Hospice Is About Living
Posted by Katie Horton, APN
As a palliative care nurse practitioner, I get an opportunity to meet a variety of patients that are at differing stages of their lives. A new patient, who I’ll call Caroline, recently taught me that we should never ever make up our plan of care before we meet the person.
What I read about Caroline made me think I was about to meet somebody who was dying.
She was in her late 90s. She had cancer. She had metastasis in her bones. She had significant weight loss. She had multiple comorbidities (several diseases simultaneously). She had pain.
My plan was to meet her and the family, develop a rapport and transition her to hospice so she could get the care a person needs when she is dying.
But when I walked through the door and met Caroline, she was sitting up in her favorite chair in her beautiful sunroom, overlooking a garden and bird feeders.
She was wearing a pressed shirt and skirt with nylons and had her heels on. She was doing a cross-stitch — and not just any needlework but a beautiful depiction of all the different American flags through the years. It was a work of art that she had been working on for months. She had a book by her side and discussed literature with me. She talked lovingly about her family, her great grandson, nature, the garden, and her needlework club. She described her life in detail.
She was living.
This inspired a huge change in my understanding of the difference between a patient you read about versus a patient you meet. Meeting Caroline and learning about her in person added a vital component to her plan of care. This helped me understand how hospice can not only help someone who is dying, but someone who is living. We could help her live better.
We used medicine to alleviate her pain so she could visit with her grandson. We used strategies to help her bowels so she could finish her flag piece. By providing support and education to her family, she was able to stay in her home.
Caroline finished the flag piece and her son-in-law had it framed and hung it in the sunroom above her chair. It is a piece of art that can be handed down and illustrates so much about her. The hard work, skillful technique and diligence she put into her needlework in her final month of life says a lot about Caroline and how she lived, and how she died.
Caroline was so full of life, even when she was dying. I know I will never forget her.