Sea of Love

Love is a mighty splendid thing. It is a wonderful emotion that is vital to our very existence. It is the thing that keeps us going when times get hard, it is that thing that gives us warm fuzzies inside when it happens. When we fall into that sea of love it tends to overtake all that we are, and occupies us to a whole new level. Love is that very thing we draw to when we have feeling have been hurt or someone / something has wounded our heart. Love lives within us. It is there and we chose who and when to display that love to others. Amazingly there are different kinds of love, there is the loves we have for our spouse, our children, friends, family members, church family, out priests or pastors, the teachers that our children love, or hate because they are a little tough on them to help them achieve their full potential in the classroom. Yet, we don't really think about Love that way, we know the thoughts and feeling of love, and we seem to run with it when it happens.

Yet, there is so much more to love then the simple emotion. There are the actions of love as well. That someone thinks of you often helps you when you are down because they care for you and about you. Love is there in the daycare, where you leave the children for 8 to 10 hours a day. Love is present in the nursing homes where the elderly are left and no one come to visit. The staff is there to talk to them, hold their hands, listen to their stories, and simply share life with them when they are feeling blue. Love is there in the ER when the doctors and nurses are running around to save or help the one that you love feel better, or if one passes they are there to help you grieve, bring you resource to help you deal with the death of a loved one that is unexpected, they listen, they care for you and all that has just happened. They are there because not only do they love to help others, but they are also a source of support and a listening ear when things go wrong. There is love that is happening in rehab home as those who are there are struggling to learn or relearn skills. The staff are there to rejoice with them when small steps are going right and there is an improvement, it may be a small one that is easily overlooked, but to the individual it is amazing, and staff understand that and rejoice with them.

There is love in the supermarkets, the Target stores, the Wal-Marts, Kohls and any other business that one may go to on a daily basis for work. There is a sense of family that is able to develop around you with co-workers. We start to develop friendships at work. There are people we like to talk to when things go wrong, others we can tell anything too, and some we like to shop with or go out with at the end of the night. In it all there is a friendship that forms and binds us to one another and at the center of it is Love. Love is there when we worry about a co-worker is not coming to work, and we are not sure what has happened to them. We have a bond with those individuals that tend to go a little deeper then just a person we work with, when essential we come to care and love them as a part of a extended family. We may not celebrate holidays with them but yet we care for them and worry about them if something is going wrong in their lives and all seems to be crashing down around them.

Although, at the center of all love is God. He is love, he shows us His love by dying on the cross and taking all the sins that we have ever committed or could ever conceive of committing and wipes our slate clean. He loves us with an love that there is no other love that is able to compare to it. It is a love that is always present in us, we know that God cares and loves us on a daily basis, and that there is no way we can earn that love. Rather, His love is freely give to all those who are willing to accept Him and walk with Him, talk to Him through prayer. We are able to run to Him in our times of need and never, ever will He call us needy, or childish! He is there waiting and wanting to shower us with His love is we go to Him. We are able to learn about Him through reading and worshiping Him in our homes, along with attending mass / church on Sunday morning. If we are truly lucky we are able to attend church or mass more so we are able to commune with Him on a more intimate level. By growing in God and in His Love we are able to reach out to other and show them the Love of Christ through our action, our words and by just being a Child of God in these hard times. We have the opportunity to love and be loved by the Father in Heaven, why not accept the free gift that he offers us and walk in His love daily.

Depressed Elderly?!

I work with the elderly almost on a daily basis, and when you work with people all the time you tend to notice things, and it does help that I am a nurse. I have seen depression in the elderly population and the little to help them. I can tell you if you are in your 20's, 30's, 40's, 50's and even early 60's and you live at home that you will be probally treated differently for depression then if you were living in a nursing home in your 60's, 70's or older. In the general population you call the MD and make the appointment to talk to the doctor about what is going on, the signs and symptoms. Then if they feel you are displaying signs of depression they will refer you out to see a therapist. So that  you may explore the feelings, the root of the issues that may take years to find or months to surface but you are there and want to feel better so you take the risk and develop that therapist / patient relationship that becomes so vital to your well being. This relationship is one that you know in a moment of crisis you can pick up the phone and the one that you talk to will know you, what is going on inside you because you have shared the past and the emotions that goes with all the pain and hardship with them already. So when you are in a moment of need, real need that goes beyond your husband, wife, girlfriends, and all other family members you reach out to them for a word of direction, you know they are there no matter what and will not laugh at you, tell you that you are crazy, rather listen and get you through the moment, hour, or minutes what ever the case may be at the time to bring you back to the place where you are able to function again  in your life, then they will see you in the office usually that day or the following day depending on the time that your crisis occurs. Then you build that relationship til you have the skills to function and live as your need to without feeling as if life is always in the toilet, knowing in the back of your mind that if you need to see the therapist again in the future they are there a phone call away. But what happens if you are sad and in a nursing home, if depression sneeks up on you there now what do you do? Do you dare talk to the nurse? Do you want to have the staff think your crazy, what will your family say? Will they tell your family? Will they be disappointed? After all they are an adult, and they should know how to handle things being they are now old right and have lived all their life and now they are depressed? What do they have to be depressed for they have people all around them all the time, they have relaxation to the max.  Why would the elderly be depressed or have symptoms of depression?  Yet the elderly is a population that depression is rapid in and often can lead to suicide. I cannot say that I have ever heard of a elderly person committing suicide in a nursing home, but the elderly living on their own it has and does happen. The staff in the nursing home start to notice things about the resident and tip them off to the possibility of depression. They then have to call the doctor and get a referral for the resident to see the Psychiatrist. Now, before they resident can run off and talk to the Psychiatrist the family has to be notified and they have to agree to their family member seeing the new doctor (psychiatrist). If their family mainly their power of attorney say no there is nothing that the staff can do other then monitor them, talk to social services and see what they can do on their end. Unless the resident makes threats to harm themselves or others, but you then have to take into account do they have dementia? Is this there dementia talking or is it an expression of their true feelings? The key here is the consistency of staff, knowing  your residents, paying attention to them as their nurse. Talking to them and building that Nurse - Patient relationship. This relationship is vital at this moment, because you are there to take care of them, and that is so much more then passing the medications, and doing dressing changes. This nurse - resident relationship in a nursing home is vital to them and vital to your care of the resident. The nurse in this situation is key, because if you are working and you don't have that vital relationship established, because you are only there to deal with medical issue, pass the medications then you are missing what nursing is all about, it is about taking care of the residents. Yes, that does include the whole person, physical, mental, and spiritual issues. You have to talk to them, get to know them so you can care for them they way that they deserve to be taken care of, you have to care about them in order to reach them and talk to the doctor about the mental health matter that is at hand. So after all the careful consideration you call the family and talk to them about their loved one and they agree that their family member is down, or not acting right and agree for them to see the Psychiatrist. In other cases they were just waiting for the nurse to say something, because they have noticed a change yet were unsure how to approach the subject matter with the nursing staff. So when you finally bring it up they are relieved that they will get the help for their loved one. They agree to them seeing the Psychiatrist to find out what is going on, so then we get the consent signed, and make the appointment. Now depending on the facility the resident may go out or the Psychiatrist may come in to the facility and talk with the resident in their room. After they are seen the Psychiatrist will make recommendations based on their findings when they spoke to the resident. They may recommend a new medication or two, then the Nurse will take the orders and process them, but before anything can be filled, we have to have permission again. The nursing staff will have to call the residents power of attorney and speak to them about what the doctor has recommended for their loved one. If they agree then we get the consent and start the new medication(s), and they sign the paperwork for the new medication(s) when they come in to visit their loved one. Simple right, well not always, sometimes the family refused the medications and then the nurses hands are tied, they can just talk to the resident and their family and refer them to social services. Also if the family doesn't call often or visit often it can take a week or longer to get the consent verbally for the new medication(s). Meanwhile the resident is sad, anxious or what ever the case may be at the time, and the nursing staff cannot help other then talking to the resident or calling and having social services talk to the resident. One thing that is very different is the elderly in the nursing home usually do not have any form of talk therapy. So this is the nurses job to talk to them, help them deal with recent losses in their abilities, death of friends and residents that they are close with along with any other issues that they are experiencing. Again that Nurse - Resident relationship has to be there otherwise they are not going to open up to you as the nurse. The Psychiatrist will follow the resident and monitor the resident's progress, monitor their behaviors, are they getting better, has the nurse and staff seen an improvement in the residents behavior. They will monitor the medication(s) and make the necessary adjusts to the medication(s) as needed. Yet, if there is a change in dosage, frequency then the nurse is calling the power of attorney again to discuss the change and get the consent(s) signed for any changes that need to be made so the resident can enjoy life to the fullest even if they are living in a nursing home. It is a different world if you live in the nursing home and you are depressed, but their is help, if the nurse and staff take the time to know the resident and are not there just for the paycheck. Nursing in a Nursing home is different then any other setting we are more involved with our residents, because we have to be and should want to be for the care of the residents.

The Guilty Left Behind

Being a nurse that works with the elderly, I deal with dying a lot, not daily but often, it comes with the job. I end up watching my residents die and helping them in some sense move on to heaven. I am there to give the medications, keep them comfortable, when they are restless, talk to them, hold their hand, and let them know it is ok to let go and to move onto the other side. It all come with the job, yet there is an annoyance that come with all of this too.....that is dealing with some of the residents families! The ones that you haven't seen in years, the ones that never call or even bother with the resident, until the end is near. When you have to call the family to let them know that their dealy beloved is declining and dying, yet not telling them that they are dying all at the same time. As the days shorten and they move closer to death we call again to update the family that their beloved is approaching the end of their life. Then the fun begins.........they come in and now question every move and that you make, along with wanting to know why this is happening now, they were fine a week or so ago! Yet, did you call them a week ago? Have you been in to see them? Sadly, unless you are the residents power of attorney or on that list that says we can talk to you about the resident, we cant tell you a thing over the phone or in person with out permission. It is the law. Now with that said, when the families do come in, and some are a emotional wreck, while others I am not too sure of their status, other then they are there to watch them pass on. Until the guilty ones walk in, now they are the fun family members. They are the ones that cry at the moment and try to tell the nurse that their dying family member is not that bad, they will pull through this, that this is just temporary thing! Now they are here to visit, they wont leave the residents side other when aides and nurses need to tend to the resident. It is then that they will walk out of the room. Then promply return and sit in with the resident, this is the funny thing though, they are not talking to the patient that is dying, they are not telling stories to them, no stroking their hair, not holding their hand, NO! They are not there for the dying family member they are there because they are obilgiated. They are there to sit and talk among themselves about everything that is going on in the world other then the issue that is at hand. They are sitting in the room watching t.v and act as if it is the nursing job to wait upon them hand and foot! Now granted we bring in food, coffee and juice for them, but this is not a joyous time, they are dying! Yet, now they want to be all involved in there care, know everything that is happening, and yes they too expect us to know how long will this whole thing take? What? I don't have that answer, talk to God, I can judge a little, depending on what is going on but they all go when they are ready not when we think they are ready. They want to know why and we explain to them the dying process and answer all their questions, but asking me their care for the last 2 to 3 months is not going to change the fact that they stop eating, they stop participating in some activities. We cannot make them eat, drink or any other thing in the nursing home. It is all part of the dying process, they all go through the same steps, and if you are not here and do not call and check on them, we cannot force you to care for your family member that you left here for us. It is so sad to watch some o them go, but it is even sadder when the family is there and you can tell it is all out of obligation, and not out of love, care and concern for them. Then when your guilt sets in, we will help you grieve, but we are not there to take your guilty conscious away, that is now between you and the dying and God!