Wishing Our Readers

The best possible Thanksgiving holiday!
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An American tradition: A warm family Thanksgiving dinner
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Death and Turkey

The history of Thanksgiving as a holiday of life, death and mourning
Credit: Wikipedia

Credit: Wikipedia

In American culture, there are two different thought processes behind the history and tradition of Thanksgiving. The most prevalent of which is the school-taught story of a celebration between the Pilgrims and Indians (most likely with the Wampanoag tribe) in 1621. In this child’s version of the history, the Pilgrims invited the natives to a celebration feast at the onset of the harsh winter months that would likely ravage their settlements in the coming months. This tale reflects another old-standing tradition in which Americans feast during the winter months as a celebration of the fall harvest and a celebration of life in the face of the ever-present looming threat of death. It is for this reason that we spend the coming days gathering food and preparing it for a feast with our own families and friends to this day.

Americans feast during the winter months as a celebration of the fall harvest and a celebration of life in the face of the ever-present looming threat of death.

But history is often far more complicated than the story that we may have been told as children. In truth, Thanksgiving was not made a holiday until at least 1863 during Abraham Lincoln’s presidency. Instead, history tells us that while the fateful feast did occur in 1621 after a treaty was brokered by the American native Squanto, who was a former European slave and the last surviving member of the Patuxet tribe, between Pilgrims fresh off the Mayflower and the Wampanoag tribe, the feast was not as significant as your first grade teacher may have led you to believe.

Credit: Wikipedia

Credit: Wikipedia

In fact, history shows us that the first feast that was named ‘thanksgiving’ happened much later in 1673 amidst a war between the Pilgrims and the Pequot tribe. This feast took place in Groton, Connecticut on the eve of the Pequots’ celebration of the green corn dance—a feasting tradition that takes place in the summer months. In the dawn, English and Dutch mercenaries ambushed the unsuspecting tribe, which resulted in the death of 700 unarmed men, women and children. Afterwards, ‘a day of thanksgiving’ was declared by the governor of Massachusetts. Likewise, many more thanksgiving days were declared in the future as all-out war continued between native tribes and settlers.

American Indians from throughout the country have been campaigning to list Thanksgiving Day as a national day of mourning

While this story is dark, it is no less important for everyone to remember on Thanksgiving Day as Americans are told to give thanks for the people and events in their own lives. And while this holiday is not lost to American Indian descendants, the bloody history of our past has transformed this into a holiday of grief, mourning and memorials for the ancestors that were lost in these violent wars. Protest for the Thanksgiving holiday picked up especially in the 1970s, as representatives from Indian tribes shared the message of the 19th century Pequot minister William Apess, who encouraged “every man of color” to mourn the day that the settlers landed on Plymouth Rock. More recently, American Indians from throughout the country have been campaigning to list Thanksgiving Day as a national day of mourning.

As an American fully of Northern European descent, It is hard to place my own thoughts on this subject. While the tradition that I have grown up with as a child has left me many great memories that I can cherish with my family, my heart also goes out to those who must consider this a day of mourning as well. Regardless of what your heritage may be, the point remains that it is important to give thanks to the sacrifices and losses that we have built our own lives upon. Perhaps for those of us who are celebrating Thanksgiving this year, the first step that we can take is to remember and appreciate the culture and heritage of others as well as our own.

Related SevenPonds Articles:

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The Pitfalls of Choosing Hospice Care

Why a nonprofit hospice may be a more sensible option when choosing end-of-life palliative care
caregiver providing end of life care to terminally ill

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What if you’ve cared for terminally ill loved ones until your resources have been exhausted? You are exhausted too, having taken on a role of a nurse while grieving over the impending loss. Finally a decision is reached to find palliative hospice care and that choice brings a welcome relief. You know that whether at home or in a nursing facility—your loved ones will be expertly cared for by professionals and you can return to their bedsides with enough energy to give them the needed emotional support as their loving mates, family members or friends.

The heartbreaking truth is: hospice care that has begun with an objective of humanizing care for the dying has become a business that puts profit above the interests of people going through the dying process—the very group it is supposed to serve.

But what if this arrangement abruptly ends as the treatment expenses exceed the Medicare cap and you are once again left alone as the caregiver for your loved ones during their most difficult final days? The heartbreaking truth is: hospice care that has begun with an objective of humanizing care for the dying has become a business that puts profit above the interests of people going through the dying process—the very group it is supposed to serve.

caregiver holding the hand of terminally ill patient

Credit: hrgalfriday.com

According to The New York Times‘ online blog, The New Old Age, the Medicare Payment Advisory Commission has discovered that 20 percent of hospice patients are let go before their deaths. While some may have chosen to die at home or have voluntarily left a hospice care facility, the majority of these patients were discharged alive and with more advanced stages of their illness. While both nonprofit and for-profit hospice providers had released patients prior to their deaths, a national survey published in JAMA Internal Medicine revealed a 40 percent higher rate of disenrollment by the for-profit hospice care providers than their nonprofit counterparts.

In her conversation with The New Old Age, Dr. Melissa Aldridge, a health researcher at Mount Sinai School of Medicine in New York, explains that the differences in ownership influence the care and services provided to the dying patients and those close to them. According to the study cited by Dr. Aldridge, for-profit hospice providers are more likely to enroll their clients for longer periods of stay and care for them in a nursing home or an assisted living facility.

 The differences in ownership influence the care and services provided to the dying patients and those close to them.

While Medicare reimburses for-profit hospices at a fixed daily rate, not all days cost the same. The first few days, when the care for the patient is being planned and determined, as well as the last days when more medical attention is necessary, are more expensive. The time between the start and end of care is more advantageous for the for-profit hospices since during that period care is most routine and less expensive. Therefore, the for-profit hospices recruit their patients for longer stays and disenroll them when the cost of care exceeds an “aggregate annual cap,” which was $26,157.50 in 2013. Nonprofit hospices ware more likely to enroll patients closer to their times of death, when such care is most needed and are less likely to exceed the cap. 22 percent of for-profit hospices have exceeded the cap, while only four percent of nonprofits have done the same.

It’s impossible to predict mortality; dementia patients, for example, may have longer survival rates than cancer patients. There is also a chance that with good hospice care, the patient’s condition may even temporarily improve. During the tough period of caring for a terminally ill loved one, it may be difficult to thoroughly research all the available care options. However, when seeking a hospice care that is less likely to discharge the patient three weeks before death, going with a nonprofit hospice may be a safer choice.

A list of features to look for in hospice care from ConsumerReports.org:

  • Not-for-profit status and 20 or more years of experience.
  • Hospice-certified nurses and doctors on staff and available 24 hours per day.
  • Palliative-care consultants who can begin care if you’re not yet ready for hospice.
  • An inpatient unit, where patients can go if symptoms can’t be managed at home.
  • Ability to provide care in nursing homes and assisted living residences.

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“I love you simply, without problems or pride: I love you in this way because I do not know any other way of loving but this, in which there is no I or you, so intimate that your hand upon my chest is my hand, so intimate that when I fall asleep your eyes close.”

- Pablo Neruda
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A Brave Face

Conversation and cooking become a balm in the face of death

This is an Anonymous’ story, as told by Sandra Fish. Our “Opening Our Hearts” stories are based on people’s real-life experiences with loss. By sharing these experiences publicly, we hope to help our readers feel less alone in their experience of grief and, ultimately, to aid them in their healing processes. In this post, we tell the story of a woman whose friend died of cancer.

Breast cancer, MRI scan

Credit: http://www.dailymail.co.uk/

Just 8 years ago, in 2006, a friend of mine died from cancer. It feels like a million years ago. We were so young and so much has happened since her death. I’d met Lisa through mutual friends just a few years before she found out she had breast cancer. I believe she was still in her twenties when she was first diagnosed. At that point, I guess we were all shocked. None of us had ever known anyone with cancer, so it was strange. Yet I think we all had a big awareness about the disease, so we were dreading for her. When she found out, it was quite advanced. She worked for a company that more or less was in the health insurance industry—it was related to her work there that led her to having an exam; and that’s when it showed up. I think I knew very little at that time. The word “cancer” made me think someone was going to die. We were so shocked because she was so young. She was soooo, well…I don’t know if she did it to save face or what, but she was brave about it.  She made it not a big awful heavy thing for everyone—she wanted to minimize the drama. She kept everyone current as to where she was, and sometimes would disappear for a little bit and come back and organize get togethers. She always wanted to be super independent; she didn’t want to burden people— she was a friend, but she didn’t want people to feel sorry for her.

I told her I didn’t really know how to talk to her about it or if she wanted to talk about it—it was then she started confiding in me. She was telling me when she had a rough round with chemo or whatever the case was.

I told her I didn’t really know how to talk to her about it or if she wanted to talk about it—it was then she started confiding in me. She was telling me when she had a rough round with chemo or whatever the case was. As soon as she found out she had cancer, she had aggressive chemo, and it took everything out of her. She hated it; she was very unhappy. It did make her better. They were able to deal with the cancer, but she was doing SO much chemo. Now seeing other people going through this, it was nothing like it was for her. Even though she was strong, the effects were so dramatic. Eventually it did go into remission so after she was stable, she quit her job and decided to go into nursing, which was a little bit of a scary move because while she was employed she was getting health benefits.

She moved to New York City to go to Columbia and finished there—although a couple times she was so exhausted, she would get sick. I remember when she was in nursing school, right before returning to San Francisco, she spent a summer program in Switzerland doing some exchange thing. Her family didn’t want her to go as they were afraid that her health would turn, but she wasn’t ready to accept excuses to not do what she wanted. She became very sick in Switzerland and ended up returning.

After having had cancer, she got tested regularly. That’s how they discovered she had liver cancer.

columbia_univ_20090928

Credit: Outlookindia.com

She did her residency at UCSF.  After having had cancer, she got tested regularly. That’s how they discovered she had liver cancer.  I can’t remember the timeline, but she knew she wasn’t going to recover this time. She swore she wouldn’t do chemo ever ever again. From that point on it was very much a roller coaster—she would be wanting to do stuff and be organizing things then disappear. She didn’t do any chemo for a year and then she did. I remember her saying that her doctor was giving her a year, but she kept outliving the time. There was a point that once it got bad it just didn’t get any better. In the end, she was suffering and the doctor was telling her to do chemo, so she went on really heavy bouts of chemo even though she was so miserable—-but she did it because I think she realized she wasn’t ready to die.

I would call her and talk. She was a foodie. She loved life. A large part of our friendship was going out to eat. When she was in Switzerland, she met another nurse, a Filipino—she was making Filipino food  and bringing it to work. Lisa had a favorite dish. I’m Filipino and was like, I’ve never made that stuff, but I made it for her. I knew someone who wrote a Filipino cookbook so I got her a copy.

When she would go to chemo, one of the things she hated the most was losing her appetite and not being able to taste. The only thing she could really taste was anything sour—so she told me how she put lots of lemon juice on salad and laughed.

When she would go to chemo, one of the things she hated the most was losing her appetite and not being able to taste. The only thing she could really taste was anything sour—so she told me how she put lots of lemon juice on salad and laughed. There is a Filipino dish made with tamarind. She would ask me to make the dish and I would make it extra sour. We’d laugh about it.

It’s so strange I think, I was going through a lot of stuff in my life when it got bad for her. I had been in a relationship for ten years, got pregnant and lost the baby. I wasn’t planning to have a child, so it was very mixed emotionally. I think talking to Lisa sort of galvanized the idea that I wanted  to have children. She would say, “You have to have one.” She sort of brought it out—encouraged me to admit that I really wanted them. She even told me “you are going to get pregnant in the next year”—she was right. I now have a son.

She would tell me all the things happening to her body, always in a humorous way…

arroz-caldo-1024x768

Credit: foodforpinoy.blogspot.com

Her family lived on Long Island, across the country. She would go back for holidays, but her life was here and her friends were here and she would die here. She moved into a hospice at Laguna Honda. We were all in the hospital when we were waiting for the end. I was there the day before she died. She was very weak, but conscious. She would tell me all the things happening to her body, always in a humorous way: how much water she was taking on, her huge gut, always joking; she continued to do that.

She requested her ashes be scattered. She loved Marin Headlands and Mt. Tam so we took half her ashes to Mt. Tam—we went to the highest point and went to Muir Beach. The other half a friend brought to Italy, where her family is from.

The biggest thing was to be able to have the conversations with her about what it felt like.

The biggest thing was to be able to have the conversations with her about what it felt like. A couple of close girlfriends have been diagnosed with cancer and I’ve felt better equipped to talk to them about it. It is always kind of awkward- you don’t know how they’re processing and how much to share or not share. It’s so tricky, but having been through that with Lisa has helped me be a little more comfortable with it.

Lisa was so active, ambitious — her illness was such a contrast to who she was, but she made it not so uncomfortable to talk about. She made it seem natural.

Were you touched by this story? Read more Opening Our Hearts stories.

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Monday Hearts for Madalene

Page Hodel creates the most beautiful hearts in an ongoing celebration of love

Thanksgiving copyHappy Thanksgiving!

It’s an honor for SevenPonds to share with our readers the story of the Monday Hearts for Madalene project, a true account of the power of love in the midst of death.

The project’s origins take us to 2005: the moment Page Hodel encountered Madalene Rodriguez and fell “instantly, dizzyingly in love with her.” The couple’s first meeting was electric, and Page felt inspired to do something unique for the woman who captured her heart. So, she began leaving handmade hearts – made from flowers, leaves, and other materials – on Madalene’s doorstep.  The hearts became a ritual, and they were there to greet Madalene as she left for work every Monday.

“To start her week with a visual reminder of our beautiful love.” – Page Hodel

Just seven months later, Madalene was diagnosed with ovarian cancer and passed away on June 20th, 2006. But Page’s love for her hasn’t ceased, and she continues to make a heart for her every Monday in celebration of her life.

If you would like, you can also receive Page’s “Monday Hearts for Madalene” by emailing her at page.hodel@gmail.com with “subscribe” written as the subject. Images of the hearts can also be purchased on individual cards and in her beautifully compiled book, Monday Hearts for Madelene. Please also visit her website and Facebook  page. A portion of all sales will go to the Women’s Cancer Resource Center in Oakland, California (www.wcrc.org).

See more Monday Hearts for Madalene here.

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