Hospice at its caring work

By Susan Vaughn - August 17, 2006

Linda McGuire and Margaret Oliveira are two among hundreds of beneficiaries of the services of Hospice of Martha's Vineyard during its 25-year tenure. Both had nothing but praise for the help and support they have received in dealing with the difficult experience of a loved one's advanced illness.

"I do not have enough kind words to say about hospice," said Ms. Oliveira of Oak Bluffs, whose mother, Mildred Rocker Gonsalves of Tisbury, has been receiving hospice care for more than a year since she was diagnosed with cancer. "They are a wonderful group of people, like extended family," she said.

Ms. McGuire of West Tisbury called the experience with hospice for her and her late husband, Dennis McGuire, "incredible.... It made all the difference in the world." Mr. McGuire was 71 when he died in May 2004. He had suffered from congestive heart failure and an enlarged heart for years and was under hospice care several months before he died.

Ms. Oliveira, the oldest of six children, emphasized how her entire family, including grandchildren, have benefited from the island's hospice services. "We all had things to deal with," she said when her family learned that their mother had Stage 4 colon cancer fourteen months ago and was given four to six months to live.

"It was devastating," Ms. Oliveira said. She and her siblings had no idea how to deal with the diagnosis, the medical terminology, and care-giving. The hospice nurses helped the family and her mother understand the medications in simpler terms than the doctors were able to do, she said. Their nurse, Ann Ledden, also met with the entire family before one of their mother's surgeries and explained what was going to happen.

Ms. Rocker Gonsalves received counseling to help her deal with the illness and understand why she was having strange dreams, Ms. Oliveira said. The caregivers also talk to their mother about preparations for dying, which Ms. Oliveira said she was not comfortable doing. The nurses and counselors also have helped her with the difficult subject of death.

"They make me face things I'd rather not," Ms. Oliveira said. She said she can now more easily talk about death and terminal illnesses with her family and friends who have had similar experiences.

The hospice counselors and volunteers also help Ms. Oliveira's 12-year-old daughter understand what is going on with her grandmother. Ms. Oliveira described her mother as the true matriarch of the large family and an "active, young grandmother of 66," who worked full time and has been very involved in her children's and grandchildren's lives.

Ms. Oliveira said it is "miraculous" that her mother has defied her initial diagnosis and can still live at home alone. She even baked chocolate chip cookies recently. The hospice nurse checks on her once a week and volunteers will take her out for a ride, because she cannot drive anymore.

Ms. Oliveira said she feels comfortable calling on any of the hospice staff whenever she has questions or concerns.

"They are very professional and upbeat," she said. "I don't think I could do it without them."

Similarly, Ms. McGuire said she learned about care giving and much more from the hospice staff, adding that there was always a lot of humor involved. "It was very light," she said. "It was a very cheerful, wonderful thing."

That attitude and the way hospice nurse Cathy Brennan gradually worked into her role with Dennis McGuire were most helpful, Ms. McGuire said, because her husband was resistant to any outside help at first. "It was casual, not about death," she said.

Eventually her husband accepted Ms. Brennan and other hospice caregivers into their home. Mr. McGuire also opened up to a male hospice volunteer, Bill Hall, who visited regularly. She said he could grumble with him and say what he felt like doing or not doing that day. "It gave him an element of control," she said.

Although the McGuires did not discuss his impending death in depth, the presence of hospice workers helped them both, she said. She described the hospice staff as "very finely tuned" to the progression of a patient's illness.

"We spend all of our lives thinking about living," she said. "When you're dealing with death and what they're doing for you, you're seeing life in the perspective of death, a new perspective. It ultimately gives you a new lease on life in a way. I find that very comforting."

Ms. McGuire said her husband knew what was going on when the end was near. "He was ready."

After he died at 5 a.m. on a May day, Ms. Brennan was at their home by 6, taking care of arrangements and making phone calls. "It was truly a unique and wonderful experience," Ms. McGuire concluded.