deodorant, and Harold put a couple of books that Jerry likes in his suitcase. His favorite present was a TV Guide, so he could see what shows were on, and also which are the news shows.
It was an empty feeling when they left Dad in his room, and Dad had met a nice man, and they seemed to like each other. They both liked checkers, and they were assured that they could ask the nurse, and she would bring them to the game room.
And, Family Feelings in Poetry
Who WAS this man, some years ago?
Who now will not eat, the food he throws.
And what about that lady, there-
Who sits alone and simply stares?
Who was this feisty woman, who
Didn't know her children, too.
Where are their minds?
Oh God, do tell !
And in your mercy,
Make them well.
Who is the man who smiles at me
He wants a date, but he's ninety three.
As they are seated, ready to eat,
Tablecloth's down, and wheelchairs meet.
Who was this child, with parents who cared-
Who once was loved and an adult who fared.
And what of the once little girl, bathed and dressed,
Who said prayers to Jesus, her head on Mom's breast.
What happened to all folks, nice-looking and fine
They grew up, went to school, then grew old, at their time?
Mem'ries in pictures, with fine sparkling faces,
Looking happy at other times, and other places.
They passed many birthdays, had good and bad times
Then everyone wondered, "What's wrong with Mom's mind?"
Trip to the doctor, they found out at the table
Their mom, who once cared for them, now she's not able.
The disease robs identity, some cannot talk-
Others won't eat, some others don't walk.
They can't understand "present", nor who are their friends
They don't know their loved ones, it then starts to end.
Bewilderment seen when they can't find their beds-
Short term mem'ry is gone now, confusion instead.
The disease, it progresses, it's never the same
Most don't know others, nor know their names.
Where are their minds?
Oh, God, please do tell-
And in Your mercy,
Do make them well.
Once, all had enjoyed a regular life,
Perhaps getting married, a husband or wife.
And somewhere, at sometime, their lives went awry-
A disease of the month, as I sit here, I cry.
Lord, please help these families cope with their loved ones, though-
The loved ones, no longer recognized their parent's or children.
This poem is about emotions when one sees or cares for an
Alzheimer's patient. The story is fictional, the poem expresses
the emotions of loved ones, or those who care for them.
© Toni D. Helfrick, R.N.
“QUALITY FAMILY TIME”
(a Hospice short story)
They are a special and loving family, and their laughter resonates and echoes from the Dining Room. Earlier, I had helped their father into a wheelchair, so he could be with his wife, and his married children.
Many of the family have flown here from the north, to be with their father, as he is failing. He is a little weak, but was encouraged by his family to join them at the table, and he agreed, despite being tired. This loving man has but a few short weeks of his life, but he wants to spend his time in the midst of his loved ones and hear stories told over and over amidst laughter, as it helps him remember all the good years, when he was well.
I am in another room, so that these family members could share all their time with him. I told his wife that if there were any problem, I would come when called. I felt he needed to be just with his family this night. It is a beautiful thing to hear or see these loving grown children and his wife who all love this man. And, they each have given of themselves to spend quality time with their father.
These are the things that will reverberate for many weeks in my mind, and they are thoughts he will likely take with him to the grave, perhaps even smiling inside. A very fine man he is, he and all the others, who have the New Jersey/New York accent, much like mine, and I feel right at home, having lived in the Northeast U.S. most of my adult life, and all of my childhood.
This is a special group of people, caring, loving and kind. One of his children cooked most of the dinner, and made all his favorite foods, just for him. Their laughter goes on and on as they relive old memories of the past...
“Hey, do you remember Grandma catching a blowfish on the Long Island Sound, and throwing it back in the water, thinking it was pregnant?” (Laughter)
They again laughed at one of the stories of an adult son, who was strip searched at the La Guardia airport, as his backpack held an old rusted Boy Scout knife... We all laughed again. It was almost contagious, and though the stories were not the same as those my family told, they were very familiar.
These memories and others had been told and retold, and definitely were to the delight of all those at the table. Each of them loved the stories, and knew when the funny part came, and they all laughed many times over. When it became time for bed, I walked into the family’s diningroom, and I saw the patriarch, my patient, with a big smile on his face. I told him I wanted to make sure he was feeling well, and then I added, “With that big grin on your face, Angelo, and the twinkle in your eyes, I am certainthat you have enjoyed this”.
He agreed, and admitted he was “just a little” tired. After getting him ready for bed, he finally admitted that, “You know, I really didn’t want to get out of bed, but it’s the best thing that ever happened to me. It was wonderful”. I told him it was wonderful to see the smile on his face, and shortly thereafter, he fell asleep.
His children would care for him, as would his wife, throughout the nights when there was no nurse available... These are the special parts of a loving family- love for each other, trust, caring for all of their group, teasing, laughter with cackling and lastly, everyone pitching in to do the dishes at the end of the meal, and... the laughter.
I was blessed to have been raised in such a family, and I thank God for the very fine people, my parents, who loved me as a baby, a toddler, a child, and a free thinking teenager, which I was, and as an adult, also. Acceptance is a part of love, and we all went through the teenage years.
This lovely family gave me some fine, happy feelings being in their midst, and I felt very much at home. And, I felt very thankful that I had this type of family, and I know this was what I was given as a child, mostly love, caring, trust, a feeling of safety, and all kinds of childhood laughter. For that, I thank God, and I shall spend the rest of my life helping my children understand how to raise their own children...
And I will continually seek to comfort the Hospice families and the patients, to make their last time with each other as pleasant as possible.
~AUTHOR’S NOTE: The names, situations and other situations have been changed, for the privacy of the patient, and the family.
© T. Helfrick, R.N.
Poetry by Toni D. Helfrick
Story-Poems by Toni
“Another Day” - story-poem series
“The Colorado Gambler and The Lady” - story-poem series
“River For the Lonely” - story-poem series
Essays by Toni
Short Stories by Toni
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