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Schwerkrank und trotzdem zu Hause (English translation of the article below)

Artikelautorin: Bea Blaser, Einsatzleitung kispex Kinder-Spitex Kt. Zürich für INTERCURA Nr. 98, Sommer 2007.

Auch Kinder leiden an schweren, chronischen, zum Tode führenden Krankheiten. Die kispex, Kinder-Spitex Kt. Zürich pflegt und betreut seit 1995 kranke Kinder von 0-18 Jahren zu Hause, in ihrem gewohnten Umfeld. Leiden Kinder an einer unheilbaren Krankheit, haben sie und ihre Eltern oft den Wunsch, möglichst viel Zeit zu Hause zu verbringen. Die Kinder sehnen sich, nach ihrem gewohnten Tagesrythmus, den bekannten Gerüchen, dem Zusammensein als vollständige Familie. Mit Unterstützung  der Pflegefachfrauen der kispex, könnenKinder welche auf Sauerstoffverabreichung , Sondenernährung, Schmerztherapien, Infusionstherapien uzw. angewiesen sind, zu Hause gepflegt werden.

Fallbeschreibung

2006_11_23Ingrid ist gerade drei Monate alt, als sie bei ihr die Diagnosis einer schweren, unheilbaren, zum Tode führenden Krankheit gestellt wird. Für die Eltern bricht eine Welt zusammen. Sie können sich nicht vorstellen, ihre kleine, fröhliche Tochter zu verlieren. Nach dem ersten Schock beschliessen sie, die verbleibende Zeit mit Ingrid intensiv zu geniessen.

2007_01_06Während einer Hospitalisation wegen einer Infektion der Atemwege, haben die Eltern den Wünsch, Ingrid sobald als möglich nach Hause zu gehen. Da sie auf Unterstützung durch Pflegefachfrauen angewiesen sind, werden Einsätze durch dir kispex organisiert. Kispex klärt den Bedarf ab, und es werden vorerst Einsätze tagsüber geplant. Die Pfelegefachfrauen übernehmen einen Teil der medizinischen Massnahmen wie: inhalieren, orales Absaugen, sondieren, sonde neu stecken, Lagerungen, Besonderes Gewicht wird auf eine erfolgreiche Schmerztherapie und die Bekämpfung von Symptomen wie Übelkeit, Obstipation, Juckreiz uzw. gelegt. Auch die Anleitung und Beratung der Eltern gehört zum Tätigkeitsbereich der Pflegefachfrauen.

Der Zustand von Ingrid verschlechtert sich kontinuierlich. Sie kann ihre Händchen nur noch wenig bewegen, hat viel Sekret im Mund, welches sie nicht mehr schlucken kann. Die Nahrung muss ihr über eine Magensonde verabreicht werden, immer öfters braucht sie Sauerstoff und die Schmerzmittel müssen immer wieder neu angepasst werden. Die kispex passt die Planung der Einsätze oft täglich den Bedürfnissen von Ingrid und ihren Eltern an. Tagsüber übernehmen die Eltern einen grossen Teil der Pflege. Nachts pflegen und überwachen Pflegefachfrauen der kispex Ingrid. Zwischendurch hat Ingrid gute Phasen in denen sie herzhaft lacht, plaudert und das Zusammensein mit Mama und Papa richtig geniesst.

2007_03_10_3Viele Freunde und Bekannte kommen zu Besuch. Ingrid freut sich darüber. Sie ist abgelenkt und es ist immer etwas zu sehen, zu hören. Es gibt aber auch Situationen, in denen Ingird Atemnot und/oder Schmerzen hat, etwas trinken möchte, aber nicht mehr schlucken kann. In solchen Momenten sind die Eltern froh, dass sie die Pikettnummer der kispex wählen können. Somit werden sie bei Bedarf Tag und Nacht kompetent beraten und falls nötig, organisiert kispex zusätzliche Einsätze. Die interdisziplinäre Zusammenarbeit funktioniert gut. Zusammen mit der Neurologin bespricht kispex den Zustand von Ingrid  immer wieder und Verordnungen werden den Bedürfnissen des Kindes angepasst. Die guten Phasen halten immer kürzer an, Probleme nehmen zu. Die Atmung von Ingrid ist immer stärker beeinträchtigt. Ihr Sauerstoffbedarf stiegt. Das viele Sekret bereits ihr grosse Probleme. Dazu kommen noch Übelkeit und Obstipation. Der Pflegebedarf wird intensiver. Ingrid hat nun auch Oedeme. Die Medikamente müssen immer wieder überprüft und ihrem aktuellen Zustand angepasst werden. Die Eltern pflegen Ingrid mit grosser Liebe und Hingabe. Trotz schwerer Momente, hat ein herzhaftes Lachen der Eltern und ein zuletzt nur noch zartes Lächeln von Ingrid immer Platz.

2007_05_13_9Ingrid ist erst 8 Monate alt und trotzdem lassen die Eltern sie mitbestimmen. Ingrids starke Persönlichkeit ist immer wieder spürbar – sie will leben, sie kämpft, sie weiss sehr genau, was ihr gut tut und was nicht und kann dies gut ausdrücken. Und dann kommt der Tag, an welchem die Kraft zu leben nicht mehr ausreicht. Bereits in der Nacht hat sich der Zustand von Ingrid weiter verschlechtert und alle wissen, dass nun der Zeitpunkt des Abschiednehmens gekommen ist. Ingrid liegt entspannt und ohne Schmerzen, ruhig und geborgen in den Armen ihrer Eltern.

 

English translating done by Karin Andersson Hagelin

Children also suffer from severe, chronic diseases leading to death. The kispex – child home care team in Kanton Zurich supervises since 1995 chronically ill children from 0-18 years at home, in familiar surroundings . Children suffering from a terminal illness and their parents often have the desire to spend as much time at home as possible. The children and their families want to be able to keep their usual daily rhythm, the familiar surroundings and being able to spend time together as a complete family. With the support of the nursing staff of the kispex children who needs oxygen administration, tube feeding, pain therapies, infusion therapies etc.  can also be cared for at home.

Case Description
Ingrid is just three months old when she is given the diagnosis of a serious, incurable, and terminal illness. The world collapses for her parents. They can not imagine losing their little cheerful daughter. After the initial shock they decide to enjoy the remaining time that they have with Ingrid.

During a hospital visit treating a respiratory infection, the parents requests to take Ingrid home as soon as possible. Since they are dependent on support from nursing staff, the medical organisation that is needed to care for her at home is taken over by kispex. Kispex plans the care and medical equipment that is needed and organises the schedule. The nurses take over a part of the medical measures such as: inhalation, oral suctioning, enteral nutrition and pain management. Special emphasis will be on a successful pain management and the control of symptoms such as nausea, constipation, itching etc. Also, the guidance and counseling of the parents is part of the activities of the nursing staff.

The state of Ingrid continuously deteriorate. She can only move her hands a little, she has a lot of secretions in her mouth which she can no longer swallow. The food must be administered by enteral nutrition, and more often Ingrid needs oxygen. The pain medicines have to be adjusted again and again. The kispex changes the schedule daily to support the care and needs of Ingrid and her parents . During the day, the parents take over a large part of the care. At night kispex nurses take over the care and supervision of Ingrid.

Ingrid has good phases in which she laughs heartily, chats and enjoys being with mom and dad. A lot of friends and family come to visit. Ingrid love it! She is distracted and there is always something to see  and to hear. But there are also situations in which Ingrid’s shortness of breath and / or pain takes over. When she want something to drink, but can no longer swallow. In such moments, the parents are happy that they can choose the kispex emergency number. They always have access to expert advice day and night if necessary. And kispex can always organise additional care for Ingrid at home.

The interdisciplinary collaboration works well. Together with the neurologist kispex discusses  the state of Ingrid repeatedly and regulations are adapted to the needs of the child. The good phases keep getting scarce, problems with Ingrid’s deteriorating health are increasing. Her breathing is increasingly impaired. Ingrid’s oxygen demand is increasing. In addition there are nausea and constipation. The care needs are now intense, and Ingrid has now developed oedema. The medication must be reviewed and adjusted again and again. The parents care for Ingrid with great love and devotion. Despite serious moments, the hearty laugh of the parents and Ingrid’s smile always fills their home.

Ingrid is only 8 months old and yet her parents makes sure that she is let in on all the decisions and their family life. Ingrid’s strong personality is always noticeable – she wants to live, she fights, she knows very well what she needs  and she expresses it very clearly. And then comes the day, when the strength to live is no longer sufficient. In the night, the state of Ingrid has continued to deteriorate and everybody knows that the time to say goodbye has come. Ingrid is relaxed and without pain, quiet and secure in the arms of their parents.

It took me nine years to face my grief

scared as hellIt took me NINE years to reach that point of exhaustion where I just said to myself “I really, really, really need to get help to finally let go of the all the pain and drama in my life”. By that time I had lost my dad, moved abroad and lost my first born daughter (in that exact order).

What would happen if I finally took charge of my emotional system? What would need to change? Who or what would I have to let go of in my life? What patterns, behaviours and thoughts would I have to change? What would I have to start doing or who would I have to start being if I got well, finally felt unstuck, started to live my purpose, quit that awful, life draining job? Who would I have to become if I let go of all the drama that defines me?

That’s a lot of scary stuff… I know, that’s why I waited for so long. But I refused to define myself as the bereaved mother, stuck in pain, guilt and sadness forever and ever. There had to be another way!

Only you will know when you have reached that crucial point when changing how you define yourself and your pain and drama is the only sustainable thing you can do in order to move forward. Why don’t you grab the opportunity and start getting clear for the new year NOW by redefining how you want to show up in the world? How you want to feel? What you want to contribute to?

There are a million-and-one techniques out there, I’m teaching ONE of them, but I encourage you to go out and investigate which one rings true to you. Only you know whats best for you.

Can broken dreams cause grief?

Broken dreamsA lot of people react when I tell them what I work with, and most of them say “Luckily nothing terrible has happened to me yet.” or “I haven’t lost anyone close to me, but when I do I know who to call.” That’s all fine, of course, it’s not that I wish for anyone to have a traumatic experience so I can have something to do!

But what about the time you had a really bad break up with someone? Maybe that shattered not only your heart, but also the dream of you two being together, starting a family and growing old together?  Or what about the loss of a job, and hence loss of financial security and a dream of a career within that company or field? Or moving abroad (as we expats have done), not only being a big adventure, but also bringing with it the loss of familiarity, language, friends, and (often) the ability to be present at big life events such as weddings, christenings, funerals, or birthdays.

So in what way does the Grief Recovery Method® help you get rid of the pain and frustration that broken dreams brings with it? You might have been trying a number of different things to feel better again, but are tired of trying and “failing” yet another “self help” method. What could possibly be different with this Program?

For me, it’s been the simple fact that I got to take a good look at all my disappointments, losses and broken dreams in my life so far. I’ve looked at the myths I’ve been taught how to deal with loss, all the intellectual comments I’ve heard when in grief, and all the (often unconscious) behaviours I’ve been using in order to avoid facing my feelings triggered by a traumatic event (food, anger, frustration, TV…).

It’s like taking out the weeds by the roots instead of either ignoring them completely (yet knowing perfectly well that they are still there), or swearing about their presence but refusing to do anything about it!  For me, it was a clear and logical step-by-step action plan that finally quietened a majority of my extremely limiting “Why’s?”, “What if’s” and “If only’s”. I say majority, because the job never gets completely done. I would be lying if I said that you would be living happily ever after just by working through this Program.

But your you will have a brand new set of extremely helpful tools to help you handle major life events. You will have taken back the responsibility how you let those events affect you, and therefore you get to decide how to feel and what kind of support you need. I was so good at giving away the power over my own emotions to others, but now I ask myself this question when faced with a situation that triggers all these scary emotions: “To who or what do I give the power to control how I feel in this very moment, and why?”, and that is something I did not do before!

So if you want to know more about me, what the Grief Recovery Method® is, and if it is for you at all(!), please feel free to book a first meeting for FREE with me either in person or on Skype!

Karin Andersson Hagelin

Here you can read what others have said after finishing the Grief Recovery Outreach Program with me. 

 

Much Love, Karin

 

WHY I do what I do

There are so many ways to pitch your business… But what would happen if I started telling people WHY I’m really in the business I’m in, from the heart? 

That question struck me as I was thinking of sending yet another “sales pitch” mail to all the networks I’m in. Do I want to sound like the current “Newsletter trend” or do I want it to come from the heart? When is it actually OK to speak from the heart without following all the sales pitch rules and formats? Are people going to find me weird if I do?

There is only one way to find out I guess, and that’s putting it to the test!

So WHY I’m in this business of Grief Recovery?

When we lost our firstborn daughter it dawned on me how little help there was for us as parents. We had received excellent medical care for our child, but when she had left us and all the medical equipment had been collected we were standing there with an empty crib, diapers, baby clothes, toys and all the rest of it that comes along with a baby. We now had to arrange all the practical details like organising the funeral, tombstone, documents for flying back to Sweden with an urn, insurance, medical bills having to be clarified etc etc etc.

Having to deal with all of that while in a state of chock and grief was mind boggling. There was no real list of support options presented to us, and I had to muster the energy to look for help myself.

I immediately signed myself up as support parent at the Children’s hospital and the palliative home care team here in Zürich to at least give other parents with the same diagnosis a chance to contact a fellow parent. But what about all the other people being stuck in loss and grief? How could I be there for fellow expats experiencing loss, living far away form their natural support system of family, friends, language and familiarity?

That’s when I decided to do the certification to become a Grief Recovery Specialist. I now work with my passion to help others getting unstuck, feel less alone in their grief and have someone listening to their story. I wake up every day feeling so blessed to be able to do this kind of work, and that our daughter taught me so much about life, death and all the things in between. Like my coach Edson Williams said yesterday, “Karin flipped the script from a bereaved parent to using the loss as an inspiration to help others.” That really warmed my heart.

So that’s WHY I’m doing what I’m doing! I just can’t stand the fact that so many are stuck and limited by their unresolved grief, and if I can just help a handfull of these people it’s worth it! And I just have to trust that the people needing my help will find me, in one way or another. Have a great weekend and start of February!

change

Almost Christmas

We are a few days from Christmas and this year there will be people missing around the Christmas table, maybe they have been gone for a long time or maybe they left during the year. Regardless if it is “the first Christmas without…” or if it is “yet another Christmas without…”, please know that time will not heal all wounds so don’t be surprised if the pain from a loss flares up again during the holidays.

IMG_2039For you who know of people that are missing loved ones, please acknowledge this by talking about the missing person, mention their name, let the family know that you care and dare to talk about the more difficult aspect of celebrating this holiday. People in grief have not forgotten about the departed one and will only appreciate that you are there to listen and to talk.

Have a lovely Christmas and a wonderful new year 2013! Much love, Karin

Grief Recovery: How does it work?

Hi all, today I would like to start with a quote from the book “the Grief Recovery Handbook” written by John W. James and Russell Friedman – also the same handbook I use when I work with clients:

“Recovery from loss is achieved by a series of small and correct choices made by the griever. “

So how do you go about taking these small steps?

During the 8-week one-on-one Outreach Program or the 12-week group Outreach Program I guide you through the Grief Recovery Handbook, making sure that we look at all the aspects of how you have been taught to deal with loss and grief. For example, time heals all wounds might be a myth that you have grown up with? Here is a picture:

If you broke your arm, would you then sit down and wait for it to heal by itself or would you go to the hospital to get it looked at and cared for properly? So why are we told to wait for time to heal our hearts when they got broken from a loss?

I lost my father in September 2001, just days after the 9/11 tragedy in USA. My world crashed and I wasn’t able to function properly for a long, long while. In 2003 I was introduced to the Grief Recovery Method, as the book was translated into Swedish by Anders Magnusson at the Swedish Grief Recovery Institute in Stockholm.

However, the steps in the book seemed overwhelming to do on my own. Also, I didn’t have to courage to ask someone to do it with me, so I left it, as you do…

It took me another nine years to actually sign up for the course myself, so trust me, I know how big the resistance is to do this work! It was a lot easier when I felt the support from the other people in the group to move forward and do the very important action steps. Without that help I wouldn’t have finished the Grief Recovery process.

I can also confidently tell you that when you decide to do the Grief Recovery Outreach Program, alone or guided by me in a group or one-on-one, you will be able to move on in life without dragging the old weight of unresolved grief and un-communicated feelings!

Drop me an e-mail or give me a call on +41 76 282 98 23 if you want to know more or have questions about how I can help you! Much love!

“Please place the oxygen mask over your own mouth and nose before assisting others…”

“Should the cabin lose pressure, oxygen masks will drop from the overhead area. Please place the mask over your own mouth and nose before assisting others.”

We have all heard it, on every flight we have ever boarded, and they are many as we live abroad. And I see a very clear comparison with how we can assist our kids through loss and grief.

We simply do what we have been taught ourselves, Don’t be sad, Replace the Loss, Grieve alone, Be strong (for others), Time heals all Wounds and Keep yourself busy, or something similar might be behaviours that you have been taught as a kid. And as we all know, kids do what we DO, not what we SAY!

So the first thing to do as a parent or guardian, is to look at our own way of dealing with loss and grief. Painful as might be to look at our own stuff, we need to look at what we have been taught and see exactly what “knowledge” we are teaching our kids. As long as we are unaware of what we have been taught, we are passing the same (sometimes false) information on to our own kids. Simple as that!

So if you feel like making the commitment to deal with your own grief and make sure that you have your “oxygen mask” on before you help your child, feel free to contact me or read more under “the Grief Recovery Method®”. Love, Karin

“When children Grieve”

What an important theme that is, how we as adults can assist our children through loss and grief.  It could be anything form dealing with death (of a grand parent, parent, relative, sibling, animal…), divorce, pet loss, moving, illness, changing school, losing confidence, self worth or power to get out of a bad situation…

So how can we teach our children those useful skills to deal with their feelings surrounding the topic loss and grief?

That’s exactly why I’m committed to create a workshop for you all that want to be able to give your children the right tools and skills to deal with loss from an early age.

Stay tuned for January 2013 and sign up for my newsletter to be notified when and where the workshop is taking place.

Love, Karin

I feel truly blessed!

For the first time ever I feel that I’m doing something meaningful! The amount of trust I’m given from the clients I meet, and to witness them work through really difficult issues makes me feel so blessed!

Grief is so much more than death, separation or divorce and there are so many people living a limited life because they are carrying around old, unresolved grief. These unresolved issues could be anything from moving, changing schools or losing a beloved pet to loss of trust, loss of self worth or loss of your physical body through illness or abuse. It’s just that we haven’t been taught that these issues, and many more, needs to be taken care of and resolved so that the person can move on in life. It’s so easy to be stuck with old memories and wrongdoings. We get reminded of them from time to time and all of a sudden we find ourselves experiencing the whole emotional trauma over and over again!

Have you ever thought about a sad memory and felt that thug in your heart?

I have, many times. I only had to think about the day we got Ingrid’s diagnosis and the day she passed away and immediately I was feeling the same exact feelings, remembering every detail about what I wore, what she wore, what was said and who was sitting where. That was so incredible painful! Now I can look back on these days and cherish the memories without being thrown in to all those traumatic feelings, and what a relief that is!