HOSPICE: BRINGING CARE FOR THE TERMINALLY ILL BACK HOME

Faced with a terminal illness, a growing number of patients prefer living out their days in the comfort of home rather than within the sterile confines of a hospital or nursing home.

But the mental and emotional strain of caring for a terminally ill loved one can take its toll on family members.

That's where Cape Girardeau area hospices come in.

As in days past, hospice programs are designed to permit terminally ill patients to reside at home in their last days.

Physicians, registered nurses, social workers, pastors and volunteers all work together in the hospice to provide for the physical, social, emotional and spiritual needs of the patient and his family.

Charles and Dixie Hopkins of Marble Hill spend a good deal of their free time working as volunteers for the Southeast Hospital Hospice.

Dixie's been a volunteer since 1989. "I started helping out, because I was looking for a meaningful caring ministry," she said. "I find that it embodies Christian service.

"I have felt a calling to give my time to people who are faced with an impending death in the family, and I find it rewarding to be able to give them something."

Charles began to work with the Hospice to help out his wife. Since then, he's received extensive training -- as all hospice volunteers do -- and is a regular volunteer.

"You do it because someone is in need, and we're in a position where we can devote our time to it," Charles Hopkins said. "After you get in with the family, it's so rewarding because they're so thankful that you're able to give any help."

Judy Aslin is director of hospice services at Southeast Hospital. She said the hospital started the service in 1986, and it's grown steadily since.

The Southeast Hospice earned Medicare certification last July, which enables the hospice to provide more benefits to a greater number of patients.

The Medicare hospice designation permits coverage for medications and equipment needed to manage the patient, social and spiritual counseling, nursing and home health aid services, volunteer and homemaker services, private duty nursing services, respite care, acute care in a hospital setting should the need arise, and bereavement services for the family.

"It seems to be coming full circle," Aslin said. "People used to take care of the terminally ill in their homes, but with the onset of some of the high technology in the medical field that care moved into the hospitals.

"Now there seems to be a switch back to the homes."

And although the service is aimed at benefiting the dying patient, much of the focus is on the surviving family, Aslin said.

"Our counseling is there for everyone," she said. "But it seems to focus on the family and how they're going to function after the death."

Southeast Hospice follows the family with counseling and care for 13 months after the patient's death.

"We also get local ministers involved in the process," she said. "It's really a comprehensive approach to care."

The Visiting Nurses Association also provides hospice care for patients in Southeast Missouri.

Vicki Moore of Sikeston is the VNA Hospice coordinator. She said the VNA has provided home health care in Southeast Missouri for the past 20 years, but only recently (in June) started a hospice.

"We focus on a holistic approach to care," Moore said, "not just the physical, but the spiritual and mental well-being of the patient."

The care is provided through teams of medical, pastoral and social workers. As with Southeast's hospice, volunteers are the key to the success of the VNA program.

"That's the unique thing about hospice," Moore said. "It's just people out of the community that might go in and sit with the patient while the care giver is away. In hospice, we focus on making the last days of life as pain free and comfortable as possible."

Moore said it's important for volunteers and the family of a dying patient to realize that death is merely the final stage in the process of life.

"What we focus on is telling them that this is the natural progression of life," Moore said. "We're all going to die, and our volunteers -- anybody -- will have a wealth of experience in their own lives to draw from to help bring that point across."

She said many of the volunteers provided hospice care to their own family members before working for the hospice.

As selfless as volunteering to provide hospice help is, Moore said most volunteers confess that it's not that difficult.

"A lot of times, they'll just sit and talk with the patient about the `good old days,'" she said. "They can just reminisce with them, and it helps.

"We rarely lose volunteers once they come into the program, because it's so rewarding."

The Hopkins' agreed.

"Of course, there's an emotional void with the passing of someone who quickly becomes a friend," said Charles Hopkins. "But we feel like it's their release. They've gained their reward that they've been looking forward to."

Dixie added: "It's helped me to come to terms with my own mortality. I find that I receive more of a blessing than the person I'm trying to help."

"The big part of hospice is knowing that someone is out there who they can call," said Moore. "We can't do it all, but we are there to help them."