Adonis Diaries

Posts Tagged ‘Sylvie Garoche

Heavenly haven for terminally sick

Posted on March 17, 2010

Are you afraid of regular hospitals? You should be. 

These centers of health care where a patient is a corps to be operated upon and dispatched quickly to make room for other patients.

Palliative health care facilities are the opposite of regular hospitals for the terminally ill: the patient is the center of attention; pain and suffering is the target of treatments. The goal is the dignity of the patient to die as comfortably as feasible.

Palliative facilities welcome the brave incurable patient who opted for stopgap measures on relentless treatments and experimentation of protocols: he decided to take charge of his destiny and dying peacefully.

Usually, palliative facilities are associated with mobile network of medical groups managing terminally ill person in their residences.

These kinds of network medical care units are constituted of representatives of physicians, nurses, psychologists, and administrators working as a group to catering for the well being of the patient who decided to spend most of his dying days at home.

The team notes down the patient’s needs and wishes, tends to the financial, clinical, health insurance, psychological, and social demands and regulations related to the patient; and it can be contacted 24 hours 7 days a week for feedback and critical moments.

The first meeting is done in the presence of the treating or family physician that must agree with the team and also be part of the association. They cooperate for the kinds of treatments, medicines, approaches, and methods.  

The mobile team does not deliver medical care but coordinate with health insurance, the appropriate specialized physicians, nurses, and pharmacies ready to rush on call for emergency needs of the patient.  

The patient is the center of the activities in the team system; the patient can stay at home as long as his health conditions permit.

For example, when the person is in terrible pain then the wife or a member of the family can call at 2 am, say what was given to the patient so far, and the mobile team would give the proper feedback of what to do next or just pay an emergency visit.

In periods of relative calm, when the patient is feeling fine then the team would call or just pay a visit: the team is like this brick wall patients and family members can lean on.  Mobile teams charge double a visiting physician but they take the time by the patient and meet with him to synthesize and evaluate the progress of the illness. 

This mobile system save a lot to health care institutions and State health budget since the patient is taken care of in his home.  I think these mobile palliative teams are suited to gather the most complete relevant data in a timely manner for the progress of an illness for health researchers.

Hospitals dedicated to palliative health services are very different from regular hospitals. These specialized hospitals are concerned with the terrible pain and suffering of a terminally ill patient; they tend to his physical, emotional, and mental requirements as the patient gradually feels dispossessed of life belonging, control, and management of others.  

The patient comes to these centers because he decided to stop treatments for his ill and just wish to be relieved of the pain, suffering, and indignity.

As you enter a palliative facility you hear “Here we take charge of your suffering. Suffering less is feasible”

There are no limiting visiting hours; you may bring kids and even pet animals to visit the patient; a private kitchen is completely equipped for family cooking or heating of plates; there are furnished spaces for an entire family to feel comfortably at home.  

Family members and friends can sleep over. Patients are allowed to redecorate their rooms with pictures, paintings, and special furniture.

Patients can go outside in their rolling chairs and wander in the park, watching farm animals in total liberty, or taking naps in the sun. Medical personnel do not wake up a patient to eat, but wait and reheat plates. Quality of life in the last days of a patient is the name of the game.

In “Intimate death”, Marie de Hennezel writes “I learned three things from life:

First, I will not avoid my death or any member of my family;

Second, man is not reduced to what we think we are seeing: he is far larger, far deeper than our judgments; and

Third, man has not said his last word yet: he is capable of transforming to a mighty person throughout a series of crisis and life’s trials”

France passed the Leonetti Law in 2005 which says:

First, relentless therapy is illegal;

Second, patient has the right to refuse treatment, including forced artificial feeding;

Third, physician must use all of what is available to reduce pain and suffering of the patient; and

Fourth, patient has the right to write his final wills as anticipatory directives and to designate the person in charge of respecting and enforcing the final directives.

Note: I got aware of this topic from the book of Sylvie Garoche in “Quand la vie tutoie la mort”

Part Two: “When we befriend death”; (Mar. 23, 2010)

In part one, Sylvie, the wife of Pierre Garoche, learned that her husband has an incurable bone cancer.

A treatment was supposed to remiss his disease from developing for an average of two years, but Pierre discovered that his case extended his normal life for only three months.

Within these 3 months, Pierre managed to quit work as physicist researcher and arranged to be free from all social responsibilities in order to tackle his new life conditions.

Pierre had a year to experience the denuding process from all attachments: material, mental, and emotional. He also had to witness during the short periods of relative painless physical well-being the kinds of close friendship with his friends and members of his family, total openness, joy, and laughter.

A few friends had to face death in Pierre and they initially felt relieved that death is not so scary after all.

The example of Pierre’s family cool approach to death was a catalyst for visitors to talk freely and discuss openly on topics they cared about.

The number of cancer markers doubled every 15 days and eventually, the doses of pain-killer had to be changed in quality and in quantity.

Sudden pains, in various parts of Pierre’s body were like knives inserted in these locations. Pierre began to sleep more frequently and for longer duration.  Natural bodily functions degraded.

Soon, morphine was king. When well controlled, morphine does not provoke hallucinations or addiction until it saturates the blood after prolonged constant usage.

As long as he was in his mental capacity, Pierre followed the medical procedures methodically and in details:  he kept statistics and tried to forecast the next phase in his sickness. He wanted to figure out from data the exact date of his death. They redecorated the rooms: “I want to die in a pretty room” said Pierre.

Soon, Pierre needed a specialized hospital bed installed in his room at home. When asked “Why are you in such a hurry to pass away?” Pierre would reply: “Yes, I am in a hurry. It is becoming too difficult to resume living.”

His wife Sylvie once said: “at least you experienced how it is to live in old age, one step of the staircase at a time

There were periods when Pierre could no longer eat or drink.  Pierre wanted to die at home; his wife at first refused to play the nurse because she was untrained for that job.  Then they discovered mobile group care facilities that were associated with a palliative hospital (specialized in focusing on pain and suffering of terminally ill patients).

This 24 by 24 seven days on the job call mobile facility made Sylvie task easier to handle.  Sylvie learned to administer the medicines on time as Pierre gradually relinquished his control and management over details.  Pierre had stopped counting and anticipating.

Once, as Pierre could no longer suffer being among the living, the entire family prayed in the presence of Pierre: “Lord, we ask you to come and fetch Pierre in June, if it is possible…” This prayer reassured Pierre that his family had given him authorization to passing away.

By the by, Pierre reached a phase where dreaming and reality were confounded.  Higher doses of morphine increased secondary deleterious effects.  The palliative hospital was the proper place for a few days to changing his blood and recalibrating the variety of pain killers. Pierre would return home in better state mentally and physically for shorter and shorter durations.  Nurses were hired for the morning washing.

Note 1: You may read part one: https://adonis49.wordpress.com/2010/03/15/part-one-%E2%80%9Cwhen-we-befriend-death%E2%80%9D/

Note 2: I described in two previous articles the denuding process of a terminally ill and how palliative hospital functions as a haven of dignity for these patients.

Total denuding process of terminally ill; (Book Review, Mar. 17, 2010)

The hardest part for an incurable dying person is not necessarily being reduced to nothing after death; it is to be consciously reduced to a totally dispossessed non-entity before his death.

Willingly or coerced to, an incurable dying person is forced to undergo total stripping of all his material belonging and his mental and physical potentials.

For example, in the article “Befriending death”, Pierre “the fix it all”, had to finally ask specialized companies to do home repairs and finish off works in progress; he had to desist doing research work at his physics research institution.

Pierre had to find capable replacement researchers to resume his projects; he had to give up positions in associations and organizations.

Pierre had to stop computing from statistics the exact date for his imminent death; he had to teach his wife and grown up children how to fix and repair things at home.

Pierre had to give up reading, listening to music, communicating, surfing the net; he had to forget what he accumulated in tools for home repairs.

Pierre had to accept loosing possession of part of his body, his strength, sensations, taking interminable time to getting out of bed, unable to eat, to talk, to walk.

Pierre had to be resigned to let go controlling and managing his family.

The last phase in dispossession is to let go of praying.

Come what come, the dying person is already “a prayer”.  It is not only totally useless to pray by the dying patient’s bed; it is also frankly infuriating to the patient and family members: the dying person is already in another dimension and care less of what’s going around him.  Pierre is entering a sort of “no man’s land of the mind” in silence.

It is entirely naïve and insane for friends to tell a dying person “You still can decide for life!”

People usually lack the burning pains of what the terminally ill is experiencing. There is a time when living and dying is same different.

Suppose a person has reached the final phases of total dispossession and then was told “Congratulation, you are cured. You can recapture your former job and get your previous activities back.”  

Do you think that this completely denuded person would still have the heart and energy to restart life from scratch like a newborn baby?

Note: this topic was extracted from “When befriending death” by Sylvie Garoche.

Heavenly haven for terminally sick; (Mar. 17, 2010)

            Are you afraid of regular hospitals? You should be.  These centers of health care where a patient is a corps to be operated upon and dispatched quickly to make room for other patients. Palliative health care facilities are the opposite of regular hospitals for the terminally ill: the patient is the center of attention; pain and suffering is the target of treatments; the dignity of the patient to die as comfortably as feasible is the goal. Palliative facilities welcome the brave incurable patient who opted for stopgap measures on relentless treatments and experimentation of protocols: he decided to taking charge of his destiny and dying peacefully.

            Usually, palliative facilities are associated with mobile network of medical groups managing terminally ill person in their residences. These kinds of network medical care units are constituted of representatives of physicians, nurses, psychologists, and administrators working as a group to catering for the well being of the patient who decided to spend most of his dying days at home. The team notes down the patient’s needs and wishes, tends to the financial, clinical, health insurance, psychological, and social demands and regulations related to the patient; and it can be contacted 24 hours 7 days a week for feedback and critical moments.

            The first meeting is done in the presence of the treating or family physician that must agree with the team and also be part of the association. They cooperate for the kinds of treatments, medicines, approaches, and methods.  The mobile team does not deliver medical care but coordinate with health insurance, the appropriate specialized physicians, nurses, and pharmacies ready to rush on call for emergency needs of the patient.  The patient is the center of the activities in the team system; the patient can stay at home as long as his health conditions permit. For example, when the person is in terrible pain then the wife or a member of the family can call at 2 am, say what was given to the patient so far, and the mobile team would give the proper feedback of what to do next or just pay an emergency visit.

            In periods of relative acalmy when the patient is feeling fine then the team would call or just pay a visit: the team is like this brick wall patients and family members can lean on.  Mobile teams charge double a visiting physician but they take the time by the patient and meet with him to synthesize and evaluate the progress of the illness.  This mobile system save a lot to health care institutions and State health budget since the patient is taken care of in his home.  I think these mobile palliative teams are suited to gather the most complete relevant data in a timely manner for the progress of an illness for health researchers.

            Hospitals dedicated to palliative health services are very different from regular hospitals.  These specialized hospitals are concerned with the terrible pain and suffering of a terminally ill patient; they tend to his physical, emotional, and mental requirements as the patient gradually feels dispossessed of life belonging, control, and management of others.  The patient comes to these centers because he decided to stop treatments for his ill and just wish to be relieved of the pain, suffering, and indignity.

            As you enter a palliative facility you hear “Here we take charge of your suffering. Suffering less is feasible” There are no limiting visiting hours; you may bring kids and even pet animals to visit the patient; a private kitchen is completely equipped for family cooking or heating of plates; there are furnished spaces for an entire family to feel comfortably at home.  Family members and friends can sleep over. Patients are allowed to redecorate their rooms with pictures, paintings, and special furniture. Patients can go outside in their rolling chairs and wander in the park, watching farm animals in total liberty, or taking naps in the sun. Medical personnel do not wake up a patient to eat but wait and reheat plates. Quality of life in the last days of a patient is the name of the game.

            In “Intimate death”, Marie de Hennezel writes “I learned three things from life: first, I will not avoid my death or any member of my family; second, man is not reduced to what we think we are seeing: he is far larger, far deeper than our judgments; and third, man has not said his last word yet: he is capable of transforming to a mighty person throughout a series of crisis and life’s trials”

            France passed the Leonetti Law in 2005 which says: First, relentless therapy is illegal; second, patient has the right to refusing treatment, including forced artificial feeding; third, physician must use all of what is available to reducing pain and suffering of the patient; and fourth, patient has the right to write his final wills as anticipatory directives and to designate the person in charge of respecting and enforcing the final directives.

Note: I got aware of this topic from the book of Sylvie Garoche in “Quand la vie tutoie la mort”

They are not stupid; their mind is not crippled; (Mar. 16, 2010)

            The new French author Sylvie Garoche wrote in “When we befriend death” that her father was in a convalescence home and she was convinced that he was no longer aware of anything since he kept his silence and his eyes were kind of looking in a void.  “I brought my father a CD of an opera he loved and then I asked him a simple question just for conversation sake “Do you recall the tune?”  He replied “I constantly sing in my mind all the operas that I memorized and the concerts that I attended. I sing the old ballads related to wild trails that I used to walk summer times” This erudite old man, fond of literature, music, and trekking, was still reviewing the trails, the wild passages, the majestic views from mountain tops, the wild flowers on the way; he was assisting to his favorite concerts; he was walking in his mind his favorite wild trails by torrents and streams, dense forests; he was feeling the warmth of the sun and the ticklish wind.

            Most of old persons that look vegetables, who fail to react, who can no longer talk or communicate efficiently, are reliving their internal lives made of emotions, sound, and visual sceneries; they are recalling of what they weaved during a life time.

            Most of these old persons would be recalling far greater events, richer sounds, more vivid sceneries if they could enjoy beautiful facilities where care is centered on the person and where location is made as home.

            It is never too late to train your memory and get hooked to a hobby: you might need them in old age. 

They are not stupid; their mind is not crippled; (Mar. 16, 2010)

 

            The new French author Sylvie Garoche wrote in “When we befriend death” that her father was in a convalescence home and she was convinced that he was no longer aware of anything since he kept his silence and his eyes were kind of looking in a void.  “I brought my father a CD of an opera he loved and then I asked him a simple question just for conversation sake “Do you recall the tune?”  He replied “I constantly sing in my mind all the operas that I memorized and the concerts that I attended. I sing the old ballads related to wild trails that I used to walk summer times” This erudite old man, fond of literature, music, and trekking, was still reviewing the trails, the wild passages, the majestic views from mountain tops, the wild flowers on the way; he was assisting to his favorite concerts; he was walking in his mind his favorite wild trails by torrents and streams, dense forests; he was feeling the warmth of the sun and the ticklish wind.

            Most of old persons that look vegetables, who fail to react, who can no longer talk or communicate efficiently, are reliving their internal lives made of emotions, sound, and visual sceneries; they are recalling of what they weaved during a life time.

            Most of these old persons would be recalling far greater events, richer sounds, more vivid sceneries if they could enjoy beautiful facilities where care is centered on the person and where location is made as home.

            It is never too late to train your memory and get hooked to a hobby: you might need them in old age.

Part One: “When we befriend death”; (Mar. 15, 2010)

            Pierre is never afraid; he is also a fix it all at home and at his laboratory: he is a physicist in solid states.  Once, the very ancient water burner (or boiler) lacked a spare part that the manufacturer stopped producing; Pierre fabricating it and the boiler got a new life for over 10 years. Another time, his car gas pump broke down on the highway; Pierre attached an empty plastic water bottle by his window, removed a few (totally unnecessary tubes from the engine) and connected the gas directly to the engine or something to that effect. Pierre is taking to his grandfather.

            The grandfather needed a new pair of trousers and he started from scratch.  He manufactured a weaving machine, weaved the threads, then cut and sewed himself a pair of trousers.  The grandmother had this to say “the entire process is fine; the trousers are to be desired.”

            Pierre was for social justice and a staunch far left Trotskyite in school; he still is an activist for social justice with a twist: as he started secondary studies he believed that he had a powerful ally in Jesus.  Curious Pierre had met with a group of practicing Catholics called “Focolari”.  He applied the concept of loving his neighbor and in his case it was finding ways to loving his teachers.  It dawned on Pierre to attend seriously to classes as his notion of loving teachers; his grades improved greatly though he persisted on not studying at home.

            Pierre was never afraid in childhood and he was even less afraid in middle age: he believed that after death he will enjoy a listening ear in Jesus and aid better his family and friends.  When Pierre looks sick and his wife is terribly worried he would say “Don’t you worry; I’ll pray for you” meaning that his new location by Jesus will take care of everything.

            At the age of 53, Pierre had a stroke but was conscious all the time.  As he was carried to emergency he saw his second son standing bare footed and told him “Bruno, wear your slippers.”  This curious researcher was having a field day witnessing all the maneuvers and equipments being used to re-animate him: Pierre was asking plenty of questions for detailed comprehension of this new opportunity to learn.  When Pierre recovered his son Bruno cracked this joke “Can you imagine if you died there and then what people would have retained as your last words? Bruno, wear your slippers! You certainly can do better next time”

            Pierre is suffering from a terrible backache; as a scientist Pierre reviewed medical journals, analyzed the data of his medical file and understood that he has a generalized bone cancer; Pierre also knew that it is incurable though physicians never explicitly revealed his illness: the bones formed a Christmas tree shape. Pierre studied the authorized medicines, the secondary effects, and the statistics. Pierre asked his physician to cooperate with him as partner in the procedures and treatments. The debate was: “who is in charge to decide on the treatments? Is it the physician or the patient?”  The physician position is that death does not exist and it is his responsibility to heal the patient. Pierre begs to differ. (To be continued)

Note: Sylvie Garoche wrote a book on her husband’s fight for stopgap measures (taking charge of his destiny and dying peacefully)


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