One of the many patients who left a lasting impact on me was a 92-year-old woman. I was amazed by her strength and will. Her story is that she was at home, a place where she had lived for most of her adult life. She fell down 15 stairs and broke her neck.
Since its release in December, I've watched the movie Encanto with my kids three times, undistracted, and like many families right now, the soundtrack is also playing on repeat in the car, house, and mind. I haven't experienced emotive earworms this strong since "Let it go" (Frozen 1, of course).
As I watch a snowstorm move in over the Rocky Mountains, the necessity of water comes to mind. Today’s snowfall will melt into flowing rivers, filling reservoirs, offering a balm for our scorched Denver landscape and the hope that this summer will not again fill our hearts with the terror of fire.
Feb 15, 2022
by Melissa C. Palmer, LCSW ACHP-SW APHSW-C JD
On December 24, we learned my dad needed cardiac surgery. Not just any surgery, but a triple bypass. His 90% occlusion in three arteries stymied my family; my dad is healthy, does not drink or smoke, exercises regularly, and plans to live to be 100 like many of his ancestors.
63 years old, large tumor in the liver, probably hepatocellular carcinoma but he wanted no biopsy, not a test, no treatment. I called and an overly cheerful man picked up the phone and in short order confirmed that he knew he was dying and did not want anything to slow that down. He said he was just an old hippy and he wanted to stay home and smoke pot till he died.
She was seriously ill and no longer a candidate for any type of anticancer therapy including clinical trials. She was dying. She knew it. I knew it. Her oncology team knew it and the hospice admit nurse knew it. Yet, her lifetime attorney friend would not allow the discussion.
On a human level, I believe all people understand and wish to support the alleviation of unnecessary suffering of their fellow mankind. Time and again I hear people share their perceptions that we are more humane with our animals at end of life than we are with people.
Kiker and colleagues recently published in JAMA research regarding the discordance between families prognostic assessment of their loved one with severe acute brain injury. This study found that for anyone caring for people with serious brain injuries (EMTs, EM providers, ICU providers or PC providers) were not surprised that family members often had an overly optimistic prognostic “hope” for their loved ones.
Jan 11, 2022
by Melissa C Palmer, LCSW, ACHP-SW, APHSW-C, JD
In yoga, we hold our breath to feel that space in between. Not inhaling, not exhaling, but just being in that place where life and death is suspended. If we never took another breath, we would die. But we have the ability to begin breathing again. But in that pause, we can find true peace and understanding.
Wrapping up 2021. Our team is taking the next two weeks to reenergize, recover and relax. It’s been a year! We will resume posting on Jan 11th. We look forward to re-engaging in 2022.
Dec 21, 2021
by Melissa C. Palmer, LCSW ACHP-SW APHSW-C JD
Joy is the emotion that we all search for in our daily lives. It is the bubbling up of joy that connects our souls to a feeling of well-being. In that moment, all is well with the world. During this time of year, many cultures celebrate the shortest days of the year with light and merriment to bring joy into the darkest days.
Their feet are tired; their hands are dry and cracked; their hearts are strained; their minds are processing. They come to work in darkness and leave work in darkness. They covet personal protective equipment. They often don’t drink enough water during their shifts. They eat meals in front of computers. They wonder about the safety of their families.
“You Can’t Make a Silk Purse Out of a Sow’s Ear" is one of the many Southern aphorisms that I grew up with. It comes to mind recently with several difficult deaths that we have had this last year.
My palliative rotation has instilled in me many lessons, insights, and skills. I witnessed really challenging conversations with patients and practiced how to talk about death and dying in an artful manner. A particularly informative lesson was that in the complexity of grief, and a healthcare team’s role in the processing of that grief – this lesson was offered by a patient and family.
“Milkshakes?”. My eyes blurred as they read this text. Our palliative care clinic physician colleague, who was not working in the clinic that day, was offering to bring us milkshakes. I was surprised to find myself so touched. It was just a milkshake, after all.
Hola! I am a 58yo Spanish Speaking Latina/wife/mother/friend/sister/human who practices pediatric palliative care as a nurse coordinator at Children’s Hospital Colorado. I currently manage and coordinate pediatric patient needs across the healthcare continuum which are enhanced by my bilingual speaking abilities for the Latinx community. I’ve primarily worked as a pediatric nurse in clinics, hospital settings, school nursing and department of defense as a family advocate.
Serious illness often raises spiritual questions (e.g., Why? Where is God in this experience?), and many patients want to address spirituality with healthcare providers. Yet healthcare professionals often resist conversations about spirituality, saying they feel ill-equipped to address the topic.
Nov 2, 2021
by Christine Merchant MSPC BSN RN CHPN
I am asked to participate in a simulation module to understand a sensory modality relating to an illness. I am given tools to participate. I place spiky material into my shoes, put special glasses on, earphones are placed over my ears and special gloves are put on both hands. The pinky and next finger sewn together and the pointer and middle finger are sewn together leaving the thumb by itself.
Oct 26, 2021
by Melissa C Palmer, LCSW, ACHP-SW, APHSW-C, JD
I have been reading Oprah’s “What I Know for Sure” the past few weeks before bedtime, and last night’s passage resonated with me. Her words ring true during my transition to the UCH palliative care team and facilitating assessments on communication for MSPC students. Whether we are talking with our patients, professional colleagues or our loved ones, we are most connected when we are able to listen to one another and not just hear the words. Life is about finding meaning, and quality relationships can be as meaningful as we can get as human beings.
Near Misses by Laura Kasischke is a powerful poem about the timing of near misses that inadvertently extend one’s life. Reading this poem reminded me of Mr. and Mrs. F. Life could have turned out very differently for this couple. By the time I met them, they may have experienced hundreds of near misses which could have ended their story. But instead, we now had these two octogenarians sharing a room on the Safe Harbor unit.