Hospice Care & an Alcoholic

A little more than 2 years ago, my siblings and I had made the decision to put our father on hospice care.  We had spent the previous 2 years involved in what we referred to as “fire drill” mode with him.  You see, our father was a life-long alcoholic.  Some years earlier, we had decided to do an intervention.  It did not go well.

Fire drill mode meant a constant cycle of checking on him, 911 calls, visits to the hospital, and fighting with him over driving, drinking, and his general state of health.  During one memorable trip to the hospital, we were told, “This is not a rehab facility.”  Preachin’ to the choir, that was.

During another memorable trip, he had a scheduled procedure canceled due to his blood alcohol levels.  One time he was found passed out at the wheel of his car with a blood alcohol level over 0.20.  He was 80, and the years of alcohol abuse were finally catching up with him.

The last 2 years of his life, his health was rapidly deteriorating.  His drinking was spiraling out of control.  After a particularly serious trip to the Emergency Room, the 3 of us who lived nearby initiated daily visits to ensure that he was alive and in some semblance of functioning normally.

Here he is with his 2 brothers.  He is the oldest boy on the right.  It is my guess that my grandmother made their shirts.

After the intervention and with the help of his physician, we had gotten his driver’s license revoked.  The State of Missouri, in its infinite wisdom, had allowed him to get it reinstated.  So we worked to get it revoked again.  He was drinking and driving, and we were worried about him harming himself as well as others.  It took awhile, but we managed to get it revoked again.  We had difficulty taking away his keys and car, however, as to do so would have meant he could have filed charges against us.  We did what we could to prevent him from driving and, eventually, he was no longer able to drive because of his inability to walk very well.  He resorted to hiring a taxi to take him on his daily rounds to the American Legion, which continued to serve him alcohol, in spite of our pleas to stop, and to the local liquor store which gave him a volume discount.  No kidding.

We would make sure that his garbage and recycling were taken to the curb each week.  In a typical week during this time, we would load up the recycling bin with Ten High bottles and beer cans.  One week there was 17 bottles.  No kidding.

Dad was a Korean war veteran.  I don’t know if the ascot was military reg or not, but he sure looked dapper in it.

After months of dialogue with the doctor and the lawyer and many visits to the hospital and rehab facility, we were able to implement the Power of Attorney.  Life was much easier after this.

All along, however, we talked about hospice care.  We all agreed that we thought this was a good thing, but questioned how and when to implement.  As it turned out, however, like many people, we had really waited too long to implement the Power of Attorney, and we just did not realize how sick he was.  No matter the situation with your loved one, you are always in denial about how serious it really is.

Our experience with hospice care as well as the experiences of others is overwhelmingly positive.  There are strict protocols for going onto hospice care and for staying on hospice care.  Hospice care provides palliative care for end of life.  It does not hasten death, but it provides for care and comfort as the body goes through the natural process of shutting down.  There is much emphasis on the care of mind and body for both the patient and the family.  Hospice care is covered by Medicare, and, yes, it is cost effective compared to using other end of life treatments.

We had 2 meetings with the hospice care provider about our father.  First of all, he did qualify, and he was aware that he was going onto hospice care.  What was debated was the alcoholism.  The hospice provider implemented new rules with regard to my father.  First of all, we had to all agree that under no circumstances was he allowed to consume any alcohol.  We had actually debated just going ahead and letting him drink as all he cared about was drinking.  That decision was made for us, and we no longer had to worry too much about the inappropriate behavior that resulted from his drinking.

Dad in 1984.  This is one of my favorite pictures of him because of the genuineness of the smile.  We do not have that many pictures of him smiling.  I intentionally chose ones where he was smiling for this post.

We did wonder how he would react to all of the touchy feely New Age counseling, meditations, and other related services that are provided to calm the mind about death and dying.  To our utter surprise and amazement, when he received these services, in particular the music and massages, he would be noticeably calmer.  It was like soothing a baby.

Our father was on hospice care for a total of 33 days before he died.  There were 4 of us kids with him when he died.  I am glad that I was there.  I found it to be a peaceful passing and considering the chaos of his life I thought we had given him a great gift.  One of my sisters still has nightmares – watching the person take those last breaths over several minutes can be a little traumatic.  In retrospect, there were many signs we missed and many things we learned, but one of them was that the value of hospice care is greatly undervalued.

That is why the #1 political lie of 2009 hit me so hard.  I am referring to the “death panels” label that was promoted through a Facebook posting by a politician.  This all resulted from the decision to add the hospice provision that currently exists in the Medicare program to the Health Care Reform Act.  This person has since stated that, “It was not meant to be taken literally.”  Really.  Hospice care is all about “death with dignity” not “death panels.”

Here is our father 38 days before he died.  He wanted to be home so badly and the irony was that he could see the back of his condo from his room in the nursing home.

Today is the 2-year anniversary of my father’s death.  He was a complex man.  He had many problems.  He did not deserve the love and attention that we provided him.  But, through the help of hospice, we not only gave him a death with dignity, we gave ourselves the gift of a life lived better.

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9 Responses to Hospice Care & an Alcoholic

  1. Tina DePaepe Crawford says:

    Great article, I have never seen that picture before. I suspect you are correct, Grandma made the shirts.

  2. Mama says:

    Someday I’ll finish the scanning project and get CDs to everyone! It’s amazing to me how much I recognize in the adult men who were these little boys.

  3. Lisa Lehr says:

    Theresa, I truly appreciate your kind words for Hospice. I worked Hospice for several years, and I will say it was one of the most humbling experiences of my life. I have never loved a job more! I bonded many friendships with people of all philosophies, religions, race, socio-economic cultures. I learned things about myself from them that are irreplaceable. Above all, I learned tolerance.
    I have to say tho, not to disagree with you, but Hospice communities are suffering right now from diminished funding from Medicare. That is a big reason why I lost my job there…lack of funds. Our duty is to see that each of our patients (I hate the term client) has the dignity they each deserve at this time. We would offer them any and all support to acheive the type of death that we would all like to have. Many of these available services are now cut as “not necessary” in the grand sceme of death! It is sad beyond words to know that the little things that made their days easier are now being held back. It is soooo much cheaper to allow a daily massage than to place someone in a hospital for medication therapy for pain. That is no longer the case. Change is coming, a great deal of it will sadden and slow our forward progress. Yes, some of it IS necessary. Putting a pacemaker in a patient in end-stages of prostate cancer is not necessary for their comfort. Dr.s are now afraid of what they could be responsible for if it is NOT done. There is nothing worse than having to give a deposition on something that was rightly done, only to have dire consequences. Sometimes, we cannot stop the inevitable.
    Again, I want to thank you for all your kind words….they go a very long way to those who give this care on a daily basis!! The “job” truly blessed me!

    • Mama says:

      I have yet to meet anyone, touched by hospice care, who has not become an advocate. Thanks for all you have done for the patients and families for whom you have helped.

  4. Al says:

    My family member is also alcoholic receiving hospice services in my home. We are torn up over whether hospice should ban alcohol at this point like they did in your case. Ten years ago, my dad spent his last two weeks in residential hospice. The caregivers there let dad smoke as much as he wanted where he wanted. He died of prostate cancer. So some in the family now think the same kind of accomodation should apply today. Let the hospice patient drink all she wants; it’s too late to treat that part of her ailment. I have other family and counselors saying that although it’s pretty tough love, she needs to be cut off and other more healthy therapy and meds be used to deal with her depression/anxiety. Is there a common view of this among hospice professionals? Is there a difference between a cancer patient smoking and a hospice patient who drinks?

    • Mama says:

      I don’t know if there is a common view or not, but in our case, it was a new situation for the hospice provider. They actually had to consider it and come up with a policy which was implemented in our case. We were actually thinking the same thing – at this point, why not let him drink? Unfortunately, his drinking resulted in a lot of inappropriate behaviors and, since most of the providers were women, the decision was made to cut him off. Their decision actually made it easier on us because we could say to my father that we had no choice. They won’t let patients smoke or drink in the hospital, so it was a natural extension of providing care. Good luck to you. We also dealt with this as we approached the holidays. Unfortunately, this is one of life’s situations that you enter with very little experience to fall back on, so rely on those who deal with it every day.

  5. Sad Sister says:

    Thanks for sharing your story. I found it while reading about end-stage alcoholism due to a long-distance situation in which I am not directly involved. My brother (living in another state) and I have been estranged for almost 10 years. He is, according to his wife, in his last days. He still lives at home, and she provides alcohol to keep him from driving. His doctor just prescribed hospice, so I assume death is imminent. How sad for those in your situation and in my brother’s…

  6. Norah Wilson says:

    Wow! I feel your struggles; it’s good to have a clear conscience after you know you’ve done all that you knew to do. Your story helped me in dealing with my husband. Hes a alcoholic and has terminal lung disease. Hes refusing to stop drinking and I’m wondering what will happen next. He needs to be on hospice care, but he says he dont want any care! His vitals are irregular going up and down and his body has rashe and swollen. He tells me hes dying, even makes sick humor of dying! Whenvhe has low body temperature..he says ” its higher than anybody in the grave”..

  7. Mary Smith says:

    Thanks for this. I’m struggling with an estranged complicated alcoholic after too. I’m so glad you posted this and i hope you have found peace as well.

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