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The gift of being heard

When homecare or hospice caregivers make their first visit to a patient’s home, they never know what challenges await. The home is a unique care setting where, unlike a hospital room, nursing home, or a primary care office, the caregiver is invited into the patient’s home, their life, and often their family. As healthcare workers, our inclination is to care for and heal our patients with evidence-based protocols and best practices. Sometimes, though, the best medicine, the greatest gift we can provide is to simply listen to what the patient has to say.

George and Ruth’s story

George was doing his best to care for his 97 year old wife, Ruth, who had recently taken a downward turn.  George, himself 98 years old, was tending to all of Ruth’s personal needs as well as the cooking and cleaning—she had become completely dependent on her husband. It was after Ruth’s hospitalization, when Erin Kerns, MSW, a licensed clinical social worker, the manager of hospice and palliative care services at VNA Home Health Hospice, received a referral via their intake department for their services from Ruth’s primary care physician. “We were unable to reach the patient by phone because the patient’s phone had been disconnected—this appeared to be a high-risk situation. Our hospice outreach nurse went directly to the home to assess the patient’s needs,” recalls Erin. Ruth’s doctor had requested homecare services, yet when Donna Levensalor, RN, a VNA hospice outreach nurse, met with the patient she quickly determined that Ruth had at most, six months to live.

George and Ruth had been married for more than fifty years—she was his everything. But now, she wasn’t eating, and he was becoming forgetful. After considering the wishes of both Ruth and her husband, and consulting with Ruth’s primary care physician, the VNA hospice care team got to work connecting the couple with the services they would need to support Ruth’s wish to peacefully die at home with George by her side. This hospice care team included a VNA social worker, nurse, home heath aide, chaplain, bereavement coordinator, and volunteers who worked together to address not just Ruth’s physical condition, but the couple’s emotional, social, and spiritual needs as well.

The team knew Ruth didn’t have much time. "The intensity of services from our staff shifted, as we better understood Ruth's condition. Our goal at that point was to ensure the delivery of Ruth’s medical care, confirm her safety, and provide companionship and support to her husband,” reflects Katie Thiesen, the VNA licensed master social worker who was assigned to Ruth’s case. Katie was responsible for coordinating the numerous services Ruth needed to live out her remaining days as she wished. At first glance, the amount of services provided to Ruth and her husband might seem above and beyond what is typical of hospice care organizations. However, Katie, the hospice care team, and their supervisors recognized that VNA was in a unique position to support Ruth and provide her and George much needed resources, a commitment VNA regularly makes.

Within a few weeks, Ruth passed peacefully in the night with her husband and a clinician close by. Katie returned to George’s home with a plan to offer both bereavement and healthcare support services to George who expressed his gratitude, but told Katie he just wasn’t interested—this took her by surprise. She said, “We get into this work because we love it and when you are allowed the time to do it, it’s a beautiful thing. The patients also give us so much. George was a great reminder that what the patient needs isn’t what we think they need. Having the time to be still and listen to our patients is a tremendous gift.” Katie says the leadership within the organization gives their care teams the space and time to sit and really listen to understand a situation.

“Sometimes, you just get deeply involved with a patient and their family. When Ruth died it was sad, but we also felt comforted knowing we fulfilled her wishes. It felt okay. We couldn’t fix that she was dying or fix his broken heart, but sometimes, I think all people need from us is the gift of listening and feeling heard.”

*The names of the patient and her husband have been changed to protect their privacy.

Do you know an employee who exemplifies an unwavering commitment to providing an exceptional patient experience? If so, we would like to hear from you! Share your story at yourstory@emhs.org. Your story may be the next one you see in Pathways!