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|Paynesville Press - November 08, 2006|
Family sees value in hospice care
If she could do it again - not that anyone really wants to have their parents die again - but if she could do it again, if she could go back in time, Bonnie Strobbe wouldn't wait until her mother was terminally ill to enlist the support of hospice care.|
Hospice care - offered in the Paynesville area by Rice Hospice - provided so many benefits to her mother in the last months of her life that Strobbe wishes she had known about it earlier. Now, in telling their stories, she wants other people with a need to know about the service.
Charles and Evelyn Strobbe - married in 1941 and having lived in Davenport, Iowa, since then - moved to Paynesville in 1996 to be closer to their daughter Bonnie.
Her father, who had Alzheimer's as well as heart problems, was constantly going to the doctor, said Bonnie, who was still working, with her mother serving as his main caregiver. It was a long, ugly battle, said Bonnie, that they knew they were going to lose and yet were still not ready for his death.
Her mother, said Bonnie, was "shocked" by her father's death, despite his long struggle. And she was physically exhausted and mentally unprepared for life without him after 58 years of marriage. "She was so entwined to his fight, there was no thought about what her life would be like after (his death)," explained Bonnie.
Had they utilized hospice care for her dad, which could have provided a variety of services (from medical care, pain and symptom management, and home health aides to moral support), it would have benefited not only her dying father but her mother, too.
Her mom had congestive heart failure and started to deteriorate after Charles died in March 2000, said Bonnie. A hospice volunteer, Judy Savage, was a neighbor in AllDon Park and suggested hospice care for Evelyn.
After their first introduction to hospice care, her mother said, "That's me. I'm ready."
According to its mission statement, "Rice Hospice provides end-of-life care, comfort, and compassion, affirming the sacred value and dignity of life for those we serve."
"Hospice neither hastens nor postpones death," according to a brochure for Rice Hospice. "It affirms life and regards dying as a normal process."
Hospice started in London in 1968, according to Rice Hospice, and came to the United States in 1974. There are now 3,300 hospice programs nationwide, including Rice Hospice, founded in 1982. Rice Hospice, based in Willmar, serves eight communities, including Paynesville.
Its Paynesville satellite office, which covers the service area of the Paynesville Area Health Care System, is staffed by Cindy Lundberg, a registered nurse, and Judie Dunlop, a social worker. This branch was started in November 1997 and will celebrate its nine-year anniversary this year.
Referrals for hospice care can be made by anyone (physicians, loved ones, clergy, health professionals, etc.), said Dunlop. Hospice is usually referred when a patient with an end-stage illness declines - not eating, losing weight, uncontrolled pain and discomfort, or sleeping a lot - added Dunlop.
If the referral isn't from their doctor, they need to check that the patient has an end-stage disease.
"It's comfort care for people coming to the end of their lives," said Dunlop, whether in their homes, in a nursing home, or in assisted living, wherever they call home. Hospice care works best, she added, when it is started months before death.
The benefits for her mother, said Bonnie, were:
*Home health care (which allowed her to remain at home for a long time until a fall put her in a nursing home). Staying home was very important to her mother, according to Bonnie, "That's where she wanted to be.";
*Company (including reminiscing about her life story, which is fairly common);
*Pain management ("The hospice people knew things about comforting her that the medical people didn't," said Bonnie.)
*Family involvement (being careful to include the whole family (including her sister), listening to all concerns, providing information, and reinforcing decisions.
"Being with them gave her some peace about the fact that her husband just died and that she didn't have a lot of time left," said Bonnie.
"They gave her great comfort and support, and by that to me," added Bonnie, who felt that hospice care was great support for her as her mother's primary caregiver.
"Choosing hospice is not giving up. My mother never gave up," said Bonnie. "It was about choosing the best quality of life."
Hospice helped her mother replace the "pressure to get well" with having "time to die," to get her things in order and to prepare mentally and spiritually, said Bonnie. "She had time to get through the end of her life the way she wanted."
"It prolonged my mother's life," Bonnie continued. "Because she could enjoy things again. Because her whole life wasn't about fighting the disease. Because she could sit back and enjoy her life. Because she didn't have to spend all her energy on getting well."
As a music major, her mother would have loved music therapy, one of the complementary therapies (along with massage and healing touch) now offered by Rice Hospice.
November is National Hospice Month, and Bonnie thinks that the service, which is usually covered by insurance and also is supported through donations, is "tremendously underutilized."
Rice Hospice typically has 70-80 hospice patients, including 8-16 at its Paynesville branch.
One of Dunlop's first hospice cases was an eye-opener for her. A priest, who had dealt with death all his life, still found himself unprepared for his own death, she said, learning that end-of-life care can help anyone.
"We really want people to be aware that hospice is a program to support families and loved ones during a difficult time," said Dunlop.
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