Blog
How Did We End Up Here?
I spent most of this week at the hospital with an elderly family member recovering from another medical crisis. Frequent hospitalizations, aging and a need for a better plan required some serious conversations around what the future holds. We all have visions of staying home for as long as possible and avoiding living our final years in a nursing home. Having worked in senior health care for most of my career it isn’t any easier when it’s someone you love faced with tough decisions.
Health care providers are facilitating these emotional conversations around end of life and encouraging us to talk about our wishes and preferences for care when we are dealing with years of chronic disease and the final years of our life. It is truly a conversation we must have and a gift we give our loved ones when we provide direction for the kind of care we want. I remember having a conversation with my mother several years ago when we created a Living Will with her during her treatment for Cancer. Recently I completed the Honoring Choices facilitator training and my husband and I updated our decisions using the accepted Honoring Choices Advance Care Directive forms.
I find my work rewarding to educate people and support the end of life process and I encourage communicating your personal wishes and beliefs formally using the Advance Directive form.
Yesterday my family member was discharged from the hospital and transferred to a short stay rehabilitation center for physical therapy. Once she’s gained a little more strength she will discharge home with Hospice Care and between family, friends and Hospice will spend quality time with loved ones. How do we end up here? With a little love and some honest family conversation to express our wishes and beliefs, it’s a gift one can leave their loved ones.
If you need assistance with end of life conversations or creating an Advance Directive document to outline your wishes and identify a health care agent you can contact me directly or go to the following website for resources. http://www.honoringchoices.org/
Kindly,
Mary Chapa, RN
Honoring Choices ACP Specialist
maryc@elizaoneinc.com
(612) 202-5728
Seasons
With the changing weather I’m reflecting on the span of changes over the last year, from the loss of dear friends to moving our home of 18 years, my office of 2 years and thankfully lots of interesting business. Some of the changes have been welcome and exciting while some more sorrowful, either way the end of last year reminds me that everything has a season and the new year is another beginning just like each new day.
One of the changes in life is the many people I get to meet in the work I do, from individuals and families to the business people and projects that come my way. From supporting the leadership team of a large non-profit organization striving to improve their business performance outcomes with a foundation built on quality to project coordination around end of life. I am grateful for the varied work experiences and people I come in contact with and the little learning surprises that come my way.
One of the projects I am working on is the Honoring Choices Minnesota initiative, the Twin Cities Medical Society has taken on the challenge of encouraging individuals and communities to have open conversations about end of life planning. The medical society has worked collaboratively with all the major health systems to educate professionals around having meaningful conversations and encouraging the documentation through the completion of an Advance Directive. The incentive behind this allows for individuals to communicate their wishes and providing direction for loved ones as well as health care providers.
I have had the privledge of becoming a Certified Facilitator on Advance Care Planning and I encourage you to learn more about this topic. Most of us think the topic of end of life is for those with a terminal condition or the very frail elderly but it is really for all of us. Having lost family and dear friends over the past few years unexpectedly to cancer, chronic disease or accident I encourage you to learn more and if I can assist in any way I am open to having a conversation with you.
www.honoringchoices.org
Wishing you a year packed with joy and good health!
Mary
Paying Attention
June was a busy month with the move of our home and my office. We’ve put up pictures and personal items so it looks like our home and I think we’ve settled into a comfortable routine. I just finished organizing the guest bedroom and my husband and I were at Target last week so I could pick up a pillow sham for the bedroom. Since it was hot out we stopped by the refreshment stand to buy some water, after a few sips I told my husband he could sit and finish his water while I ran to make my purchase.
I left and returned a few minutes later, I barely noticed a little girl sitting at a nearby table by herself. As I finished my water and we stood to leave a young man came up behind me to Thank my husband for his kindness to his daughter. While I was busy with my errand my husband noticed a little girl sitting by herself, she was watching another table of kids drinking and eating. My husband thought she might be thirsty so he gave her a couple dollars to buy juice or water. She told her father and as her father came by to say thank you he explained he was applying for a job and the nearby Kiosk had no place for his daughter to sit and wait for him. The young father and his daughter had sincere appreciation and warmth as they acknowledged a simple act of kindness.
On the way to the parking lot I asked my husband what happened and I noted his act of kindness was not a single act. His behavior although it might seem small is typical, he is known for passing a few dollars to a niece for gas and I’ve lost count of how many times he has purchased fishing tackle and gear for young family members or taken a niece or nephew fishing. I recall a few times he asked me to stop the car because he saw a wallet or cell phone and we would work hard to find the owner so he could return their property.
For those that know my husband he’s rather quiet and easy going. He’s comfortable in his own skin and loves the outdoors and animals; fishing is a favorite hobby and he practices catch and release. Doing the right thing is important to him, he’s clear about his values and doesn’t look for approval from other people. We’ve been married 35 years and I had to take a moment to pay attention and recognize the man who has been an important part of my life all these years, it made my heart swell with love and admiration. In some ways he hasn’t changed at all and I simply acknowledge his core kindness as a reminder to really pay attention to all the people in my life.
Hoping we will Pay Attention to those around us this week.
Mary
Feels Like Home
Well we’ve finally unpacked the last box and put up a few pictures so after moving mid June it’s starting to feel like home. We only moved about 3 blocks away from our old home so we’re in the same neighborhood but I did make a bigger move when I moved my office back home. I decided to use one of the extra bedrooms for my home office but the first room I chose didn’t feel right, too narrow so I ended up moving everything into the next bedroom which is a bit larger. I’ve filled my book cases and set up my printer and all the internet connections. I get the morning sun in my home office so it’s very bright and sunny when I entered the room this morning. My tiny toy poodle Buttons found a comfortable spot on the seat of my wicker rocker as I artfully place pictures of family or friends around the room.
This morning I took my cup of coffee down the hall to my new office and note I still need to tidy up and find a new home for a few last items but all in all our home is feeling comfortable, stamped with our personal belongings. Our move this month marked another transition with a change in my work, one contract ends as I say good by to the new friends I made. I started a new work project this month so I’m learning names and positions while I get my arms around the scope of work to be done. So as I let go of the familiar I’m reaching out to some things that are a bit unfamiliar and new.
Transition can be challenging but I find it helps me to stay alert as I learn and continue to grow. No time to relax as I look forward to another Birthday this week and wonder what the next few months ahead will hold for me.
I’m grateful for friends, family and all those little things that make a difference in our lives.
Warm regards,
Mary
Moving and Managing Change
I’ve been celebrating significant family events the past few weeks, a baptism, graduation and wedding just this weekend. As spring rolls into early summer I’m also surrounded by boxes as we pack up our belongings and prepare to move into another house. I’ve been thinking and feeling my way though all the changes in my life and I realized that this house we’ve lived in for 17 years no longer feels like our home. My husband and I have been feeling the effects of transition as we send extra furniture and clothes to charitable organizations and family members.
We had a chance to reflect on how much we enjoyed giving useful items to family members or those special gifts that held some personal significance to us. By this time next week the movers will load up our furniture and boxes so we can begin the process of unpacking and settling into our new house. It will take a little effort to make our new house a home but we’re looking forward to doing just that.
Along with the move I’m starting a new work project and that brings excitement as I meet new people and look for creative ways to build a community that will help us reach our mutual goals. I look forward to learning and collaborating as I adjust to all the new beginnings happening in my life.
Mary
Coming Home
We had a wonderful and restful week in Mexico so it was with a bit of regret that we returned home to the MN cold weather and snow. I’m grateful for our time in the sun, sand and ocean views. My husband and I have nice dark tans so our skin has a healthy glow although it’s starting to peel but at least not where it shows. We’ve unpacked our clothes, did laundry and today my husband will pick up the dry cleaning and go grocery shopping while I return to my office. I’m slowly getting my work projects organized and I’ve got a busy week ahead with a lot of catching up to do as I finalize my schedule.
Having the chance to get away and absorb the sun makes me remember how healing warm weather can be. I enjoyed being cared for, staying at a resort where the surrounding staff takes care of your every need. Good weather, a spa, long walks and fabulous food makes me grateful for this healthy healing period.
With the death of my friend Barb last month I was saddened to learn one of my dear friends lost her life partner the day before I left town. It was hard to leave and yet I know she was in good hands, we spoke last week and again when I returned. She is on my mind and in my heart as I think of her sadness and loss. I wish I could remove the path in front of her but it’s not in my power so I hold her in my heart.
Somehow even with a broken and heavy heart we find a way to put one foot in front of the other and shoulder the weight of sadness. Today I remembered a poem by Starhawk called Dreaming the Dark or as my friends and I call it “Community,” because it reminds us that family is not about blood but our spiritual relationships.
Community
Somewhere, there are people
to whom we can speak with passion
without having the words catch in our throats.
Somewhere a circle of hands will open to receive us,
eyes will light up as we enter, voices will celebrate with us
whenever we come into our own power.
Community means strength that joins our strength
to do the work that needs to be done.
Arms to hold us when we falter.
A circle of healing. A circle of friends.
Someplace where
we can be free.
I hope when you need time to heal that you have “arms to hold you when you falter, a circle of healing a circle of friends.”
Mary
Managing Change and Transition
From Personal to Organizational
I thought I was handling the loss of my friend in a very mature and healthy way but as I suffered with stomach pain and loss of sleep I began to rethink my reality. I shared my thoughts with a friend of mine when I told her “I realized I wasn’t managing so well when I came home and immediately ordered pizza for supper,” and all this was happening during my starting the new Weight Watchers program! Good grief, what was I thinking? Maybe managing transition around grief and loss isn’t so easy even if you’re an experienced health care professional and you’ve had lots of personal experience.
I know the intellectual steps around Change Management and Transitions, I’ve taught classes on the topic and I’ve certainly coached people through major business and organizational change. I’m currently consulting with a large social service organization that is working hard to align strategic planning with stronger organizational performance, this means adding data that proves to their donors and the larger community that they are making a meaningful impact. The days of just sharing glossy pictures and telling heartfelt stories about their clients is gone and using performance outcomes to demonstrate effectiveness is the new norm. While adding a change in how the organization does business there is also a leadership change so the employees of the organization are facing a time of ambiguity.
As I recall William Bridges proposes that “change is a shift in the externals of any situation: a new boss, the death of someone you know, a new job or move to a new city. By contrast, transition is the mental and emotional transformation that people undergo to relinquish old arrangements and embrace new ones.” Bridges proposes that transition has three phases: an Ending, a “nowhere land” that he calls The Neutral Zone, and a new Beginning. If people don’t deal with each of these phases, the change won’t happen and then we say, “It didn’t work.”
I am thinking about my friend Barb who’s diagnosis and illness with lung cancer was very aggressive; from November when she thought she had bronchitis to the metastasis to bone and brain she just didn’t have much time. My friend faced her impending death with grace and while she wished her situation was different she embraced each day with joy and expressed gratitude for one more day with her husband and extended family.
Last Wednesday I got a phone call that let me know her time was near so I rushed to her home because I wanted to continue to be a witness to her life until the very end. The change although we knew it was coming was her death, the transition began when we learned the diagnosis and shared her remaining time. At the funeral we all got a chance to formally acknowledge our ending, the next few weeks and months we will feel a sense of ambiguity and eventually we will define a new beginning – a life without my friend Barb.
Welcome 2011
I’m dreaming about our winter vacation in Mexico coming up in a few weeks and I’m looking forward to the warm sun and beautiful Caribbean beach. This time I am sure to have a trip free from falls and when I close my eyes I can feel the humid breeze, I breath deeply and sink into my chair and relax. We are lucky to have this time away from the Minnesota cold and excessive snow of 2010.
I wish for a healthy, happy and successful new year for my family, my friends and all my business colleagues as well as myself of course. The last year held some challenges for me and yet I am healthy and grateful for the ability to love, have meaningful friendships, to laugh, read, learn and to be able to work. My work has shifted to more business consulting with a focus on Quality programs, methodologies and the need to be able to demonstrate Performance Outcomes.
I am still practicing my holistic work with a focus on end of life transitions, I plan to explore a volunteer position with hospice this year – it’s something I’ve wanted to do for a very long time. My other passion and goal for this new year is to write more stories and to finally transcribe more of my fathers WWII stories about his POW experiences. While I don’t have children I do want to preserve as much of our family history as I can for my nieces and nephews. Some of my goals for the year have to do with staying abreast of new technology and I’d like to learn more about self publishing.
I’m excited for all the dreams and possibilities that this new year holds and I truely wish for you a profound 2011 – success in your business and joy in your personal life!
In Gratitude,
Mary Chapa
Life and Work Transitions
It seems appropriate to talk about “transitions” with the holiday season upon us and the close of 2010 allowing us to reflect on the past year. I choose to express my gratitude for all the new people who have entered my life and for those that have long been a part of my life, I’m blessed. All my strong women friends become a part of my extended family, my Sisters in spirit. Last year at this time I was lamenting my broken ankle and feeling pretty sorry for myself but after 3 surgeries I’m thankful to be walking and finally back to work. Who would have thought I’d be grateful to be standing and walking but I am.
I’m grateful for the variety of learning experiences I’ve had and especially for the work I get to do. This year I’m helping clients learn about Quality Improvement and Organizational Performance as well as the metrics that show their customers they really do what they say they do. I’m stretching my intellectual muscles and enjoying every minute, I’ve missed some of the teamwork that comes from working in a large diverse organization with the access to so many people resources. I like the balance of working in different organizations while still having the quiet time I get as a small women owned business working in my holistic surroundings.
The other side of my business is very personal, my passion to support those who need help transitioning onto end of life, it’s always an honor to work with friends, family and other clients or families during a time of grief and gentle farewells. Last year we said good by to my sister Faye and this year we’re waiting to welcome a new life as we wait for my niece Erin to have her first baby due this month. The next year will bring two weddings for my nieces and a high school graduation for my nephew as he plans for college next fall. My husband and I are continuing to downsize and our vision is to be living in a smaller place that will be easier to care for by next summer.
With my life coming full circle I’m glad to be right where I am, grateful for the people who are a part of my life and joyful for what I have. I’m looking forward to interesting transitions in 2011.
Mary Chapa
Eliza One, Inc.
“Easing Transitions”
Did you Vote?
Today is my father’s birthday, he would have been 94 years old and he would have called me to make sure I voted before the end of the day. Dad was a WWII POW and he liked to remind us that he “didn’t go over there for nothing” meaning his time overseas in the concentration camps. Whenever election time rolled around he reminded us of our right and responsibility to vote.
While there are times I’m disappointed in the candidate choices I’m reminded of my father’s military service as he often told us stories of his survival through the Bataan March, the prison camps in the Philippines and the mines in Japan where he slaved over three years before he was set free. During these challenging economic times whenever I feel overwhelmed it’s hard to feel sorry for myself, I think of the resources and opportunities I have compared to what my father had to contend with and it helps change my attitude to one of gratitude.
I’m Grateful for those military men and women that serve and protect our country so we can have the freedom and choices we have. I hope you exercised your right to Vote today.
Sincerely,
Mary
Quick Bio
Mary Chapa is a multi-talented woman with a background in nursing leadership, quality management and business development in both health care and private industry; she's also a writer and a passionate holistic health practitioner living in Minnesota.
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