Roanoke Times
Copyright (c) 1995, Landmark Communications, Inc.
DATE: FRIDAY, April 1, 1994 TAG: 9404010210
SECTION: VIRGINIA PAGE: B-1 EDITION: METRO
SOURCE: LAURA WILLIAMSON STAFF WRITER
DATELINE: ROCKY MOUNT LENGTH: Long
Now 59, her bones brittle and crumbling from the uncontrolled growth of tumors in her arms and legs, Richards no longer worries about when she will die. Her doctor gave her six months to live - six months ago.
Richards simply takes life one day at a time, nestled into the home that her husband of 42 years built for them in rural Franklin County. She knows that she is dying. But she has plenty of people to help her face the inevitable.
Richards gets support from a team of hospice caregivers at Roanoke Memorial Hospital. She is one of about 150 patients who use the services of four hospices in the Roanoke and New River valleys on an average day. And she is part of a growing movement - a movement to help those who know they are dying to do so with dignity, in the comfort of their own homes.
"I don't know why I'm still here, but I am," she says, her body perched delicately on a plush, rose-colored chair in her living room, a hospice teddy bear in her lap and the first blue squares of an afghan she is crocheting placed neatly on the table beside her.
"I try to use my time and be thankful for it."
Keeping busy - whether it's crocheting afghans, reading books or taking drives in the country - is one thing that hospice workers encourage their patients to do. The team of registered nurses, chaplains and social workers also helps patients prepare their wills, select grave sites and talk about what it feels like to die.
More than 200,000 patients in the United States use hospice services each day, according to the National Hospice Organization. The movement has been growing in this country since 1974, when the first program for terminally ill patients was created in New Haven, Conn.
The hospice movement traces its roots to medieval times, when monks provided "hospice," or shelter, to those returning from the Crusades. Later, in mid-19th century Europe, homes providing comfort and shelter for dying people began to appear, eventually growing into the modern hospice concept.
There are 1,800 hospice programs in the United States. For nearly a decade, Roanoke Memorial offered the only program for the terminally ill in the Roanoke Valley. It was joined two years ago by Good Samaritan Hospice Inc. and last year by Housecall Hospice, all of which accept Medicare, Medicaid and private insurance. They also offer free services to people who cannot afford them.
A fourth hospice program, the New River Valley Hospice Inc., serves patients out of an office in Blacksburg.
The programs offer support for the families as well as the patient, said Linda Bryant, hospice manager for Roanoke Memorial. But people often resist the services because they don't want to acknowledge that death is near.
Largely because of Medicare requirements, hospice programs don't accept patients unless their doctors expect them to die within six months. All programs require a doctor's referral. Bryant said most patients they help are dying from cancer, but they also see those with Alzheimer's disease, AIDS and other terminal illnesses.
One man told Bryant he didn't want her help "because we represented the death angels," she said.
But that's not how she and other hospice workers see themselves.
"Hospice is not about dying," Bryant said. "It's about living until you die."
And many patients don't die within six months. Some live months, even years, longer. Sometimes they continue to receive services, such as personal care, pain medication or help running daily errands. Other times, as in the case of a 75-year-old Roanoke woman thought to be dying of abdominal cancer, they go into remission and "graduate" from the program.
When patients do die, hospice bereavement counselors help the surviving family members plan the funeral and deal with their grief. They will keep working with the family for up to a year after the death.
That process helps not only the family, but the hospice worker, said Therese Rando, a clinical psychologist and grief expert from Rhode Island. Rando was one of six panelists featured on a video teleconference shown Thursday at Roanoke Memorial and 850 other sites across the United States and Canada.
"We need to pay attention to our own losses," Rando told approximately 40,000 viewers, including about 75 clergymen, hospice and social workers in the Roanoke hospital's sixth-floor auditorium.
The two-hour seminar, sponsored by the Hospice Foundation and moderated by ABC News correspondent Cokie Roberts, was one way for hospice workers to come together to support each other, panel members said. Their discussions focused on ways for hospice caregivers to help patients and families - and each other - to grieve.
Hospice workers often need to do their own grieving, said Larry Jones, one of the nurses who works with Richards. After spending six months or more with patients, he said, caregivers can grow strongly attached to them.
"You get to know them fast," he said. "You get to hear lots of little things about them. They start telling you things that they may not tell their own kids."
by CNB