Q: We always think of the winter holidays as a joyful time of celebration and family togetherness, but we often hear that it also is a time of increased stress and depression for people. I would think that is especially true for people who are dealing with terminal illnesses.
A: I think there are increased stresses when someone, first of all, is dealing with a terminal illness and someone is experiencing the holidays after learning you're dealing with that loss, and second, if someone is dealing with their first holiday after that loss. They're also dealing with a huge amount of loss because of [Hurricane Katrina]. It's really compounded for our families at this time. We are dealing with families who are dealing with all three levels of grief right now.
Q: What can you do to relieve the stress and depression?
A: There are a few different things people can do. They have the support of hospice they can turn to. The Bereavement Department ... addresses the grief issues of the family, and that may before the person dies, the impending loss. We have family members who have lost their loved ones who meet a couple of times a month. And [the holiday season] is also the time not to be afraid to turn to friends and family and share pictures, talk about good times and reminisce. Reminiscence is an excellent form of dealing with the feelings of loss. Our memories often sustain us.
Q: Do you work mostly with the patients or do families need just as much support?
A: When we admit a patient to hospice, we say we admit not just the patient but also the family. When the family first comes to hospice, a lot of the support is for the patient, making sure their medical needs are met and that they are comfortable. Then [attention] switches to the family. That's when the support of our social worker and bereavement support kick in. Each family is so individual in what their needs are at this time. I think what a lot of people forget about is the grief of children. We have a children's grief camp, Camp Swan, for children ages 7 to 12 who have experienced a loss. We take them away for three days and camp. There are other grief support services through a place called Seasons A Center for Caring, a nonprofit agency that provides grief counseling for all ages. They provide a beautiful service for the community. It was kind of born out of the hospice movement. It has support groups for all ages and is actually totally self-funded by donations. They have day programs, individual sessions, groups and specialized children's program.
Q: Hospice doesn't just involve taking care of the medical needs of the patient and alleviating the workload of the caregivers, does it?
A: It's an all-encompassing thing. It's looking at the patient and their medical condition, then the spiritual care of the patient, those things all working together through an interdisciplinary team -- the patient, the family, the physician, the nurse, the social worker, the chaplain, the bereavement team, the volunteers -- all join together to care for that individual patient and family.
Q: What is the main goal of hospice care?
A: To provide comfort on all levels and allow someone the dignity they deserve at this time in their life, which is to be pain-free and to spend this time in comfort with the family and the ones they love, whether it is at home or in a facility. Some people don't know they have the choice of hospice. [Medicare, most Medicaid and many private insurance policies cover hospice care.] I can't speak for all hospices, but Canon takes patients regardless of ability to pay ... through a nonprofit foundation. [Hospice provides] nurses on call 24 hours a day, medication and equipment. ... That added support when you are losing everything around you takes a great weight off your shoulders and allows you to grieve.
Q: When do you suggest home care, and when is round-the-clock care at your facility appropriate?
A: It's really a family or individual choice. Most of the patients who come here come for crisis intervention; they're having a pain problem, a wound that they are having trouble taking care of at home. If a patient comes in and their condition declines, they usually stay here until the end. Most come here, and when we take care of the problem they can go back home. The whole philosophy of hospice was designed to be an in-home program, because most people would prefer to be home. ... When it comes to the holidays, this is when a lot of people turn to us for support. Our admissions go up during this time. The medical community is still in an education process about hospice. The only way we can provide hospice services is by a doctor's order, so the doctor is integral, but you can be the one who brings it up and asks the doctor.
Q: What are the most difficult issues you deal with during the holidays?
A: Probably the most difficult issue we deal with is the actual loss during the holiday season. Losing someone is never easy, but losing someone around a holiday always brings that association with that holiday. It takes a long time to work through that. We always say the first year of loss is the hardest. After the first year is when we would refer a family to another organization where they can receive additional support.
Q: How do you keep your staff and volunteers from getting depressed when they constantly deal with people who are terminally ill and families who are mourning loved ones?
A: We support each other. Most of us are here because we want to be and because we've had a personal experience that drew us here. Others have been drawn to hospice ... because we share a very personal and intimate experience with the families. We are meeting people when they are vulnerable and raw. Just think about the reward of knowing you helped someone pass into that more comfortably.