A GIFT FOR THE DYING

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Sometimes the days are long and frustrating, she says as she drives home. Itís not the patients she has a hard time coping with, but the long drives, the paperwork and bureaucracy. "Patients are no problem, the good stuff comes from knowing you were there and made a difference. Itís the art of balance," Curtis says. "We love what we do, but it takes its toll."

"You meet people," she says. "Some are very difficult, especially the younger people." Managing a patientís pain is a primary concern of the hospice nurse. Once she treated a single mother with three children who would tolerate extreme pain so she could pick up her kids from school. She didnít want to be groggy from any medicine. "That was gut wrenching," says Curtis. Another was in such excruciating pain she couldnít even move her. "It was heartbreaking," Curtis says.

Sometimes the family doesnít cooperate, and she must spend most of the visit acting as referee. Whether dealing with pain management or the emotional roller coaster ride the families experience, Curtis listens sympathetically and helps them cope.

"The worst and the best of family dynamics comes out," she says.

When a patient dies, the bereavement coordinator is responsible for following the family for 13 months, sending them cards on the anniversary of their death, on the wedding anniversary and their birthday, as well as quarterly mailings to the family that explain the stages of grief. The hospice program also offers a free support group to the surviving relatives to help them cope with the grieving process.

In addition to providing patients and their families with the physical needs such as hospital beds, bath nurses, attendants, and medicines, the hospice team distributes a manual entitled "Gone from my Sight" that describes the dying process and what to expect from it. 

"A SAFE PLACE TO VENT"

Curtis wishes more people would take advantage of the positive benefits of hospice, but many donít enter hospice until late in their illness because they are unaware of its existence. And doctors have such a hard time coming to terms with end of life issues, she says. 

"They look at hospice not as a continuum of care, but as a failure on their part," she says. So the average hospice stay is only 24 days when it could be at least six months. "Itís an atrocity and a disservice to the people of the United States that this service exists and so few people know about it and are deserving of it," says Curtis. 

The hospice philosophy also focuses on the role of spirituality and the meaning of death in different cultures. There is a universal familiarity with the aspects of death whatever the culture, and by keeping an open mind and listening carefully one can begin to understand the messages of the dying. "Itís critical to be sensitive to that," Curtis says.

Curtis often attends a support group with her colleagues. Sometimes itís hard to get everyone together, she says, but it gives them an opportunity to talk about how someone has touched them. 

"Itís a safe place to vent," she says. "How can I explain my day to my husband?" Only those people who do that kind of work get it, she says. "Itís a whole different mindset in dealing with the dying. Sometimes people donít understand it."

Two weeks later Curtis learns that her 91 year old lung cancer patient died. "You know itís going to happen, but it still upset me," Curtis says sadly.

To learn more about Hospice contact:

The National Hospice Organization (1-800-658-8898) www.nho.org