Hospice provides more than a peaceful end
By Nick Tabor, New Era Staff Writer
Kaye Pugh says her mother, Nancy Walker, has wanted
pampering since Pugh was a little girl.
Though Walker
married a farmer, John Walker, she preferred shopping for purses or shoes over
spending time outdoors. Dirt didn’t suit her clean, tidy sensibilities, Pugh
said. Whenever Pugh and her siblings came in with red clay dirt on their
clothes and in their fingernails, they knew she would scold them.
After Walker
retired from her sewing job at Hopkinsville Clothing Factory, and after her
husband stopped working at Thomas Industries, he would rise early and fix her
breakfast.
John Walker died in 1994. For years afterward, Walker lived alone in
their farmhouse on Gary Lane.
Pugh often called two or three times a day to check on Walker, and Pugh’s
brother stopped by almost every morning to check on the farm — often while
their mother still slept.
Around 2002, after several back surgeries, Walker started falling in
her house. She left the farm property and moved back and forth between the
houses of Pugh and Walker’s
other daughter, Faye Thomas.
Her health continued declining as she entered her
80s. In June of last year, on a Thursday at Thomas’ house, Walker’s chest seized up and she couldn’t
breathe. She could hardly speak. Thomas gave her CPR and called an ambulance.
A doctor at Jennie
Stuart Medical
Center determined Walker had chronic obstructive pulmonary
disease, meaning damage to her airways was interfering with the exchange of
oxygen and carbon dioxide in her lungs. No treatment could reverse the damage.
The doctor said Walker’s
heart was beating at 30 percent of the healthy rate.
She would probably die, the doctor said, in three to
four weeks.
A social worker told the family about Pennyroyal
Hospice. Contrary to most people’s impressions, she said, hospice staff didn’t
limit their scope to the comatose and those just a day or two from death. A
month wasn’t too early to start using their services, she said. Anyone diagnosed
with a terminal illness could qualify.
Since the family showed interest, a Pennyroyal
Hospice employee visited to tell them more. Hospice services were usually
funded by Medicare, Medicaid and private insurance. Sometimes hospice workers
could help patients fulfill their final wishes: visiting the mall, eating at a
favorite restaurant, going fishing. Once Pennyroyal Hospice treated a patient
with a brain tumor for six years until the tumor went away. For all that time
the hospice helped him fight to stay alive.
In short, the worker said, the hospice aimed to do
more than palliate the death experience. It aimed to help patients live better.
With time running out to remove Walker from the hospital, due to insurance
limitations, the family considered its options. They could send her to a
nursing home, or they could bring her back home and let Pennyroyal Hospice take
over.
They chose hospice care.
---
The day Walker
returned home, hospice staff brought in a portable oxygen tank and a hospital
bed.
Tiffany Craft, who had joined Pennyroyal Hospice a
month earlier after working for a year at Jennie Stuart, took charge of Walker’s case. She
brought in a social worker to help with non-medical needs: insurance contacts,
coaching on preparation for death, comfort during difficult times.
The hospice’s chaplain began visiting periodically.
A music therapist came and helped Walker
play with a keyboard.
And Walker
received a personal aide who attended every weekday to bathe and clothe her,
check her vital signs, and fix her hair.
Meanwhile, Craft visited every week to examine Walker and keep the
family abreast.
---
Last week, about 10 months after Walker received her terminal diagnosis, Craft
pulled into Pugh’s driveway on a sunny morning and went to the side door. She
looked forward to her visit with Walker, whom the hospice workers call “Miss
Nancy” and count among their favorite patients. At 87, Walker was one of only two patients Craft
received during her early months in the job who were still alive.
Pugh let her in. They stood in the kitchen, Craft
scribbling notes and Pugh drinking a Diet Coke.
“How’s she been sleeping?” Craft asked.
“She sleeps really good.”
“Did you get the new sleeping medicine for her? Has
she had it?
“Yes. She slept all night all week.”
Craft asked whether everything was all right with Walker’s personal aide.
“Oh, wonderful,” Pugh said, chuckling. “That girl,
she’s the best in the world.”
Craft looked up from her notebook. “Is there
anything you want us to do differently? Or anything we’re not doing that you
think we should do?”
Pugh said the staff had treated her family
wonderfully. Then she led Craft through the house, to the bedroom where Walker sat in a chair
wearing a blouse and slacks. Her daughter-in-law had fixed her gray hair earlier
that morning. The framed artwork above her seat depicted the Cerulean Springs
hotel, now only a memory of Walker’s
hometown.
Craft spoke over the hum of a humidifier.
“You are just all fancied up,” she said. You got
your hair fixed, you got your rings on. I think you need to go out on the town
tonight.”
Walker answered in a quiet rasp:
“I don’t think so. I can’t walk.” There was humor in her voice.
Craft inquired about Walker’s coughing, then about her recent
difficulty breathing. Walker had been on roughly
three antibiotics in two months’ time, Craft said, so she had to be honest: Another
antibiotic might not solve Walker’s
problem. But breathing treatment and the humidifier should help. Meanwhile, was
Walker taking
pain meds when her hands hurt?
“I don’t ask for it,” Walker said.
Craft lectured her gently.
“Remember how we talked about your pain and
breathing, how everything kind of goes hand-in-hand?” she said. “If you’re
hurting, and you don’t take anything for it, what’s that going to do? It gets
you kind of anxious and worried, and that messes up your breathing.”
Before Craft left, the women talked about getting Walker outdoors after
allergy season. Walker
said she last went outside last year.
---
Visits from hospice workers give Walker something to look forward to, Pugh
said. Between visits she fills out crossword puzzles and watches “The Young and
the Restless,” and if she naps through an episode, Pugh records it so Walker can catch up in the
evening.
The family still pampers her, Pugh said.
Walker keeps a golden bell between
her bed and her easy chair. She rings it when she needs help from the family.
But occasionally she has said “Call,” which Pugh takes as a code: It means Walker’s airflow has
stopped and she wants all her children at her bedside. Pugh’s three siblings
have rushed to the house.
Each time Pugh’s siblings have rushed to her
bedside. But she has recovered within a few days.
Pugh suspects that in a nursing home, without this sense
of the hospice staff and the family fighting for her, Walker wouldn’t have made it this far.
In her children’s view, her will power keeps her
alive.
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