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.