Another good article explaining it all: Hospice not just an end-of-life assistance | newarkadvocate.com | The Newark Advocate

"COPD" and "Hospice."

Those are terms Debbie Brewer, 58, has become all too familiar with.

COPD, short for chronic obstructive pulmonary disease, she grew up with -- and has lived with -- although it was only given a name much later by a diagnosing doctor.

The other term -- Hospice -- she will die with.

But for Brewer, hospice care has not been with her just at her end of life, but for more than four years.

Debbie was familiar with Hospice of Central Ohio because both of her parents, her husband's parents and several other family members have used the only not-for-profit hospice-care program in the county.

"I believe that hospice is a place you go to that allows you to pass away in a dignified manner, rather than in home moaning and groaning, not knowing what to do," Brewer said. "I can't imagine my life without hospice. I would be dead."

Linda Webster, the community relations coordinator for Hospice of Central Ohio, explains it is important to get people into the program early so the patient and family don't end up in a crisis.

With more time, the program is able to make sure patients receive the quality of care they deserve, including pain management, education for the family and help with advance directives, finances or funeral arrangements.

Hospice offers a team of people for each patient, including a medical director, registered nurse, hospice aide, social worker and chaplain. The program even has more than 200 volunteers who will come in to do odd jobs or practically anything that needs to be done.

"A study was done two years ago where they took two people with the same diagnosis, one in hospice and one not," Webster said. "The patient in hospice lived longer. Hospice focuses on the quality of life, and that is the big message. But (the word hospice) scares people."

Hospice does not just deal with patients with cancer, but any limiting illness, Webster said. All the care is free to the patient, and no one is turned away.

All of her life, Brewer had trouble breathing. She was told it was allergies, then bronchitis.

Eventually, she received the diagnosis of emphysema, which is a form of chronic obstructive pulmonary disease.

Because the symptoms of COPD develop slowly, some sufferers might be unaware that they are even sick.

It's been more than four years since Brewer called Hospice of Central Ohio, and she since has been more or less house-bound.

In addition to the team helping her, the hospice program also has been able to supply Brewer with a hospital bed, wheelchair, a portable toilet for her bedside and, most importantly, oxygen.

"They have done everything," Brewer said. "I don't know what we would have done without them."

"They don't do windows," her husband, Tim Brewer, said, teasingly. "But they do give you the quality of life that you deserve."

Brewer's nurse and case manager, Stacey Hartshorn, usually comes in twice per week. Right now she cares for 13 patients -- managing their care, pain management, checking on their medications, and sometimes playing chaplain and social worker. She sees each patient between one and three times per week, depending on their needs.

But above all, Hartshorn sees her job as being a friend to all.
All members of hospice wear many hats, she said.

"We don't cure people. We help them to achieve their goals for end-of-life care," Hartshorn said. "This is the only type of nursing I ever want to do. We treat the whole person and the whole family."

Hartshorn says this is not a job you can do if you don't have faith in God. She admits she does have to take the time to grieve and absorb the realities to replenish her reserves.

"You have to know there is a better place," Hartshorn said. "You help them transition from this world to a better place. You have to know that God is waiting for them on the other side."

But there also are many rewards for Hartshorn.

"The wonderful part is when you can relieve their pain and suffering for a little while," Hartshorn said. "It's an honor and a privilege to be a part of someone's life at such a delicate time. Dying is very personal. Everyone does it in their own way, and it's a privilege to be a part of that."

As Brewer's social worker, Ruth Robson visits Debbie about three times per month. Robson helps by offering emotional support to both the patient and family, which includes being a good listener.

She educates the family on the disease, can make referrals to community resources and assists with advance directives if necessary.

"There are days when this is a very challenging job, emotionally draining," Robson said. "But it is much more rewarding than what others may think. Sometimes we can do even the smallest thing and that may mean the world to someone else. At the end of the day, we feel like we have really made a big difference for someone else and that is so rewarding."

Robson is just one of the six full-time and two part-time social workers for Hospice of Central Ohio. Robson sees about 20 patients and families per month, but that number goes up and down.

"It is one of those jobs where I receive far more than I give," Robson said.

Rocky Fork Church of God Pastor Tom Myers also has been a hospice pastor for 15 years. His typical day might include visiting patients at home or in the Selma Markowitz Care Center on the top floor of Licking Memorial Hospital, receiving notes from nurses about a crisis that needs some spiritual support, or performing funerals.

"Because I minister to home patients, sometimes they don't always allow me to visit right away," Myers said. "Some people perceive that calling the preacher in is near the end."

Myers has been calling on Brewer the whole time she has been in hospice care.

Myers is one of four full-time and two part-time pastors for the program.
The job can be draining, knowing a patient you might have known for years is dying, but Myers sees the other side of it.

"God has called me to help nurture and talk to people trying to find peace and leave this world, preparing to the enter the next," Myers said. "It's an awesome honor to guide someone, tie up loose ends and talk about the anticipation of the next world. That is what fuels me. It doesn't cause me burnout. I get a sense of fulfillment knowing I am helping to lead somebody to the Lord, helping to give them spiritual direction and peace, knowing that the work we do pays eternal dividends.

Tim Brewer has been by his wife's side, tending to and caring for her daily, during these housebound years. Married for 37 years, the couple has two children, Nicole and Nathan, and two grandchildren. Tim's mother and aunt also are in hospice care, although they had to talk his mother into it.

"My mom thought it was an institution where you go to die," Tim Brewer said. "She changed her mind when she saw how well hospice treats Deb. Now she loves it (and has been in hospice care for three years). Hospice is our friend."