Hospice News Fall 2016

Hospice News FALL 2 01 6

Reflections Thoughts on hospice care from our social worker

Volunteers Meet those who help us deliver Hospice’s mission

Spirituality in Health Care From a doctor’s point-of-view

Brookings Health System Hospice would like to acknowledge with appreciation the following donations (received through 09/30/16): In Memory of Kris Rivas

Doug and Tracy Repp

R/E Goldsmith

Rodney and Mary Lamb

Joan Jamison

David and Marcene Lenander

Floyd and June Wiesner

Viola and Marc Richards

W. Timothy and Laurinda Fitzgerald

Lionel and Fran Torgrude

Van and Barbara Fishback

Kelly and Patrick Kelly

Amy Foster

In Memory of Susan Goens

Owen and Darlene Scott

Terry and Linda Wendt

Darrell and Ruth Deboer

Robert and Clark Holborn

Mary and Douglas O’Neill

Carrie Hagberg

Lavonne Riechers

Julie and Dennis Walkins

Duwayne and Maxine Krause

Darwin and Delores Hunt

Michael and Ann Monnens

Julie and William Moe

In Memory of Tom Holmquist

Darwin and Marlenna Walker

In Memory of Glen Nachtigal

James Nachtigal

In Memory of Henry Bucholtz

Linda Smidt

In Memory of Willard Hodges

Lorraine Hodges

MEET THE VOLUNTEERS ROGER BROWN Roger is one of two volunteers in our We Honor Veterans program which emphasizes a focus on the unique needs of our veterans who are in hospice. Roger was in the Army for more than 20 years and has brought his knowledge of the military and interest in connecting with veterans to his work in hospice. Clients have appreciated that Roger has found tangible ways to connect them with their WWII experiences such as bringing pictures of the ship they were on or a list of the soldiers who served at their side.

REV. DAVE JOHNSON Having served for a time as an Army chaplain, Dave appreciates the opportunity to connect with veterans who are in hospice. He has visited a number of them and provided spiritual support as well to them and their families. Dave also volunteers for hospice by singing with the Hopeful Spirit Chorale. This group, directed by Dr. Rick Holm, sings most weeks for one of the hospice clients. Clients and families have expressed much gratitude for the joy and beauty the group’s singing brings to them.

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NANCY GRIES Another source of music for our clients is that provided by Nancy who plays her key board by ear. Nancy is well known in the area for her playing

on many occasions including church services and special events. She has a very portable keyboard which she takes on her visits to clients. Clients very much appreciate her music and that she has a very large repertoire stored in her memory so she can play numerous pieces on request.

CARRIE HAGBERG Carrie is a retired nurse practitioner and brings a wealth of knowledge and experience to clients. Hospice clients have really appreciated her compassion, her flexibility and regularity in visiting them. Carrie has accompanied clients to appointments, on occasion riding the BATA bus with them. She has gone to coffee with them and followed up with client family members after their loved one in hospice has died.

DR. RICHARD HOLM Dr. Holm has volunteered his services as the Hospice Medical Director since the founding of Brookings Health System Hospice in 1995.

He is part of the hospice team which meets weekly. In his role as medical director he is a resource for the nurses who are caring for the hospice clients.

His knowledge of the disease process of a client and pharmacological and other interventions provides a solid support for the care of hospice clients. As noted above, he directs the Hopeful Spirit Chorale and enjoys bringing their music to hospice clients.

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M E A N I N G M AT T E R S :

A Doctor’s View of Spirituality in Health Care There is a lot of talk about spirituality in health care these days. This is because Gregg TeBeest Chaplain

patient surveys reflect that patients expect that their spiritual and religious beliefs be considered as part of their care plan, especially in end-of-life care.

A study from the Journal of General Internal Medicine found that patients who had discussions of religious/ spiritual concerns were more likely to rate their care at the highest level on four different measures of patient satisfaction, regardless of whether or not they said they had desired such a discussion. Did you catch that?

Even patients who expressed little interest in receiving spiritual care in their hospice or health care experience reported benefitting from it. Conversely, patients whose spiritual needs were not met reported lower ratings of quality and satisfaction with care. What does this mean?

I believe it’s pretty simple. As health care is increasingly measured on a number of quality indicators, including patient satisfaction and outcomes, administrators are more readily devoting resources to ensure that spiritual care is incorporated into patient care. This is good business practice. Happy patients mean a better bottom line for health care institutions. But more importantly, it’s good people practice. Treating patients holistically (mind, body, and spirit) is a means of providing quality and compassionate care. It’s just the right thing to do.

So patients are driving the spirituality movement in health care. People want to go where they’re cared for, not simply where they’re fixed. But are health care teams getting it? I’m confident they are. In a recent medical article a doctor reflects on how a person’s spirituality can affect their health care choices and behaviors. She experienced that when she encouraged patients to make lifestyle changes they would often get stuck after a brief period of success. This, she said, frustrated both her and her patients. She discovered that instead of talking to her patients about health, which is pretty ambiguous, she needed to talk to them about things that gave them meaning. So rather than simply recommend they avoid drive through meals and vending machines, she reminded them that having the energy to play with their grandchildren, for example, was dependent upon their choices. She gave meaning to their choices. This in turn changed their behavior. This is was spirituality is about.

Every person is different. Your spirituality is as unique as you are. It is an experience first and words second. Whether you realize it or not, your spirituality influences your choices and behaviors, especially in palliative or hospice care. This is why your hospice care team includes a clinically trained chaplain. And this is why physicians are recognizing and addressing spirituality with their patients. Dr. Sethi says, “I was not taught in medical school, to make the connection between a person’s spirituality or that which is held sacred, and their health outcomes. I know now, after finally feeling comfortable enough to talk to my patients about that which gives meaning to their lives that this is what helps them get ‘unstuck.’ The sacred moments of laughter with friends, playing soccer with their child, or enjoying the hug of a lifetime from their grandchild are what will sustain them in the moments of difficulty as they are faced with a choice to order those extra fries or dessert.”

Don’t overlook the opportunity that spiritual care in the hospice experience provides. Spirituality is about more than religion. It’s about meaning, your meaning. So talk with your doctor about your spiritual needs. And then schedule a visit with your hospice chaplain. You might be glad you did.

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Reflections I am retiring in November. I would like to share some reflections about my experiences and what I have learned during my more than five years of working as the hospice social worker. I have learned much about myself, Mavis Gehant Hospice Social Worker

about my colleagues and about clients and their families.

I am retiring in November. I would like to share some reflections about my experiences and what I have learned during my more than five years of working as the hospice social worker. I have learned much about myself, about my colleagues and about clients and their families.

I learned that I am capable of sitting with someone who is dying and with their family members. Before beginning this job I had not thought much about that.

However, when seeing my first client, an elderly woman in a nursing home, who was unresponsive and had only days to live, I had an uncomfortable feeling in my stomach and questioned whether I could really do this.

Then I witnessed the arrival of the woman’s grandson who obviously loved her very much. He embraced her, kissed her forehead and told her he loved her. He then sat by her bedside holding her hand and caressing it.

The image of the two of them, she in a fetal position, laboring with each breath, he, tall, lanky, and so grounded in and assured of his love for her, was beautiful.

What I learned about my colleagues is that they have a tremendous capacity to truly care for clients, physically, emotionally and spiritually, during probably the most difficult time of the client’s life. Their care extends beyond the client to family and loved ones as well. A most poignant memory is our helping in a situation when a client had many physical difficulties and serious mental health issues. The client’s care had been challenging for the hospice staff and for the adult child who was the caregiver.

It was the care giver who called to request that we (chaplain, nurse and social worker) come to talk and to pray. We did talk about the difficulties of the client who was now unresponsive and affirmed the caregiver for the good care and support provided to the client. We entered the client’s room and each of us placed a hand on the client while our chaplain prayed aloud. It was a peacefilled moment and one for which the care giver was grateful. So were we. The client died within a day.

I witnessed variations of this scene over and over again.

I found I could comfortably offer support to families and that sitting with someone who was dying had something sacred about it. What love often fills the room of those who are dying as family and friends keep vigil at the bedside. It is a privilege to be present at such times.

The nurses and the aides spend hours with clients and families providing care and support. Sometimes the nurses must see clients in the middle of the night or on the weekend. They continually assess the client’s situation and seek out interventions to promote their comfort, often collaborating with the chaplain and social worker. They are phenomenal. It has been a privilege to work with such a caring and competent team.

Those scenes of gathered family members were not always the case. There have been clients who had no family to be with them and sometimes no funds for burial. Staff members from hospice and the nursing home where the client resided became their family. Staff members were the ones who sat at the bedside and gathered for a service to remember the one who died. I grieved for the dead client’s sparse connections with others in this world.

Some clients want to talk about what they are experiencing, not just physically, but emotionally and spiritually as well. Others do not. Some are initially reticent, but after some trust has been built and they experience our sincere interest and our listening ear, they begin to reveal more of themselves, their fears and their hopes. We do a sometimes complicated dance of asking questions but trying not to be intrusive, of searching for clues as to the client’s emotions without

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KNOW YOUR OPTIONS! poking so much that we push them away. Empathy, I have found, is always well received, even if there is no verbal response. When we verbalize to clients what they may be experiencing and thus demonstrate our attempts to understand them, they visibly relax, sometimes become teary-eyed and sometimes tell us more.

Most clients want to have normal conversations about every day events, about family, the weather, their dog, sports, about all the things any of us enjoy talking about. They want to have those moments of normalcy.

They want to know what’s in their hometown newspaper.

They want to play cards, joke around and watch TV. I have had many mutually enjoyable games of cribbage with clients who were very ill and in their last weeks of life.

Learning about your care options if you or a loved one is facing a serious or life-limiting illness can offer hope during difficult times. Hope to live life as fully as possible – even up to the final moment.

Hospice brings you and yourcare familyoptions compassionate a cure Learning about your if youcare or when a loved isn’t possible.

Palliative Care provides comfort and support earlier in one is facing a serious or life-limiting illness can offer the course of a serious illness. And advance care planning lets you hope during difficult times. Hope to live life as fully make your wishes known. The time to learn about your options is as possible—even up to the final moment. before you’re faced with a medical crisis.

Hospice brings you and your family compassionate care when a cure isn’t possible. And advance care planning lets you make your wishes known. The time to learn aboutKnow yourYour options is before you’re Options! faced with a medical crisis.

Learn what options might be right for you at www.momentsoflife.org/options.

However, sometimes it is silence that is required. Just being present is what is needed. That means being fully aware of the client and not thinking about something beyond being with this particular client, now, at this particular time. A special quiet and calm often accompanies that silence, that being present. I value the gift we offer when we are truly present with someone.

It is not possible, if one is paying attention, to work in hospice and not contemplate one’s own death. I have asked myself: What will cause my demise? How will I react if told I have a terminal illness? How would I attempt to retain control of my life? What sort of treatment would I want, if any? How would I want to spend my final months and days? How well will I cope?

Who would I want to be at my bedside during my last hours?

My experience as the hospice social worker has enriched my life. For that I am truly grateful and feel very blessed.

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Gracious

D E AT H He was my neighbor, a guy my age, not my patient, a man of many talents and

Richard P. Holm MD

interests, and a dear friend. He was one of those fellows who would give the shirt off his back to help you if needed.

When he was diagnosed with cancer of the pancreas that spread to the liver, he, his daughters, and his friends knew how this was likely going to go. But we didn’t realize how graciously he would handle his dying process until it happened.

He was treated and truly helped by chemotherapy for a while, but gradually the tumor cells developed resistance to the drugs and the oncologist suggested no more chemo. He was ready to have only pain meds and hospice. In the end, per his direction, with the help of hospice and the caring people at the Arlington Nursing Home, he shuffled off this mortal coil comfortably, surrounded by his family and friends.

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Fortunately, he had a compassionate and grounded primary care doctor and oncologist team who were realistic and knew when to stop intervention; loving daughters and friends to surround him with support; plenty of ready-to-heatand-eat tater-tot-like hot-dishes; an advanced directive that said he was not to have medical intervention if pointless; and plenty of pain medicine for comfort. When I visited him two days before his death, despite an expanding belly full of cancer, he told me he was without pain. Most important, he was absolutely not fearful but courageously accepting of the dying process.

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In comparison, I find it tragic and too common that patients and families are overwhelmed with a fear of death. Some suggest this disabling-dread comes from our cultural practice of protecting children from seeing death with the intent to make life easier on them.

Thus, a lifelong apprehension and running from death has become the norm.

Consequently, we expect modern medicine to save us in the end which can be a desperate, futile, and harmful hope, especially in an end-of-life situation. What’s more, physicians struggle taking the time and challenge of helping people in denial face their dying process.

Bottom line, too many people chose to be dragged through unnecessary suffering at their end of life and too often doctors comply.

Rather, dying people should ask for and be reassured that enough comfort medicine will be provided and that it’s going to be alright. Our profession has been improving in this regard, but certainly could do better.

When it’s time, we should all have the opportunity for a gracious death, just like my neighbor.

Aiming To Inspire Health Fundraiser A record-setting 33 teams registered in Brookings Health System Foundation‘s seventh annual Aiming to Inspire Health sporting clays fundraiser on Thursday, Aug. 11 at Medary Creek Hunt Club, rural Aurora, S.D., presented by First Bank & Trust.

Top Team: Big Dogs

Net proceeds of $19,637 will help purchase three new infant warmers for New Beginnings Birth Center, providing top-of-the-line neonatal resuscitation technology.

“When the newly expanded hospital opens in 2017, we want newborns at Brookings Health System to benefit from the latest technology,” said Foundation Director Barb Anderson. “Thank you to our sponsors, participants and volunteers whose involvement supports the future of health care in our community.”

Approximately 130 participants took turns completing the ninestation sporting clays course, aiming for a perfect individual score of 50. Three youth teams were underwritten by Ardelle Roberts, Back in Motion Chiropractic, Brother’s Pharmacy, The Exchange, Owens & Minor and US Foods.

“This competition helps us improve our skills,” said Dane Wika, member of the Brookings Bobcat clay target team. “We are already looking forward to next year.”

Along with the competition, Brookings Health System Paramedic Wendy Long, provided a hunter’s first aid demonstration including hands-only cardio pulmonary resuscitation (CPR).

In addition to First Bank & Trust, other event sponsors included ammunition underwriter Runnings; US Foods; Thompson Electric; Banner Associates; Kerry’s Landscaping & Irrigation; Dacotah Bank; Helsper, McCarty & Rasmussen; Kraus-Anderson Construction; Avera Medical Group Brookings; Larson Manufacturing; Valero Renewables; Dimensional Insight; Kjergaard Sports; Scheels; Barrett’s Flooring & Decorating; Metropolitan Mechanical; Kone Elevator; Jensen Masonry; Cubby’s Sports Bar & Grill; Sanford Brookings Clinic; Syverson Tile & Stone; Briese Iron Works; Clites Electric; FM Acoustical; Owens & Minor; HyVee; Outlaw Graphics; CDW-G; Central Business Supply; Allegra; Gas N Mor; Brookings Register; Swiftel Center and Walmart.

The following businesses sponsored adult teams: 3M Brookings; Regional Home Builders; Twin City Fan; Brookings Auto Mall; Deer Creek; WW Tire; Iberdrola Renewables and MG McGrath. Six teams were organized by individuals including three teams made up of SDSU employees.

For more information contact (605) 696-8855 or foundation@brookingshealth.org.

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Top Youth: Hunter Neuman

W inners from the event include : First Place Adult Team: 141; Big Dogs: Rich Widman, Conor Rude and Terry Wieczorek all of Brookings, S.D. and Mark Widman (Tea, S.D.) First Place Adult Individual, Tie: 44; Danny Faber (Aurora, S.D.) and Conor Rude Second Place Adult Individual: 42; Rod Brandenberger (Brookings, S.D.) First Place Youth Individual: 41; Hunter Neuman (Brookings, S.D.) Second Place Youth Individual: 40; Landon Moe (Brookings, S.D.)

Drawing, Individual Participant: Chad Bachman (Brookings, S.D.) Drawing, Team: Basin Electric Power Cooperative, Deer Creek Station #1 Ghost Clay Drawing: Dane Wika (Brookings, S.D.) Lowest Individual Score: Jamin Bridge (Coleman, S.D.) Top Score Station Eight: Jim Kramer (Brookings, S.D.) Early Bird Drawing: Fereidoon “Fred” Delfanian (Brookings, S.D.)

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300 22nd Avenue Brookings, SD 57006 ADDRESS SERVICE REQUESTED

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Hospice News is published by Brookings Health System. This publication in no way seeks to serve as substitute for professional medical care. Consult your physician before undertaking any form of medical treatment or adopting any exercise program or dietary guidelines.

We Extend Sympathy to the families of patients lost through September 2016: Charles Blazey

4/2/26–7/12/16

Glen Nachtigal

6/17/27–7/31/16

Henry Buchholtz

5/9/25–7/13/16

Tyler Nielsen

4/10/82–9/22/16

Beverly Craddock

7/11/28–7/17/16

Norma Pittenger

6/26/22–7/23/16

Rose Davidson

2/17/63–7/8/16

Betty Rasmussen

7/27/25–9/7/16

David Dotson

5/20/49–8/15/16

Ruth Royer

Susan Goens

2/13/53–7/12/16

Darlene Schulz

Bradley Hanson

10/13/53–7/29/16

Olga Stafford

4/29/23–7/13/16 1/8/45–7/6/16 11/4/71–9/17/16

Thomas Holmquist

7/24/38–7/28/16

Spyridon Theodosopoulos 6/13/39–9/10/16

Earl Lovro

11/1/33–7/14/16

Gracia Wicks

4/30/40–9/23/16

Lyla McInroy

11/16/39–9/13/16

Mary Zerby

1/23/33–7/19/16

Joanne Moe

6/16/38–7/28/16