Community Care Connection
The holidays aren’t the only time for giving. Year in and year out, nurses, social workers, case managers and hospital staff dedicate their days to providing comforting, dignified end-of-life care to terminal patients.
December 16th, 2013 by: Lianna Patch
“At a time when people are terrified, confused, angry and fearful, we provide resources and answers to bring them comfort.”
-Chris McMahon, Passages Hospice & Sanctuary
All About Support
Working hand-in-hand with hospitals, hospices fill a pivotal role in guiding families and patients through the end-of-life process. Chris McMahon, CEO of Passages Hospice and Sanctuary in Uptown New Orleans, explains how Passages social workers ease patients’ transition into terminal care by providing support, resources and solutions to families in crisis.
“A terminal diagnosis has a way of bringing out the best or the worst in people,” says McMahon. “At a time when people are terrified, confused, angry and fearful, we provide resources and answers to bring them comfort.”
Passages social workers offer onsite liaison support to local hospitals, focusing on maintaining a high level of patient services and support. Along with home care, Passages provides compassionate support and medical care for those with terminal or life-limiting illnesses in an upscale, 16-bed inpatient facility.
Patients often find comfort in the option to spend their final days in a calm, supportive environment. “Because we have our own facility, we’re able to make the transition with much more tranquility,” says McMahon.
McMahon notes that hospice care is also about supporting a patient’s family and loved ones. To that end, Passages offers counseling resources and bereavement support.
“I’m very passionate about making sure my patients have everything they need and making their wishes come true.”
-Ada Marion, St. Tammany Parish Hospital
A Gift of Care
During high school in Covington, La., Ada Marion belonged to a club that visited nursing homes once a week. That’s when she fell in love with the elderly. “It’s a population that does not get enough respect,” she says. “Our society puts such emphasis on youth and beauty.”
Now, Marion is a social worker specializing in hospice care at St. Tammany Parish Hospital. “I felt drawn to the patients because they still so much need touch and socialization,” she says. “They need to sit, and talk and tell their stories.”
Marion works with clients and families in their homes, as well as at local nursing homes. Along with anticipatory grief counseling, she provides emotional support for patients and their family members. Guiding grieving family members who may be in conflict with each other can be a tricky path to navigate. “Sometimes it’s challenging for family members who don’t understand this process,” she says.
Marion admits her job is emotionally taxing at times. Some patients are simply not financially equipped to handle end-of-life expenses, and it can fall to her to deal with things like making sure a patient has electricity and food to eat.
“I’m very passionate about making sure my patients have everything they need and making their wishes come true,” says Marion, who has worked at the hospital for almost four years. “I sometimes say that I ‘beg, borrow and almost steal’ to get my patients what they need.”
Recently, the last wish of one of her younger patients, a father with throat cancer, was to take his kids to a New Orleans Saints game. Marion arranged for tickets to be donated.
It’s cases like these when leaving work at the door can be a challenge. “I have to debrief before I go home,” Marion says. She was recently nominated for—and won—St. Tammany Parish Hospital’s Ambassador award for her work.
“Patients and their families don’t care how much you know, how many degrees you have. They just want to know that you care about them.”
-Richetta Black, Slidell Memorial Hospital
Richetta Black, RN, is a case manager in the oncology unit at Slidell Memorial Hospital. Growing up in New Orleans, Black “always wanted to serve and help people,” she says. She began her medical career as an orthopedic nurse at Charity Hospital, eventually gravitating toward oncology.
As a case manager, Black’s role is to discuss end-of-life processes and decisions with patients and their families. She strives to give patients control over where and how their lives will draw to a close.
“Once doctors broach the conversation about end-of-life care, you can only imagine that [it raises]
a host of questions for patients and families,” Black says. “What’s rewarding is that once that conversation has been had, the patient can be involved in making the end-of-life decisions. [Not] everyone gets the opportunity to have a say in how their life will end.”
Along with hospice representatives, Black focuses on easing the anxiety of patients and families. She addresses issues that can be difficult for families to bring up with their loved ones, such as wishes for funeral services, burial locations and legal considerations.
In working with end-of-life patients, ranging in age from as young as 25 years old on up, Black sometimes needs a moment to compose herself.
“There are times when I’ve gone to my office and had to cry—walk out of the hospital, and walk around the block and cry,” she says. “It goes without saying that it is an emotional time. At the same time, I think what’s rewarding to me is that my emotions lie with the patients and the families.”
Having worked with many end-of-life patients over the course of her career, Black describes herself as “more comfortable” with the idea of dying than she used to be, but says each case poses unique emotional challenges. “It doesn’t matter how many times I’m involved; each case is a new case,” she says.
“We’re trying to walk the line between knowing what the patient truly wants, which is paramount, and where the family is at and what they can actually do to help.”
-Stacey Adams, Touro Infirmary
Stacey Adams, LCSW, pursued social work after a period of transformation that included the loss of several family members and a divorce. Adams, originally from Topsfield, Mass., enrolled at the Tulane University School of Social Work in the fall of 2003 with the goal of earning her master’s degree in social work. Her studies at Tulane included an internship with River Region Hospice. “I knew I wanted to do medical social work,” Adams says, citing a desire to help families remain intact and move positively through traumatic diagnoses and the pain of loss. “I didn’t realize that there are as many choices for end-of-life issues for the patient and family as there are at the beginning!”
When Hurricane Katrina hit, Adams continued her master’s degree studies in Topsfield, eventually returning to New Orleans. She completed her internship at Touro Infirmary, where she has worked since 2006.
Along with seeing chronically ill patients, Adams works with end-of-life patients, including those in Touro’s oncology ward.
In this role, “The challenge is assessing the patient and the family—where their hearts and heads are,” Adams says. “There are so many different variables: for instance, if a patient is ready and a family is not.”
Adams’ day-to-day routine involves visiting patients and getting “snapshots” of their lives before they arrived in the hospital. With end-of-life patients, her goal is twofold: to follow through on a patient’s wishes, and to help both patients and families understand the process
of letting go. “It is one of our goals to get the family to come up with a plan,” she says. “We’re trying to walk the line between knowing what the patient truly wants, which is paramount, and where the family is at and what they can actually do to help.”
When a death goes badly or is unplanned for, Adams says, families can lose their center.
“All those silences start—those closed lines of communication,” she says. She sees her role as helping bereaved families figure out how to move forward.
“To me, it’s nothing but spiritually fulfilling [and] emotionally fulfilling,” Adams says, reflecting on her work. “I’m dedicated to figuring out how to support families through this process.”
“The type of job that I do from day to day takes time, patience, organization and compassion.”
-Patricia Brown, West Jefferson Medical Center
Nurturing and support have earned Patricia Brown her role as lead social worker at West Jefferson Medical Center.Patricia Brown, lead social worker at West Jefferson Medical Center, has focused on helping others since her school days at John Ehret High School. “In high school, I was the one who broke up the fights, stopped the arguments,” says Brown, who grew up in the Marrero area.
Brown’s compassion led her to earn her master’s degree in social work from Southern University at New Orleans. After graduating, she worked for a grant-funded program that focused on supplying community resources to women trying to get back into the workforce.
Six years after starting at West Jefferson Medical Center as an entry-level social worker, Brown became the hospital’s lead social worker. In November, she marked her 13-year anniversary at West Jeff. Brown primarily works in labor and delivery, offering counseling for postpartum, NICU and bereavement, as well as adoption assistance. She also works in end-of-life care, helping patients and their families to understand the diagnosis and their options.
Brown’s toughest challenge in caring for end-of-life patients is when family members are “not on the same page, and you have a split decision,” she says. She urges patients and families to consider their wishes before the need arises. “You don’t have to have a terminal diagnosis to have a power of attorney,” adds Brown, who also counsels her coworkers through bereavement and emotionally trying cases.
On the flip side, Brown finds it rewarding when end-of-life patients know what they want and have completed the necessary documentation. “It’s refreshing, knowing that all of their wishes were carried out,” she says.
Brown enjoys the “family camaraderie” within her department. “The type of job that I do from day to day takes time, patience, organization and compassion,” she says. Though she has no plans to leave West Jeff, her personal goal is to complete her LCSW certification.