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Derek Frost, our chaplain, making a presentation during the Lunch and Learn at Gracepoint Church”

Fri, 29 Jan 2010 21:00:00 GMT

29-Jan-10 3:00 PM

CBS 60 Minutes: Cost of Dying 11/22/2009

CBS News 60 Minutes — Sat, 05 Dec 2009 13:00:00 GMT

CBS 60 Minutes "Cost of Dying" 11/22/2009

Many Americans spend their last days in an intensive care unit, subjected to uncomfortable machines or surgeries to prolong their lives at enormous cost. Steve Kroft reports.

5-Dec-09 7:00 AM

Hospice of Montgomery holds annual memorial

Markeshia Ricks — Tue, 24 Nov 2009 00:00:00 GMT

Hospice of Montgomery holds annual memorial

By Markeshia Ricks

Lorraine Hall said she doesn't know what she and her family would have done if it weren't for Hospice of Montgomery.

They helped her care for her husband of 62 years, Oliver, and it's something she'll never forget.

"It got hard, especially after I tripped over his wheelchair and broke my pelvis," she said. "But his nurse, Marinda, was a godsend."

Oliver Mason Hall was a World War II veteran and a proud member of the Montgomery Masonic Lodge No. 11 for more than 50 years. The 85-year-old had developed Alzheimer's, and died seven months ago.

His name was one of several called Sunday during the Hospice of Montgomery's annual memorial service.

Hospice staff, board members, volunteers and the families of hospice patients gathered at Immanuel Presbyterian Church to honor their loved ones who died in 2008 and 2009.

Nicholas Thornton, 6, attended the service with his father, Willie, and Uncle Alfred to honor his grandmother Louise Thomas.

"I just miss her so much," Nicholas said. "She used to give me Santa boxes with real money in it and I like real money. She would tell me secrets. It was like being friends. I wanted to give her flowers before she died. She was my favorite grandma."

Alfred Thornton said Hospice of Montgomery was not only there to support his mother through her final days, but they were there for the whole family.

"They were a relief valve for the family and they really were there to ease our burdens," he said.

Willie Thornton agreed, adding, "They were able to meet my mother's needs physically, emotionally and spiritually and she trusted them, which made it better for her transition."

Volunteer Amy Webster said supporting families through a loved one's dying days is what it's all about.

She should know. Her grandmother received hospice services and seeing hospice staff in action influenced her decision to become a volunteer.

"Volunteers are so crucial to the program," she said. "They help around the house -- they become part of the family."

Hospice past board president Lee Sims said he could attest to that, having had a loved one who received hospice services.

"It's a real learning experience," he said. "I was amazed by what they really do."

Hospice of Montgomery was the first hospice organized in the state in 1976 by Sister Elizabeth Parpart, director of social services for St. Margaret's Hospital in Montgomery. It is still the only independent, non-profit in Montgomery, according to bereavement counselor Christy Black.

The organization helps every family it can, regardless of its ability to pay or insurance status. It raises money to make sure things stay that way.

Black said the memorial service has been a tradition for the organization for the families of patients who have come through its doors over the years.

"It's sort of a touchstone for them to remember their loved ones and reflect," she said. "I also think it's helpful for them to be around others who have lost someone and to see that a lot of other people have gone through this. It gives them strength."

From a Montgomery Advertiser: November 18th, 2009 News Report
http://www.montgomeryadvertiser.com/apps/pbcs.dll/article?AID=2009911160305

23-Nov-09 6:00 PM

Photo at Sixth Annual Alzheimers Professional & Caregivers Conference -- Christy Black at our booth

Sun, 06 Sep 2009 17:00:00 GMT

6-Sep-09 12:00 PM

Sept. 2009 Newsletter

Jenille Ball — Sun, 23 Aug 2009 16:30:00 GMT

Sept. 2009 NewsLetter

23-Aug-09 11:30 AM

Cicely Saunders and the Modern Hospice Movement

Tue, 16 Dec 2008 17:00:00 GMT

I would like to bring to your attention the life and accomplishments of a remarkable person whose actions and writings have had a profound and beneficial effect on thousands of people. Her work has benefited more people than that of the Nobel Peace Prize winners Mother Teresa (1979) and Albert Schweitzer (1952). The names of Mother Teresa, "The Saint of the Gutters," who worked in Calcutta, and Dr. Schweitzer, whose humanitarian work was done among the natives of French Equatiorial Africa (now Gabon), deserve our recognition. Even more deserving of our recognition is that of Dr. Cicely Saunders, the Englishwoman who founded the modern hospice movement. Her work is likely to touch the lives of our families, or neighbors, and ourselves. This cannot be said of the work of Dr. Schweitzer or of Mother Teresa.

Cicely Saunders was born in 1918, the first of three children and the only daughter of an unusually prosperous and well-established household. Her father was the head of John D. Wood, a company engaged in property management and real estate development and sales at the upper end of the market. The management of the enormous Grosvenor Estate of the Duke of Westminster, the richest man inEngland, was one of its interests. The Saunders family lived in "a vast and impressive William and Mary house" with three cottaages, a large garden, a small dairy..., two grass tennis coursts, a hard court, a squash court, a walled garden, a fig tree, peach trees, nectarines and greenhouses." They had a cook, a butler, a kitchen maid, a house maid, three gardeners, a chauffeur, and a part time man to look after Mr. Saunders's model trains. They had a fishing lodge in Scotland. When she was fourteen, Cicely Saunders was sent to Roedean, a famous boarding school for girls. Despite theses advantages, Cicely Saunders (I am quoting from one of her admirers) "apparently managed to attain that prerequisite of future eminence, a not entierly happy childhood and adolescence." As a girl Cicely Saunders was described as "very tall, very bright, not popular, and very shy."

The subsequent academic career of Cicely Saunders, a career which eventually ended triumphantly, could be characterized by late starts and many changes in direction. It could also be called "flexible" and "opportunistic." Having failed her Oxford entrance examinations, she went to a crammer in London and was eventually accepted by her last choice among institutions within Oxford, the Society for Home Students. The Society did not have full collegiate status at that time. One of her professors at Oxford commented that Rodean had prepared her poorly for the study of Politics, Philosophy, and Economics, the challenging course of study she had chosen. World War II, that changer of career paths, was declared after Cicely Saunders's first year at Oxford. Resolving to do "something practical," she decided, against family opposition and against the advice of her teachers at Oxford, to become a nurse even though entry into nursing school meant a year at home waiting for admission. Cicely Saunders was enrolled in the Nightingale Training School at St. Thomas's Hospital, London, in November, 1940. After three years she graduated with honors only to find that, because of chronic back pain, she was unable to do the work of a nurse. She then decided to become a social worker. In England in the 1940's "social workers" were referred to as "lady almoners," the name deriving from people who had dispersed alms and administered hospitals in the Middle Ages. (In the 1950's almoners became "medical social workers" in Britain.) In the 1940's lady almoners were responsible for, among other things, arranging admissions to convalescent homes for people being discharged from hospitals, planning special diets for patients, and assessing financial circumstances. Enrolling in a course of study qualifying her for accreditation as an almoner required further preparatory work. It was during this period that opinions of the academic abilities of Cicely Saunders began to change. For example, a professor who had initially classed her ability as "ordinary second to third class" began to predict that she would graduate with distinction. Others found her "quite brilliant" and were surprised at the ease with which she passed her examinations. In 1947 at the age of 29 she got her first job, assistant almoner at the Northcote Trust, again at St. Thomas's Hospital. She specialized in the care of cancer patients.

It was this exposure to cancer patients -- and through a degree of emotional involvement with some of them which an objective observer would consider dangerously unprofessional -- that Cecily Saunders began to consider how the circumstances of the terminally ill might be improved. Especially influential was the dying of a patient named David Tasma. David Tasma was a 40 year old Polish Jew, an agnostic, who had come to England from the Warsaw ghetto before the Uprising. Poorly educated, he had worked as a waiter. He was dying with inoperable cancer, separated from his own country and family, desperately lonely, suffering great physical pain, and resentful of the fact that his life had been unfulfilled. He felt that when he had received a diagnosis of terminal cancer he had been essentailly abandoned by the medical profession. Cicely Saunders and David Tasma met only 25 times before he died. She said that they were in love with one another. Several years later, after she had become a physician, she had a similar important relationship with another patient, Antoni Michniewiez, another Pole with terminal cancer. Dr. Saunders kept a diary of her meetings with him, all of which took place in public in a six-bed ward. Here is a passage from her diary. "And he kissed and kissed my hand and stroked it and held it to him and said, 'My love, my love, my only love....' and we were quiet and happy just loving each other -- till nurses came and lights on, etc. So I gave him his Chloromycetin and Ephedrine and said, 'Good night and God bless you.' " She mourned him for three years. Some time later Cicely saunders worked aas a volunteer at St. Luke's Hospital, a home for the dying. The idea at St. Luke's was to keep the dying patient as comfortable as possible -- yet alert. The relief of pain was improved by administering medication at regular intervals rather than waiting for pain to assert itself. Drugs were given by mouth when that was possible.

Through these experiences Cicely Saunders found that she "yearned." (This is the word used by her biographer.) to be with the terminally ill. She already had in mind the idea of creating a hospital for the dying.

Cicely Saunders was advised that if she wanted to make advances in the field of care for the dying she would need to go to medical school. She already had degrees in nursing and in social work. Neither degree satisfied the requirements for admission to medical school. However, by now important people recognized Ciecly Saunders as a gifted person. Rules for admission were bent. She was admitted to the medical school of St. Thomas's Hospital. (St. Thomas's being one of the premier medical schools of Britain, it can afford to take some risks with the students it admits.) She found the initial experience "hell." (Her word.) Most students were fifteen years younger than she was. All were better prepared in the sciences. But school records say, "Her industry is overpowering." One of her final examiners said that she was the best student he had ever examined. She graduated with honors in 1957 at the age of 38. After her internship she was, through the influence of her father, given a research grant to work at St. Mary's Hospital, Paddington. There 20 research fellows were at work on the problem of pain management. Cicely Saunders alone chose to work on pain in the terminally ill. Importantly, she began working three days a week at a Roman Catholic institution called St. Joseph's Hospice, Hackney. Here she found a situation that was among the best of its day: patients felt accepted in their pain and anxiety, not "abandoned" as David Tasma felt he had been. Patients received devoted care, but its was unskilled care. The nuns at St. Joseph's were not equipped to cope with acute pain or with intractable vomiting or with breathlessness. Cicely Saunders began experimenting with the frequent administradion of morphine and heroine. The medical profession, then and now, was "nervous" about giving these drugs frequently, fearing that patients would become addicted to them or that they would become so tolerant that the medicaions would cease to be effective. Dr. Saunders began to develop the idea of a modern research institution specializing in optimizing the care of patients nearing death. And in a very short time (ten years after her graduation from medical school) she was able to create such a place, St. Christopher's Hospice. She went about persuading people from the group the British call "the great and the good" (Forty years ago it was referred to as "the establishment.") to support her project. These were people from the field of medicine, from the world of philanthropy and fund-raising, and from he Church of England. And all the time Dr. Saunders was raising money, buying land, and building the hospital she had patients at St. Joseph's "praying like beavers."

The dissimilarities between the educational experiences and the personal styles of Florence Nightingale and Cicely Saunders are glaring. Miss Nightingale was a woman of no scientific education who, even years after the validation of the discoveries of Pasteur and of Lister, ridiculed what she condidered "the germ fetish." Cicely Saunders was a woman with three advanced degrees. But Miss Nightingale and Dr. Saunders shared at least two assets which are especially important in Britain. One was the ability, enhanced by firm social origins, to move among and influence the most powerful elements of society and through them raise money for their projects. The other was the conviction, based on faith, that they were acting in accordance with Christian tradition. Miss Nightingale had originally had the idea of founding "something like a Protestatnt sisterhood" and Dr. Saunders's ideas about hospices had been elaborated from the Christian idea of places of refuge.

If the intellectual development of Cicely Saunders can be characterized as non-linear and unorthodox, so can her religious and emotional development. The courses of her religious and emotional development were non-standard, unusual, even odd. I call your attention to these facts because they influenced her accomplishments. I have already described the unusual degree of her emotional involvement with two dying men. In 1963, when she was 45 years old, while driving in her car, she spotted a painting, "Blue Crucifixion," in the window of an art gallery. "Magnetically drawn to it," she parked her car, entered the gallery, and bought a painting called "Christ Calming the Waters" by the same artist, Marian Bohusz-Szysko (1901 -- 1995). She began a correspondence with the artist, a married Pole seventeen years her senior, and then a love affair with him. Cicely Saunders married the artist seventeen years later, after the death of his wife. The religious life of Dr. Saunders also followed an unconventional course. For a period she considered herself an evangelican Christian, as such doing counseling for the Billy Graham crusade. At aother period she was a high Anglo-Catholic. Towards the end of her life she described herself as someone somewhere in the middle of liturgical practice. Her religious practices included prayer and meditation and were occasionally punctuated by mystical experiences.

I would like now to step away from the personality of Dr. Saunders and say something about what has become known as "the hospice movement" which she is credited with founding. Sir Douglas Black, a past president of the Royal College of Physicians, put it this way. "But for us all there comes a stage of illness, whether sudden or gradual, in which the possibilities of cure have become exhausted, and what remains is to make possible a course of dying which is free from avoidable pain and anxiety." The making possible of such a course of dying is termed "palliative care" and it is this care that hospices give, either in the patient's home or in a dedicated facility. The evolution -- and the evolution is still taking place -- of hospice care has been different on the two sides of the Atlantic Ocean. In Britain, where Cicely Saunders's St. Christopher's Hospice was an early model, a dedicated center housing patients was originally the norm. In the United States the emphasis from the beginning was on care at home. In Britain there existed a comprehensive system that included home care services by doctors and nurses. Inpatient hospices developed to supplement the system, responding primarily to the needs of patients, mostly cancer patients, whose needs could no longer be met at home. Over time it became clear that most people preferred to die at home so the emphasis has shifted toward home care, the lessons learned in specialized palliative care settings being applied there. In the United States early hospices services were provided almost exclusively in the homes of patients and outside the established health care system. More recently the trend has been for palliative care to begin in hospitals with extension of that care to the home setting. Even more recently, specialized "hospice homes" have been developed in the United States. The need for them has been underlined by the fact that families at home are often aging and less able to care for dying family members. Demographic studies of Montgomery show that its population has a rapidly advancing median age. Fewer and fewer families have the physical strength to care for a dying person at home, even with skilled help from experienced hospice personnel.

From the vantage point of an American one of the most remarkable things about Cicely Saunders -- perhaps it is a consequence of her having been British, and a British person of a certain class and style -- was her lack of a desire for self-aggrandizement. She accepted honors: many doctorates, knighthood (hence, "Dame Cicely"), and the Templeton Prize for Progress in Religion are but a few of them. But she always maintained that she was accepting the honor on behalf of St. Christopher's Hospice. For example, years ago an American writing a book on the care of the dying asked Dr. Saunders for permission to print her photograph along with those of Elizabeth Kubler-Ross and Mother Teresa on the jacket of a book. She refused permission, sending instead a photograph of St. Christopher's Hospice. The web site of St. Christopher's indicates only that Dame Cicely's biography is available in its bookstore and that photocopies of some of her early writings can be obtained. The formation of a cult of personality about Dr. Saunders was actively discouraged. The hospice movement owes a debt of gratitude to this sense of decorum. Think: in the wrong hands the hospice movement, palliative care, supportive care of the dying, grief counseling, could have become part of the fanatically marketed American self-help movement represented by the likes of Anthony Robbins, Deepak Chopra, or "Dr. Phil," the television psychologist.

I once met Cicely Saunders. The meeting occurred in about 1968, not long after the opening of her St. Christopher's Hospice. I was in England visiting a friend, a Londoner who had been my superior, the physician to whom I reported, during my tour in Vietnam. My friend told me that a medical school classmate of his had established what he called "a hospital for the dying." I had never heard of such an sititution. I was not eager to visit it. St. Christopher's turned out to be a surprisingly cheerful place, the harder edges of hospital decor softened by paintings, flowers, and the small personal belongings of the patients. My friend's classmate, Dr. Saunders, turned out to be a woman at least ten years older than he was. Her personality seemed more positive than amiable, but I did not find her intimidating. The tenor of her relationships with the hospital staff reminded me of something I had seen at a Catholic orphanage in Vietnam: the relationship there between the sister superior and the other nuns had been respectful rather than warm. Dr. Saunders was exceptionally well-groomed. She wore a white lab coat over a fashionable dress. She wore conservative jewelery. A tall woman, she emphasized her height with high-heeled shoes and an upswept hair style. She took us around the hospice, introducing us to staff and patients and pointing out to me the things she thought I, an American, would find particularly interesting. (I remember many photographs of dogs.) She called my attention to a large signed photographic portrait of Princess Alexanria of Kent, the Queen's cousin and the patroness of St. Christopher's Hospice. She explained to me that Princess Alaxandra was the most sympathetic and perhaps the most intelligent member of the royal family and that her patronage gave the project legitimacy in the eyes of potential donors. Dr. Saunders lamented the fact that the medical establishment in the United states had been slow to adopt the widespread use of orally administered pain medication for terminally ill patients. There was some good-natured banter between Dr. Saunders and my friend about their both having been honored by the Queen with the Order of the British Empire. They could both write OBE after their names. "Who would have thought it?" they asked each other. On the way home from the hospice my friend and I agreed that when our time came it might not be so bad to end our lives at a place like St. Christopher's. My friend's time came several years ago, unfortunately at a place not at all like st Christopher's but at a hospital in Cambridge. His wife, an anesthesiologist, is convinced that he died as the result of a medication error. Dame Cicely, among others including the Archbishop of Canterbury, spoke at his memorial service. Cicely Saunders was more fortunate in her place of dying. She died at St. Christopher's in 2005. Her memorial service was held at Westminster Abbey.

I believe that, many years from now, Dame Cicely Saunders will be remembered as an emblematic figure of our times and as one of humanity's great benefactors and that if anybody ever writes a book called something like Eminent Elizabethans she will have a prominent place in it. The Book of Common Prayer of the Episcopal Church seems hardly to dare ask for freedom from pain in this life, a mute acknowledgement that pain is an integral part of the human condition. Instead, it welcomes death as a place "where sorrow and pain are no more." Yet the longing for freedom from pain is a potent human wish which I believe is expressed in the prayer that asks, "And grant us grace always to live in such a state that we may never be afraid to die." An obstacle in the way of the fulfillment of that wish is the fear of a difficult and painful death. Cicely Saunders made it possible for many, often with the help of hospice care, to overcome that fear.

Bibliography

1) du Boulay, Shirley: Cicely Saunders, The Founder of the Modern Hospice Movement. Hodder and Straughton, London, 1984.

2) Strachey, Lytton: Eminent Victorians. G.P. Putnam's Sons, New York, 1918.

3) World Book Encyclopedia, Volume 19, 1992. "Mother Teresa."

4) World Book Encyclopedia, Volume 14, 1992. "Florence Nightingale."

5) World Book Encyclopedia, Volume 18, 1992. "Albert Schweitzer."

6) Legendre, Gertrude S: The Time of my Life. Wyrick & Co. Charleston, SC. 1987.

7) Book of Common Prayer. The Church Hymnal Corporation, New York. 1945.

8) Book of Common Prayer. The Seabury Press. 1979.

9) Web Site: St. Christopher's Hospice.

10) Streisand, Betsy: "Guru of Profit Potential." New York Times, 31 August 2003.

16-Dec-08 11:00 AM

Hospice of Montgomery's memorial service is Sunday at Immanuel Presbyterian

Wed, 03 Dec 2008 16:00:00 GMT

Hospice of Montgomery's annual memorial service is at 3 p.m. Sunday at Immanuel Presbyterian Church.

"The service is an effort to further touch the lives of families in a caring way," said Jenille Ball, the organization's executive director.

This gathering has been a special time through the years for many families who have come together to remember loved ones. Sunday's service will honor Hospice of Montgomery's 2007 and 2008 patients. The Rev. Elizabeth O'Neill of Immanuel will conduct the service, and it will be followed by a reception.

Cecile Webb and her daughter Maryla Webb attended this past year's service following the death of Cecile Webb's husband, Dr. John Webb. Both women said the event was a blessing.

Maryla Webb said, "It was really sweet and a healing time to have him recognized and acknowledged." The service also gave them a chance to meet other families whose loved ones had passed away, and that was comforting.

Those who attend the service will also have an opportunity to view the site of a new Hospice of Montgomery facility that will be built on land that Immanuel donated. Drawings of the building will be on display that day. The facility will have accommodations for about eight patients as well as office space.

Immanuel Presbyterian Church is at 8790 Vaughn Road. Call Hospice of Montgomery at 279-6677.

3-Dec-08 10:00 AM