The sign on the fence surrounding her home declared Private Property, reflecting the way Mrs. Jackson lived her life. She did not want me in her home. However, her physician referred her to home care because she could no longer come to his office. Over the past three months, her condition had slowly deteriorated with progressive anorexia, weakness and muscle wasting.
Mrs. Jackson spent most of her time in bed, but for my visit she had asked her two caregiver daughters to dress her and transfer her to a wheelchair. Mrs. Jackson sat poised in her chair, neatly dressed, with her head held high and dignified. As I entered her home, the atmosphere felt cold and unwelcoming.
Macular degeneration had robbed Mrs. Jackson of her vision. I wondered how she saw me-no doubt as an intruder and a threat to her privacy. Later, I learned that she feared that I would place her in a nursing home. She refused to answer many of my questions during my first visit, but her daughters offered information about her recent medical history and current condition. After the initial assessment, I told Mrs. Jackson that I would like to continue visiting on a weekly basis.
"That won't be necessary," she replied. Her daughters supported her decision, although they admitted they needed help caring for ther.
Her daughter Debbie stated, "Mom's the boss and if she says no, then it's no."
I offered my card and encouraged the daughters to call with questions or concerns. I left with a sense of relief that I would not have to return. However, God had different plans.
Two months later, I received another call from the physician's office, reporting that Mrs. Jackson's daughters needed help caring for a small pressure ulcer on her buttock.
I phoned the home to arrange an appointment. While driving to the house, I asked God to change my attitude. My heart was heavy. I felt reluctant to enter this home again. "Lord, I trust that no encounter is by coincidence. You've brought Mrs. Jackson into my life for a reason. Please fill me with your love. Help me to love, even when it's not returned."
This time Mrs. Jackson did not greet me from her wheelchair. She was lying in bed. Her body was weaker, but her spirit was just as strong and resistant to my presence as before. Her daughters helped her roll to her side, revealing an area of loosening eschar the size of a silver dollar. I told Mrs. Jackson and her daughters that we could not determine the severity of the wound until the dead tissue was removed. With Mrs. Jackson's permission, I began debriding the wound. As the eschar fell away, my heart sank. A cavity, bigger than my fist, was hiding under the surface. A stage IV pressure ulcer tunneled down to her bone.
For the first time, I saw a crack in Mrs. Jackson's toughened exterior, and a trace of fear crept out with her question, "Will it take long to heal?"
With honesty, I replied that the wound had been forming for a long time, and yes, it would take time to heal. We discussed the importance of good nutrition, continence management, pressure relief and wound care. She insisted that she wanted to remain at home so her daughters agreed to learn wound care. Reluctantly, and with skepticism, Mrs. Jackson allowed me to follow up with visits to evaluate the healing.
In the following weeks, Mrs. Jackson remained distant and reserved. She answered my questions curtly or ignored them. In my frustration, I determined to win her acceptance, but I was also aware of my inadequacy. I began praying regularly, as I drove to Mrs. Jackson's home, asking that God would soften her heart and allow her to feel his presence. I prayed that God would show me practical ways to show his love to her.
Each day I entered her room with joy, regardless of her flat affect. I included her in the teaching that I did with her daughters and helped her to understand what she could do to speed healing. We turned her gently in bed and repositioned her comfortably after the wound care was completed. I tried to show her kindness and love, but still she remained distant. She had opened her home to me but would not open her heart.
The change came one November morning. When I entered the home, I could tell from the look on Debbie's face that something was wrong. Debbie explained that she was worried about her mother because she wouldn't eat, was having hallucinations and was sleeping more than usual. I went in to visit with Mrs. Jackson and found her soaked with sweat and coughing up thick, yellow sputum. Her lungs sounded heavily congested.
I presented the options to Mrs. Jackson and her daughters-admission to the hospital, treatment at home or transitioning to palliative care with hospice. An emotional discussion followed. Mrs. Jackson made it clear that she did not want to go to the hospital, but fear overcame her as she considered the consequences. In that moment, I heard the Holy Spirit saying to me, You need to pray.
Oh Lord, no. Not with Mrs. Jackson. She hates me!!
The voice came again, It's not about you. Ask her for permission to pray.
I turned to Mrs. Jackson, "There are times when I just don't know what to do. I've done all that I can, and that doesn't seem to be enough. In times like this, I look to God for help. Would it be okay if I prayed with you today?"
To my amazement, I saw Mrs. Jackson smile for the first time. It was so wide, I thought her face would crack. She said with a sense of relief, "That would be good." I gently took her hand in mine, and together we went to the Lord. We asked for his wisdom, his guidance and his healing.
As I finished praying and wiped a tear from my eye, Mrs. Jackson said, "Thank you. That means more to me than anything else you've done." For the first time, she could see that I cared.
Mrs. Jackson decided to remain at home while receiving treatment for her infection, so my visits continued. Beginning with that short prayer, God slowly began to break her toughened shell. Just as we had debrided away the eschar that covered her wound, our heavenly Father began to peel away the hardened spirit that guarded her heart. She began to share stories from her past and her hopes for the future. She uncovered areas of hurt, anxiety and fear. We talked about the hope of eternity and what she wanted to accomplish before she died. We shared laughter and tears. In the process, God changed my heart too. Loving Mrs. Jackson became less of a challenge. I began to look forward to my visits with her.
Weeks passed, and the Christmas season neared. Mrs. Jackson grew weaker, but she was determined to remain at home. As I was leaving one day, she called out to me, "Do you like chocolate?"
A rather odd question I thought, as I replied, "I love chocolate. Why do you ask?"
With a smirk she answered, "No reason."
Debbie escorted me out the door and explained, "You know Mama's gonna send me out looking for chocolates, so just tell me what kind you like." Together we laughed and said goodbye.
Christmas Day arrived, and it was my holiday to work. As I dragged myself out of bed and onto the snowy streets, I was disappointed that I couldn't worship and spend the day with my family. However, I was looking forward to one visit that day. I made Mrs. Jackson my initial stop because I wanted to be one of the first to wish her a merry Christmas. The air felt warm as I entered her home, and I could smell the turkey cooking. Mrs. Jackson joyfully anticipated the events of the day. As we completed her wound care, she bubbled over with excitement about family members who would be visiting, the food preparations and past holiday traditions. I listened and marveled at the change God had brought about in this woman. I gave her a hug and was about to leave when she asked me to wait.
She called her daughters into the room and told me to turn my back to her. I'll never forget what I saw when I turned around. Lying in her hospital bed with a radiant glow, Mrs. Jackson's hands were extended toward me holding a box of chocolates. Eyes that had once been dark and empty were now filled with light and love. Her blinded eyes darted back and forth searching for me until I spoke. Then our eyes connected, and it was as if for a moment she could see me. Her eyes became a window to her heart. In them I saw a peace and joy that only our Father could give.
God's lessons come in many forms. Mine came that Christmas in a box of chocolates. Through it, God taught me how the power of his love can break down any barrier, no matter how great. Amid the technical skills I may perform as a nurse, I learned anew that "The greatest of these is love" (1 Cor 13:13). I was privileged to watch the Father soften a heart of stone and bestow on Mrs. Jackson a crown of beauty instead of ashes. She did not receive a physical cure, but she did receive his healing.