Greetings! So, the last two weeks, I wrote about things I love about working in hospice, both little, and big. To make it easy, I’ll just keep going with that formula. So, this week I’ll talk about some of the day-to-day challenges about hospice. Then, next week, I’ll delve into some of the larger issues.
While previously I wrote about how much I love making home visits, it does pose some challenges, and none of them are very pleasant. Once again, control raises its ugly head: we have no control over our patients’ home environments. And this can cause some issues. I am far from a neat freak, but some people’s homes are really kind of disgusting. It’s hard to blame them: my house is kind of messy now; god knows what it would look like if I were sick or dying. We in hospice can do what we can to get someone in to clean it a bit, but still. I remember hearing about a patient who smeared feces all over the place (apparently on purpose).
So, there’s that.
Along with the mess, bugs are sometimes a problem. Roaches, obviously. But more worrisome is the constant threat of bedbugs, as they like to hitch rides on friendly hospice workers. I carry around garbage bags in my trunk for the times when we suspect there might be bedbugs, so I can immediately take off my clothes once I’m home and tie them up tight before I wash them. “Death with Dignity” might be the official hospice motto, but “Travel Light” is a close second.
Oh, and some of the neighborhoods are not…great. I love that I work for an urban hospice, as I’ve written before. The diversity is amazing and wonderful. But some of the neighborhoods are not safe. We have a really high murder rate here, and a lot of those statistics are based on what goes on in some of the neighborhoods that we visit. Depending on where I am, drug deals on the corner are not uncommon. I always go to these neighborhoods before noon. Winter is better than summer. I don’t like the summers. We obviously try to be safe, and will go with other team members if it seems like there is a safety issue. If it gets to be too bad, we may not be able to provide care for these families, which is also too bad. We don’t have a lot of patients who live in these areas, but we do have some. (I should add here that they often tend to be some of my favorite families.) There is a hospice license plate available here, but I don’t think any of us have one. In some people’s minds, hospice = good drugs, and that is not something you want to advertise. We never have drugs on us–they are always delivered to the home by a pharmacy–but that’s a hard conversation to have if someone has already made that assumption about you. So, at times I am on a heightened state of alert. Nothing’s happened to me, and I certainly hope that nothing will. But it can be stressful. If it’s stressful on me, a gal who only enters those areas now and again, I can’t imagine what it is like for people who live there, and deal with that level of fear and uncertainty every day.
As I’ve mentioned before, my coverage area runs the gamut, covering both the bottom and top five percent. And while I don’t usually worry about my safety with the top five percent, it’s not always easy on that side of town, either. Expectations tend to be very high, and you run the risk of being treated like the hired help (I guess we sort of are, but no one wants to feel that way, including the hired help.) Many of these families are lovely, but I do remember once being asked if I provided chauffeur services. Upon learning that I did not, the family dismissed me, saying that they did not think they needed my assistance.
Here’s another fairly petty job hazard: Last week I mentioned that sometimes people shower me with praise when they learn that I work in hospice, telling me what a special human being I am. This is always very heartwarming, of course. However, it’s sometimes paired with their own experience of hospice. And this is completely understandable. It’s just that sometimes I’m not really able to listen to those stories in the way that they deserve to be listened to. Like when I dashed into the Container Store between patients and stupidly forgot to take off my name tag. It turns out that the cashier had a family member in our hospice, and shared her story with me. That was very sweet, but, you know…I had like five minutes, four of which I spent waiting in line to get to her in the first place. I hate cutting people off when they are sharing their loss, so I end up being late for whatever I’m rushing off to do.
And, at the risk of sounding completely heartless, sometimes I don’t actually want to hear those stories. Most of the time I do, and I love that people share them with me. But sometimes….well, I get a lot of death on my job. Sometimes I just want to hang out with my kids at the park, or drink a cup of tea in peace.
But, you know, there are worse things.
Actually, really the worst thing (of these little problems) is this: I happen to be someone with a tiny bladder. I also happen to be someone who drinks quite a lot of liquids, especially in the morning. You may see where I’m going with this… I am always looking for a bathroom. And, as you might understand from my first paragraph, sometimes you don’t want to use your patients’ bathrooms. And I go through a number of neighborhoods where I don’t want to stop at the McDonald’s to use those bathrooms, either. So, at times I find myself planning my day to accommodate my frequent potty breaks. Some people who do home-health just try not to drink anything during the day. That sounds like that could lead to them needing home-health themselves, but I can see the appeal. I personally like to stay well-hydrated. And, as a result, my most pressing concern is not usually meeting the needs of the dying, or any other lofty goal that would warrant my inclusion in the group of “special people” that I am often assumed to belong to.
No, for me, my biggest (little) problem with my job is this: I don’t have a toilet in my car.
Next week: some slightly more profound (though certainly less frequent, and sometimes less urgent) challenges.
As always, thanks for reading. And, I hope all of you Moms out there had a wonderful Mother’s day. I know I did.