Hospice Care: ‘A higher quality of life’
Grand County, CO Colorado
Lisa Wild enters people’s lives at one of the most intense moments any of us can imagine. A registered nurse, Wild works for Heart of the Mountains Hospice in Grand County, and when she’s called, it’s because somebody has been told they have less than six months to live.
Her patients suffer from a variety of diseases -cancer, heart disease, dementia, old age – but the discussions she has with them during that first meeting are invariably difficult.
What do you want to get out of the time you have left? What do you want your quality of life to be? If time becomes short, what is most important to you?
“People think of Hospice as a death sentence,” Wild said. “I like to think we are providing a higher quality of life.”
Hospice is in the business of helping people die well. Its staff are advocates for the patient. They understand – better even than many doctors – how to make a terminally ill patient comfortable. They understand what medicine is necessary, how to adjust the bed just right, and even how important a weekly hairdo can be.
“There’s a fine line between making somebody comfortable and helping them reach other goals,” Wild said. “It’s not just about treating the physical suffering. If they can’t go out and sit on their riding lawn mower once a week – and that’s what they really want to do – then they are suffering from a different kind of pain. Sometimes it’s worth living with a little more pain so that you can still do the things that are most important to you.”
It’s this focus on quality of life that seems to make such a difference for Hospice patients, which is perhaps why so many of them seem to defy the odds.
“I’ve had people who were told by a doctor that they only had weeks to live, who ended up on Hospice for a year. I’ve even had people do so well that they don’t qualify for Hospice any more.”
Wild said that its the being at home in one’s own natural environment that makes the biggest difference.
“It’s one of wonderful things Hospice does, we care for people right there in center of their lives.”
On average, Wild has four to five patients she’s working with at any one time, spread out across Grand County. Once a week, she visits them, whether at their condos, ranches, senior living facilities or long-term care hospital beds.
She’ll sit down at the kitchen table with them, check their vitals and ask about meals, pain levels and medication.
“But, most of all, I just visit with them,” she said. “I don’t want to get too caught up in listening to heart sounds because then I’m not listening to the patient.”
She asks them what they have done since they last saw each other and discusses goals for the next day or week.
“We have a lot of really tough conversations,” she said.
There is an overwhelming amount of anxiety that comes with a terminal illness, and part of Wild’s job is to help her patients negotiate that anxiety – anxiety about death, suffering, loved ones and finances.
Sometimes Wild asks patients about their funerals. What music will be played? Who will speak?
“Just initiating that conversation lets people know it’s OK to talk about those things,” Wild said. “When I leave, people start talking about it more on their own and then the next week we’ll talk about what they decided.”
When Wild starts noticing things declining, certain changes that let her know the end is near, she’ll ask the most difficult question: What do you want these last few weeks to look like?
“It’s a very hard, very tearful conversation,” she said.
Which, begs the question: How does she do it time and time again. Because the outcome is certain for Wild – her patients are all going to die.
“I work with an awesome team that really helps me,” she said.
The Heart of the Mountain Hospice staff includes Executive Director Joan Gaskins, medical directors Randi Wagner and Rick Bortz, nurse Carol Kelly, a psychologist, a social worker, volunteer clergy, four part-time nurses and a small bevy of volunteers who have helped more than 160 Grand County families in whatever way is best – from assisting with showers and dusting the house to walking the dog or sitting and reading a book to a patient while the caregiver runs errands.
“What keeps me going is that this job is really rewarding,” Wild said. “I feel that I am really helping people and their families at an intensely emotional time – when they don’t know what to do or how to act. I feel blessed that these people allow me to be a part of their lives at those times. It’s an honor.”
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