VNA Hospice

By Frannie Carr

(Listen to an audio version of this story).

November is National Hospice month. Hospice services were created to provide care and support to patients and families facing terminal illness. Care is diverse and can include anything from home nurse visits, physical therapy, and eventually bereavement services.

Christal England sits down and cries every time one of her patients dies. Though she tries to maintain a professional distance, she says, she can't help it.

Christal England: "It is hard, you might only be in their life for a short window of time but they touch your heartstrings and it really is hard when you lose them."

Christal is a Hospice Nurse for the Visiting Nurse Association of Cape Cod. And since hospice provides care for the terminally ill, all of her patients die eventually. The VNA has both a hospice and a palliative care program. Palliative care starts earlier in the disease process than hospice. Hospice usually starts when the person has six months or less to live. The emphasis is on comfort rather than treatment.

The VNA of Cape Cod covers Wareham to Provincetown. Christal's area includes much of the upper cape. But she can still clock up to 120 miles and see up to six patients per day. On one recent afternoon, Christal packed up her silver minivan, which is stuffed with equipment.

On this day, Christal is going to see Connie Carey in Bourne. Connie went to the hospital in May for a routine procedure. When they were operating, doctors found pancreatic cancer and gave her four to six months to live. Connie started chemo, but in August, she discontinued it and became a hospice patient. Christal has been Connie's nurse since then.

Christal is greeted by Connie's daughter, Lynn.

Connie shuffles into the room. After her check up today, she's going to visit her husband at a local nursing home, so she's taken extra care to look nice. Lynn removes one last roller from her white hair.

Once a week, or more if she's not feeling well, Christal checks in on Connie. She checks her vitals, her edema. She tells Connie how impressive her blood pressure is.

Even though Connie says it's hard to deal with the reality that death is looming, she says Christal makes it easier.

Connie Carey: "She's wonderful. She's caring, compassionate, professional. I can't describe her. You not only get good medical care, the nurses that do hospice are really right on the ball. She's very caring and very real. You know, not just, oh, that's too bad, well, take these pills-type."

Melody Collis is the Hospice Manager at the VNA of Cape Cod. Melody says that a common misconception about hospice is that it promotes or helps to hasten death. She says this isn't true. Rather, hospice encourages people to live completely and fully for as long as they possibly can.

Melody Collis: "I really truly felt that I learned a lot about living from patients. Things that we all think are so important, you think if you'll say, well, if I get told I have a limited prognosis, I'm going to just jet off to France or whatever. But when you find out about the simple things people really do want in the end, to be able to get out on the porch and have one more cup of coffee, to see their flowers or their roses bloom in the spring. That's kind of what really becomes important in the end, the ability to do this one more thing, one more time."

Connie has a goal. She wants to enjoy the holidays with her family.

Connie Carey: "I think I can manage to stay to Christmas. Maybe even to Easter, who knows. But, we'll see, we all gotta go sometime."

Cicely Saunders, who's the founder of the modern day hospice movement, said that "you matter until the last moment of your life." The VNA's mission is to make those moments as comfortable as possible.

VNA Hospice and Palliative Care
434 Route 134
South Dennis, MA 02660
Toll-free 1-800-978-0838

Broadcast November 30, 2006

Frannie Carr reports for WCAI, the Cape and Islands NPR Station