As Good as Goodbyes Get | A Window into Death and Dying
Lingua: inglese
Editore: Balboa Press AU, 2017
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As Good as Goodbyes Get | A Window into Death and Dying | Joy Nugent | Taschenbuch | Kartoniert / Broschiert | Englisch | 2017 | Balboa Press AU | EAN 9781504306133 | Verantwortliche Person für die EU: Libri GmbH, Europaallee 1, 36244 Bad Hersfeld, gpsr[at]libri[dot]de | Anbieter: preigu Print on Demand.
Codice articolo 108509463
- Titolo
- As Good as Goodbyes Get | A Window into Death and Dying
- Autore
- Joy Nugent
- Editore
- Balboa Press AU
- Anno di pubblicazione
- 2017
- Condizione
- Neu
- Rilegatura
- Taschenbuch
- Lingua
- inglese
- ISBN 10
- 1504306139
- ISBN 13
- 9781504306133
- Peso dell'articolo
- 254 grammi
- Dimensioni
- 229 x 152 x 9 mm
- Cataloghi dei venditori
- Bücher
Joy Nugent left a comfortable life as the wife of a successful orthodontist to follow a calling and vocation. For more than three decades she was a student at the bedside of people who were dying. It is her belief that in order to live a fuller and more meaningful life we need to become more open in our conversations about death and dying. This belief has the potential to lead a person to die with confidence and faith in a cosmic purpose rather than fear of the unknown. As Good as Goodbyes Get is a bridge from a traditional medical approach to an approach that considers the eternal soul of the person.
Andrew Harvey, editor of The Tibetan Book of Living and Dying by Sogyal Rinpoche, internationally acclaimed author, and mystical scholar and teacher.?And I benefitted from having your book, which is written in a very sensitive, sensible way and provided an easy read with very valuable advice. I hope you market it internationally to oncology nurses, oncologists, medical oncology departments, and nursing homes?
Jorge F. Cassir, MD, An oncologist from New YorkThere is no greater endorsement I can give of Joy Nugent?s work than to say when it?s time for me to make my transition she is someone I would choose to accompany me to the threshold. Joy is a person of deep wisdom, intuition, and grace. She knows how to listen and reflect to others their own truth. The gems shared in As Good as Goodbyes Get help the reader learn what is healing and beneficial for those who are approaching the end of their physical lives. Hope, peace and love are the treasures that can be mined in a good death experience. With compassion and kindness Joy helps people find the path that will lead them ?home.?
Sarah G. Schwartz, Music Educator: Cellist and Therapeutic Harpist in Medina, Ohio"Riassunto" può appartenere a un’altra edizione di questo titolo.
Estratto. © Ristampato con autorizzazione. Tutti i diritti riservati.
As Good as Goodbyes Get
A Window into Death and Dying
By Joy NugentBalboa Press
All rights reserved.
Contents
Acknowledgements, vii,
Foreword, ix,
About the Author, xiii,
CHAPTER 1: Introduction, 1,
CHAPTER 2: When is it Time to Die?, 22,
CHAPTER 3: Different Ways of Dying, 25,
CHAPTER 4: Where to Die?, 28,
CHAPTER 5: Visitors, 31,
CHAPTER 6: The Anniversary, 33,
CHAPTER 7: Music and Photographs, 36,
CHAPTER 8: Death as a Long Journey, 39,
CHAPTER 9: The Voice Beyond, 46,
CHAPTER 10: In the Hospital Setting, 51,
CHAPTER 11: What to Wear?, 54,
CHAPTER 12: Who Inherits?, 58,
CHAPTER 13: The Importance of Symbols and Ritual, 60,
CHAPTER 14: A Good Death, 62,
CHAPTER 15: Who Decides?, 67,
CHAPTER 16: The Animals Came to Pay Homage, 73,
CHAPTER 17: The Power of Fear, 78,
CHAPTER 18: Natural Instinct, 85,
CHAPTER 19: Who Will Be There?, 87,
CHAPTER 20: An Unsupported Death-Barbara, 94,
CHAPTER 21: A Supported Death, 98,
CHAPTER 22: The Journey Continued, 102,
CHAPTER 23: On the Subject of Soul, 105,
CHAPTER 24: Different States of Consciousness, 111,
CHAPTER 25: A Peaceful End, 114,
CHAPTER 26: Seeing Soul, 118,
CHAPTER 27: A Gift to a Granddaughter, 121,
CHAPTER 28: Dying in Character, 125,
CHAPTER 29: Fear-based Care, 129,
CHAPTER 30: Reconnecting with the Church, 133,
CHAPTER 31: Sherry in the Cupboard, 137,
CHAPTER 32: Hospice in Place, 142,
References & Influences, 147,
CHAPTER 1
Introduction
Story has always been a means of learning lessons and, from fairy tales to the Bible, young and old have been able to absorb messages through the use of both the analytical left brain and the imaginative right brain. Palliative care has been called the science of the anecdote, and through sharing these stories I hope readers interested in palliative care, as well as the community at large, will benefit in whatever way is appropriate for them. Some may say after reading these stories that they would have acted differently in the past; some may see events in a new light. Whatever the reaction, I hope the stories will prove to be useful as we all struggle to make sense of our complex existence. The names and circumstances of the people involved have been changed as my intention is to protect those who may choose to see things differently through the lens of memory.
These stories represent my personal reflections and the lessons I have learned from them. They reveal my character and personal journey, for I believe we take ourselves, warts and all, to our work. We cannot give away what we do not have. Therefore, if I am full of doubts and fears, those are probably what I will project. Health professionals frequently project their personal fear of death onto those in their care, just as people with problems of unresolved grief frequently react to their projections.
My Father's Death
When I worked at Mary Potter Hospice in the early years of my palliative care work, I had the desire to assist the nuns with funds to buy more preventative equipment when it came to skin care. Years later, I realized during a course of hypnotherapy that I had not dealt with my own father's death some eighteen years earlier. When my father became a quadriplegic through suffering a spinal injury, I was expecting the birth of my first child, a son, in England, and I was not permitted to fly home. Before my father died a year later, he had developed a bad bedsore and I remember my mother writing to say that she was buying him a sheepskin for protection. I felt very frustrated at not being useful and supportive to my mother. Shortly after his death, my daughter was born in Rochester, New York, where my husband was a postgraduate student. On returning to Australia, I had two more children in a short space of time, and with four young children, and being in a new city, my time was filled for the next few years.
My grief and unresolved emotions surrounding the memory of my father were put on hold. Still on hold, they sought to surface with the image of a dying man with a bedsore at Mary Potter Hospice. Sometimes I think hospice workers are wounded healers struggling with their own insecurities and lack of sound belief systems. Certainly, many admit to the pain of some loss and how the direction of their lives turned to work in this area following an experience of loss and grief. So, for the stories and the insight I have gained into my own and others' emotions, I thank the many people who have been kind enough to share with me the intimacy surrounding an important life event.
My Early Nursing Years
When I was a student nurse in the late 1950s, death was a mysterious and fearful event to be avoided at all cost. Dying patients were given frequent sips of water in the hope of keeping them alive until the next shift of nurses arrived. When death did occur, there was a dread on the part of the nurses of having to "lay the person out." This procedure involved a gown and a mask and a lot of cotton wool to pack orifices with the use of forceps. Strips of old linen were used to tie around the head to keep the jaw closed before the body was dispatched, via a wardsman and special trolley and as quickly and quietly as possible, to the hospital morgue. Death was somehow dirty and something that one didn't get too close to. A phone call was made to the relatives who were generally kept at arms' length and not encouraged to stay beside the dying person. They were not considered an integral part of the care as they now are since the modern hospice movement began in 1967 when Dame Cicely Saunders opened St. Christopher's Hospice in London.
After completing my nursing training at the Princess Alexandra Hospital in Brisbane, I travelled to Canada and worked in an orthopedic ward. I have no recollection of death ever occurring in what seemed to be an exciting new world. Following my Canadian experience I traveled to Edinburgh, Scotland, for midwifery training at the Simpson Memorial Maternity Hospital and experienced the joys and wonders of the birth of new life. The memory of the first birth I attended is still with me as I recall the proud young mother with her newly delivered baby talking to her husband on the bedside phone. I can now see similarities in the experience of a "good birth" and the experience of a "good death." Both are charged with emotion and signify a life change, which will not only entail long and sometimes arduous struggles but also bring rewards.
My career took me to London, where I worked as a private nurse and experienced death again. I was sent by a private nursing agency to nurse a fifty-year-old woman who was dying of breast cancer. This woman was being cared for at home by her only daughter who was in her mid-twenties, which was my age at the time. It was an experience now etched in my mind by its awfulness. I was instructed not to mention the word "cancer" and to express only hope for recovery and confidence in the doctor. Medications were not named or monitored; they were just given in blind faith because the doctor prescribed them. The tension of keeping up this pretense and not knowing what to say of comfort to the daughter and mother who were being parted was great. When the mother did die, the daughter was lost, as her mother had not been allowed to help her with practical instructions for a future without her. My heart went out to a girl of my own age and I accepted her invitation to stay in the apartment with her. Not knowing anything about a normal grief reaction, I seemed to get it all wrong. When I cleaned the walls of the bathroom, it was not appreciated and my actions were taken as a reflection on the inadequacy of the mother. My cooking was wrong; my company was sought but was resented. I left, but the memory stayed stored in me for many years until the death of my own mother at the age of seventy-nine when I was in my early forties.
My Mother's Death
Several weeks before my mother's last Christmas, I was walking by a dress shop when I suddenly thought of her and went into the shop to buy her a dress for Christmas. When I arrived home, she was still on my mind and I decided to place a long distance telephone call to her. No answer. I felt uneasy. I tried to phone my brother who lived in the same country town, but there was no answer. I phoned her doctor, who told me that he had her in hospital for investigations, as she was unable to swallow. I arranged for her to be transferred to a private hospital in another town where the investigations could be completed earlier by a surgeon I knew. Having organized care for my children, I traveled to be with her. What alerted me to her need? I was her only daughter and came along late in life after a stillbirth and two boys. I was much wanted and just a "joy." I was not given a second name.
I have always been an adventurous soul and left home for boarding school on my own request at the age of fourteen. After boarding school I lived in the nurses' home before my adventurous spirit took me overseas to further my nursing career and, as it turned out, to marry. My mother must have missed the daughter of her dreams but she accepted who I was and tried to support me. Looking back, I feel that I could have been more dutiful and attentive, although the boarding school habit of writing home a weekly letter stayed. Somehow, she was prepared to pay the price for my freedom. Now, following surgery, she was diagnosed with secondaries in the liver and an unknown primary tumor. The surgeon broke the bad news gently as he held her hand and told her he was not able to fix the problem. The private hospital staff members were accepting of the fact that their patient's daughter was a nurse who wished to be involved with her mother's care. "My daughter will shower me," my mother told the nurses when I went to the hospital to take her home in the dress I had bought as a Christmas present.
We both knew that time was limited. My previous experiences of death were no preparation, so I trusted intuition and was strengthened by my mother's faith in me. My mother had fought all her life for a balance between active involvement in church and community and depression. As a small child I felt that I had two mothers and often wished with a heavy heart that the good fairies would take my sad mother away and bring back the one who played me to sleep with "Over the Waves" on the organ. Music and painting were a large part of my mother's life. She played the organ for the Methodist community and was proud that one of her paintings had won a prize at the Brisbane Exhibition. When she came home from hospital, she chose to sleep in the front room of her small cream brick house which had, some years before, been purposely built so that my father could live there when he came home from hospital as a quadriplegic after a spinal hemorrhage at the age of sixty-six. My father died in the local town hospital before coming home for his final days could be a reality.
The front room had been kept for visitors but now it was where my mother chose to end her days. Her garden was her pride and joy and she knew all the botanical names of the plants in her care. The day we arrived home and wheeled up the ramp prepared for my father's wheelchair, her gardener came and she could hear the reassuring sound of the lawn mower. I picked flowers from her garden and placed them in her room. The atmosphere was good as neighbors called and well- wishers phoned to receive the news that jaundice was setting in and it was just a matter of time. The local doctor did house visits and was supportive of my wish to keep her at home — at least until she became unconscious. The minister visited and read her familiar Bible passages. Perhaps her biggest comfort was her little tape recorder and the Scottish tapes of empowering songs and hymns which she played, especially in the early hours of the morning when she felt most vulnerable to negative thoughts. One night she dropped her bundle and was bemoaning her worthlessness, and I begged her to stay strong so that I would have happy memories of our last days. She said that she was trying. Now I say to parents who are dying that they are about to give their children a most precious gift: the gift of example and courage. Stories are told about the need for children to release their parents and "letting go" is encouraged. "I'll see you tomorrow, Mum," may mean that Mum will be there because that is what will please her daughter. "Mum, I know that you are having a struggle and although I love you and will miss you, please let go if you are ready," may be an example of how to "let go" is also to love.
My mother and I only had a week together, but each moment was special as I sorted through her belongings, knowing that the time I could spend away from my four children was limited. She told me who was to have her paintings, her dinner set, the electronic organ she took to old folks' homes for sing-alongs, and her clothes. The nursing homes she visited were for other people and, although she was nearly eighty, she had never thought of herself being in one. While sorting through her desk, I came across a letter to Santa Claus that my brother had written and I found letters of utter despair written when my mother lost connection with her God. I filled many garbage bags with what I thought was rubbish and put aside the special requests. I now know that haste in these matters is not a good idea, and I regret so much, having thrown out the sheet music that she had kept from her youth, including my favorite, "Over the Waves."
One brother chided me for having thrown out rags, which would have been useful for cleaning his trucks. It was a time of high emotion when rational decisions were not made. My childhood memories, good and bad, were flooding over me. My relationship with my elderly parents, my father's death — which I discovered later was a matter of unresolved grief — my rebellion against the religion of my parents, and the relationships within my own family were all issues that were surfacing. Through all this were the demands of hosting the visitors, nursing my mother, involving my two brothers in the decision making, providing food, and being concerned with the activities of my own family. I was getting little sleep and hired a night nurse so I could spend a day with my family, who had arrived at the local seaside for a holiday. Before I left, I had my mother's medications and opioid injections organized and documented. I knew nothing in those days about hospice or the principles of palliative care, but I knew I didn't want my mother to suffer. She was worried about her bowels, which to her mind, had to open daily. Even they were organized before I left with the reassurance that I would return in twenty-four hours. When I did, I was greeted by a most unhappy mother, who asked me why I had taken so long. The night nurse had not kept up her regular injections because in her opinion it was too early. "Too early" were words that would ring in my ears years later when I heard the same fear of pain relieving medication being expressed. How can it be too early to be comfortable when one has a terminal illness? How can it be too early for the relief of physical discomforts, which hopefully will make way for retaining control of the mind?
From that moment my mother's condition deteriorated. I could scarcely move her feet to get her back to bed from the commode chair. The district nurses came to help, putting my mother on an alternating pressure mattress and inserting a catheter to avoid the strain and stress of going to the toilet. The doctor asked if I wanted her moved to hospital. In my mother's mind, nursing homes and hospitals were places to visit other people, and I remembered the many months of hospital visits she had made to my father. I felt there was no way I could move her from the security of her own bed, in her own home, and all that was not only familiar to her but her. I could not abandon her to the care of strangers. I wanted no more bad experiences with hired nurses. She was my mother and I was determined to see it through.
My eldest brother came to support me and we were both with her when her breathing stopped. The district nurses had just been there to wash her and sit her up on her pillows. A few minutes after the realization that my mother had died sank in, the nurses appeared again. Something had told them to come back because I needed them. A neighbor appeared and took my brother and me for a cup of tea while the nurses contacted the funeral directors. When I returned, the bed was empty and the bedspread was neatly replaced on the bed. It was as if the event of a few hours earlier had been erased and now numbness set in. Like a robot, I made phone calls and looked forward to a lot of rest and the comfort of my own family. I didn't know anything about grief reactions and it was years later when I began to learn about hospice care that a lot of what I experienced at this time made sense. What I did know was that I had somehow been there when I was needed, as if I had fulfilled a bargain that my mother and I had made when I was given my freedom all those years ago.
In hindsight I realize that survival then took over and the demands of a young family largely put my grief on hold. I took comfort from the number of people who came to the funeral service and from the letters and cards that I received and diligently answered. When my nephew bought the house he needed a shed. This meant that some of the garden had to go. I was sad when I thought of my mother's love and care for her garden. Now I understand the lesson of impermanence. The garden was a part of her life's work which was now ended. It was now time for another to leave an imprint of a different kind.
For many years, moments of sadness would randomly surface. They came on the golf course, they came when I received flowers, they came at my children's end of year school activities, and they came when I wanted to share something special. The feeling I had through all my adventures was that my mother was always there, just like a baby playing peek-a-boo, and that while other people cared for me, no one cared in the same way. A mother's death is tied up with our own sense of beginning and ending, our own sense of love and nurture, our own sense of sacrifice and lifetime commitment. I was a mother of four children and had a strong spirit of independence and survival, yet it was humbling, painful, and very valuable to play a part in supporting my mother at the time of her death. It wasn't at all like the deaths I had experienced as a student nurse, or like the death in London of that other mother who had a daughter my age. It was an honest occasion and I wished more people could have this intimate knowledge of death.
(Continues...)
Excerpted from As Good as Goodbyes Get by Joy Nugent. Copyright © 2017 Joy Nugent. Excerpted by permission of Balboa Press.
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To exercise your right of withdrawal, you must inform us (preigu GmbH & Co. KG, Lengericher Landstr. 19, 49078 Osnabrück, Telephone number: +49 (0) 541 / 580 72 84, E-Mail address: mail@preigu.de) by means of a clear declaration (e.g. a letter sent by post, or an e-mail) of your decision to withdraw from this contract. You can use the attached model withdrawal form for this purpose, which is, however, not mandatory.
You can also exercise your right of withdrawal online by clicking on a button labelled accordingly (such as ‘Withdraw from contract' or similar) on the AbeBooks/ZVAB website. If you use this online function, you will immediately receive a confirmation of receipt on a durable medium (e.g. via email) containing information on the content of the withdrawal notice, as well as the date and time of its receipt.
In order to safeguard the revocation period, it is sufficient that you send the notification about the exercise of the revocation right before the expiry of the revocation period.
Consequences of the revocation
If you revoke this contract, we shall repay all the payments, which we received from you, including the delivery costs (with the exception of additional costs, which arise from that fact that you selected a form of delivery other than the most reasonable standard delivery offered by us), immediately and at the latest within 14 days from the day on which we received the notification about the revocation of this contract from you. We use the same means of payment, which you had originally used during the original transaction, for this repayment unless expressly agreed otherwise with you; you will not be charged any fees owing to this repayment.
We can refuse the repayment until the products are returned to us or until you have furnished evidence that you have sent the products back to us, depending on whichever is earlier.
You must return or transfer the products to us immediately and, in any case, at the latest within 14 days with effect from the day on which you inform us of the revocation of this contract. The deadline is maintained if you send the products before the expiry of the 14 day deadline.
You bear the direct costs for returning the products.
You must pay for any depreciation of the products only if this depreciation can be attributed to any handling with you that was not necessary for checking the condition, features and functionality of the products.
Criteria for exclusion or expiry
The revocation right is not available for contracts
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for delivery of products, which are not prefabricated and for whose manufacturing an individual selection or stipulation by the consumer is important or which are clearly tailored to the personal requirements of the consumer;
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for delivery of products, which can spoil quickly or whose use-by date would be exceeded quickly;
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for delivery of alcoholic drinks, whose price was agreed at the time of concluding the contract, which however can be delivered 30 days after the conclusion of the contract at the earliest and whose current value depends on the fluctuations in the market, on which the entrepreneur has no influence;
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for delivery of newspapers, periodicals or magazines with the exception of subscription contracts. The revocation right expires prematurely in case of contracts
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for delivery of sealed products, which are not suitable for return for reasons of health protection or hygiene if their seal has been removed after the delivery;
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for delivery of products if they have been mixed inseparably with other goods after the delivery, owing to their condition;
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for delivery of sound or video recording or computer software in a sealed package if the seal has been removed after the delivery.
Specimen - revocation form
(If you wish to revoke the contract, please fill up this form and send it back to us.)
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To preigu GmbH & Co. KG, Lengericher Landstr. 19, 49078 Osnabrück, Email address: mail@preigu.de :
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I/we () herewith revoke the contract concluded by me/ us () regarding the purchase of the following products ()/
the provision of the following service () -
Ordered on ()/ received on ()
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Name of the consumer(s)
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Address of the consumer(s)
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Signature of the consumer(s) (only in case of a notification on paper)
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Date
(*) Cross out the incorrect option.
Privacy e sicurezza
Data protection declaration
Unless stated otherwise below, the provision of your personal data is neither legally nor contractually obligatory, nor required for conclusion of a contract. You are not obliged to provide your data. Not providing it will have no consequences. This only applies as long as the processing procedures below do not state otherwise.
"Personal data" is any information relating to an identified or identifiable natural person.
Responsible person
Contact us at any time. The person responsible for data processing is: Ansas Meyer, Lengericher Landstr. 19, 49078 Osnabrück Deutschland, +49 (0) 541 / 580 72 84, mail@preigu.de
Collection and processing when using the cancellation button
If you have entered into a contract via this platform for which a statutory right of cancellation applies, the platform provides you with a cancellation function (cancellation button) through which you can submit your notice of cancellation immediately.
When using the cancellation function, your personal data (name, email address, details identifying the contract or part of the contract you wish to withdraw from, and the time (date and time) of sending the notice of withdrawal) will only be collected to the extent that you have provided it.
The purpose of data processing is to provide you with the statutory option to withdraw from your contract and to ensure the proper processing of your withdrawal.
The platform operator collects your data on the basis of Article 6(1)(f) of the GDPR, namely the legitimate interest in ensuring the general accessibility of the statutory withdrawal function on the platform. You will receive a confirmation email from the platform operator acknowledging receipt of your notice of withdrawal.
The data is then transmitted to us by the platform operator.
If the contact relates to a contract already concluded between you and us, this data processing is carried out on the basis of Article 6(1)(b) of the GDPR. Otherwise, data processing is carried out on the basis of Article 6(1)(c) of the GDPR, to fulfil a legal obligation to provide an electronic withdrawal function.
We use your email address solely to process your notice of withdrawal. Your data will subsequently be deleted in accordance with statutory retention periods, provided you have not consented to further processing and use.
Collection, processing, and transfer of personal data in orders
When you submit an order we only collect and use your personal data insofar as this is necessary for the fulfilment and handling of your order as well as processing of your queries. The provision of data is necessary for conclusion of a contract. Failure to provide it will prevent the conclusion of any contract. The processing will occur on the basis of Article 6(1) b) GDPR and is required for the fulfilment of a contract with you.
Your data will be shared, for example, with shipping companies, dropshipping or fulfillment providers, payment service providers, service providers for order processing, and IT service providers. We will comply strictly with legal requirements in every case. The scope of data transmission is restricted to a minimum.
Duration of storage
After contractual processing has been completed, the data is initially stored for the duration of the warranty period, then in accordance with the retention periods prescribed by law, especially tax and commercial law, and then deleted after the period has elapsed, unless you have agreed to further processing and use.
Rights of the affected person
If the legal requirements are fulfilled, you have the following rights according to art. 15 to 20 GDPR: Right to information, correction, deletion, restriction of processing, data portability. You also have a right of objection against processing based on art. 6 (1) GDPR, and to processing for the purposes of direct marketing, according to art. 21 (1) GDPR.
Right to complain to the regulatory authority
You have the right to complain to the regulatory authority according to art. 77 GDPR if you believe that your data is not being processed legally.
You can lodge a complaint with, among others, the supervisory authority responsible for us, which you may reach at the following contact details:
Landesbeauftragte für den Datenschutz Niedersachsen Prinzenstraße 5 30159 Hannover Tel.: +49 511 1204500 Fax: +49 511 1204599 E-Mail: poststelle@lfd.niedersachsen.de
Right to object
If the data processing outlined here is based on our legitimate interests in accordance with Article 6(1)f) GDPR, you have the right for reasons arising from your particular situation to object at any time to the processing of your data with future effect.
If the objection is successful, we will no longer process the personal data, unless we can demonstrate compelling legitimate grounds for the processing that outweigh your interests or rights and freedoms, or the processing is intended for the assertion, exercise or defence of legal claims.