Bismarck, North Dakota - News

NEWPORT NEWS, Va. — 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.

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.

Couple planned ahead for husband’s death

NEWPORT NEWS, Va. — Joyce and Alton “Al” Hedgepeth were planners. In 1995, when Al developed a lung condition called chronic obstructive pulmonary disease, or COPD, he and Joyce discussed what they would want to happen if they were very sick.

“And we both agreed that hospice was the way for us,” says Joyce, who is 72.

Al died May 19 in his James City County, Va., home, pain-free with Joyce by his side. He was 86. Easing the way during his final four weeks was Sentara Hospice.

One of Al’s doctors had asked, “Mrs. Hedgepeth, have you given any thought to hospice?”

And Joyce responded, “That’s the only way to go.”

What happened next was like a “well-orchestrated Broadway show,” she says. “It’s like the hospice people came out of the woodwork. And every way I turned, they were doing something to make Al’s and my life easier.”

Al’s oxygen equipment and hospital bed materialized at the house.

A hospice nurse, who would attend Al’s funeral, made regular visits to monitor him, answer questions and discuss NASCAR racing with Al.

The day before he died, Al’s condition worsened. Joyce knew he was slipping into a coma. That evening, she phoned the nurse on call to update her but saw no need for her to come. Al’s Do Not Resuscitate order was in place. “Just let him go,” the nurse told her.

“I felt very much at peace,” says Joyce, who was married to Al for 34 years.

She sent her neighbor home and her brother-in-law upstairs to get some sleep.

“I want both of you to leave me alone with my husband,” Joyce told them.

At about 1 a.m. May 19, Joyce kissed Al on the cheek. He didn’t respond.

“I thought I needed to get closer to him,” says.

So she took down the rail on one side “and got into the bed and put my arms around him and rubbed him, and talked to him and experienced his death.”

She watched his breathing grow more shallow, then, finally, cease.

Joyce stayed with Al like that for about 30 minutes.

Then, she called the nurse to come back to pronounce her husband dead.