HOSPICE HELPS PATIENTS PASS AWAY WITH DIGNITY
Joan Atkin's family reflects on their experience with hospice care
Watching someone you love live out their final days can be heartbreaking, but fortunately for individuals facing this inevitable part of life and their family Hospice of the Plains is there to provide support.
Bonnie Brownell, a nurse practitioner in Sterling, was already familiar with Hospice and the “wonderful services they could provide,” having worked with them when some of her patients used the service and her sister, Luann Atkin Koester, knew of them after her mother-in-law was supported by the organization in her final days. So, when their mother, Joan Atkin, was diagnosed with stage four pancreatic cancer with metastasis to the bowel and lung in October 2021, there was no question they wanted hospice involved.
“They’re just really important,” Koester said.
Hospice provides palliative (comfort) care to individuals whose illness is not curable. Palliative care focuses on making the person as comfortable as possible by managing the symptoms of the disease. The goal is to maximize a person’s quality of life.
It is paid for through Medicare, Medicaid, private insurance and the Colorado Indigent Care Program.
Atkin’s cancer diagnosis came after she got sick and started vomiting. Brownell took her straight to the emergency room and scans showed the devastating diagnosis. Aktin was then sent to North Colorado Medical Center, in Greeley, and after more scans, she was given a terminal diagnosis, with the palliative care team in Greeley telling the family she had about three weeks left.
This was all happening amidst a COVID-19 surge, so Brownell was the only one who could get into the hospital to see her. Other family members would stand at the window and wave, but that wasn’t enough, Brownell and her family were adamant that their mother needed to go home so everybody could see her and say goodbye. Doctors were hesitant that she would be able to make it home,
given that she had had surgery and was more acute, but Brownell told them in no uncertain terms that it was happening and after talking with Laura Bacon, Hospice’s clinical director and RN case manager, from the hospital in Greeley, soon Joan was on her way home.
“These guys were amazing,” Brownell said of the hospice team. “She was a unique situation; she needed a little more advanced medical care and with my base knowledge and their services we could pull that off.”
After a week in the Greeley hospital, Atkin arrived home where she spent the last two weeks of her life.
“Once we got her home and hospice arrived, we were able to get her set up in the living room — she wanted to be by the front picture window — and hospice just immediately came in with the services, including chaplaincy, nursing, aids, equipment,” Brownell said.
She and Koester couldn’t speak highly enough of the hospice team as well as Lorenzo Apothecary, whose pharmacist came in on a Saturday and filled meds for Atkin, so that when she made it back home they were already there waiting for her.
“As soon as we got hospice involved, they were like, ‘these are the meds we usually use.’ The hospital docs were ‘let’s do this, this, this’ and in reality, we didn’t have those meds down here. Hospice got involved and just made it (snaps fingers),” Brownell said. “They’re able to just coordinate everything you need to take good care of her, keep her comfortable.”
An emotional Koester was acutely aware that her family was fortunate to have Brownell and her medical knowledge, but for families without that hospice is vital.
“Your knowledge and your skill set helped tremendously to be able to bring her home, because she knew what we needed her to do in the home and that’s not a set of skills that normal families have; it’s like a special set of skills and that helped tremendously,” Bacon said of Brownell.
“But then you guys were able to expedite everything so well,” Koester added.
At one point Brownell, herself, got COVID, but that didn’t stop hospice from providing support. She would call and let them know what she needed and then they would bring it to her doorstep and drop it off. The hospice nurses did come inside the house at least once too.
“If we have to we will come in, in certain situations, whether they’re Covid-positive or not. We do have some patients that are Covid-positive, but we try to limit the exposures to our other patients and families for safety of them as well,” Bacon said.
Along with providing medical support to keep Atkin comfortable, being a very religious person, Brownell said her mother very much appreciated the hospice chaplain who stopped by to visit before COVID hit the house. “It’s an extra service that’s so important,” she said.
“We focus on every aspect of a person’s life, so not only the physical and emotional, but we also focus on that spiritual piece as well. So, we provide total care for the patients,” Bacon said.
She encouraged families, though it may difficult, to have the hard conversations about death and dying before you get to that point, because then you can preplan and know what your loved ones’ wishes are and have those in place.
Part of the support that hospice provides families when a loved one is dying is a booklet, “Gone From My Sight,” a guideline to the different aspects of what a patient might experience as they progress towards passing and the signs and symptoms loved ones might see. Koester said she was appreciative of that when her mother-in-law died because it happened just like the booklet said it would.
“Not every patient has every single sign that’s in that book, they may not have any of them or they may have all of them, but it’s a resource for the families so then when, if they are able to read it, then they can be like, ‘ah, yes I know that this is normal.’ So, then they’re not like panicked,” Bacon said. “But if it’s something that they can’t read, we’re in there, we’re watching for those different signs and we can let them know this is totally expected and this is what’s going to happen, this is what you could expect moving forward and just help them through each phase.”
The support doesn’t stop after your loved one has died either.
“We’re very fortunate we have a very faith-filled family with an understanding of expectations of death and what’s going to happen, but the follow-up care, the surveys, the ‘how are you guys doing, do you need someone to come out,’ (it’s appreciated), Brownell said, sharing that on the one-year anniversary of her mother’s passing she received a nice note from hospice letting her know they were thinking of her. “It’s a lot of support for families that would be struggling.”
For the hospice staff, their patients become like family.
“Each one of our patients, they all hold a special place in our hearts and in our minds, even after they pass. I’ve been with hospice for almost two years now and each one of the patients that I have had I remember so much about them and they hold a special place in my heart and their families too,” Bacon said. “The patients and their families, they tend to kind of become your family essentially as well. You get to know them personally as you’re in there providing care and helping and supporting them.”
While Brownell’s mother had a rapid death, she wants families to know the sooner you can get on hospice the better, because they can help you start to understand the process and work through multiple things that need to be in place to make the dying process smooth and respectful.
“Not, ‘oh I’m going to die in five days, let’s get hospice.’ Really, months ahead would be ideal. There are many cases you can start them even a year out or more,” she said.
Bacon agreed with that, sharing they have had patients on services for well over a year.
“It allows us to come in and assist with each transition that the patient and the family is going to go through, help prepare them for the different aspects of grief that they’re going to be going through as well and be that support and resource that they need,” she said, adding that just because someone is admitted to hospice doesn’t mean they’re going to die within a day. “Some do because they come to hospice late, but just because you’re admitted to hospice doesn’t mean that you’re going to die tomorrow. We want you to live the remainder of time that you have left to the fullest of your capabilities and how you would like it to be.”
“There’s just some dignity with it. It’s something we never want to have to use, but boy we are a lucky community to have you there, because I know that it’s not an option in some communities; it’s a tragedy,” Koester said.
Hospice of the Plains relies heavily on donations to offset the incurred expenses of providing endof-life-care and bereavement support and while the Sterling Elks Lodge held its 20th Hog Roast benefit for the organization earlier this month there is still time to donate, by going to www.coloradogives.org/organization/hospiceoftheplains.