Natural way to let go: Hospice care can ease pain and even prolong a patient's life

Daily Press (Newport News, Va.) (MCT) - Eighty-six-year-old Joan Meier is living out her final days in her den, cocooned in a hospital bed overlooking the patio. Beyond the window is a pot with a bunch of tired-looking gold flowers.

They are fading, just as she is.

While her spirit and faith are strong, Meier's body is wearing out.

Even her words are diminished, reduced to hushed single syllables or half sentences.

Nearly five years ago, Meier had a stroke that paralyzed her left side. She developed kidney problems and eight months ago became bedridden. With a steady decline in her physical condition, Meier has what is called failure to thrive.

She has chosen to die at home with the help of a medically directed Bon Secours Hospice team of registered nurses, a certified nurse aide (CNA), Meier's doctor, a social worker, chaplain and volunteers. Close friend Kay France is her primary caregiver while Meier's son, Mike, is at work.

Last year, U.S. hospice providers served 1.4 million dying Americans, according to information from the National Hospice and Palliative Care Organization.

As important as the team's professionals are, so, too, are the volunteers.

Fifty-eight-year-old Sally Spreder of Newport News, Va., is a Riverside Hospice volunteer. She might read to a patient or just sit quietly. Her presence lets a caregiver run to the grocery.

A cancer survivor, Spreder says, "Sometimes, you just feel so blessed, you want to give something back."

One of the myths surrounding hospice is that it is only for patients with cancer or AIDS. In fact, 50 percent of hospice patients have diagnoses other than cancer or AIDS, according to the hospice organization.

When professionals determine it's considered that there are no curative treatment measures left and, when it is estimated that a patient has six months or less to live if the condition runs its normal course, hospice is a natural next step for supporting both patient and family.

"We are just truly a midwife at the other end of life," says registered nurse Brenda Laughhunn, a Bon Secours Hospice complementary therapist, who comes weekly to give Meier a Swedish body massage that helps her circulation and sense of well being. "Birthing and dying are just very natural processes."

A philosophy of care, hospice combines a holistic approach embracing the patient's physical, emotional, social and spiritual needs. The palliative concept of managing pain and controlling symptoms is also an integral part of the care. Hospice is covered under Medicare Part A (hospital), Medicaid and most private insurance plans and HMOs.

Comfort and quality of life while there is life are the heart of hospice, which can be provided in settings that include the home, hospital or nursing home.

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Meier's been a hospice patient for more than a year. Another myth about the care is that it's only for the last few days of life or for the six months or less life expectation. But patients can have hospice for six months or longer depending on the illness' course, according to the national hospice organization.

"They can be in and out (of hospice care)," says Terri Bean, administrator of Heartland Hospice Services in Newport News. "It's not a one-time benefit."

"Everybody thinks hospice is what you do at the very end," adds John Austin, Heartland's account liaison, "but it can actually prolong life."

Mike recalls his first conversation about "hospice" for his mom. He was at the Jefferson Avenue Silver Diner in Newport News, Va.

"I remember sitting there and starting to cry," he says. "Oh, my gosh, it's the beginning of the end," he thought. "The word scared me. But my God, what a program. It has made my mother's life so much better."

Care-giver France asks her patient friend Meier what she likes best about the people with hospice.

"The massage," Meier says.

"To me, it's the most important piece," says France. "It actually reaches into her being, and she's at peace."

And Judy Johnson, the CNA, France asks?

"She keeps me happy," Meier answers.

Johnson "has just become like a member of the family and how personal is that when someone is bathing you," says France. "Joan looks forward to her visits."

Death and dying should not be dirty words.

"What hospice does is it validates that you're doing everything as a family that you can do, and that if the individual is ready, then it's OK to let them go," says France. "Dying is a process. Get hospice in that process."

Is she afraid to die?

"No," says Meier.

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© 2008, Daily Press (Newport News, Va.).