By Mary Faulds, AFA Journal staff writer
November-December 2009 – John just heard the news. “Terminal colon cancer,” the doctor says grimly. “You may have six months to live, best case scenario.” John’s wife, Lisa, weeps quietly. John sits there, not knowing what to say, but words fall from his mouth. “What do we do next?”
The doctor suggests John and his wife check into some hospices. “They’ll take care of your pain,” he says, “and you’ll continue to be able to enjoy the things and people you love.
Lisa, a devout Christian, finds a nice hospice with good inpatient care and lovely facilities, but most importantly, a strong witness for Christ. John isn’t so sure, but he’s not the one who is going to be left alone, so he agrees.
At first, the hospice staff bonds with John. Lisa and their grown children. They talk of fun vacations and old times while the nurses refill John’s IV with pain medication. One Sunday John talks of going to church with his mom as a kid. “She always found such solace in Jesus,” he says. The nurse, taking a cue, asks John if he would like to pray. He says yes, and humbly turns to Christ in saving faith.
It doesn’t take long for the disease to progress, and soon John spends most of his days unconscious or incomprehensible. The hospice staff continues John’s pain control, but they also help the family come to grips with John’s impending death. They pray, they comfort, and they cry with Lisa and the children.
Lisa tells her sister after John’s funeral, “I knew that seeing John go would be horrible, but having the hospice staff with us was like seeing Jesus in person every day.”
History of hospice
Hospice, or care for the dying, has been around since the Middle Ages, but modern day hospice care was only established in the mid-1950s. Dame Cecily Saunders founded the modern hospice movement when she started St. Christopher’s Hospice in South London, England.
As a Christian, she knew compassionate care didn’t simply require pain medication. She started the modern principle of treating a saying patent’s “total pain,” meaning physical, psychological and spiritual aspects. She also realized that part of caring for a terminally ill patient meant caring for the family and their needs as well. Her work inspired Florence Wald, a dean at Yale’s School of Nursing, who then went on to found modern hospice in the U.S.
Heart of hospice
Dr. James Avery, a spokesman for the Christian Medical and Dental Associations, is the chief medical officer of Golden Living, a for-profit company that owns hospices and nursing homes across the country. Avery said he became involved in hospice in 2000 and this kind of service is one that is a wonderful way to show Christian love.
“I was in a private office as a pulmonologist, and I was trying to do more whole person medicine. As a born-again Christian, I was trying to figure out how to do this, how to do more dimensional than just physical.”
Avery said he read how Dame Saunders was a strong Christian, and treating the whole person was her philosophy. “People at the end of life need more whole person care than those that are normally sick.” he said.
He said when he was offered a position with a hospice in Clearwater, Florida, he brushed it off at first. But he said the Lord soon opened the doors and it seemed like a great opportunity. “I really felt that this was a calling that I had,” said Avery, “that it was something that met my strengths and met the needs of the patient. Sort of like you are meeting the physical need, but taking care of the spiritual ones became more obvious.”
Avery said a hospice colleague, Dr. Ira Byock from Dartmouth University, really hit the heart of the ministry of hospice when he listed five things all patients want to say before they die to bring closure to their families.
“‘Please forgive me;’ ‘I forgive you;’ ‘Thank you;’ ‘I love you;’ and ‘Good-bye.’ If you think about those things, the first two are forgiveness. That right away begins you in the spiritual realm in many ways. Then gratitude and the whole concept of love, and good-bye, saying, “I’m going to a different place.’ I have often found that these five things open up a spiritual dimension in people who would otherwise say they were not spiritual or religious.”
Avery said he has been amazed by ow people at the end of life are much more open to spiritual matters. “I was able to pray with people who I was working in hospice in New York City. You know, that’s not the Bible Belt, and I was surprised by the number of people who would say yes, when I would ask if i could pray for them.”
Another aspect that surprised Avery was the fact that his colleagues were no depressed by constantly dealing with the dying. “It is sad at times, and it is sad frequently,” he said, “but most people have found it helps them to live better. The physicians that I’ve worked with, many non-Christians, say, ‘You know, just dealing with people who are dying helped me to realize what was important in life.’”
Health through hospice
Many seem to have the perception of hospice as “giving up on live,” but hospice care may actually prolong the lives of some terminally ill patents. In a recent study published in the Journal of Pain and Symptom Management, the mean survival was 29 days longer for hospice patients than for non-hospice patients. In other words, patients who chose hospice care lived an average one month longer than similar patients who did not choose hospice care. The largest difference in survival between the hospice and non-hospice courts was observed in congestive heart failure patients where the mean survival period jumped from 321 days to 402 days.
At the same time, hospice may be healthy for the economy as well. According to the National Hospice and Palliative Care Organization, the findings of a major study demonstrated that hospice services save money for Medicare and bring quality care to patents with life-limiting illness and their families. Researchers at Duke University found that hospice reduced Medicare costs by an average of $2,309 per hospice patient. Additionally, the study found that Medicare costs would be reduced for seven out of ten hospice recipients if hospice had been used for a longer period of time.
Help for hospice
All hospice organizations receive funding from Medicare. However, hospice is unique in the fact that volunteer hours are required as a condition of participation in getting those federal funds. In fact, at least 5% of all patient care hours must be volunteer time.
Because of that requirement, Avery said hospice organizations are always looking for volunteers to help. Volunteers can really minister to the patients in a variety of ways. They can simply sit with the patient while family members go shopping or just get some much needed rest time of their own. They can also spend time with the patient talking, listening to music, playing a game, whatever the patient or family wants to do.
“We had one man who liked to play chess and he met up with a patient who liked to play chess,” said Avery, “and that was the highlight of his week, when this college student would come and play chess with him.”
Avery said with the growing elderly population there are more and more needs for volunteers in hospice and nursing homes. “Almost every nursing home needs volunteers, where people will say, ‘How can I help?’ Bring people to the dining room, or just take them outside for a moment. It’s a great place, I think, for the churches to really help folks in hospice and nursing homes by being volunteers.”
What about the person who is not really a “people person” but would still like to serve the dying? Direct patient care is where most volunteer hours are given, but two other areas need volunteer work.
The first is providing clerical services for the medical staff at the hospice. Taking care of some paperwork gives the staff much needed assistance and allows them to better focus on the patients. The second is helping with fundraising. Although the tide has turned and many hospices now are for-profit agencies, many are sill supported by donations and Medicare. People with a gift in donating or rallying others to donate will find that they can also serve those in the last stages of life. 
The Next Step
With over 2,000 hospices across the U.S., those looking to serve as volunteers with one should have no trouble finding one under “hospice” in the telephone book. However, the National Hospice and Palliative Care Organization also has a search engine on its Web site. (www.nhpco.org, 703-837-1500)
