Hospice helps families deal with inevitable

In death, fear and hope make strange bedfellows. Fear of life ending and the unknown ahead. Hope that maybe there is a cure, or magical life-breathing medicine that will stave off the inevitable.

Nathan Adelson Hospice is well acquainted with how pending death transforms an individual. For 20 years in the valley, they have been helping families deal with life-limiting illnesses.

Their focus: limiting pain, enhancing life, educating the mind, soul, and spirit ... keeping death a part of a journey, not a mournful and painful end.

"It is a team effort treating the whole person," said David Watt, 61, a hospice patient in his home. Watt, who was diagnosed with prostate cancer after it had already metastasized to the bone, says he benefits from the care of a medical director/physician, a registered nurse, a social worker, a chaplain, as well as frequent visits from a certified nurse assistant.

Watt relates the philosophy and mission of hospice care from his own experience. Nationwide, hospice care is defined by Medicare as end-of-life care. A patient must be certified by their treating physician to be experiencing an illness that will complete their life journey in six months or less.

In the Las Vegas area, there is only one nonprofit hospice that is available to anyone who needs care. Nathan Adelson Hospice, which is named after the first Chief Operating Officer of Sunrise Hospital, operates three facilities in Southern Nevada. Adelson, who died in a hospital 20 years ago, experienced pain from his illness. Professional colleagues felt there might be a way to make death less painful and more dignified, so Nathan Adelson Hospice was started in his honor.

"We have a mission to serve the community," said Dr. Karen Cross, medical director of the Swenson facility. To dignify that commitment, the hospice is nonprofit.

Between three facilities, one on Swenson, a new facility on Buffalo which opened in September of 2000, and a smaller office in Pahrump, the hospice is caring for approximately 235 patients, most of them currently in their homes. Both facilities have a small number of in-house patients, but the hospice focuses on in-home care. They are hoping to open a new facility in the Green Valley area by the end of 2001.

"Hospice is underutilized by the general public and the medical community," said Cross, who feels the difficulty in putting a time limit on life when family members are hopeful makes the call a tough one. She added, "Nobody wants to die today."

"Our goal is to enhance the quality of life for the last days," said Sharon Johnson, director of social work for the organization. Although she says the treatment of patients in hospice is highly medical -- she cites pain management as a primary goal -- social work and counseling play a major role in the care Nathan Adelson hospice provides.

"The role of social work is more to help family members contact community resources, develop acceptance of death and dying," said Johnson. The hospice offers bereavement counseling and support groups for families who have lost loved ones, the latter is open to the public at the Swenson Street facility.

"I think the greatest benefit is that we have a team to offer support -- to come to the house and offer a wide range of services," said Johnson. She adds that the case manager for each patient, a registered nurse, is able to communicate with the treating physician so that ordering medications, equipment, or other interventions can be made to increase the comfort of the patient.

The team at the hospice, which makes their gentle care so comprehensive, is made up of a medical director, several registered nurses, social workers, chaplains, nursing assistants, and volunteers. "Volunteers are a huge part of our organization," Johnson said.

The social work director underscores the role of hospice as comfort care, or palliative care. "It is not giving up hope -- it is improving the quality of life," said Johnson, "Hospice is broadening its perspective on what can be offered to a patient."

Medical director Karen Cross, who specializes in internal medicine and has been with the hospice since 1992, said "We concentrate on physical symptoms -- pain, nausea, vomiting, anxiety, any suffering," she added, "Our concept is to treat the whole person, not a tumor or other illness."

"Hospice adds life to each day," said Michael Delaney, public relations director for the hospice. Delaney, who has a radio show on KNUU (KNEWS, AM 970) at 8:05 on Saturday mornings on the topic of hospice, says he wants to educate the community on the fact that hospice is an "opportunity rather than a sentence."

"Hospice is a compassionate, dignified way to spend the last days, surrounded by the people who love the patient," Delaney said.

David Watt, who personifies what Delaney aims to relate, says that hospice should be used to a greater extent in the community. Hospice, heavily used by European families, is still misunderstood in the United States, says several Nathan Adelson Hospice caregivers.

The hospice, which is one of a handful of hospices in the valley but the only nonprofit, is partially funded by the United Way of Southern Nevada. Funding provided by the United Way of Southern Nevada pays for programs like their indigent care program. "The sole purpose of this foundation (fund-raising at the hospice) is to fund indigent care, other programs and projects the hospice needs to perform," said Judith Hantin, vice president of the foundation and fund development. Hantin adds, "If they are medically appropriate, we will care for them." The hospice gave approximately $800,000 in free care to the community last year.

End-of-life care, Michael Delaney said, is often about families coming together, learning those hard-to-say tales of the past, sharing the joy that the individual brought to the family. In those final weeks, days, "there are no more barriers."

To learn more about Nathan Adelson Hospice, call 733-0320. For information about United Way-funded programs, call 734-CARE.