Participants: James Marcum & Danny Miller
Series Code: WM
Program Code: WM000385
|
00:01 The following program presents principles
00:03 designed to promote good health 00:04 and is not intended to take the place 00:05 of personalized professional care. 00:08 The opinions and ideas expressed are those 00:10 of the speaker. Viewers are encouraged 00:13 to draw their own conclusions 00:14 about the information presented. 00:36 David proclaimed praise God for I'm fearfully 00:41 and wonderfully made, I'm Dr. James L. Marcum, 00:44 And I wanna welcome you to wonderfully made. 00:47 Thank you for taking time out of your hectic 00:50 schedules and busy weeks to join us today. 00:53 We've a very interesting topic today 00:55 but one that's sometimes hard to talk about, 00:57 we're gonna talk about today's program about 01:00 caring for the terminally ill. 01:02 I'm fortunate to have Ron Mahlo with me today, 01:05 he's an expert in this area and he's gonna be 01:08 sharing some of his insights with us today. 01:10 Welcome Ron we're glad you're here, 01:11 thank you Jim. Now, tell me Ron what got 01:14 you interested in working with hospice. 01:17 Well Jim, I've been in medicine 01:18 for the last 15 years, probably about 01:22 10 years ago I really didn't know too much 01:23 about hospice, unfortunately my parents 01:26 became patients and that was my exposure 01:28 as a rewarding experience. 01:29 Now, for our listeners that might not 01:31 understand what hospice is? 01:33 Just give us an overview of what hospice is 01:37 and how does it differ then other programs like 01:39 Assisted living and other programs like 01:42 Home health, what's hospice is all about? 01:44 Well, the main focus for hospice is we focus 01:47 on comfort and care, not so much about 01:49 curing something. That something that once 01:52 the patient has determined that 01:54 they're ready just for comfort and care then 01:56 we could impact with them. 01:57 Hospice can impact you at your assisted 01:59 living home, in your home setting itself 02:02 for perhaps in a nursing home setting. 02:04 Okay, well that's exciting and one of the 02:07 things that I wanna speak to each one 02:08 of our listeners out there, there is many 02:10 of you here, that have to deal with some 02:12 of these issues. You might be coming 02:14 to the end of the life and I don't look at as 02:16 coming to an end of the life Ron. 02:18 I look at to coming on something new 02:20 when we have to sort of go out or die just 02:23 as well as we began this life. 02:24 So, that's why I think this is an important 02:26 topic for us to talk about. 02:28 Now, HeartWise Ministries is a 02:30 ministries was dedicated to bringing 02:32 the truth in medicine and the truth 02:34 in the scriptures to many different people. 02:36 Our three words that sort of talk about 02:38 the theme of the ministry is truth 02:42 and once you understand truth you have love 02:44 and then there's healing. 02:46 And looking at hospice and how hospice works, 02:48 you know hospice gives a lot of love 02:50 and there's healing even though a body 02:52 might die there can be healing that occurs, 02:56 that's correct, do you agree with that? 02:57 Now I'm sure you see that many times 02:59 in hospice, many times. Well, we've collected 03:01 questions from literally all over the world 03:03 regarding end of life issues and we're gonna 03:06 talk answer these on air today. 03:08 And first we would like to start from Doug 03:10 in Tennessee and Ron, Doug writes, 03:12 as he says, I'm very concerned about pain, 03:15 my doctor says I've terminal lung cancer, 03:18 how do you know if a terminally ill person 03:21 is getting enough pain medications especially 03:25 if they are not communicating well. 03:28 Jim, sometimes that can be difficult 03:30 I mean let's just face it without communication 03:32 it's tough. I always talked to my families 03:34 or the caregiver think about when you took 03:37 care of a baby, how did you know 03:38 if that baby didn't feel well? 03:39 You picked up on some of the objectives 03:41 and subjective things that we see, 03:43 maybe grimace, maybe their breathing 03:45 patterns have changed, maybe they're just 03:47 restless and uncomfortable, 03:48 those are ways that a patient can communicate 03:51 if they don't feel well. Okay, now Rod, 03:53 I've had a lot of patients that when 03:56 they're dying and I know they're dying 03:58 they're spiritually ready but they're still 04:01 uneasy about having pain. 04:04 What are things that you actually things 04:07 that you do to help alleviate the 04:08 pain process. Well, sometimes when 04:11 we need to look at there's two different 04:12 types of pain, there is physical pain 04:14 which a lot of times we can treat with 04:15 medication and be very successful with it. 04:17 But sometimes there is that mental pain 04:19 and some of the mental pain might be an issue 04:22 that they haven't resolved in the past. 04:23 Something that they're, they're afraid 04:25 to let it go and they have a hard time 04:27 communicating that or perhaps they're waiting 04:30 to see somebody, it's the pain they wanna 04:32 get resolved what every issue that 04:34 they're dealing with. So, one way it sounds like 04:36 you deal with pain as by helping them 04:38 resolve in mental issues. Now what are the things 04:40 do you help to do with physical pains. 04:42 Well, physical pains we look at medication okay, 04:45 but before medication let's look at some things 04:47 that we can change. Perhaps it's comfort, 04:50 perhaps they just need a hospital bed, 04:52 maybe an air mattress, things to make them 04:54 more comfortable of those natures. 04:56 Perhaps it's a change in the room 04:57 or temperature; after we've kind of eliminated 05:00 those things then we can easily change, 05:02 then we look at different medications. 05:03 There's narcotics; there's different just 05:05 simple pain medications, sometimes just plain 05:08 old Tylenol, Ibuprofen can make a big difference. 05:10 Okay, well let's get back to Doug's question, 05:12 so I hope Doug that answered your question 05:14 about how they can find out even if you know 05:17 if you not communicating well 05:18 if you're having chronic pain, 05:20 I hope this doesn't ever happen to you. 05:22 On the next question comes from Rachael 05:25 and she's in Iowa and she states 05:28 if I were to have a problem needing 05:30 a hospital and I was in the hospice program, 05:34 will the hospice program support this? 05:36 I think she's saying if she's in hospice already 05:40 can she still go to the hospital and get the 05:42 services that a hospital might provide. 05:43 Well, she can, the neat thing about hospice 05:46 is you have control as the patient 05:48 or as the family, if you ever wanna stop 05:51 your hospice services you can stop it anytime. 05:53 But let's say you need to go to the hospital 05:56 but you don't wanna stop your hospice services. 05:58 Perhaps you've been at home and 06:00 you're the patient and you've fallen 06:02 and you're hurting your hip. 06:03 You can go to the emergency room 06:05 and get that checked and then we can 06:07 if it is broken then there's some pain 06:09 issues that we can, we can alleviate 06:10 towards that. If you were to break your hip 06:13 and you decided that you want to go forward 06:15 and have curative treatments for that, 06:16 more than likely at that time hospice would 06:18 step back, if you wanna pursue that 06:21 but again remember at anytime you can reop 06:24 your hospice, okay. Now, the other thing about 06:26 hospice in the hospital is let's say 06:28 you're at home, you're not doing well that 06:30 time of life is coming or perhaps you're family 06:32 in stressed. It can be an economical burden 06:35 of a family member taking time 06:37 off from work, there are programs that 06:39 if hospice is contracted with the local hospital 06:42 that they can do some respite careful 06:44 for 5 or 7 days to make a difference. 06:46 Wow, that's good well you know in caring, 06:48 in caring for the terminally ill, 06:50 I mean that's such a hard topic to talk about 06:54 because everyone seems to run away 06:56 when some ones, when you can't cure them. 06:59 But I see you know when you careful 07:01 the terminally ill there's more than a physical 07:03 death here. You know I see a lot of times 07:05 as people are coming to the end of life 07:08 they're able to heal in other ways you know 07:11 they'll say listen I have to get my life ready, 07:13 I have to make things right in my mind, 07:16 I have to you know make sure that my 07:18 relationship with God is good. 07:20 So, there's healing that occurs even though, 07:23 even though the body might not be healing 07:25 and that's sort of why I look at this, 07:27 this is such an important time in life 07:28 and it seems like we just don't talk enough 07:30 about it. Some of the best witnesses 07:32 I've ever experienced for other Christians 07:35 are those that are sick, those that are seeing 07:38 the end of their days coming and they wanna 07:40 get the word out, they've resolved 07:42 their issues, they have that strong relationship 07:44 with Christ and they wanna project it. 07:46 You know I was thinking the other day, 07:47 you know we make such a big fan fare 07:49 when a baby comes into this, you know we have a, 07:52 they have baby showers and lots of presents 07:55 and everyone's happy and wouldn't it be that 07:57 way if every situation were someone passed 08:01 or went to sleep in the Lord. 08:02 Wouldn't it be great if it was a celebration 08:04 like that and the healing process 08:06 was there. It would be wonderful, 08:08 this is a life that's experienced so much, 08:11 I've seen many changes, what a great time 08:13 to celebrate. Now, it seems like when in 08:15 families when there's a passing, 08:17 that's significant amount of stress, 08:19 not only of immediate family but the caregivers, 08:22 does hospice are they able to meet some of 08:25 those needs too. Well through hospice 08:27 they try to utilize volunteer systems, 08:29 okay perhaps come in and give that family 08:31 a little bit of break. The other thing is perhaps 08:34 if you know the hospice nurses coming 08:36 I encourage families to take that time maybe 08:39 go to the park, walk around the block, 08:41 just get out, get a breathe of fresh air, 08:43 recollect yourself before you have to go back. 08:45 Okay, well let's move on to our next question 08:48 here and this comes from Gina in Virginia 08:51 and Gina I hope your listening today. 08:53 Gina asks, who makes up the hospice team, 08:57 I assume a nurse, chaplain and doctor, 09:00 could you define the roles of each as I have 09:03 a team caring for my grandma and there seems 09:06 to be a lot of overlap. Well, the hospice team 09:09 she's right, okay, there is many 09:11 components to it. The number one component 09:13 is the caregiver or the family 09:15 okay, maybe it's a good friend, 09:16 those are the key, and we rely on them heavily. 09:19 The secondly is a doctor or medical director 09:23 for the hospice agencies. Now, what's their 09:25 responsibilities? They'll come out 09:27 and see the patient; they'll help manage 09:28 the care, they'll kind of oversee the entire team 09:31 as they go forward. Personally the hospital, 09:35 hospice director that I've worked with has been 09:37 very involved with the patient, enjoys going out 09:39 and having prayer with them and seeing them, 09:41 very instrumental. Secondly, you might have 09:43 a nurse practitioner involved that works with 09:45 the nurse and with the medical directors. 09:47 You have the nurses, nurse would come out 09:49 every day, may be they'll come out 09:51 three times a week. It just kind of varies 09:53 on the condition of the patient, 09:54 how often that they wanna be seen. 09:56 Now, will they come out every day 09:57 if someone needed it to come, 09:58 if they're needed they'll be there everyday, 10:00 okay. That's the unique thing about hospices, 10:02 there is a nurse on call 24 hours a day, 10:04 7 days a week. All they have to do is pick up 10:06 the phone and a nurse should be there within 10:08 an hour on top of that you have nurses aids 10:11 that came out and help with bathing 10:12 or small household task around the house. 10:15 Volunteers are involved, social workers that help 10:18 you work through, if there's insurance needs, 10:19 perhaps paying your bills. If there is state 10:22 assistance that need you to come through, 10:23 everybody is a unique part of it. 10:25 Okay, so this is not like treatment 10:27 for the patient, but sounds like it's treatment 10:31 for the family, helping them with another many 10:34 issues that they might not normally you have 10:35 health with. One of the regulations 10:37 of hospice is that each hospice agency 10:40 has a team meeting we would like to call it, 10:42 okay. Maybe they meet about once a week 10:44 and they discuss the patients with all 10:46 the team there. You have dietary input, 10:48 you have pharmacy input, chaplains, 10:50 social workers, the nurses involved, 10:52 the doctor, everybody approaches us from 10:54 a team approach. Sometimes we invite the 10:56 families to be a part of it, good, good I'm sure 10:58 they'll like well Gina I hope that answers 11:00 of your question and the next questions 11:03 is from Fred, Fred lives North Carolina 11:05 and he says this is a very short question. 11:08 If a person cannot swallow what other route 11:12 can be used to help with pain and nutrition? 11:16 Very good question, and we could answer, 11:18 I ask this a lot, because as the patient 11:21 deteriorates, there's gonna be issues perhaps 11:23 they can't swallow. There's different ways 11:25 to give medication and unfortunate way you know 11:28 we can crush a pill and place it underneath 11:30 the tongue much like those with cardiovascular 11:32 disease can take nitroglycerin, 11:34 on some medication we can do that. 11:36 Now, do you really want to even give medications 11:38 if you know the person is dying. 11:39 Well, if they need it, okay again we don't wanna 11:42 over medicate them, our goal is comfort, okay. 11:45 We don't want it under, we don't want it over, 11:47 we can give liquid perhaps they can swallow 11:49 the small amount of liquid, some drugs 11:51 we can make so important that just 11:53 a drop on the tongue alleviates what we need, 11:56 okay. If that's not the route, 11:57 we can also do IV, we can do a 11:59 subcutaneous injection where a little bit 12:01 of the medicine goes underneath the skin 12:03 another route is rectally. Some medications can 12:07 be absorbed that way, so there's different 12:09 routes that we can do, another great route 12:11 and this is a, a booming business starting 12:13 to come forward as topically, 12:14 perhaps a patch or a cream that can be rubbed 12:17 on the skin absorbed through the skin 12:19 and alleviate pain that way. 12:20 Now, do they still this years ago, 12:21 I had a patient that was terminally ill 12:24 and we use aerosolized, we aerosolized the 12:27 medicine and they breathed it in, 12:28 is that still being done. You know it still is, 12:31 I think a few years ago it was maybe 12:33 a little bit more popular, 12:34 I think it kind of waned, it's coming back, 12:36 you can inhale morphine, Lidocaine or different 12:39 deadening drugs to help relieve some of 12:40 the pain or information. And then you always 12:44 hear about people getting too much pay 12:46 medication and having someone quit 12:47 breathing, how is that managed, I mean 12:50 how do you where there's you know 12:52 you're giving too much and you know 12:53 and because I assume that at some point 12:56 the family is actually making decisions 12:58 on whether to give medicines right. 12:59 Well, actually the family makes that decision 13:01 probably more then the nurse, 13:02 okay so how would you tell the family not to, 13:05 what's nothing, what's not too much 13:06 as we certainly don't want anyone 13:08 to have pain. Well, if the hospice has been 13:10 involved early in the case, 13:12 that family teaching starts at day one, 13:14 okay and a lot of times they know the medicine 13:16 better than a lot of people do. 13:18 And so they'll be familiar with medicine 13:20 and they'll know things that they look for 13:23 is how faster are they breathing. 13:25 Are they very shallow breathes? 13:27 Is their level of consciousness changing, 13:29 are they over medic, or they not 13:30 responding as well. On the other side 13:32 of the coin is what if they're not 13:33 given too much, what do we look for much 13:36 like our first question, right. 13:37 Are they grimacing? Do they have this look 13:39 on their face of pain and discomfort, 13:41 are they restless, those are how they're adjusted. 13:44 Okay, I see well excellent okay the answer 13:47 of Fred's question is there's lots of other 13:49 routes the pain medicine can be giving. 13:51 Now, the next question is from Max in Kansas, 13:54 Max in Kansas writes when someone in hospice 13:58 care for terminally ill passes away 14:01 what happens after that and he says, 14:04 does a family make arrangements 14:05 with a funeral home or does hospice still support 14:09 the family and what happens after someone 14:12 doesn't need the hospice services anymore. 14:14 Well, each hospice agency is gonna has 14:17 different protocols and reactions differently. 14:19 Probably a basic way of things happening, 14:22 we've supported the family and let's say, 14:24 I get a call in middle of night that the patient 14:26 has passed away. The family is there, 14:29 I talk with the family, upfront I get an idea 14:32 of what funeral home would they like to use 14:34 have they already made arrangements. 14:36 Now, let me stop you there, do you find 14:37 that hard to talk about you know which you know 14:40 is that harder? It can be tough, 14:41 you know pick it out you know whether 14:43 they wanna be I guess some people are cremated, 14:44 some people care you know how do you, 14:46 do you sort of let them make those decisions 14:48 or do you led them. I let them make the 14:49 decision wholeheartedly. If I know the patient's 14:52 choice upfront I try to reiterate that 14:54 with the family, to make sure that 14:56 they're following the patient wishes. 14:58 Sometimes a patient has confided in me 15:00 without telling the family at those points 15:03 I tried to share that information and 15:05 make sure that the family is aware of the 15:07 patient's wishes that was known. 15:10 Funeral arrangements are normally made 15:12 by the family and a lot of times 15:14 I encourage patients that if they're able to, 15:16 to go down and work with their spouse 15:19 and make the arrangements for their funeral. 15:21 The family does not need to go through that 15:23 after the passing, they need time to grieve 15:26 and if it's all said and done ahead of time 15:28 that way the patient's wishes are done, 15:30 the family is respectful for that, 15:32 it's much easier for everybody to go through 15:36 the grieving process. Okay, so your patient's 15:38 been in hospice and you know had a wonderful 15:41 experience all these issues have been resolved, 15:43 they pass away and you think you've got 15:45 the family ready. Is there still any 15:48 interaction with the family and for how long 15:50 does that interaction occur, because you know 15:53 they have some healing that needs to be 15:54 occurring too. I always tell families that 15:56 hospice just doesn't stop there, 15:58 hospice continues on. The guidelines say 16:00 that for thirteen months after the passing 16:02 of the patient that bereavement care 16:04 can be given, many hospices might be 16:07 through the chaplain service, 16:08 a nurse might still stay in touch or a social 16:11 worker counselor, that they can talk about 16:13 these issues and help someone as they grieve 16:14 through the process. You know I wish that 16:17 could be done more often because 16:18 I think of my patients that aren't in hospice 16:21 and their loved one dies and I see all the 16:24 depression and grief that they go through 16:26 and they don't really have that supports. 16:28 Now, if someone was not in hospice 16:31 and wanted to get some bereavement support, 16:34 what would you advice them to do? 16:36 You know for instance you know someone dies 16:38 suddenly and you know you're heartbroken 16:40 there is really no one else to go, 16:42 you know we were that person you know 16:43 I guess the church would be a place 16:45 they could go but could they, they volunteer 16:48 for hospice or get help from hospice. 16:49 They can volunteer for hospice or even just 16:52 pick up the phone and say and explain 16:54 the situation, I don't know if any hospice 16:56 worker that would turn that caller down, 16:58 I think that they would like to talk to them 16:59 and maybe put them in touch with different 17:02 support groups because you know that's such 17:03 a major loss you know, it's a loss of a loved 17:06 one or a spouse or someone and you know 17:08 that's something that requires healing 17:09 and it requires healing, you know people 17:12 have to help with that, that type of feeling. 17:13 Well, a common scenario is a patient's 17:15 passing away, think of all the activity you have 17:18 nurses coming in and you have doctors 17:20 coming in. Bath assistants, social workers, 17:23 everybody is concerned, your friends 17:24 and neighbors. After the passing 17:26 everybody is gone, whose left alone 17:28 as the spouse we don't want that to happen. 17:30 Yeah and from the heart standpoint that 17:32 could be one of the most stressful things 17:33 there is on a heart because all of a sudden 17:36 your stress hormones go up, your loneliness 17:38 factor goes sky rocket, so there is a whole 17:40 ministry right there. Let's move on to our 17:43 next question, the next question comes from 17:46 Ted and Ted writes to us from the great 17:49 state of Alabama and he says can hospice 17:52 care be given even if a patient is in a 17:55 nursing home or a hospital or they still love 17:58 them for that care. They sure are James, 18:00 that's the neat thing about hospice 18:01 no matter where you live a hospice 18:03 nurse can come. I've seen patients that 18:05 were living in a camper, in a park 18:08 that was their residence for that time. 18:09 I've read stories where the hospice nurse 18:11 went underneath a bridge down by the river 18:13 to take care of a homeless man, 18:15 'cause that's all they can do, 18:16 and it was compassion. Hospice can take of you 18:19 where ever you're at, many patients 18:20 are at home, some patients are in assisted 18:23 living or nursing homes. It doesn't have, 18:25 the comfort doesn't have to stop just 18:27 where you're living, it can be where ever that 18:28 you are. Well, that's great you know when 18:30 I think about caring for the terminally ill 18:33 another word that you could actually use 18:35 is loving the terminally ill and loving just 18:38 you know to me it just means putting 18:39 someone else's interest above your own. 18:41 And unfortunately you know in modern 18:43 medicine now we're so focused on the disease, 18:46 you know we have to heal the diseased, 18:49 you know if we can get the disease cured 18:52 we're successful, but I'm getting you know 18:55 as I look at it you know the disease 18:56 is sort of inconsequential what 18:58 we wanna do is heal the soul. 19:00 Jim, I've worked in numerous areas 19:03 of medicine, be it trauma, open heart surgery, 19:06 intensive care units, but you know the greatest 19:09 reward that I have is knowing that 19:11 I was able to grand somebody their last wish 19:14 here on this earth. That's just a 19:15 powerful reward, I've gotten so much more 19:18 than that perhaps some of the other curing 19:20 stories that I've been involved with. 19:21 You know and it's a shame 'cause you just 19:23 don't see people running up to sign up to say 19:25 hey I wanna spend my life taking care of people 19:28 that are terminally ill, I mean you just 19:29 don't see that and yet it could be so as you 19:32 say so rewarding. You know the subject of death 19:35 is so taboo within the Western culture, 19:37 yeah, that I myself did not know 19:39 and I can't say I persuaded it, 19:41 I felt like I was kind of shoved by God into 19:43 this position with my parents but coming 19:45 out on other side. I think he gave me 19:47 a calling and I was glad that I was able 19:49 to step forward. You know this is sort of an 19:51 interesting story, I'd a patient that was 19:55 terminally ill and I can't remember whether 19:56 he was in hospice or not but you know 19:58 he you know I said you know you wanna spend 20:00 your time at home and be around your things 20:02 and you know he was ready spiritually. 20:05 And you know for years he was a heart patient 20:08 he was on a diet and he says listen, 20:10 could I have some, some of this you know candy 20:12 or whatever I said you know you can eat 20:14 whatever you want. And he was so happy 20:17 with that you know he just, he just really 20:19 ate whatever you know I said you know 20:20 why not let's make this guy happy. 20:22 And then the more I realized I said you know 20:25 him eating he was relieved he was becoming 20:28 happier and we got him to release these 20:30 natural substance called endorphins 20:32 and the happier he became made him joke, 20:35 make him laugh, looked back to his life. 20:37 And show him what a success he was, 20:39 his pain control became so much better 20:42 as his own natural chemistry 20:44 endorphins increased, it was almost like giving 20:46 a pain lesson. I've had patients that 20:48 have been cooped up in their house 20:50 so to say over winter and finally spring came 20:53 and their pain medicine that they require 20:55 we needed more and more and clearly 20:56 that their disease process is winning 20:58 the battle. Spring came and the wife asked 21:01 me is there anyway that we can get him out, 21:03 we struggled, got him in the car, they went 21:06 for a drive to see the spring and the birds, 21:08 it was wonderful and you know what Jim, 21:10 his endorphins kicked in and I did not have 21:12 to use as much pain medication. 21:13 Beautiful, beautiful, now I'm gonna ask you 21:15 personal question you know out there, 21:17 there are people all over that 21:18 are terminally ill and as society gets older 21:20 we're gonna have more of these issues 21:22 do you find, you probably work with Christians 21:24 and non-Christians is there any different 21:27 approach that you take to a non Christian 21:29 then in a Christian, do you try to, 21:31 do you try to introduce Christ to them 21:33 if they never had Christ before, 21:34 I mean how do you work with the family, 21:36 I mean what's the differences between 21:38 those two groups. First, I like to explore 21:40 with them just where their spirituality 21:42 is what's their concept, and can you talk 21:44 about it, outright at front, okay, okay. 21:46 I make it clear to them right at front 21:47 what my beliefs are, never trying to push 21:50 what I believe upon them, but I want to 21:53 be able to know that I offer them something 21:55 that maybe they know nothing about. 21:57 And perhaps they've been a Christian 21:58 all their life, but they have this fear of dying 22:00 and I try to encourage them and refocus 22:03 them to have that daily walk, the daily 22:05 devotion with God, just to make that difference, 22:07 keep God number one in their lives. 22:09 You can see a huge difference when they, 22:11 when they reach this plato, this peak 22:14 of comfort. Yeah, now I guess you see, 22:17 have you ever been there when someone 22:19 passed? Many times and at times it's 22:23 very peaceful, at times it can be kind of hard. 22:27 Again, medicine can make difference, 22:29 we can relax the patient, make a difference. 22:31 But the biggest difference I believe 22:32 is the touch of, of a human being, 22:35 knowing that somebody is there with them. 22:36 We've such a great fear of dying alone 22:38 and knowing that their families at the bed 22:40 side or perhaps I'm holding their hand 22:42 or somebody else. You can see the calmness 22:45 knowing that they're not alone and Christ 22:46 is with us we're never alone. 22:48 That's great because you know, 22:49 you always wondered how would people 22:51 that didn't have Christ in their life how will 22:53 they deal then it would really be a. 22:54 Now terminally ill really doesn't fit when 22:57 you think about a Christian's life 22:59 you know they're not terminally ill 23:00 I mean they're just gonna be ill for a 23:02 little bit longer and then the next thing 23:03 they know is they have something far greater 23:06 and in my practice of medicine Ron. 23:08 I've learned through the years that you know 23:10 the disease is just part of the treatment 23:12 you know and if you can change you know 23:14 the chemistry of the body you introduce 23:16 the spiritual side, get them to actually know 23:19 God to find the peace, to find the love, 23:22 that's when you've really made the biggest 23:25 difference and you really getting to heal 23:27 what's really important. 23:28 Christ is the ultimate healer, 23:31 let's go to the next question here 23:35 the question is let me see who it's from here. 23:38 It's says have you ever experienced 23:40 a person who did not need pain meds 23:44 when he was getting ready to pass 23:46 permanently? Many times, death does not 23:49 have to be something painful okay, 23:51 yes we do at times have to give pain medication 23:53 to alleviate some of the discomfort, 23:56 many times perhaps the patient as we say 23:59 historically has fallen asleep. Okay, 24:01 perhaps they need a little pain med, 24:03 I don't wanna say pain medication 24:04 but a little bit of medication to help their 24:06 breathing a little easier but many times 24:08 it's not unusual for patient to close 24:10 their eyes and fall asleep in Christ. 24:11 What a blessing I think you know that 24:13 would be, what a gift you know 24:17 and I guess when they pray, 24:19 you know the patients that pray for a 24:20 peace like this. Yes, okay, let here's Martin 24:24 from Florida, is writing us here and the last 24:26 one is from Judy in New Hampshire 24:27 didn't include Judy's name so sorry Judy. 24:30 Martin from Florida says, I'm putting my father 24:32 in hospice this has been advice by the 24:35 medical team, his doctor, this has been 24:38 an agonizing decision for me. 24:40 'Cause I have the power of attorney. 24:42 Will his own doctor and pastor still be 24:46 involved in his care, and Martin write this 24:48 from Florida. We would encourage it, 24:51 it's always best when someone familiar 24:53 is involved with the patient's care, 24:55 the physician or the pastor or chaplain 24:58 involved. We would encourage them 24:59 to be part of it, Medicare provides that, 25:02 you as the patient have the choice 25:04 and if your doctor's willing to stay 25:06 on the case. All they have to do is work 25:08 with the hospice team and be involved 25:10 with the case on weekly or daily basis 25:13 if that's what they determined. 25:14 We want them to be involved, 25:16 the patient feels better, the family feels better 25:19 and many times the physician has maybe 25:21 seen this patient for many years has formed 25:23 a relationship with them and they wanna be 25:25 involved also. Okay, now you've worked on, 25:27 around the terminally ill for a number of times 25:30 what do you see the greatest challenge 25:33 in caring for this group and their families. 25:35 I think the greatest challenge is perhaps; 25:39 there are some unsaid baggage in the past, 25:41 okay. Perhaps, you mean like 25:43 relationship baggage, a relationship issue 25:45 and perhaps that, money. Money might be 25:48 an issue, okay and maybe religion is an issue, 25:50 okay. Perhaps there was just a simple 25:53 disagreement over a Thanksgiving dinner 25:55 and the only way that they can get along 25:57 was to brush underneath the rug. 26:00 But usually when that time comes 26:02 there's a heavy heart and the patient 26:04 wants to make a resolve or perhaps 26:06 the patient is okay with it but that 26:08 son or daughter, brother and sister wants 26:10 to have resolve. They want to take care 26:12 of the issue before it's too late and sometimes 26:15 those are the most difficult cases. 26:16 Now, one of the things that I've seen working 26:19 with the terminally ills is I always try 26:21 you know to give them a change, 26:24 you know to open up spiritually 26:26 if they want to, if they still can both them 26:29 and their families and I just found that to be 26:32 so rewarding, both to me and to them 26:35 you know I might not be able to help 26:36 you anything physically to heal you. 26:38 But maybe we can help you know God 26:40 and you work things out before, 26:42 before the end. But the family issue 26:44 I've seen all sorts of things happen 26:46 with family, I've seen them argue about 26:49 whether they should put you know father 26:50 at the end of life on a ventilator. 26:52 Even though he's got terminally illness, 26:54 I've seen them argue about money, 26:56 I've seen them you know just argue about 26:58 everything, almost right in front of him 27:00 and it's really sad. Sometimes it's hard, 27:02 you just still like getting everyone in room say 27:03 hey listen wake up you know lets get on 27:06 the ship here and lets focus on the 27:07 major issues. It just sometimes can be very 27:11 frustrating from the caregiver when you see 27:13 all the squabble when, when you see you know 27:15 what's happening here. One thing that how 27:17 you can get around that as a individual 27:20 make your wishes known, perhaps have a 27:23 paperwork drawn up to express your wishes 27:26 that way there is no argument it's down 27:28 on paper your family know what you want 27:30 and they could follow through also. 27:31 Okay, Ron we have a few seconds, 27:33 is there anything you would like to add 27:35 to audience go on as caring for the 27:36 terminally ill before we close today. 27:39 I just want to say that taking care of people 27:41 who are dying is such a rewarding issue. 27:43 Volunteers are needed, nurses are need, 27:45 yeah, step forward remember Christ said that 27:47 he's preparing a place for us and some day 27:50 we'll be there. And I wanna remind everybody 27:53 in the medical care not only it's the beginning 27:55 of life and through the life but there is 27:57 proper care at the end of life too. 27:59 And I wanna encouraged everyone to continue to 28:01 praise God for we are indeed wonderfully made. |
Revised 2014-12-17