By Frannie Carr
to an audio version of
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.
"It is hard, you might only be in their life for a short window of time but they touch your
and it really is hard when you lose them."
Christal is a Hospice Nurse for the Visiting Nurse Association of Cape Cod. And since
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
when the person has six months or less to live. The emphasis is on comfort rather than
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
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
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
"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
misconception about hospice is that it promotes or helps to hasten death. She says this
Rather, hospice encourages people to live completely and fully for as long as they
"I really truly felt that I learned a lot about living from patients. Things that we all think are
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
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.
: "I think I can manage to stay to Christmas. Maybe even to Easter,
But, we'll see, we all gotta go sometime."
Cicely Saunders, who's the founder of the modern day hospice movement, said that "you
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
Broadcast November 30, 2006
Frannie Carr reports for WCAI, the Cape and Islands NPR Station