Avoidance.

Alida Van Klompenberg, aged 76, of Grandville, went to be with her Lord on Friday, January 15, 2010. She was preceded in death by her husband, Howard. She is survived by her children, Deb and Bruce Kadzban, Dave and Kathy Van Klompenberg, Nancy and Doug Kadzban, Joel and Melissa Van Klompenberg; nine grandchildren; one great granddaughter; her brother and sister, John and Virginia Dantuma, Fran and Ron Aardema; her in-laws, Winnie Dantuma, Wayne and Hazel Van Klompenberg, Martha Van Klompenberg, Don and Millie Mulder; many nieces, nephews, and cousins. Funeral services will be held on Monday at 11:00 a.m. at the Zion Reformed Church with Rev. Greg Brower officiating. Interment Jamestown Cemetery. Friends may meet with the family at the funeral home on Sunday from 2 to 4 and 7 to 9 p.m. Memorial contributions may be made to Grandville Senior Neighbors.

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I'm pretty sure I've been avoiding this entry for about a week now, and for good reasons.

1) How is it possible that while somedays I'm insanely bored from sitting in this house all day, by the end of the day I look back and realized that I have barely had a moment to myself?

2) I think I'm just unsure how to talk about this entry.... one that I know people have been waiting for... because it's not only close to my heart, but quite overwhelming.

So for the sake of my sanity, I'm going to try and keep this entry brief. I know I've said that in a number of my other entries that have turned out ridiculously long, but this time I hope I mean that statement.

This morning, I woke up and realized that Grandma VK has already been gone one week.

I realized that one week ago, I made a phone call to my husband at work that broke both of our hearts.

That one week ago, people who I love dearly lost their mother, grandmother, and great grandmother all in a single moment.

The flowers from her funeral sit in our entryway. There are three red roses sitting on my windowsill above the sink that I look at 20 times a day. Both are repeated reminders that she's gone and aside from the memories and pictures, that's all we have left of her. 

And flowers can only live for so long. I think of that every time I see them and I wish I could keep them alive forever.

But if you know me, you know that's not likely. (Insert laughter here)

I also realized this morning that while it's often easy for me to discuss other people's losses in this journal, it's not easy to discuss my own. I'm all too aware that my family may read this and I don't want to inflict any more pain or sadness into their lives right now, so I'm not sure what to say.

However, the social worker in me knows that Grandma VK needs to be discussed. We can't go on in life acting like she wasn't here. She was. And what kind of justice would I be doing to my family if I ignored the subject? What kind of signal would that send? A message that she wasn't important? Because she was. She was important to this family and because she was important to them, she was important to me.

I hate to see my family grieving. I hate watching "The Sob Sisters" sob (and I say that lovingly, Aunt Nancy and Deb!). I hate that they're hurting. I feel so much compassion for them because I know that someday, that'll be Brittany and myself and we'll surely take over that title. I hate to see Dan, an otherwise comical and strong guy, let his guard down and then feel badly about it. I hate seeing my husband ignore/avoid his grief and just plunge forward into his busy life at 150%.

But I love seeing our family come together. I love seeing the support that's there when one of us is in need. I love that all too suddenly, we want to be together.

Grandma VK wasn't a healthy woman and so it didn't come as a surprise to me that we got that phone call last Thursday night. However, you're never ready for a loss in your own family. You're never ready to see your loved ones be brought to their knees with grief. To look around at the funeral and realize, "Wait, this is real. This is my family sitting in these pews. These are our tears. This time, I'm not on the outside looking in... I'm in the depths of this." I walk in and out of situations every week where my patients and their families are presented with a loss, sometimes suddenly and sometimes not. I'm able to walk into those situations and know my role, know what to do and most of the time, know how to help. But with my family? I wasn't sure of these roles. All I could do was be there. And I was.

I realized something else in all of this... it's amazing the kindness of friends during a time of loss. My coworkers were amazing to me last weekend. During a time when I wasn't sure I could be strong for others because I was trying to be strong myself, they were kind and protective of me. While I felt/feel guilty for not being there 100% to help them, I love them for what they did and I'm so appreciative of it. Certain friends were there and certain ones weren't... both by which I was surprised by.

This loss is one that's going to affect our family for quite some time to come, I know that much. Summer cookouts, Sunday get-togethers, Christmas, Thanksgiving, Saturday morning coffee, Tuesday afternoons, birthdays... those are all going to have a very different look and feel to those I love now that Grandma's gone. But while she's not here to spend those occasions with, she's still with us. We'll still feel her around us.... for me, I'll see her in Deb. In Nancy. In Joel and Dave. I'll make note of that "empty" chair that she "should have" been sitting in. And while I know that'll make me sad for a moment, I know I'll also rejoice because I remembered her.

I will remember her.

All of those things will be a reminder that she's in heaven now, dancing with Grandpa Howie.

And that will make me smile.

(short and sweet... go me!)

Sorrow.

Mike's grandma VanKlompenberg passed into the arms of Jesus this morning around 2 am.

While our family grieves this sudden loss, I find great comfort in knowing that she's again with Grandpa Howie.

Rest in peace, Grandma Alida.

We love you.

A sense of faith.

First, let me say that IOU an entry about NYE. As I'm short on time today but desperately need to journal, that one's going to have to wait.


So, here's my entry on last weekend... just in time for this weekend to roll out the red carpet for me.


Last weekend was by far the saddest hospice weekend I've encountered over the past year of me doing this kind of work. Because of the intensity of the emotions involved and the fact that this may be a topic I've covered a few times already, I'm going to try and keep this as brief as possible. 

Last week Friday, I did something I don't often do during the week. I checked my work blackberry to look at the "Weekend Report" sent out by the office. While it hadn't been sent yet, I did get an email regarding one of the patients in the hospital that I'd be working with over the weekend. There was much discussion amongst our staff on what the best practice would be for this patient, ethically and morally speaking. Because of the dynamics involved, I started preparing myself for what could possibly turn into a pretty intense Saturday.
Saturday morning arrived and I touched base with the triage nurse in the office as soon as my shift began. We laid out a plan for my day and off I went to the hospital. My first patient, the one I had been preparing myself for, was only 27 years old. After weeks of being in a nonresponsive state following the injuries she sustained from a car accident, her parents decided to discontinue all "aggressive treatments" that were keeping her body alive. 

Thankfully the patient, unlike many people her/our age, had discussed her wishes regarding life support and end of life care with her parents prior to her accident. While her parents had done everything necessary to save her life, once it was determined by the patient's doctors that she would not survive her injuries, they made the impossible decision to follow her wishes and let her go. That's where our hospice team came in.

I arrived on the unit with the intentions of supporting this family as they're daughter died following the removal of her last "aggressive treatment". It was expected that as soon as this form of treatment was removed that she would pass very quickly. However, as I walked up to the patients hospital room and noticed the door was shut and the blinds were closed, I knew she was already gone. My nurse, who had gotten there just 20 minutes before me, affirmed this to be true and stated that the patient had died just as she herself had walked onto the floor. 

It's amazing how impeccable my timing often is. I can't even tell you how many times I've walked into a room to find that the patient I was arriving to see had died only moments ago.
Anyways, I did my thing and provided the support that I could to the family.

However, unlike most visits I make, this one was drastically different. Of course it had a lot to do with the patients age.... it isn't often that we have young people on our service (although, we have had three now in just the past 6 months). But that wasn't the only thing... there was more to it than that. I couldn't put my finger on it during the three hours I sat outside that patients room, waiting for other family to arrive so that I could be there to provide them with any support needed by me. (Inevitably, they didn't really want any. Could I blame them though? No. They were probably looking at me and thinking to themselves, "She's [insert patient's name here]'s age. How could she understand this?" Or they were angry because here I was, a walking and talking person their daughter's age, while she lay motionless in a bed. I get it. It was completely understandable.) However, after I arrived home that night, I realized why this case was really different from the rest.

For the first time in a long time, my heart was numb during this visit. While I sat outside her room for those three hours, I opened the blinds a few times to look in at her lifeless body. My heart felt empty as I looked at her laying so peacefully in that bed. I expected a rush of emotion but it just wasn't there. At the time I couldn't explain that.

Later though, I could.

Yes, this girl was my age. But she too had a young daughter at home... one she adored and loved on just as much as I love Liana. One she called "peanut", just as I call Liana. There were so many similarities to our story and while our lives seemed to be very different otherwise, that one connection was all I needed. For self preservation, my heart was numb during that visit. Afterwards however, was a very different story.

Saturday night was rough. Actually, it was hell. You could've wiped the floor with me that night and I wouldn't have known. I felt defeated, horrified, sad, lonely. I grieved that night.... something which I don't normally have to do. Yes, all deaths are sad, but you learn to maintain your "social work boundaries" very well while doing this job because if you don't, you won't make it in this line of work. I wouldn't be able to be a hospice social worker if I connected with each of my patients... it'd be too emotionally difficult and draining.  But this patient I connected with on a superficial level. Like I said, it wasn't on many levels, just on one, but that one level was enough.

All I could think about was how this little girl just lost the most important person in her life. How on top of losing her mom, she'd now be losing the grandparents she'd been raised with too. I thought about how her grandparents lost both their daughter and their grandchild all in such a short amount of time. About how empty that house will suddenly feel. About how today, that little girl woke up in a new home with a new family after moving in with her daddy who lives three hours away from the place she has always known as "home".  So many losses for one family to face. So many.

So, Saturday night was rough. After sitting on the couch for hours and allowing myself to think about this patient and her family non-stop, I finally decided I had to get up. I had to do something to distract myself. Hence, I took down all the Christmas decorations and completely reorganized the basement (and boy, was that a task). Mike, who'd been out for hockey, came home at 1130 to find me still up. We went to bed but I couldn't sleep. My mind couldn't think about anything else. The last time I looked at the clock it read 2:30 am.
Sunday came along. And just when I thought things could only get easier, they didn't.


Sunday morning we did a vent removal. The husband of this patient broke my heart... those elderly men who have been married for 60 years usually break my heart the most. Once the patient was off the ventilator, she held on for five hours before peacefully and comfortably passing into the arms of Jesus. While her husband broke my heart as he sat next to her bedside talking about how lonely he was going to be without her while also telling her how much he loved her, he knew from the bottom of his soul that he had made the right decision for her. He knew that life on a vent is not a life at all under these circumstances and faithfully he let her go. He encouraged her that he'd be okay and told her to go home to finally be with her mother and sisters in heaven. She did. It was amazing.


And during this visit there was one moment that I'll likely remember forever. The floor nurse taking care of this patient shared a story about how her mother had died while on the operating table during surgery. While her mother ended up surviving, she came back to tell her family about what death was like. She explained that she saw this beautiful white light and found herself in a flower garden with her father, who had long ago died. They walked together, hand in hand, and after some time her father turned to her and explained that she "had to go back" because it "wasn't her time". The nurse stated that her mother didn't want to come back because heaven was so beautiful. While the nurse said that her mother would have typically done anything to be with her children, heaven was so wonderful it made her forget about all the people she was leaving behind.


Hearing this story gave me hope and a renewed faith during a time in which I wasn't sure why God would take a young mother away from her young child. I'll touch back on the subject of faith in a little bit. But this visit was good for my hospice heart. It renewed my love for the work.


After my visit with this family ended, we received another referral. Once again, I felt like I got sucker-punched in the gut as I received my report from the triage nurse on the patient I was heading over to see. This patient, who was only 40 years old, was dying from AIDS & lymphoma. My nurse and I walked onto the floor and received a second report from the floor nurse who had been caring for the patient throughout the week. She explained that during the week the patient's mother had visited and gave her some unauthorized medications (we're not just talking Tylenol here, either) during her visit. When hospital staff became suspicious and the patient's brother requested a drug screen be run, they ran one and found her positive for the meds. The patient's brother, who had been her primary caregiver for the past year and had devoted his whole life to caring for his sister, was beside himself. (Actually, that's a serious understatement.) Since being given the meds, the patient had taken a significant turn for the worse and while it's still unknown whether the decline was because of the meds or because of something else, her brother feels that their mother has "killed" the patient and plans to pursue legal measures.


Obviously, this visit was very dramatic and intense. I was actually quite thankful to be able to put my social work skills to use on this one because I had felt pretty helpless all weekend when it came to providing support to the families I was working with. I sat with the patient and her brother and tried to work through his feelings of guilt and grief. He shared with me the patients story about how she got AIDS and why he's such a fierce protector of his sister. It all made sense. I looked at the woman laying in that bed and my heart ached for her. 


No person deserves to be mistreated the way that she had been all her life. Her brother said during our visit, "Her entire life has been about pain."


This statement sent me reeling and left me feeling angry inside. I'm a faithful person, through and through. I may not attend Mass regularly, but I believe in God and in Jesus to the depths of my soul. I feel their love every day and am not naive to all the ways they've blessed my life. But why then, was this woman's life so painful? Why did she have to suffer so much? Why does any one person have to live 40 years of pain and hurt?


That's what I struggle with.


And while I became angry during this visit and even afterwards, that faithfulness didn't leave me. I don't know why He allowed so much pain in her life, but I hope there's a reason. A really good one.


Sunday night I was drained all over again. I walked into the house at 7:30 (my shift ends at 8) and hadn't even started my charting. I got through it as quickly as I could and went straight to bed around 10. Because I hadn't slept well the night before, I crashed that night. 


Monday, I got right back up and went back to work. It was a much better day and by the end of it, I couldn't stop thinking about the fact that without my faith, I couldn't do this work. How could I walk into a dying person's room each and every day if I didn't believe they were only beginning a journey that was more wonderful than anything else they've ever known? That with the end of one life comes another?


I couldn't. I believe that there's so much more beyond this life that we can't even possibly imagine. And that's what gets me through each and every one of my hospice days, no matter how bad they might be.
Last weekend was my saddest weekend yet but somehow, I came out of it feeling okay about life. Someday, when the loss is my own I realize it will be much, much harder to feel that way. But for now, I'm thankful. 


I'm thankful for the health of my family, the blessings in my life, and for my patients and their families because every day I go off to work I come home with a new or improved sense of purpose in life. While I may help them, they help me too.


What other job can provide me with that?