Hospice

One interesting aspect of a healthier response to approaching death is that of the hospice. To better understand, we went straight to the source - a hospice in Poway, CA. In another strangely benevolent coicidence this nearby service had been handing out magnets at a local fair just as we were looking for someone to interview.

So we sat down with Dyana Penner, Executive Director of Horizon Hospice, and Bruce Ackerman, Chief Executive Officer, and discussed their experiences with hospice. Although Mr. Ackerman did not speak on camera, he did explain that he feels "privileged" to work with people at this point in their lives. The message constantly reiterated that hospice was an underutilized service that really could alleviate pain and make the end of life wonderful - it's not really about death at all.

Real Video (28.8)

Transcript

First, could you explain what a hospice is?

A hospice provides care for people who have a terminal illness and prognosis of six months or less. We provide all of their skilled nursing care, their medical equipment, their pharmaceuticals, their supplies, emotional support, social work. Volunteers provide respite. Anything that is related to their primary terminal diagnosis.

And how did you get invovled in this work?

My family had several person experiences with terminally ill family members. We cared for them in our home and hospice was not available to us at that time, and so when hospice was presented to us as an opporunity to be involved, we thought it was a great idea, and jumped at it. We've been at it even since.

What have you learned in working with hospice?

Oh, um, lots. Lots. I've learned about the endurance of the human spirit, and about people's will to live, and I've learned about the value of life, and that every minute, no matter what, counts, for every human being, and that it's important that everybody live every moment to their absolute fullest.

What do you think of society's approach to death as opposed to the hospice's?

I think modern American society has tended to push death into a sterile and clinical type setting, unlike what we did in the previous century, where we had our elders living with us in our homes, and death was just a part of life. It just progressed that way - it was to be expected. And Americans have separated themselves from that experience, and what hospice has done is kind of go back to some of the old ways, in allowing people to die with dignity and in peace in a setting that is familiar to them, such as at home. Wherever they want to be.

Are there any interesting anecdotes that you think might help people who are trying to understand death better?

Probably be . . . I can think of two of them. One of them, both of them, show how people live until the time that they're supposed to, in that we had a gentleman by the name of Jake, he was a couple of years ago, who had been a real Vegas fan. He used to go to Vegas all the time - Las Vegas - and gamble, and he had a favorite hotel. And one time when he was there, many years ago, he was playing one of their jumbo slot machines and he wasn't playing enough coins, and he was playing one coing at a time, and it's what's called a progressive slot so you need to put in all three coins to get the big jackpot. Well, on his one coin, the big jackpot, all the numbers rolled up - he didn't get the million dollars because he was only playing with one silver dollar. So Jake always wanted to go back and get even with this machine, and unfortunately Jake did develop a terminal diagnosis - cancer - and came under our care and we found out through our interdisciplinary meetings that Jake had this wish to go get even with this slot machine, and didn't have the means to make this trip. So we were able to get plane fare donated from Reno Airlines, and get the hotel, the Four Queens in Las Vegas, to donate suites and to help facilitate Jake and his caregiver to go to Las Vegas on a two day trip and Jake got to go and play again. Now, he didn't win the million dollars, but when he came back, Jake's words to us were that every minute's worth living and never give up, because you never know when your dreams are going to come true, because his dream did come true then, and Jake did live with us for a couple of more months after that, and it was great. He kept telling everybody about it.

Another story that I can think of is not necessarily quite as uplifting, but is very poignant, in that we had a gentleman who by all means should have died, he had a very serious illness, very drastic symptoms. He was basically comotose for about a month, and none of us could understand why he hadn't passed away - why was he holding on? Why was spirit feeling that he needed to hold on? And we found out that he had been on the Arizona at Pearl Harbor, and this was in November, the year that we had him, that we found out about this, and he just kept holding on, holding on, and it wasn't until December 7, that he did pass away, exactly at the time the attack would have started on Pearl Harbor 50 years before. And it was his will that held him there living that long. For some unknown reason.

And so how exactly do you implement the care?

We get a referral from any number of sources, be it a doctor, hospital, family member, community organization, that somebody has gotten a diagnosis or prognosis of six months or less and we call the family and talk to them about what hospice is, go out into the home with the nurse, sometimes a social worker as well, and visit with them, explain to them what are the services that we can provide. And we also get a doctor's order - we are required to have a doctor's order because we are a medical service to provide hospice services. And if the family feels our philosophy and our services are what they're looking for, then we bring out care to them. The nurses make home visits, so does our social worker, so does the volunteers. Anything that needs to be done can be provided in the home, 99% of the time.

Is there anything else you'd like to add?

Many people feel that hospice is about dying, and it's very much the opposite. Hospice is about living. Hospice is about hanging onto every moment and having the most quality time that you can have, and making sure that every moment that somebody has is as comfortable and as lived to the utmost - they get the most out of every moment - and that every moment counts.

Thank you.