The importance of a living will

This week's readings were very interesting, although they did bring up a lot of feelings both good and sad.  This week I would like to reiterate what the text said about filling out a Durable Power of Attorney or Living Will.  I feel like this is the most selfless thing you could do in life.  Having a Living Will may release your close family from having to make those difficult decisions, as well as granting you your final wishes.  No one is too young to complete either of these forms.

My uncle (age 51) passed away one year ago, in his passing he did not have either of these in place and furthermore hadn't discussed his wishes with any one.  Being a "young" healthy man there was no reason to have either of these in place right?  Until he became very ill with pneumonia.  He was unable to speak and was being kept alive by machines in the ICU.  A week into the dying process family had a meeting and had to make a very difficult decision.  This raised several issues, most of the family did not want to prolong death and some wanted heroic measures.  Just when the family should be coming together they were being torn apart by this horrible decision looming ahead.  Ultimately they decided to "pull the plug", my uncle had passed with all of his family at his side within 3 hours.

After my diagnosis of Lymphoma, I recalled the difficulty my family had with this huge decision.  I was handed a living will at my first oncology appointment, I held on to it for a couple weeks not wanting to face the fact that what I have could be fatal.  After having many discussions with my husband about what I wanted in death I filled it out.  There is no reason I should leave that decision to my family.  My young kids and husband would be devastated to have to make that decision, and having seen how my mom and dad reacted to my illness I wouldn't want them to make the decision due to the "selfish" nature of parents.  I'm not saying my parents are selfish, rather they would want to keep their child safe and "alive" what ever that meant to them.

Again, I really enjoyed this weeks readings and can't believe how fast this quarter has gone, I would like to encourage all of you reading this to create a living will or fill out a durable power of attorney as we really don't know what may be around the corner.

As Good as it Gets

This week I enjoyed the article "As Good as it Gets".  I have often felt Europeans have the right way of thinking, not only do they enjoy nice pensions they have discounted/free travel!  For the younger generations Europeans are allowed much more time to stay home for child rearing in some countries new moms are able to stay home with their children with pay for up to two years.  This compares to our maximum of 12 weeks with many new moms only getting to take 6 weeks due to the need to get back to work to earn money. 

It was really eye opening to me to hear of the cancer surgery and 32 chemotherapy treatments that Trees had was free of cost to them.  The article also states that it could have cost them $30,000 if they had to pay for it.  The government putting limits on what can be charged for certain items must really limit the cost of items.  For each one of my chemo sessions (two days) my insurance was billed $44,000!

It is awesome to hear how the Dutch people are so willing to support each other.  It seems as if in the US we  are all about only helping ourselves, sometimes even family members are struggling and we won't/can't help them out, never mind helping out strangers.  Again I feel like this article was very informative.  Hopefully the Dutch will be able to continue on in the future in the same manner, since the population like that of the US is aging.

Midlife

Well after reading this week's topics I can't wait for midlife!  In some respects I think I am there.  After my diagnosis of Lymphoma I realized my limitations as noted in the article.  My educational/career goal was to become an ARNP  After my diagnosis I feel that RN is the right place to stop in my education/career goals.  This decision was very hard to make but, given that I would like to spend more time with my family it is the right decision for me and my family.  The changes in appearance in midlife as discussed in the text are not frightening to me either, in fact, when my skin matches my gray hair I won't have to explain to "every" patient why I look so young with gray hair.  By the way, don't ask your nurse how old she is then try to cover the rude/inappropriate question with "Well your skin looks so young, but your hair is white!"

I don't think midlife has to be a crisis and in fact, In the article "Midlife Myths" surveys showed only 10-12% of respondents felt as if they had experienced "midlife crisis".  What they often meant was that a crisis took place during midlife such as: divorce, loss of a job, or serious illness.  The text states the secret to successfully negotiating midlife seems to be ego resilience, a powerful personality resource that enable people to handle midlife changes.  I hope I am one of the lucky participants in life that posses ego resilience! 

I look forward to this time in my life.  I look forward to seeing that all of the work of raising my children has been fruitful (hopefully).  I look forward to new adventures, challenges, and retirement.  As I stated earlier I feel like in some aspects I am already moving on to midlife and I hope I am able to experience this time of my life gracefully and enjoy every moment of it, just like the other times in my life! :)

Domestic violence

I think I say this each week and I really mean it!  This week's reading was awesome and very informative.  I did though find myself really reading and re-reading the domestic violence articles from the instructor's notes and podcast.  I have experienced abuse both as a child and as an adolescent/young adult, I was also witness to my mom "taking a beating".  Fortunately for me my mom was very strong and decided to leave after only 7 months of marriage. I was only 5 at the time and distinctly remember the "Last Fight", after he pointed a shot gun at her head, my mom (all 5feet and 100 pounds of her) got up, grabbed the gun, punched him in the face and knocked him out, we ran to the car and left leaving all of our belongings behind!  I wish someone would have talked to her about domestic violence, or interveened sooner!  Looking back I now realize she had many of the listed warning signs long before I even knew what was going on; saying how clumsy she was she was always "falling and getting a black eye", not communicating with friends, and a lowered self esteem. 

I found the information on "helpguide.org" to be very informational.  The cycle of violence is so true, unfortunately I have experienced this first hand both as a child and a young adult.  I made the choice to leave knowing this is not what I wanted for my life.

Working in OB/GYN one of the questions we ask patients is "Do you feel safe at home?".  When I first started asking patients this, I felt as if I was intruding on their private life.  Now it is second nature and I feel like "If I don't ask, who will?".  I was very surprised at how many "No's" I got.  We support these women by giving them the DVSAS (Domestic Violence and Sexual Assult Services) 24 hour crisis hotline wallet card, we lend a caring non judgemental ear, we encourage them to phone 911, we also will set up a code word so if the patient doesn't want the spouse in the appointment she may use the code word and we will ask him to leave for this part of the exam. 

I loved the Do's and Don'ts and would encourage everyone to live by these items:
DO - Ask if something is wrong, express concern, listen and validate, offer support and support his or her decisions.
DON'T - Wait for him or her to come to you, judge or blame, pressure him or her, give advice, or place conditions on your support.

Now is the time for all of us to step up don't shy away from the warning signs if you see them, offer a kind smile and a warm "Is everything ok?".  I'll bet you might be surprised at the answer!