Comfort Care

Providing Support In the Last Phases of Life

by anna paige

Certified hospice and palliative nurse Carol Heath doesn’t view end of life care as a way to deal with death, but rather as a way to help someone live.

“Hospice care is about providing the highest quality of life,” said Heath, who is part of a team of caregivers at Rocky Mountain Hospice that cares for terminally ill individuals during the last phase of life.

     Through hospice and palliative care, people afflicted with a life-limiting illness receive emotional support, medical care, and pain and symptom management to relieve suffering caused by the illness.

     As a nurse, Heath’s primary focus is to assess the medical needs of the patient and manage symptoms. She routinely works with patients who are full of pain, are uncomfortable or afraid of what will happen to them.

     “To find a plan that will alleviate their suffering and to see it effectively work within a short amount of time, to see their relief and see their happiness, that is the reward for me,” Heath said.

Though it’s never quite certain how long a patient will live, a terminal prognosis of six months or less from a doctor is necessary for hospice care. Hospice is provided in private homes as well as in long-term care facilities to supplement care the staff is already giving.

     In November, hospice care receives national attention due to Hospice and Palliative Care Month, which highlights the professionals who provide care and recognizes the patients and families coping with terminal illness.

     A holistic approach to care, hospice encompasses more than just medical aide to the patients. Kathy Wise, director of social services for Rocky Mountain Hospice, works alongside Heath and others to provide psychosocial services to patients and their families. While a nurse addresses the physical care of a patient, Wise address nonmedical, emotional and pre-bereavement needs of the patient and family.

     Wise works with the inner-family relationships and is intimately involved with the mental anguish people suffer when seeing a loved one in pain.

     “We sometimes have a different role, but we’re all doing the same thing to help prepare that patient and family for what is to come and deal with their physical and emotional needs,” she said.

     In her position, Wise has learned to be a good listener. “The patient and family can, if they choose, discuss those more difficult emotional issues with you. This means being available for them to share what they need to share when they need to share it.”

Battling Misconceptions

     Hospice and palliative care are sometimes misunderstood and often a referral for care comes too late to fully benefit the patient and the family.

     “There’s a misperception that hospice is for the very end of life, during those last few days,” Wise said. “We’re always out there educating families and medical staff to make that referral to hospice earlier in the game and allow us to do what we do best, to help that family along that road and not wait until the very end.”

     “A lot of people, when they hear the word ‘hospice,’ it just scares them,” Heath said. “But we’ve seen people live literally for a couple years. But without hospice, truly they would have gone a lot faster.”

     The sooner hospice is referred, the (continued on pg. 14...)

sooner the staff is able to manage the patient’s symptoms, and often hospice becomes part of their family, Heath said. “They look forward to the aides coming in, and it brightens their day. Hospice is a family that joins their family.”

     Heath finds helping patients and families through their journey the most rewarding aspect of hospice care.

     “Sometimes it’s very traumatic and very fast because they just received the news. Others, they’ve seen the decline of their loved one for a year or more. (Hospice) is helping them be prepared to face every corner, and every jog, and every bump in that journey.”

     Dealing with death every day may seem like the most difficult part of Heath and Wise’s work, but both women have found ways to keep moving forward after a patient dies.

     “In the beginning, it was very difficult,” Heath said. “But after a while, we learn how to protect ourselves from that kind of thing and be a professional and not become so enmeshed in the situation.”

     Heath describes becoming a hospice caregiver as “a learning process. It doesn’t happen automatically. When we discover we can be very professional and do our job and keep ourselves healthy, then we’re more effective,” she said.

     “You always need to know that there is another patient after that patient passes away that needs us just as much as the previous one did, and we need to move on,” Wise said.

     As patients come to terms with their mortality, often the family hasn’t and holds onto many fears about what comes next. Heath sees patients that have endured prolonged suffering and are tired of the struggle and want to find peace. On the other end of the spectrum are the loved ones who often haven’t let go.

     “It’s the letting go for them that’s very, very difficult,” Heath said. “We can’t fix it, we can’t make it all go away, but we can ease it. If there’s just someone there that they can talk to, it’s just so very important.”

What now?

Hospice care

continues after a loss

     Hospice services don’t end at death, and many hospice organizations ,including Rocky Mountain Hospice, offer follow-along bereavement services for the family or other loved ones involved with the patient after he or she passes away.

     Services through Rocky Mountain Hospice extend for 13 months after a death and include support groups, counseling, access to resources on grief, hospice and end of life illnesses, and an annual memorial service held the first week of December.

     The groups are informal and open to the public, as is the memorial service.

     Kathy Wise, director of social services for Rocky Mountain Hospice, said it’s important for people to realize they’re not alone in such trying times.

     “Joy shared is doubled, and grief shared is cut in half,” Wise said, quoting one of her favorite sayings. “People come in thinking that their grief is somehow abnormal or are feeling so alone. Here they can talk with other people that have been through or are going through the same thing and know that everyone has the same fears and emotions.”

     Ongoing support groups are open to the public and meet at 2 p.m. and 7 p.m. each Tuesday at Rocky Mountain Hospice, 2110 Overland Ave.

     The annual memorial service takes place at 6 p.m. Dec. 3 at the Billings Depot and is open to the public. Patients who have passed away during the year are honored and loved ones are presented with an ornament bearing the deceased’s name. For more information or to attend the event, call 294-0785.

Anna Paige is a freelance writer and journalist based in Billings and founder of Pen and Paige, a marketing, editorial and promotional company. Contact her at www.penandpaige.com.