WHEN I TELL PEOPLE that I am the social worker for Hospice of Washington County, Iowa, some of them say, “Ugh! How can you do that?” Others tell me how grateful they are that hospice has helped them. One of those is Caroline Larson, who called hospice two and a half years ago, when her father, Alven, was dying in Des Moines. “Hospice workers changed that from a nightmare to a beautiful experience for the whole family,” she says. “They uplifted us, as their attitude is that death is a natural part of life—you don’t have to fight it.”
What the people who say “Ugh!” in response to hospice do not see is that hospice work has a sacred quality. When someone is dying and it is accepted, time is known to be short. There is no time for non-essentials—they fall away. It turns out that what is left, what is essential, is love. In the homes I visit, I feel the patients and families’ sadness, I observe their hard work, self-sacrifice, and courage—and it all speaks of a love I can only call sacred. I am there to help them, but I feel privileged and awed to be in their presence at this tenderest time.
What do I do? I am there to listen if the patient or caregivers want to talk. For the patient, I can conduct an end-of-life review or ask them to consider what their short-term goals might be. I can offer connections to financial and legal services, organ donations or crematoriums, expedite signing forms for durable power of attorney or living will, inform their clergy, or invite the hospice chaplain to visit.
In hospice, we are there both to educate and to serve our patients’ needs and wishes, and we follow their lead, while offering the knowledge we have gained from our training and experience.
Lynette Sievers, a nurse at Hospice of Washington County, likes to let patients know that she will be with them to the end. “Itell them we can’t change the direction, but we won’t abandon you,” she says. “We counter society’s avoidance of death by just being present and not afraid of it. I like that quality of really being with people, really present. One of the fears of dying people is isolation. Our major theme is being present, guiding, forewarning.”
Hospice workers explain every step of the process—what they are going to see, hear and feel—to the patient and the family. “It was pretty amazing how kind and caring they were,” says Caroline Larson of her hospice experience. “All my uncles and aunts who met the hospice workers felt how nice they were. They knew the different stages and could say, yes, this is okay, this is what to expect.”
Going into people’s homes in the Washington County area has given me a healthy respect for the unadorned goodness of people and for the power of their faith. I have met people who genuinely walk through the valley of the shadow of death and fear no evil. I met one man with little faith in a loving God but who loved his wife so much that he was illuminated, sustained by that love. I have met people who continue to be thankful or think of others even as they fade away, and a few who are dying unfulfilled, depressed, or sad, but never have I met one who does not have love for someone or is not dearly loved by someone—and this love never fails to come to the fore before the end of life.
Usually patients are ready to be done with it all as the end approaches. Some people do not start hospice services until they are so close to dying they are no longer speaking, and I never get to know them. I find myself regretting that they had not sought us out sooner.
When to Call Hospice
Hospice services are available when the patient and the physician agree that a cure is no longer to be pursued. Patients may be referred by their doctors, families, or friends, or they may call us themselves. Rather than a cure, we offer palliative care. That means we are very effective at the elimination or control of pain and we minimize other discomforts.
Everyone deserves compassionate care at the end of life, and no one is turned away due to finances, though our services are covered by Medicare or private insurance. Memorial, fundraisers, and donations also support us.
It is fitting that November is National Hospice Month because in the fall, the leaves turn glorious colors. The leaves are dying, but what we see is their beauty. Working for hospice, I see the beauty when people are dying, the poignant beauty in their own hearts and in the love that surrounds them.
For information: Hospice of Washington County: (319) 653-7321. Hospice of Iowa City:(800) 897-3052. Crossroad Hospice of SEIowa: Fairfield: (641) 472-2242, Mt. Pleasant: (319) 385-6767.
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