“Bucket Lists” are a hot trend these days – as a headline for countless travel articles online and in magazines. The phrase originally referred to a few special things people wanted to accomplish before they died. Now it has been co-opted as an endless compilation of far-flung travel destinations and exotic activities (underwater cave diving, anyone?) whose checking off is a competitive activity – who can do the most, and of course post the photos on Facebook or Instagram. We’d like to remind people that those nearing death actually get comfort and joy from much simpler things, like visiting a beautiful garden, getting together with friends, or a last horseback ride. Life is not about who dies with the most “toys” or passport stamps. Find what is important to you and do it – not to impress others, but to bring lasting happiness to you and those you care about.
If you have a few minutes to read this article: https://splinternews.com/how-to-not-die-in-america-1822555151 (it’s a few pages long) – it is a worthwhile time investment that highlights the healthcare disparities in the employer-driven US insurance market. As more people, both younger and older, find themselves self-employed they are at risk for bankruptcy if they become seriously ill. Being hospitalized and intubated in the ICU for a bad case of the flu might not kill you, but could wipe out your savings. There is no fairness in a system that charges an accountant working in a temp agency tens of thousands of dollars for a hospital stay, while an accountant who is a full time employee pays a maximum of $5,000 out of pocket for the same services and procedures (or better ones, depending on their plan’s affiliations).
Hospice care is the only part of our healthcare system where everyone has access to the same support and services regardless of insurance plan. Everyone gets home visits from RNs, aides, social workers, chaplains and volunteers. At Care Partners, an RN will come every day if your condition requires. Our social workers help with a wide variety of non-medical needs, from legal documents to family dinners out to arranging travel. Whether wealthy or indigent, you will get the best care we have to offer. Hopefully one day the same will be true for the rest of healthcare in America.
Five months ago, I moved from my hometown of Chicago, IL to the Pacific Northwest to begin an AmeriCorps year of service through Jesuit Volunteer Corps Northwest, my first full-time position after graduating from the University of Notre Dame last May. With the help of gut instincts and a strong support system, I had committed to spending one year serving as the Immigrant Community Outreach Coordinator at Care Partners Hospice & Palliative Care, a community-based non-profit located just outside of Portland, Oregon. I was to reside with four other Jesuit Volunteers (JVs), learning together how to live out the program’s core values: community, social & ecological justice, spirituality/reflection and simple living. I will admit that although I had recited my post-graduate plans dozens of times since committing, I had little conception of what my new, long-winded title really meant—nor any idea just how much this year of hospice work would bring me life.
Considering that I am now nearly halfway through my experience and that we are entering a new year, it is only natural that I have spent much of the past few weeks reflecting on my experience here. Most of this reflection, though, happened from across the world, in a small town called Kurumalloor in the state of Kerala, India. Approximately three weeks ago, I learned that my maternal grandmother, who lived in my mother’s childhood home in South India for most of her life, had passed away. Having spent the past five months engrossed in the work of accompanying the dying, I have noticed a few things, and it was this very learning which prompted me to immediately board a flight to Kerala, India, to be with my family. I knew there was nothing more important.
Hospice taught me to pay attention to the complex thoughts and feelings that arise as we grieve a loss. I can see that grief is not linear, that there are no clear-cut stages. In fact, I have come to know that nothing about death is clear-cut except that it will happen to each of us. Moreover, I have learned that encountering the death of our loved ones changes us. I can now embrace this; I allowed myself to feel moved by the experience of supporting my mother. I recognized it as integral to my developing understanding of myself as an adult daughter, one who can hold her parents, in addition to them holding her.
My time at Care Partners has given me the gift of listening to the wisdom of those close to death. My observations have taught me that death is as sacred as birth, that end-of-life work involves the family as well as the patient, that hospice is about living well in the days remaining more than dying itself, that in this healthcare field compassion and socio-emotional support blend with medical, nursing and social work practice in profound ways, and ways which help the patient feel like a person again. Most of all, my time in hospice has reminded me that we are all human beings—that we exist with limits, but that we can live with abundance, no matter our circumstances. As a hospice volunteer, I have sat with people who sing and dance with more life than even my twenty-two year old body can, who contain stories as unique as snowflakes, and who still have the need to be heard, to be seen, to be loved. In watching and working with families, I have noticed that while nothing can prevent grief, there is healing in the acceptance that your loved one lived until the very end. There is comfort in realizing that if she or he met the process with acceptance, maybe you could, too.
I am grateful for the opportunity to engage with such meaningful work at my young age, and I recognize that the lessons I am learning here in hospice will only be reiterated as I myself grow, age and, eventually, die, hopefully with the abundance of love and support I have now witnessed surrounding many of my patients and my own grandmother. From the beginning of human history and from Oregon all the way to Kerala, death remains a most sacred and human thing.
A recent article in the New York Times (“This was not the good death we were promised” published on 1/7/18) highlighted once again that not all hospices are the same in their prioritization of patient and family needs. Glossy brochures and service “extras” don’t substitute for being able to count on a highly trained healthcare professional to respond in times of crisis – which can be at any hour of the day or night. Cancer patients in particular have a less predictable disease course, and the potential for unanticipated symptoms arising in their final weeks.
Care Partners prides itself on having a nurse on-call 24 hours a day, 7 days a week. If needed, one of our physicians will also evaluate the situation and recommend a course of action – even at 3 am. We often visit patients more than once a week (potentially multiple times in one day if required) and we are in contact with the home at least four times in the first 48 hours after admission. There is never a time, including holidays, when our phone is not answered. We always do advance planning and coaching with our families, making sure that an adequate supply of medications is in the home, as well as specialty “kits” we have created for emergencies like seizures.
Hospice has the potential to help patients through a good death experience (see another New York Times article, “One last visit to see my patient” published on 9/25/17), but Medicare payment reforms are needed to insure that funds are available to cover services for patients with high needs. Currently hospice is the only type of care with flat reimbursement unrelated to patient acuity. As a result, for-profit agencies have fewer incentives to care for medically-complex patients with short stays, while non-profits whose mission is to provide exceptional care without exception are under pressure for incurring costs far above the daily rate they are paid.
Do you know someone who is spending the holidays alone for the first time? Or perhaps not for the first time? More than 20% of US adults over age 55 live alone, and 60% of nursing home residents have no regular visitors. Make the decision today to help! Call and offer to stop by for a visit, or if the person is mobile, meet somewhere within walking distance during the day (10 am-2 pm may be the best window). Find out what kinds of activities they would enjoy, choose one, and block time on your calendar. Then do some online research and find out what other services are available in the area, and mention a few might be of interest. Drop by with a small edible or floral gift on Christmas morning, and check in the week after during the “post-holiday letdown.” Start a new tradition – and remember that doing something for others does as much or more for the giver as for the recipient!
The Oregon Hospice Association has named Care Partners hospice aide James McGaha to its annual Hospice and Palliative Care Dream Team, which honors individuals who exemplify the best in quality hospice and palliative care.
Pictured right: Care Partners patient and U.S. Marine Corps Veteran Dave Steel with his Hospice Aide, James.
James entered college with his sights set on becoming a registered nurse, but his musical talent and love for rock and roll took him down a slightly different path. While pursuing a music career in the evenings, he spent his days as a certified nursing assistant at Martha and Mary Ministries, an adult foster home for dying patients in Southeast Portland. At Martha and Mary, James quickly became a leader among his peers, helping to ensure quality patient care and a smoothly operating facility.
James transitioned to Care Partners in 2015, where he has since established himself as an invaluable asset. He is a strong advocate for the hospice aide team and has taken an active role in looking for ways to improve the daily lives of his colleagues. More importantly, he has continued to maintain a special connection to his clients. His calm and composed demeanor sets patients and their families at ease, and his continuous demonstration of compassion positively touches the entire Care Partners organization.
As a person of many talents and interests, James’ journey is just beginning. Although we don’t know exactly where it will take him, we do know that his attentive, knowledgeable and compassionate care has been an appreciated addition to the Care Partners team. We thank him for all of his service and hope that he continues to play an important role in his patients’ lives for many years to come.
MAJOR Underwriting Sponsor: $3500
- Recognized as a Major Underwriter of the event in all promotional materials
- logo on promotional flyers, website, social media postings
- On-site announcements
PARTNER Underwriting Sponsorship: $1,500
- Recognized as a Partner Underwriter of the event
- logo on promotional flyers, website, social media postings
- On-site announcements
SUPPORTING Underwriting Sponsorship: $500
- logo on promotional flyers, website, social media postings
MUSIC Sponsor Package: $1,500
- Music area signage, logo on event sign and promotional materials
- Intro prior to music performance
- On site tent (10×10) (includes tent/table/chairs)
DANCE Lesson Sponsor Package: $1,000
- Dance area signage, logo on event sign and promotional materials
- Intro prior to lessons, On site space (10×10)
SUPPORT Sponsor Package: $250
- Logo on event sign, promotional materials, onsite mentions
- On site space only (10×10) (no tent provided)
Local Artisan Booth Vendor – $50 (up to 30 available)
- On-site space (10×10)
- (if we provide tent/table/2 chairs – $80.00 additional)
“Just be nice to them, and they’ll be nice to you.”
Wise words for dealing with people and animals, from Wilbert “Wib” Dale, an attractive and thoughtful nonagenarian (92 years old) who Care Partners had the pleasure of honoring with a “Pinning Ceremony” for his service as a medic in the United States Army during World War II.
“Wib” (nicknamed by his father) grew up with four brothers and one sister on his family’s 250 acre cattle and hay ranch in Remer, Minnesota. Some of his favorite memories as a child were riding his horse “Mike” to school and church, and sharing an occasional “treat” with the family cats and dogs while milking the cows – directing the stream directly into their eager mouths. Just over a year after graduating from high school, his 1944 Army induction noted his civilian experience, “Fed and cared for 45 head of cattle and 50 sheep, and drove horses four abreast to plow, drag and cultivate the crops.” Wib “didn’t want to carry a gun” so chose to serve in the Medical Corps. He wasn’t told about the bombing of Hiroshima, yet found himself on a plane headed for Japan to serve as a medic at the Takeshima Rest Center in Gamagori, Japan. It was tough duty for him. He saw women and children suffering, and has painful memories from that time. “They are human beings.” Wib shared that he has some memory loss now, but lamented that he has some memories that he wish he could, but can never forget.
Wib served both Americans and Japanese while in Japan. His Army letter of appreciation for his service stated that Wib “rendered prompt and accurate diagnoses” and his “competence and quick action have not only relieved the suffering but possibly saved the lives of the individuals concerned.”
After serving his country, Wib lived in many places and served others in many different roles, including pastor, teacher, real estate broker and school principle. He earned his Bachelor’s Degree and Ph.D, but rarely told anyone about his advanced degree; “I didn’t want them to think I was going to leave because of my education.” His love for horses and other animals is carried on by his daughter Laura, who together with her husband Steve (a Vietnam Era Veteran who served on nuclear submarines) run a non-profit for rescue horses. Wib has recently moved into their home, where he is surrounded by rescue cats, dogs and horses, and also gets to spend time with his grandchildren and great-grandchildren. While Laura is proud of her Dad’s military service, she also talks about his other gifts, “He taught me how to do ‘spin brodies’ (donuts) in his 1966 Buick Wildcat.”
“The main thing is to stay in love with your family” says Wib with a big smile. While he was sad to have to give up driving at age 88, he is hoping to live to be 100, and attributes his longevity to his faith, being a vegetarian and his motto: “Live a long time, but don’t get old in the process.”
Join Care Partners as a Hospice Nurse!
This position has been filled.
You are a highly motivated nurse who takes pride in providing excellent care to patients and family members. You enjoy working both independently and as a member of a cohesive team of dedicated interdisciplinary professionals. You enjoy the challenges of caring for the elderly and individuals living with serious illnesses. You like to empower, educate and support caregivers. You enjoy performing physical and psychosocial assessments, developing care plans, thinking on your feet, creating order out of chaos and solving problems creatively. Bringing comfort to others makes you happy. For you nursing is a calling, not a job. You want to work for an organization that is motivated by mission, that recognizes and values your engagement and voice, that believes that high performing nurses are a necessity not a luxury. You believe that death is not a medical experience, but a human one. Providing holistic, body-mind-spirit care is second nature for you.
We are one of Oregon’s oldest, community-based not-for-profit hospices. We value nurses. They are the back bone of our organization. We care for patients throughout the Portland metropolitan area in home and long-term care settings from 2 offices. A majority of our patients have a cancer diagnosis. We provide home-based palliative care through strategic partnerships with progressive health insurers. We are constantly innovating to make Care Partners the best place to give and receive care. We have a calling to comfort. We mentor. We make every day the best day for our patients. We invite you to check us out in person or on-line at www.carepartnersor.org.
Hospice Nurse Position Responsibilities
The hospice nurse working the evening shift assists with patient admissions and other urgent care needs working with a team of triage nurses and case managers. Provides skilled nursing assessment, planning and coordination/care management across settings to patients in a private home, adult foster home, residential/assisted living care, and/or nursing facility. Maximizes the comfort and health of patients and families consistent with our philosophy, policies and procedures. Maintains up to date patient records so that problems, plans, actions and goals are accurately and clearly stated and changes are reflected as they occur in accordance with policies and procedures.
- Requires current Registered Nurse (RN) State of Oregon license prior to first day of employment.
- Prefer one- two years of nursing experience, preferably in hospice, palliative care, home health or medical surgical care.
- Requires well developed critical thinking, patient assessment and problem solving skills.
- Requires the ability to work independently and as part of an interdisciplinary team.
- Requires strong verbal and written communication skills and familiarity with use of an electronic medical record
- Must have a valid driver’s license and access to a reliable automobile to travel to and from patient homes.
- Basic Life Support CPR card for Health Care Provider. Valid card must be obtained prior to patient contact and within two weeks of hire.
- Certification in Hospice and Palliative Care Nursing is helpful.
- Must pass a background check and drug screen following a job offer.
To apply for this position please submit your resume along with a brief letter describing why you are interested in working with Care Partners to Director of People Services, Ciara Rogers, email: firstname.lastname@example.org.
While many people look forward to yearly holiday traditions, gatherings with family and friends and the general good feelings associated with the season, some people dread the holidays. For those who have lost a loved one during the past year, the holidays may emphasize their grief.
The holidays, especially the first ones after losing a loved one, are especially difficult for people who are grieving. Often, friends and family members of those affected by a loss are unsure how to act or what to say to support their grieving loved one during the holiday. Below are some helpful tips:
- 1. Be supportive of the way the person chooses to handle the holidays. Some may wish to follow traditions; others may choose to change their rituals. Remember, there is no right way or wrong way to handle the holidays.
- 2. Offer to help the person with baking and/or cleaning. Both tasks can be overwhelming for someone trying to deal with raw emotions.
- 3. Offer to help him or her decorate for the holidays.
- 4. Offer to help with holiday shopping or give your loved one catalogs or on-line shopping sites that may be helpful.
- 5. Invite the person to attend a religious service with you and your family.
- 6. Invite your loved one to your home for the holidays.
- 7. Help your loved one prepare and mail holiday cards.
- 8. Ask if he or she is interested in volunteering with you during the holiday season. Doing something for someone else, such as helping at soup kitchens or working with children, may help your loved one feel better about the holidays.
- 9. Donate a gift or money in memory of the person’s loved one. Remind the person that his or her special person is not forgotten.
- 10. Never tell someone that he or she should be “over it.” Instead, give the person hope that, eventually, he or she will enjoy the holidays again.
- 11. If he or she wants to talk about the deceased loved one or feelings associated with the loss, LISTEN. Active listening from friends is an important step to helping him or her heal. Don’t worry about being conversational…just listen.
- 12. Remind the person you are thinking of him or her and the loved one who died. Cards, phone calls and visits are great ways to stay in touch.
Source: The National Hospice Foundation and the National Hospice and Palliative Care Organization