Ok so I truly dislike the following article - because even tho the author says she believes hospice had the best of intentions - she goes on to preach her moral outrage at them suggesting hospice patients (or any patient also often referred to as people by some hospice workers) should actually consume such GMO laden, unnatural crap.
No one here is pretending this is a road side farm stand - and most hospice workers aren't keeping a cooler of these in their trunk to drink during break - the truth tho - they're effective and a lot of seniors, especially ill seniors will choose them over fresh alternatives for numerous reasons.
Allow me to explain a few - besides the idea that many may just feel that there are bigger existential issues to confront during hospice time than the labels on their food products. (Yes there are exceptions and if this were my only argument I'd flame me too, but it's not - please, read on)
So ensure is what it is - a means of artificial, packed in nutrition - in a highly condensed form that seniors tend to like the taste of, tolerate the volume of, and aren't turned away by it causing increased frequency of urination or bowel movements.
For many struggling with issues in health and aging - tastes have changed. They also have less appetite. We pack things like this with calories and protein - to do so in as little volume as possible requires high sugar content - also more appealing to the taste buds of aging and elderly as they lose more of sweet and salty tastes and retain bitter and sour.
Mobility is often an issue- they seek easily prepared foods that don't cause frequent bathroom trips - incontinence is often an issue - as is dignity - little in and little out. They know this. When it hurts to walk 20 feet to the bathroom or you're scared you'll fall - that drink that satiates, tastes at least ok and doesn't make you pee or poop a lot- hey that's awesome.
Your fresh alternatives - even if you make them for them - will require a lot more natural sugar added (honey, sweet fruit) than I bet you'd be inclined to add, in order to be palatable. Also they'll contain a lot more volume in water content etc, oh and fresh plant matter most likely. Well hello bowels are working now! Oh crap! Literally! So now they've got to drink more, it doesn't taste as good to them, it causes them to have to move more and potentially embarrassing situations, pain and falls.
Maybe your mom would have been the exception, maybe she would have reached for a fresh smoothie. For many tho, don't be surprised if they reach right past for the boost or ensure.
Beyond that - as far as hospice goes. Distributing fresh veggies and fruit and preparing fresh smoothies - well I'd love to think there was time allotted for that - but that's not covered in the Medicare benefit or any private insurance I know of (except maybe congressional plans) - and they know all too well - when you're trying to pack in calories and protein efficiently - these drinks, much like artificial nutrition that would be given through a tube feeding, are more easily digested and absorbed and also accepted by many we are trying to help. It's economical and effective not ugly and nefarious.
If labels and nutrition are your passion then do what's right for you and yours, by all means. I won't look at you and yell "what the heck are you doing feeding that woman fresh non-GMO food!", I promise. Understand however, that for many, this road won't be the right one at the end, even if they've been committed to clean eating for years. Priorities change often due to necessity.
Oh and if you or someone you love is on hospice - I will absolutely encourage you to use what works, eat what tastes good, to hell with labels and all that - love and live and laugh - because no matter how healthy and clean you live and eat - you won't live forever. Put down the labels and pick up a hand, spend a little less time worrying if that corn is going to rob you of a nanosecond of your potential life span, it already did, and you really can't even but Non-GMO in this country anymore.
Maybe these companies get that, maybe they're just making a buck - but they won't be the first or the last to make a buck off the aging process. For many a senior, I've seen this stuff allow them autonomy for longer - and when that was truly synonymous with their definition of quality - well grab a bottle and I'll drink to that.
I often keep a few of these around....I find they are amazingly loved gifts for families especially when caregiving through end of life at home! A great way to encourage legacy work and memory sharing!
Imagine you're laying in bed feeling rotten, you're half asleep and you open your eyes to someone advancing at you from above with an over-sized Q-tip which tastes of synthetic mint or sweet fake lemon. Mmmmm you'd open right up huh?
For many, those swabs we hand out as if they're delicious lollipops are something they'll soon clamp their mouth closed to - and that's actually pretty natural. We tend to project our own discomforts on someone in the Dying process and the body actually secretes it's own endorphins that counteract many of the discomforts people would experience from not eating and drinking at the end of life. However, until that kicks in and sometimes regardless, dry mouth is an issue and it's a difficult one.
So here are a few tips:
Those pink and green swabs - when your mouth is dry it's hard to open wide. A lot of times these are too big - you can clip them down with a pair of scissors - try to keep the edges rounded tho.
Try dipping them in water or juice or any favored drink (theirs not yours) - pop them in the freezer for a bit before using. Cold and wet is often even better - especially if it's hot out!
Try coating them with virgin coconut oil and raw honey - try it yourself - it's actually rather refreshing and nice and it leaves a lingering taste and residue that keeps the tongue exploring to the roof of the mouth which can encourage salivation.
Scoop some fresh cold fruit (melon works best) with a spoon or melon baller. Make sure to keep the balls small enough to move inside the mouth but big enough to not be a choking hazard! Put on the end of a chop stick (don't use anything with a pointed end that could jab through and poke the inside of the mouth!)
Make ice cubes of flavored juice or water - many stores sell the ice cube trays with rounded silicone bottoms - fill them only a little and make a semi-circle. You can stick in a lollipop stick from a local craft store or ordered from Amazon if you're concerned about choking. (You can actually use this method for disguising liquid medications as well - just keep your medicated ice labeled and secure! I do recommend a sweeter juice for this - as we age we taste salty and sweet less and bitter more. Gram always got raspberry - I'd drain the juice off a bag of frozen raspberries into the ice cube tray. )
Try soaking cucumber slices In lemon water, add a little mint if you like, you can use fresh or food grade essential oil. Lemon triggers salivation, mint soothes the stomach and freshens the mouth.
There's also biotene which is available at many drug stores. I often recommend to stay away from the tablets as they can be choking hazards. The spray can be great but I usually recommend spraying it on a swab or cloth and wiping the mouth with it.
If the person can't tolerate any liquid intake but is awake enough to not have to worry about choking - the cool of sucking on plastic ice cubes (you know the ones that don't dilute your drink) can at least be refreshing. Otherwise teething rings are an option too.
Yes, I have tried these things, and more. You see at the point that someone you love is unable to swallow a drop of liquid without vomiting and is miserable from dry mouth - you'll try anything - and I mean anything.
To save you the headache, I will mention, Athena's Wet Head Dry Mouth spray seemed like a brilliant idea one night. Juicy apple, sure, why not! Well - let's just say I hope it's better for its indicated use.
Now I hope you're laughing....and that one of these gems works for you should you ever need it. If you have more suggestions please drop me a line! I love learning new ways to ease symptoms and passing them on to others!
Just remember tho, if someone is refusing and closing their mouth, please don't force, it's likely that the dry mouth isn't bothering them as much as it is you. Ask and offer but then respect wishes!
How is hospice like Brussel Sprouts?
Incredible. Absolutely incredible.
Love is always hardest when it asks you to let go. Thank you to all the parents who find their way to give their sick children just a few moments to be children in the face of terminal disease. Your courage, the amazing depth of your love - it is incredible.
We have very little pediatric hospice care here in Maine. This has to change. The smallest Angels on earth need more guardians to help them and their parents through these excruciating times.
We owe it to them to ask the hardest questions, consider all the information and when the cures become too hard - to let them show us their beautiful little wings here for a bit before they fly away.
She lay with broken wing
As beautiful as ever
Upon the forest floor,
Hidden away, few saw her
Fewer recognized her beauty.
Until the day she learned to fly again,
And her wings glistened,
Capturing rays of sunshine
As she flew through the air she had missed
For so long.
Her wings once again whole.
Just watch her fly,
With Angels on her back,
A broken dragonfly no more.
Great training opportunity with Teepa Snow coming up!
So Close Cathy Zheutlin! Keep up the amazing work!
Please - consider supporting the work of this amazing documentary.
Sad but true.
Why is it in our society that we term facing a prognosis and choosing quality over quantity even if that includes cessation of curative treatment "giving up" while viewing "head in the sand" blind optimism and "fighting" to the bitter and often horrible death as courageous?
Isn't choosing the right path for you based on all the information the way you'd want to live your life to the end?
If you ever come within 50 feet of a person with dementia - i will advise you to check out the teaching and works of Teepa Snow. I thank my friend Liz May Patterson endlessly for mentioning her just in time for me to realize how valuable a recent opportunity at Stroudwater Lodge in Westbrook was (gorgeous facility with some top notch staff btw)
In the past few days since experiencing her in person, I have been devouring her works. I wish for so many opportunities back to do over with this knowledge, and my god I hope this is showing up in nursing school curriculums. She will be to the field of dementia care, if we are fortunate, what Kubler Ross has was to the academics of grief and death.
If you care for someone you love or expect to care for someone you love with dementia - do yourself a favor - learn from this woman.
I'm afraid the article actually has a good number of very valid and fair points. It points out the current short comings and barriers to use of the system and they are many - even in well serviced areas. Family caregiving is no small task in this day and age where we have lost a great deal of our community structures and our climate of death is a lot like - every man for himself.
**Please note here - I will remain forever an advocate for those who wish to die at home and those who wish to help them.
I get it, I work in hospice and end of life and I believe wholeheartedly in what we do - and we work hard for our patients - at least most of us. There will always be exceptions - bad apples in every bunch, I'm not talking about those.
I'm talking about no matter how hard we work and how much we do, there are people for whom the lack of assistance is devastating. They kill themselves to honor their loved one, every last penny, every last ounce of energy, sometimes even pre-decreasing their hospice bound loved one.
It is a reality that the current structures leave large gaps where good home caregiver help can be difficult to find, Moreso if they need to be able to give medications. Hospice does not provide 24/7 in home care.
The decision to care for a loved one at home is complicated and multifaceted - and it should be thought out. Which means I just said to you - do as I say not as I did, because when I brought Gram home it was a leap of faith, one I'll never regret taking.
But I know first hand how much it can wear you out and down, how it can physically destroy your body and how it changes your life. I'd never trade our experience for anything - but it's a leap some people won't survive making.
The system has to change - it's not the idea of Dying at home that's flawed. It's a culture that denies death, it's a medical system that sees death as failure and honesty in prognosis as destruction of hope. It is consumerism that demands immortality and a system that tries to comply.
There is a better answer. We knew it once, maybe someday we will remember again - that we are born and we die - the only two certainties in this life.
It's a two question test my friends, do you really want to get half of it wrong? 🙂
I'm considering a summer series, "Meditations and Ruminations on Death to Inspire Your Life." Please let me know if you'd be interested in being part of it.
Also, if you're interested and have a moment, could you assist me with a few answers to more questions?
Would you prefer an all-online format, all in person, or meditations online and ruminations* in person?
Are there any works of poetry, music, or ideology that you would like to see brought into this series? I have tons of ideas but I always want to hear yours!
What times, days and places would work best for weekly or bimonthly meetings this summer? ***
* No actual cud will be involved.**
** You are not rquired to get that joke in order to join the discussion.
*** I have the vision of park grass on warm, starlit summer nights. I also fear that waxing romantic may come with the consequence of some very damp nights laying in wet grass. But that would be one compelling meditation!