Finding Hope, Healing and Purpose after a Devastating Tragedy

I met Polly Fick a few years ago after I gave a talk about physician-assisted suicide and my own daughter’s suicide in 2009.

Polly told me the tragic story of her and her husband’s loss of their daughter, son-in-law and baby granddaughter. She also told me what she and her husband were doing to bring awareness of postpartum depression because of this loss. She and Frank hope this information may help or even save another mother and her family.

Polly has been spreading this message on local radio and most recently in the December 22, 2021 St. Louis Review Catholic newspaper article titled “St. Francis of Assisi couple finds hope through tragedy in spreading awareness of postpartum depression”

THE TRAGEDY

Polly and Frank were very close to their daughter Mary Jo Trokey and son-in-law Matthew and celebrated with them when their new granddaughter Taylor Rose was baptized in 2018.

Tragically, all three of them were found dead when Taylor Rose was 3 months old. Investigators believed “that Mary Jo, possibly suffering from postpartum psychosis, killed her daughter and husband, then died by suicide.”

Polly Fick and her husband, Frank, were stunned. “We had no idea she was going through this,” Polly Fick said.

The Ficks have since dedicated themselves to raising more awareness of postpartum depression and related illnesses. Now the members of their parish are also spreading the word about resources through their involvement with Postpartum Support International (PSI) as well as local groups mentioned in the article.

“When this sort of thing happens, you either grow from it or you end up being broken by it,” Frank Fick said. “As horrible as it was, we wanted something positive to come from it.”

POSTPARTUM ILLNESSES

According to PSI,:

“While many parents experience some mild mood changes during or after the birth of a child, 15 to 20% of women experience more significant symptoms of depression or anxiety. Please know that with informed care you can prevent a worsening of these symptoms and can fully recover. There is no reason to continue to suffer.”

“Postpartum psychosis is a rare illness compared to the rates of postpartum depression or anxiety. It occurs in approximately one to two out of every 1,000 deliveries, or approximately .1% of births. The onset is usually sudden, most often within the first 2 weeks postpartum.” 

Postpartum Support International runs a helpline (1-800-944-4773), in-person and online support groups, a mentor program and a directory of care providers. See http://www.postpartum.net/

GRIEF SUPPORT

The Ficks were moved when their parish held a prayer service the evening the family learned about the deaths.

“People that I didn’t even know stepped forward,” Polly Fick said. “Left things on the porch. All of the South County deanery (parishes) really stepped up to the plate. And people prayed for us.”

“We would not be sitting here right now without the support,” she said. “It’s only by the grace of God.”

CONCLUSION

Polly and Fred Frick’s willingness to publicly talk about their tragedy has led to significant new information.

As the St. Louis Post-Dispatch October 28, 2018 article titled “Following tragedy, St. Louis hospitals renew commitment to postpartum mental health” reported:

“Until recently, mental health screenings were not standard for pregnant women and new mothers even though at least 20 percent will experience depression or anxiety that can be exacerbated by hormonal surges, lack of sleep and the demands of an infant.

The screenings can be lifesaving — as many as one in five deaths of women in the postpartum period is caused by suicide.”

and in 2018, “the American College of Obstetricians and Gynecologists issued new “fourth trimester” recommendations for women’s ongoing care after childbirth, including a full assessment of their emotional well-being. The American Academy of Pediatrics also recommends depression screenings for new mothers at all of the baby’s checkups during the first six months.”

Nothing can bring back our deceased loved ones but Polly and Fred Frick are an inspiring example of how help, hope and healing can be brought out of even the most devastating tragedy.


Our “Covid” Christmas

My husband and I were excitedly looking forward to finally having all our blended family members to our home for Christmas this year but Covid 19 almost ruined it. We will forever remember it as the “Covid” Christmas.

We felt fortunate that one of our families was driving to Ohio for an early Christmas with their vaccinated in-laws before driving home in time for our Christmas celebration, especially after we saw other people around the country waiting in lines for hours to get a Covid test before the holidays. We were also glad that they decided to drive when we saw thousands of airline flights delayed or cancelled because of Covid, bad weather and staffing shortages.

However, it turned out that one vaccinated in-law in Ohio attended a large rock concert a few days before the Christmas celebration. Although he showed no symptoms at the time, our youngest grandchildren started to cough and get sick on the ride home.

Early on Christmas morning, the parents were notified that the in-law now tested positive and they tried frantically to get covid tests for themselves and the grandchildren, one of whom was recently diagnosed with asthma. But there were no covid testing kits available and the pediatric emergency room near them told the parents that they could not do a covid test unless the children were admitted.

After two days, they all finally got their covid tests and were negative.

They missed the Christmas party with the other relatives but celebrated with us grandparents a few days after Christmas and it was wonderful.

HOW COULD THE DEARTH OF COVID 19 TESTS HAPPEN ON CHRISTMAS?

As I wrote in my January 7, 2021 blog “When Can We End Lockdowns for Covid 19?”:

“the FDA (food and Drug Administration) approved the use of several rapid Covid 19 tests, some that can even be done at home. This can be a gamechanger with some experts saying that the massive distribution of rapid self-tests for use in homes, schools, offices, and other public places could replace harmful sweeping lockdowns with knowledge.

And as the FDA (Food and Drug Administration) itself has reported:  

“Since March 2020, the FDA has authorized more than 400 COVID-19 tests and sample collection devices, including authorizations for rapid, OTC at-home tests. The FDA considers at-home COVID-19 diagnostic tests to be a high priority and we have continued to prioritize their review given their public health importance.” (All emphasis added)

However in a December 21, 2021 interview, President Biden was said to “express some regret that he didn’t ramp up necessary supplies before the nation got hit with yet another winter coronavirus surge” and announced a plan for the government to “distribute 500 million free rapid in-home test kits in an effort to slow the spread of the virus” and admitted  that ““I wish I had thought about ordering half a billion [tests] two months ago”.

However, as reported on December 24, 2021 at webmd.com:

“President Biden has promised Americans that 500 million coronavirus tests will be available for free, but the kits won’t arrive for several weeks or longer”

and

“the Biden administration hasn’t yet signed a contract to buy the tests, and the website to order them won’t be available until January, according to The New York Times.

CONCLUSION

I have been writing blogs on the various aspects of the Covid 19 pandemic for almost 2 years and I am frustrated by the missteps, lack of accountability and the constantly changing rules that often seem to often be more based on politics rather than science.

We need to demand better from ourselves, our leaders and our country to become a healthier nation mentally, physically and spiritually.

My 2000 Voices Magazine Article: Who Wants a “Defective” Baby?

This month, it was revealed that President Joe Biden “wants Congress to pass a law making abortions legal up to birth” after the US Supreme Court refused to temporarily block the Texas Heartbeat Law.

While talking to a friend about this, I remembered a 2000 Voices magazine article I wrote about why every unborn child deserves protection and she asked that I send it to her. Sadly, this magazine is no longer publishing.

This is the article I wrote that appears on my other blogsite that contains articles, op-eds, etc. that I wrote up to 2014, when I started this blog. The reflection at the end of this article was published by the National Down Syndrome Association and was-to my surprise-eventually reprinted in several other countries.

Voices Online Edition
Summer 2000
Volume XV, No. 2 – Jubilee Year

Who Wants a “Defective” Baby?

by Nancy Valko, R.N.

“Of course, no one wants to adopt a defective baby. ” This was said with much emotion (and not much charm) by an older gentleman in a class at a local university where I was speaking this past April. I had been invited to discuss the legalities and effects of Roe v. Wade from a pro-life point of view to a class of senior citizens studying the Constitution and the Supreme Court.

While several of these senior citizen students defended abortion as a matter of complete privacy for the mother, their arguments centered around the “need” for legalized abortion as a solution for social problems.

Since I had told the story of my daughter Karen, born in 1982 with Down Syndrome and a severe heart defect, the pro-abortion students were extremely vocal about the personal and societal justifications for aborting a baby like Karen. Hence the statement about no one wanting to adopt a “defective” baby.

“Happily, sir,” I told the senior student, “You are wrong. Even back when I had Karen, I found out from the National Down Syndrome Association that there was a list of people waiting to adopt a baby with Down Syndrome. Just the night before, I added, I had found a new website for matching prospective parents with children who had chromosomal and physical defects.”

The student refused to believe that this could be true.

The effects of Roe v. Wade
Life of the mother, incest, rape and fetal defect are the four hard cases usually cited to justify what has now become abortion on demand. All of these are uncommon reasons given in the estimated 1.3 million abortions every year; but the possibility of having a child with a birth defect is a common fear nearly all expectant mothers experience and, not surprisingly, polls show that the majority of the public support abortion in this circumstance.

Although I have always been pro-life, I could understand the fear underlying these poll results — until my own daughter was born.

Just two weeks before the birth of my daughter Karen, I saw a mother trying to pry her young son with Down Syndrome away from a display case at the supermarket. She looked exhausted.

“Please, Lord,” I silently prayed, “Let this baby be ok. I can handle anything but Downs.”

When Karen was born with Down Syndrome, I was stunned. But I was quickly put in touch with mothers from the Down Syndrome Association who replaced my fears with information and realistic hope.

Then a doctor told me the truly bad news. Karen had a heart defect, one so severe that it seemed inoperable and she was not expected to live more than 2 months. That certainly put things in the proper perspective.

What “pro-choice” really means
It turned out later that Karen’s heart defect was not quite as bad as originally thought and could be corrected with one open-heart surgery, but I was shocked when the cardiologist told me he would support me 100% if I decided not to agree to the surgery and allow her to die. This was especially hard to hear because, as a nurse, I knew that the doctor would have been otherwise enthusiastic about an operation offering a 90% chance of success — if my child didn’t also have Down Syndrome. Apparently, even though Karen was now a legal person according to Roe v. Wade by the fact of her birth, this non-treatment option could act as a kind of 4th trimester abortion.

It was then that I realized what pro-choice really meant: Choice says it doesn’t really matter if a particular child lives or dies. Choice says the only thing that really matters is how I feel about this child and my circumstances. I may be “Woman Hear Me Roar” in other areas according to the militant feminists, but I was not necessarily strong enough for a child like this.

I also finally figured out that Roe v. Wade’s effects went far beyond the proverbial desperate woman determined to end her pregnancy either legally or illegally. The abortion mentality had so corrupted society that it even endangered children like my Karen after birth. Too many people, like the student in Supreme Court class, unfortunately viewed Karen as a tragedy to be prevented.

Medical progress or search and destroy?
In the late 1950s, a picture of the unborn baby using sound waves became the first technique developed to provide a window to the womb. Ultrasound in recent years has been used to save countless lives by showing women that they were carrying a living human being rather than the clump of cells often referred to in abortion clinics.

But while expectant parents now routinely and proudly show ultrasound pictures of their developing baby, there is a darker side to prenatal testing. Besides ultrasound, which can show some birth defects, blood tests like AFP testing and the Triple Screen to test for neural tube defects or Down Syndrome are now becoming a routine part of prenatal care. Amniocentesis and chorionic villus sampling are also widely available tests to detect problems in the developing baby. It seems that every year, new testing techniques are tried and older ones refined in the quest to find birth defects prenatally.

97% of the time, women receive the good news that their baby seems fine; but the tests are not foolproof, and they can only test for hundreds of the thousands of known birth defects. Relatively few such birth defects can be treated in the womb at the present time. Some women want testing so that they can prepare for a child who has a birth defect, but when the tests do show a possible problem like Down Syndrome, up to 90% of women will abort.

While some hail prenatal testing as a way to prevent birth defects, the effects of such testing has led to what author Barbara Katz Rothman calls the “tentative pregnancy” in her 1993 book of the same name. Although Rothman calls herself pro-choice, her studies of women considering amniocentesis led to her conclude that such testing has changed the normal maternal-child bonding in pregnancy and the experience of motherhood, usually for the worse.

“I might not be pregnant”
I observed this firsthand several years ago when I ran into an acquaintance and congratulated her on her obvious pregnancy. I was stunned when she replied, “Don’t congratulate me yet. I might not be pregnant.”

Diane, the mother of a 5-year-old boy, went on to explain that she was awaiting the results of an amniocentesis and said, “I know what you went through with your daughter but I can’t give up my life like that. If this (the baby) is Downs, it’s gone.”

I reassured her that the test would almost surely show that her baby was ok, but I added that if the results were not what she expected I would like her to call me. I promised that I would give her any help she needed throughout the pregnancy and that my husband and I or even another couple would be willing to adopt her baby. She was surprised, as I later found out, both by my reaction and the information about adoption.

Diane gave birth to a healthy baby girl a few months later and apologized for her comments, saying that she probably would not have had an abortion anyway. But I understood her terrible anxiety. Society itself seems to have a rather schizophrenic attitude towards children with disabilities.

On one hand, people are inspired by the stories of people who have disabilities and support organizations like the Special Olympics; but, on the other hand, many people consider it almost irresponsible to bring a child with disabilities into the world to suffer when prenatal testing and abortion are so available.

But as the vast majority of parents who are either natural or adoptive parents of children with disabilities will attest, all children are born with both special gifts and special limitations. No child should be denied birth because of a disability or even a limited life expectancy.

Women who do abort after a diagnosis of a birth defect are also hurt. Besides depriving themselves of the special joys — which occur along with the difficulties — of loving and caring for such a child, these women often experience unresolved grief, guilt and second-guessing instead of the relief and peace they expect.

A few years ago, a local hospital which performs late-term abortions for birth defects asked a miscarriage and stillbirth counseling group to help with their distressed patients. The group declined, citing the fact that the most reassuring message they give grieving mothers is that there is nothing they did or didn’t do that caused the death of their babies. Obviously, that was not a statement they could make to mothers who abort. There is a very real difference between losing and terminating a child.

How many of these mothers knew before their abortions that, in practical terms, there has never been a better array of services and support for children with disabilities and their parents? Or that their children were dearly wanted by prospective adoptive parents? Such information might have been just the support they needed to choose life for their children.

Final thoughts
Despite the best medical care, my Karen died at the age of 5 and 1/2 months, but the impact of her life has lived on. At her funeral Mass, the priest talked about how this child who never walked or talked had transformed the lives of those who met her.

Especially mine.

After Karen died, I sat down and tried to put into words what Karen and all children with disabilities have to teach the rest of us. The following reflection was published in the National Down Syndrome Association newsletter in May, 1984.

THINGS NO TEACHER EVER TAUGHT
In 1982 my daughter, Karen, was born with Down Syndrome and a severe heart defect. Less than six months later she died of complications of pneumonia. Karen may have been retarded but she taught me things no teacher ever did.

Karen taught me:

That life isn’t fair — to anyone. That self-pity can be an incapacitating disease. That God is better at directing my life than I am. That there are more caring people in the world than I knew. That Down Syndrome is an inadequate description of a person. That I am not “perfect” either, just human. That asking for help and support is not a sign of weakness. That every child is truly a gift from God. That joy and pain can be equally deep. That you can never lose when you love. That every crisis contains opportunity for growth. That sometimes the victory is in trying rather than succeeding. That every person has a special purpose in life.

That I needed to worry less and celebrate more.


Sources:

1. “Prenatal Testing”, by Nancy Valko, R.N. and T. Murphy Goodwin, M.D., pamphlet, Easton Publishing Co.

2. “Doctors have prenatal test for 450 genetic diseases” by Kim Painter. USA Today, 8/15/97

3. Rothman, Barbara Katz. The Tentative Pregnancy. Revised, 1993. WW Norton and Co.

4. “Advances, and Angst, in a New Era of Ultrasound”, by Randi Hutter Epstein. New York Times. May 9, 2000.

Nancy Valko, R.N., a contributing editor for Voices, is a former president of Missouri Nurses for Life who has practiced in St. Louis for more than thirty years. An expert on life issues, Mrs. Valko writes a regular column on the subject for Voices.


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The “Population Bomb” Fizzles, but Now There is a Birth Dearth with Grave Consequences in Many Countries

 Dr. Paul R. Ehrlich was an entomologist (a scientist who specializes in the study of insects)  at Stanford University when he published his bestseller “The Population Bomb” in 1968.  Although initially ignored, it incited a worldwide fear of overpopulation and ultimately became one of the most influential books of the 20th century.

In his book, Ehrlich predicted that unless population decreased, “hundreds of millions of people are going to starve to death” in the 1970s.

That did not happen but 50 years later in a 2018 interview with Smithsonian magazine writer Charles C. Mann, Paul Ehrlich claimed that the book’s main contribution was to make population control “acceptable” as “a topic to debate.”

However, as Mr. Mann wrote:

” But the book did far more than that. It gave a huge jolt to the nascent environmental movement and fueled an anti-population-growth crusade that led to human rights abuses around the world.” (Emphasis added)

But even 50 years later and with the population declining in many countries, Paul Ehrlich continued to insist that:

“Population will fall, either when people choose to dramatically reduce birthrates or when there is a massive die-off because ecosystems can no longer support us. (Emphasis added)

THE HARSH REALITY TODAY

In 1980, China began a strict one child per married couple policy that even included forced abortions for women who did not comply.

In 2015, China raised the limit to two children, citing a “rapidly aging society and a shrinking working-age population”.

China has now increased the number of children to 3 children but as a June 3, 2021 Wall Street Journal article states “China Delivers Three-Child Policy, but It’s Too Late for Many.

Even with years of declining birthrates, there are fewer young people willing to buck the trend of postponing or forgoing marriage and children.

The result is an aging population with a shortage of children. In one Chinese province almost 40% of the province’s population of 880,000 are 60 or older and there is a surging demand for nursing homes. The local government is looking for private investors to help some 7,000 elderly residents who cannot take care of themselves.

Even beyond China, a May 22, 2021  New York Times article titled Long Slide Looms for World Population, With Sweeping Ramifications recognized that:

“All over the world, countries are confronting population stagnation and a fertility bust, a dizzying reversal unmatched in recorded history that will make first-birthday parties a rarer sight than funerals, and empty homes a common eyesore.” (Emphasis added)

HUNGARY FIGHTS BACK

A replacement rate of about 2.1 is necessary to sustain a population but the population in Hungary had been declining since 1981. It reached an all-time low of 1.23 in 2011.

Katalin Novák, the Minister for Family Affairs in Hungary, has facilitated a family-friendly approach that has seen birth rates start to rise. The birth rate is now up to 1.56, still low but improving.

As Minister Novak states:

“The government’s measures of the past ten years have evidently moved demographics in the right direction. The number of childbirths, abortions, the infant mortality rate, marriages, and divorces have all moved in a favorable direction. This also proves that we have made the right decision when we made family-centered governance a priority and are now on the right path. Families are enjoying government support, and we are helping our youth by giving them the opportunity to start a family whenever they want.” (Emphasis added)

THE SITUATION IN THE UNITED STATES

As of 2019 (the latest year for which data is available), the U.S has the lowest fertility rate on record and the lowest number of births in 35 years.

As the New York Times noted in its article about population decline:

“The change may take decades, but once it starts, decline (just like growth) spirals exponentially. With fewer births, fewer girls grow up to have children, and if they have smaller families than their parents did — which is happening in dozens of countries — the drop starts to look like a rock thrown off a cliff. (Emphasis added)

CONCLUSION

The “population bomb” theory has had unintended and disastrous consequences, even in the U.S. and despite immigration.

In 2018, a US Census Bureau article predicted “The Greying of America: More Older Adults than Kids by 2035 for the first time in US history-joining other countries with large aging populations.

As the US Census Bureau states:

“With this swelling number of older adults, the country could see greater demands for healthcare, in-home caregiving and assisted living facilities. It could also affect Social Security. We project three-and-a-half working-age adults for every older person eligible for Social Security in 2020. By 2060, that number is expected to fall to two-and-a-half working-age adults for every older person.” (Emphasis added)

A country with more older people than children can unbalance a society socially, culturally and economically.

Even worse, legalizing abortion and assisted suicide/euthanasia will only make the situation more dire the US.

Since the US Supreme Court legalized abortion in 1973 with the Roe v. Wade decision,  more than 62,000,000 abortions have been performed and now the new Biden administration wants to roll back restrictions on abortion  and make abortions taxpayer-funded

And as efforts by groups like Compassion and Choices to legalize assisted suicide throughout the US has now spread to 9 states and the District of Columbia despite pro-life and disability rights opposition, we should not be surprised if there is another US Supreme court case in the future like the 1997 Vacco v Quill Supreme Court case  that attempted to establish physician-assisted suicide as a fundamental right for the terminally ill like the Roe v. Wade abortion decision legalizing abortion for (initially) just women in the first three months of pregnancy. 

Instead of threats to human beings at the beginning and end of life, we should be welcoming new lives and families as well as caring for the elderly, disabled and poor to improve and stabilize ourselves and our country.

Sweden and Covid 19: Families Complain That “Palliative Care” Instead of Treatment Is Being Given to the Elderly

A June 18, 2020 article in the Wall Street Journal titled “Coronavirus is taking a high toll on Sweden’s elderly. Families blame the government”  starts with a disturbing story:

“When 81-year-old Jan Andersson fell ill with Covid-19 at a nursing home in the Swedish town of Märsta, a doctor consulted by phone ordered palliative care, including morphine, instead of trying to help him fend off the infection.

Mr. Andersson’s son, Thomas Andersson, says he was told his father was too frail for other treatment. The younger man disagreed and, after arguing with the physician, summoned journalists and insisted his father be given lifesaving care. Mr. Andersson has since recovered.

The county that runs Mr. Andersson’s nursing home said all decisions on medical treatment for the residents were made by doctors employed by a company that provides medical services. (All emphasis added)

The Wall Street Journal reports that cases like this have sparked a public outcry from not only relatives but also from some doctors and nurses. There is now an investigation by Swedish national health-care authorities into the treatment of older patients in nursing homes and Stockholm hospitals. There are now 5,041 people in Sweden who have died from Covid 19 with about half being nursing home residents.

“Many people have died unnecessarily,” said Yngve Gustafson, a geriatric-medicine specialist in Sweden, who looked into more than 200 cases in which people were denied care. He said that doctors were too quick to put patients on palliative care. He also said that he believed many would have survived and lived year longer had they been provided basic care.

Furthermore, a June 12, 2020 British Medical Journal article “Has Sweden’s controversial covid-19 strategy been successful?” stated that Dr. Gustafson also spoke to the Svebsja Dagbladet newspaper and “expressed concern about the increasing practice of doctors recommending by telephone a “palliative cocktail” for sick older people in care homes.

He also was quoted as saying:

“Older people are routinely being given morphine and midazolam, which are respiratory-inhibiting,” … “It’s active euthanasia, to say the least.”

Thomas Linden, chief medical officer of Sweden’s National Board of Health and Welfare, said the triage guidelines for Covid 19 were developed to prepare the health-care system for a potential crisis while ensuring best-possible treatment for all patients.

However, the Wall Street Journal article reports that Swedish critics say these guidelines have too often resulted in older patients being denied treatment, even when hospitals were operating below capacity.

“Dr. Cecilia Söderberg-Nauclér, a physician at Karolinska University Hospital in Stockholm, said that “the ICU wards were comparatively empty “because elderly people were not taken to hospitals—they are given sedatives but not oxygen or basic care.”

The Wall Street Journal article also notes that “About 90% of nursing-home residents who succumbed to Covid-19 in Sweden were never admitted to a hospital, according to official estimates. ” (Emphasis added)

Most poignantly, Latifa Löfvenberg, a nurse  for a company providing medical services to several nursing homes, said she sought treatment for residents with Covid-19 and was told by company physicians to administer morphine and a sedative.

She  described what happened:

People suffocated, it was horrible to watch. One patient asked me what I was giving him when I gave him the morphine injection, and I lied to him,” said Ms. Löfvenberg, who is now working at a hospital in the Swedish capital. “Many died before their time. It was very, very difficult.” (Emphasis added)

COULD-OR HAS-THIS HAPPENED IN THE US?

As I wrote in my May 20, 2020 blog “Covid 19 and the Culture of Death” about the dangerous and unethical responses to Covid 19 in the US:

“(T)he National Hospice and Palliative Care Organization (NHPCO) has a new resource for Crisis Standards of Care for the “ethical allocation of scarce medical resources during a disaster” that:

‘provides a framework for healthcare professionals to utilize a predetermined framework to determine which individuals will receive life saving care during an emergency event or disaster and which ones will not.’ With the event of the COVID-19 Public Health Emergency (PHE), it is important for palliative and hospice care providers to be familiar with Crisis Standards of Care.” (Emphasis added)

However, access to the actual crisis standards is restricted to NHPCO members only.

But transparency is not the only  problem.

Unfortunately, I have also personally and professionally seen cases of deliberate overdose sedation. I have written about this, most recently in my 2019 blog When Palliative Care goes Horribly Wrong”.

CONCLUSION

While Sweden has not yet legalized physician-assisted suicide, Sweden’s National Board of Health and Welfare did authorize passive euthanasia in 2010, whereby “patients may request the termination of their treatment knowing that this will lead to their death”. This ruling came in response to a request by a 32 year old woman who was totally paralyzed and dependent on a ventilator since the age of six. She requested it be shut off when she was asleep. Whether or not she received a “palliative cocktail” beforehand is unknown.

Now, Swedish officials seem to have forgotten the part about “patient request” when it comes to Covid 19 and the elderly.

In the US, we started down a similar path when “right to die” groups focused on “living wills” and withdrawal of even basic treatment before outrightly promoting physician-assisted suicide.

The bottom line for any country is that we must not lethally discriminate against anyone, regardless of age or condition like Covid 19 and we must hold palliative care to the high standards set by the late Dame Cicely Saunders,  founder of hospice movement (1918 – 2005) who said:

“You matter because you are you, and you matter to the end of your life. We will do all we can not only to help you die peacefully, but also to live until you die.” (Emphasis added)

 

 

 

Coping in the Time of the Covid 19 (Coronavirus) Pandemic

Although we are in a time of national crisis that is causing disruption in all of our lives, we need to avoid panic and foster realistic optimism and resolve in ourselves and others. We are all in this together.

As a semi-retired nurse, I have been following the Covid 19 situation closely. We and our extended family and friends keep up with and strictly follow the sanitary and social isolation recommendations. If we all follow these precautions, this crisis may begin to abate in hopefully weeks or months.

There is cause for cautious optimism. Although the numbers of people infected will increase with more testing now available, most people will not die from Covid 19 and many will have no or mild symptoms. And a promising experimental vaccine against the Covid 19 virus has been developed in record time and is now being tested on humans. However it may take a year or more to prove its effectiveness. We must be patient.

Even better, a FDA drug long used to treat malaria has shown promise in treating Covid 19 patients in other countries and a clinical trial of the drug will start here.

However, the Covid 19 virus has and will continue to have an enormous impact on our lives for the foreseeable future not only in our homes but also in our work lives, education, the economy and the health care system.

But, as frightening as this crisis is now, in the end it may help us reorder our priorities from materialism and political/social divisions to a new appreciation for our families, our country and our ability to work together for the greater good.

One of the advantages of being older is that I am old enough to remember the polio virus epidemic in the 1950s that struck so many children and caused panic in my own parents until Dr. Jonas Salk developed a vaccine. As a nurse, I also remember the terrible AIDS virus epidemic in the 1980s and 1990s that killed so many people and even became the “poster child” for legalizing physician-assisted suicide until an effective treatment was developed in 1997. And I remember the relief and joy when the polio vaccines and AIDS treatments were found.

Like AIDS, polio and other deadly infections in the past, the Covid 19 crisis will also eventually pass. I recently asked my wonderful 97-year-old friend “Melissa” who lived through World War II about how people got through those terrible years of turmoil and sacrifice. She seemed surprised by the question and said, “We just did what we had to do”. No wonder she is one of those people now celebrated as the “Greatest Generation”  with the values of  “personal responsibility, duty, honor and faith.”

Those values are just as important today.

FIGHTING WORRY AND FEAR WITH GRATITUDE

In our current crisis, one way we can help ourselves cope is by being grateful for the often unrecognized blessings we do have. Gratitude is a potent antidote to the panic, worry and fear that can infect us, our loved ones and others.

So I am grateful that we live in a time when computers, smartphones (especially with text and FaceTime) and other devices that are available to most people now. How much worse would social isolation and access to critical information be in the past without these devices?

Personally, I am grateful that our grandchildren have access to online learning after their schools closed and that some of our adult children are now able to work by computer from home.

I am also grateful for my religious faith that encourages trust in God, prayer, hope and helping the less fortunate in times of crisis. And I am grateful that even though churches and other places of worship are closing, religious services and inspiration are easily available online or on television. And I am inspired by the efforts of religious groups like the St. Vincent DePaul Society that never stop caring for the less fortunate no matter what the crisis.

I am also grateful that I am healthy enough to help my more elderly or infirm neighbors by picking up items from the store or even just calling them on the phone to chat. We can all look for ways to help our community without endangering ourselves or others such as ordering take-out food from small businesses that had to close their dining rooms and lay off workers. I have always found that helping others promotes happiness and optimism in both the person receiving help and the person giving the help.

I am grateful for my husband and family, especially now that we are grandparents who can help care for our grandchildren-particularly those who are out of school and have (thankfully) working parents. In times of crisis, we have a great opportunity to get closer to all our loved ones and the entertainment value of family alone is worth it.

All of us should remember that it’s the tough times that strengthen us most. We have a duty to set a good example for our families and our nation so that when the crisis is behind us, we all will be kinder, wiser and better people in the future.

 

 

 

 

 

A Very Special 6th Birthday Party

Recently, I was invited to a 6th birthday for a special boy.

“John” (as I will call him for privacy reasons) was born a healthy baby boy. But when he was a few months old, he stopped breathing and 911 was called. Apparently, John had a near-SIDS (sudden infant death syndrome) event.

John was resuscitated but the doctors in the emergency room told the parents that he had severe brain damage.

John’s mom was a special education teacher and told the doctor that she often cared for severely brain-injured children and would do the same for her son. She was just so glad he survived.

I was called about John to help with information and support.

At one point months later, John became critically ill and was hospitalized. The doctors did what they could but said his chances of survival were bleak.

However, John surprised us all by getting better and going home. He was tough!

It takes a lot to care for a child on a ventilator and feeding tube at home but John’s parents were up to the task, along with help from their church and family members. John’s family later expanded when his two younger sisters were born. They obviously love their big brother.

When John had his 6th birthday a few weeks ago, it was a joyous occasion with family and friends. I was delighted to be invited. Although John is still severely brain-injured and still on a ventilator and feeding tube, he spent much of the party cuddled in his grandfather’s arms. He was the center of attention.

John’s grandfather told me about his brother who was born with cerebral palsy decades ago. The family was told that he would not live long but with supportive siblings and parents, the brother lived a good life until he died at age 60. The grandfather is still proud of his brother.

CONCLUSION

When my Karen was born with Down Syndrome in 1982, I didn’t really know what to expect and I was shocked by negative attitudes-even from her medical professionals.

But that was wonderfully counteracted by the other parents in the St. Louis Down Syndrome Association who told me how their child was a blessing and how that child opened their hearts and eyes. I was awed by these other parents’ concern, help and support for my daughter and our family.

I later asked these amazing parents if they were like this before their child was born. Every one of them said no and that it was their child that led them to open their hearts and eyes.

I eventually discovered how true this is even though my Karen only lived 5 1/2 months and I’ve been blessed by meeting other children with special needs and their parents.

Too often, people assume that a child with special needs is automatically a family tragedy.

The truth is that children with even severe disabilities can teach the rest of us so much about love, acceptance, true happiness and resilience.

And, of course, faith.

 

 

The Power of Memories

Back in the 1990s when I was a home health/hospice nurse, one of my most memorable patients was a woman I will call “Georgia”.

When I was assigned to Georgia, I was told that she had terminal lung cancer but did not feel well enough to get to her doctor visits and the doctor wanted us to find out what she needed since she did not want to be hospitalized.

I was surprised to find Georgia, her husband and 2 dogs were living in a small camper attached to a pickup truck on the gravel banks of a small river about 50 miles from St. Louis.

Georgia was a dignified and very thin older woman with a look of profound sadness in her eyes. She was getting oxygen for her shortness of breath and effective pain medication but her main complaint was unremitting nausea. Her husband was friendly and anxious to know what he could do to help his wife. Both knew her diagnosis was terminal.

Because of years working with cancer patients, I suggested a new anti-nausea regimen that Georgia’s doctor had never heard about. He checked with a pharmacist and we started the regimen. It worked well.

With her symptoms now under control, Georgia finally spoke about her fears for herself and her husband. I was able to reassure her about measures to make her comfortable and other end of life concerns but she still seemed sad.

I also found out that they moved to the little camper on the river after their home was burned to the ground. That loss was devastating for both of them but they were grateful to be able to rescue many family photos.

Then I asked if she would like to show me some of the rescued pictures and she was delighted.

Each picture had a story and Georgia was happily animated as we went through several of them at each visit. Slowly, a picture emerged of a life well-lived with family and a generous spirit at the heart of everything.

As the weeks went by, I didn’t know if we would get to the end of the pictures as she became weaker and weaker but I saw her spirits steadily improve while the sadness receded.

Georgia died late one night and her husband called to tell me that her death was peaceful for both of them. He thanked me for my help but I felt I should be thanking him and Georgia for the lesson they taught me about the beauty and importance of memories accumulated over a lifetime and remembered with love.

Today,  life review and reminiscence therapy  can be found in many hospices and nursing homes.

“REMINISCENCE THERAPY” FOR PEOPLE WITH DEMENTIA

Last week the Wall Street Journal had an article titled “To Help Alzheimer’s Patients, a Care Center Re-creates the 1950s” about a California adult day care center for people with dementia.

This first of its kind center recreates a town square representing the time period from 1953 to 1961 when most of the patients were in the prime of their life.

The rationale is that dementia makes it hard for people to remember the recent past whereas older memories are preserved better for a longer time, “especially memories from childhood and early adulthood”, according to Professor Dorthe Bertsen who heads the Center on Autobiographical Memory Research in Denmark.

According to one small study done in Europe, most participants showed no improvement on cognitive tests but there seemed to be improvement in their mood and quality of life.

In one section of the article about trying reminiscence therapy at home, Mindy Baker, director of education at George G. Glenner Alzheimer’s Family Centers, suggests going through old photos, doing a favorite activity, and telling stories to trigger memories with the family member.

The goal is to facilitate memories rather than challenging inaccuracies  because a person with dementia might get upset if their memories don’t align with the facts.

CONCLUSION

But we don’t necessarily need a fancy facility like the 1950s-inspired day care center to help people with dementia.

Over the years, I have helped care for many patients, friends and family with dementia in their homes, in hospitals or nursing homes. I saw people who hadn’t spoken for a long time light up and join me in singing songs like “You are My Sunshine”.

For my friend Dr. Anne who had dementia, I would tell stories about her achievements and show her articles that she had written and she would grin the rest of our visit.

I learned these techniques when I cared for my mother when she developed terminal cancer and Alzheimer’s in the 1980s and I saw her memory slowly fading away.

Mom finally could not remember my name or my 2 year old daughter’s but she knew we were people she liked. We would all sit together and watch Sesame Street episodes or old movies holding hands and I saw how happy that made my mother even though she could no longer speak.

Most moving to me was that almost to the very end of her life, she was still trying to load the dishwasher and making the sign of the cross. Faith and family were the two things most important to her and this was her way of showing and remembering  this.

Memories are so important to all of us and especially at the end of our lives when they may be all we have left.

Personally, I’m saving up some good ones myself.

 

3 Tips for Safeguarding Your Loved One in a Nursing Home

I have had many relatives and friends who lived in nursing homes and, especially as a nurse, I am always saddened by how few of the other residents had any visitors, even family members. I have even heard relatives say they would just prefer to remember their relative “the way they were”.

This is not only tragic for the family member’s or friend’s psychological well-being but also potentially for their safety. Nursing home residents without visitors are at greater risk of neglect or even abuse. With sometimes inadequate staffing and/or high nurse and aide turnover, it is important that people in a nursing home have someone who knows them to look out for them.

Here are 3 tips that can help safeguard a friend or relative:

  1.  Get to know the staff and tell them about your friend or relative, especially likes or dislikes. Visit at different times or days in order to know the staff and when it is most convenient to talk with them.
  1. Notice “red flags” like poor personal hygiene, unexplained injuries, weight loss, emotional changes, environmental hazards etc. and know who to contact if you see a problem.
  1. Especially if you are have health care power of attorney for your relative or friend, ask about care conferences so that you can attend them. Such conferences usually cover how the resident is doing in terms of activity, possible pain, eating, mobility, etc. It is also crucial to know what medications have been ordered and given, especially the PRN (as needed) ones. For example, you may notice a change such as sleepiness or fatigue that can be helped with a medication change.

CONCLUSION

By 2020, it is projected that the global population of human beings who are 65 and older will surpass those under 5 for the first time in human history. At the same time, families have fewer children, older adults are more likely to have never married or to be divorced and adult children often live far from their parents. This makes it harder for many older people who prefer to live independently in their own homes indefinitely without help.

According to the CDC, 1.4 million people are nursing home residents in the US and, as I wrote in last week’s blog “‘Rational’ Suicide and the ‘Elderly'”, those residents really benefit from visitors as do all of us who volunteer to help the elderly!

 

 

“Rational” Suicide and the “Elderly”

An article in the May, 2018 issue of the Journal of the American Geriatrics Society titled “Rational Suicide in Elderly Adults: A Clinician’s Perspective”  by Meera Balasubramaniam, MD, MPH  recently appeared in both medical and nursing news sources.

Dr. Balasubramaniam begins with a case study of  “Mr. A” who at age 72 is considered a “baby boomer”, along with a whole section on the “baby boomer” generation-those born between 1946 and 1964 (ages 54-72).

Mr. A was a retired widower who had recently undergone successful cancer surgery and used a walker. He had no terminal illness but  he told a nurse that he always entertained the idea of ending his life “while I’m still doing well” and that if his health showed signs of failing or became too arduous, he would consider suicide. He stated “I’ve lived a good life. I’ll see how it goes, but it’s better to die well in my early 70s than have a life in which I have to be anxious before every doctor’s visit or have repeated surgery or end up in a nursing home.” (Emphasis added) A psychiatric consult showed no mental health problem.

Dr. Balasubramaniam says she wrote this article to “explore whether ethical arguments in favor of physician–assisted suicide apply to elderly adults who are tired of living but are not terminally ill”. (Emphasis added)

While claiming to not take a view on “whether suicide in non–terminally ill elderly adults can be rational”,  Dr. Balasubramaniam states that “It is important to consider the possibility that the combination of negative perceptions toward aging and dependency, greater social isolation, increasing access to drugs, greater need for autonomy, and an overall generational familiarity with suicide may be accounting for a higher proportion of older adults like Mr. A expressing the wish to end their lives on their own terms”. (Emphasis added)

DEATH AND THE BABY BOOMERS

It may seem incredible to even consider “tired of life” and older age as a “rational” reason for medically assisted suicide. However, Holland and Switzerland already allow it and the article itself cites the UK group “My Death My Decision” (formerly SOARS, The Society for Old Age Rational Suicide) that supports the idea that mentally competent older adults should have the right to assisted suicide rather than face an uncertain life that may be “fraught with frailty and dependence”.

As a Baby Boomer myself, we baby boomers were among the first teenagers exposed to a growing societal acceptance of new concepts like divorce , “free love” with the help of the birth control pill and legalized abortion, the “population bomb” predicting global cataclysm if people didn’t stop reproducing, the use of illegal drugs like marijuana and LSD for recreation, the rejection of religious principles and the slogan “don’t trust anyone over 30”.

So perhaps it should not be puzzling that people over 55 comprised the majority of people dying by physician-assisted suicide in the latest Oregon report since we saw so many of the traditional civil and moral moorings in society pulling loose when we were at an especially vulnerable age.

CONCLUSION

As one sage said, “Old age ain’t for sissies!” But, of course, this is not a “rational” excuse for legalizing assisted suicide for anyone-of any age.

Still, our older citizens are an especially high risk group for elder abuse, household accidents, money scams, social isolation, age-related medical bias and poor or even dangerous nursing home care.

Having friends, family and a meaningful purpose in life becomes harder when older people see their loved ones die or move far away and physical or mental limitations develop in themselves. Many older people fear losing their independence as well as being a “burden” on others.

Medically assisted suicide is not the answer but what else can we do to help?

We can start with our own family members, friends and neighbors. Like all of us, older people need to feel loved and appreciated. Look for ways to assist an older person that he or she might not have considered or be too embarrassed to ask about.

When I was a young wife and mother, our church parish started a Good Samaritan program to identify and help people with special needs of any age. It was a great success and our parish became more inclusive and accessible to everyone, especially the elderly. That was a benefit to all of us.

Other programs such as visiting one person for one hour each week in a local nursing home have helped some parishes to combat the sad reality I have seen that few people in nursing get  visitors, especially people with dementia.

Many of us naturally feel uncomfortable about going to nursing homes, but such places are usually thrilled to have volunteers and most have training programs.

Personally, my first volunteer activity was as a young teenager in a nursing home and it changed my perception of “old people” and life itself. I was amazed by the wisdom and stories the residents told as well as how much they appreciated anything I did. It was a great experience for a shy, gawky teen like myself.

Many years later, I took my young children to visit their grandmother in a nursing home after telling them what to expect in terms of sights, smells and sounds. Afterwards, my youngest daughter asked why everyone wanted to touch her leg while I held her. When I explained that the residents rarely saw a 2 year old and were so glad to see her, she grinned and said “OK!”.  She understood even at that young age.

In a society that seems to constantly celebrate youth and health, we need to make sure that our elderly also feel valued and supported.

And we might just save a life!