Palliative care month
Death is one common bond that we all share in life. It is National Hospice and Palliative Care month throughout the United States. We celebrate with our community that we have had Hospice services since 1993 in the Yampa Valley. Hospice care is given in the home, at the hospital and in the nursing homes, for those whose illnesses can not be cured. The philosophy of care supports families as well as patients. Family members are often the caregivers at home and ask, "How can I do this?" With the help of the Hospice team, families are taught how to care for their loved ones, how to take care of themselves, and given support from nurses, nursing aides, volunteers, and spiritual counselors.
There are hospice benefits for all Medicare, Medicaid and most insurances. Making decisions about our end of life care is important. Hospice offers respect to the quality of life, dignity in the dying process, and care for those who are the caregivers. For more information contact Hospice and Palliative Care of Northwest Colorado at 970-879-1632 (Routt County) or 970-824-8233 (Moffat County)
Jan Fritz, Director of Hospice and Palliative Care of Northwest Colorado
"You need to come right away."
This was the unified voice of the hospice team on the telephone. I had no idea my mom was so ill. My husband and I were planning to take the family to Minnesota to visit Mom during Thanksgiving. Now, I was told, she wouldn't last that long, and had just been transferred to a nursing home. She was too weak to return to her apartment. Her demise started when she was unable to tolerate antibiotics for a bone infection. Now, she had stopped eating and walking. I blamed those damned shoes that caused the infection. I certainly blamed the podiatrist who recommended the aggressive antibiotic treatment. Why did I encourage her to take the antibiotics? I was a nurse and should have known better.
On Saturday, I flew to Minnesota and arrived at the nursing home in the evening. I found Mom in a small, semi-private room with one chair. She looked terrible. Her unwashed hair was brushed straight back and she looked small and gaunt in the large hospital bed. She had few personal belongings with her. There just wasn't any room.
"You can hear me now!" the charge nurse remarked to my mother. Until I arrived, mom's hearing aides and glasses had sat in her drawer. The buzz among the nursing staff was "the daughter is here and she's a nurse." Now that I was here, the details would be addressed.
I cared for my mother for three days. The nursing staff would help me turn Mom, which was very stressful for her. I fed her, assisted in lifting her to the commode, washed her and applied her Avon cream to her face, a skin regime she had followed for years. I questioned her medications, asked for morphine when she had pain, provided her mouth and skin care, and requested a special mattress to prevent skin breakdown. She was not eating and drinking enough to sustain anyone. She was getting weaker. At each shift, I asked: couldn't the staff please wash her hair? Like an apology for not having time to do this, I was offered more coffee.
Family visited, and crowded around her bed in the tiny room. "The nurses wanted to call a priest," Mom informed Pastor Bob, her Lutheran Minister. He laughed and prayed with her. Mom's roommate, Lillian, was a gem. I apologized constantly to Lillian. She understood our dilemma and was frequently gone from the room. Mom apologized to her too. "Get Lillian some flowers," she asked.
Mom's dinner tray held a scoop of coleslaw and a bowl of chili, despite her diet slip which read: 'dislikes cabbage, slaw, spicy foods'. In the morning, when her breakfast tray never came, I felt the system was failing Mom. The staff was doing their best, but it wasn't enough. I was too sad to be angry. I desperately needed allies, not a fight.
On Tuesday, Mom was transferred to a hospice center at my request. The center was a large home that had been extensively renovated to accommodate eight hospice patients. I placed flowers and pictures in Mom's private home-like room. Two nurses washed Mom and dressed her into a soft, flannel nightgown soon after she arrived. Hospice nurse Julie spoke to Mom, "We're going to take care of you, Doris." That evening, to my surprise, Mom fed herself.
I slept in one of the hospice center's guest rooms. I knew the nurses would care for Mom throughout the night. I'm so glad I brought her here.
The next day, the nurses washed Mom's hair and a volunteer curled it. Family continued to visit, and we had meals, prepared by the volunteer staff, together in Mom's room. We spent time looking at family photos together. We talked together about the details of her funeral. Mom asked that my children be her pallbearers. These final details were prominent in her mind.
By Friday, Mom was getting harder to arouse. That evening, she suddenly became more alert and asked for a poached egg. This time, I had to feed her. During the night, a nurse knocked on my guestroom door and informed me, "She's changing. I thought you'd want to know."
The next two days and nights, I stayed and slept in Mom's room. She no longer woke or spoke. I knew her labored breathing were clear signs of dying. The nurses still talked to her gently, and medicated her before they turned her, if she moaned or when her brow furrowed. "We'll keep her comfortable," they assured me. The nurses continued their care every two hours around the clock. Sometimes, I helped to turn Mom; sometimes I left the room to let them care for her. Pastor Bob came again. We talked for 2 hours one day. I was getting the nurturing I needed.
Early Sunday morning, Mom stopped breathing, just after the nurses turned her. For her funeral, we sang her favorite hymns, and my family, who had traveled from Colorado, served as her pallbearers. When I reflect on that week, I am so grateful for the hospice care she received. I did not want to be her nurse in those final days, just her daughter.