A “typical day” in the life of a hospice nurse?

Well, that’s a tough one. Because arguably, it doesn’t exist.

Just ask Rachel Baxter, a registered nurse with Emmanuel Hospice, who is greeted every workday by a schedule that is anything but typical.

What every day does guarantee, however, is that as an ambassador for hospice, she will be challenged to provide top-notch care and treat every patient like they’re her only one.

“You learn to expect the unexpected,” says Baxter, a healthcare provider the better part of a decade. “Often, I make a plan first thing in the morning that looks great on paper, but with a single text or phone call, everything can change, which requires me to be flexible.

“It’s what you do when you’re trying to make every moment count for every patient to whom you’re providing care.”

Serving as a hospice nurse demands you remain nimble during the workday, looking for opportunities to tap into an array of services a hospice care provider like Emmanuel offers. When caring for patients, Emmanuel Hospice draws on a holistic approach that focuses on mind, body and spirit.

“I rely on a very talented team of providers,” Baxter says, taking her cues from other Emmanuel Hospice practitioners and therapists who specialize in areas from pain management to playing music to providing medical massages.

“We differentiate ourselves in that way,” she says. “It’s what sets us apart, and makes us especially capable of helping our clients along on their journey.”

The interdisciplinary team is all about collaboration and communication, sharing resources, skills and expertise to deliver care with compassion and ensure all needs are met.

“I put my absolute trust in judgment and knowledge of my co-workers,” she says. “We all see different things, and it’s vital we share that information because it’s in the best interest of the patient and that patient’s family.”

This extends in varied ways especially when serving a patient in the privacy of their home, which can contrast markedly from treating someone in a facility.

“When you’re in someone’s home, it can begin to feel like your own,” Baxter says. “You might be there often with a spouse or other members of the family. You begin to see rhythms and patterns, and you adapt and adjust to those. You become acutely aware of the sights, sounds and other elements important to your patient.”

Baxter might see three patients in a workday or as many as six or seven. While she might serve anyone within Emmanuel Hospice’s service area, she primarily sees patients near the lakeshore before returning to her own home in Zeeland. She appreciates the flexibility of her schedule, which allows her to enjoy her surroundings and read or crochet during breaks.

While the care she provides can change from patient to patient, there is always one constant: “I’m focusing on every precious moment my patient has left. I want to be calm and confident, warm and reassuring. How do you feel? What can I do? How do you want to live?

“Living life to the fullest – no matter the time left – is what we’re all about.”

For more information about hospice care, visit EmmanuelHospice.org

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Sometimes, it’s what the patient shares by simply speaking. But a hospice practitioner can also make inroads by what patients express with a turn of the hand, the way they’re sitting, a look on their face.

“In treating the body, we’re listening in a lot of different ways,” says Joan Blessings, a licensed massage therapist at Emmanuel Hospice based in Grand Rapids. “Sometimes, you can feel patients relax and, in that way, they’re communicating. And ultimately, that helps us help them live their best lives.”

Blessings has been a massage therapist some two decades, nearly half of those years in a hospice setting.

“At first, I really didn’t know if I wanted to do this,” she says, “because our patients pass away. But what I find joy in is giving them comfort. It can be a simple foot or hand massage, but that can create a huge difference for them.

“We believe our patients are more than just their diagnosis. So, we’ll make available all kinds of complementary therapies aimed at treating them in a truly holistic way.”

It’s remarkable, she continues, the way in which the body responds to music, to scents, to time with a pet – and of course, her specialty – massage.

At times, that can mean a light touch to someone experiencing generalized pain. In other cases, it might call for zeroing in on anything from facial muscles to the entire spine. The benefits can manifest themselves in increased mobility, reduced inflammation and more.

It takes time and practice to focus on the physical needs of each patient.

“Every patient is different,” she says. “When I go in for the first time, I am seeking to meet their expectations, and working hard to understand what those are.”

While she focuses on massage, she’s also paying attention to how else that patient might benefit from others on the care team. During the massage, they might talk about craving a spiritual connection. Perhaps they want to visit the beach or a flower garden. Another might want to sing or listen to hymns.

Blessings makes detailed notes of those desires into a digital logbook that everyone else attending to that patient can discover and then act on. A variety of complementary programs can be used alongside pharmaceutical approaches to provide physical comfort and support other health needs.

“We are so team-oriented,” Blessings says. “And everything we do is integrated on behalf of the patient, so they get everything they need from everyone with whom I work. It’s a very important part of their care program, and when a situation changes, we’re all aware of it.”

The rewards are many: “I served a woman the other day who said to me, ‘I’m 94-years-old, and I have never had a massage.’ I was able to smile and tell her, ‘Well, after I walk out that door, you won’t be able to say that anymore.’”

 

To Listen is to Learn is to Nurture the Spirit

By Emmanuel Hospice

There are a lot of ways to define and discuss the ways in which a hospice professional might nurture a patient’s spirit.

For the Rev. Madelyn Thompson, a spiritual caregiver at Emmanuel Hospice, it doesn’t lean much on credentials she might bring to the bedside. Instead, it relies on her ability to listen, learn and be actively present.

“One of my favorite spiritual influences,” says Thompson, “is Henri Nouwen, who said, ‘The friend who can be silent with us in a moment of despair or confusion, who can stay with us in an hour of grief and bereavement, who can tolerate not knowing…not healing, not curing…that is a friend who cares.’

“Generally speaking, being spiritual is being in a relationship – with yourself, with other people, with nature, with your pets, with creation,” Thompson says. “What I’ve discovered is that patients can be most distressed at life’s end with regrets or unforgiveness, wishing they’ve done something differently. I might not be able to fix things, but maybe I can help them be at peace with themselves. That’s nurturing the spirit.”

Although Thompson has an advanced degree and plenty of experience, she prefers to focus on how she’s still observing and absorbing.

“I don’t have a plan when I walk through a door,” she acknowledges. “I have to rely on something other-worldly, something other than myself.”

Over the course of some 20 years working in hospice care, Thompson has become increasingly aware of how the spirit is much more powerful than any words she might bring to a patient and their family.

She’s also been struck by how an awkward moment can be placated in the most beautiful and bittersweet ways. Many years ago, flustered at not being able to reconcile all the people in a room paying their final respects to a dying woman, a 5-year-old great-grandson burst in, flung himself on the patient’s bed and said, “I will love you forever, grandma,” then kissed her and disappeared.

“The whole countenance of the room started to change,” says Thompson, who believes that moment – and so many others she’s witnessed – was rendered by the divine.

She’s quick to admit how “that’s not always the lovely case,” but more times than not, if you’re patient, “some redemption can occur.”

Thompson has worked for other hospices, and emphasizes,“Every hospice shares some components, but you can tell which ones go above and beyond, who extend complementary therapies, who continue to offer a hand and an ear to loved ones even weeks and months after a loved one has passed.”

She says the best hospices attend to the whole person, including their spirituality. “And that involves listening to their life story, to their experiences, allowing them to guide us into how we can help them, rather than walking in and saying, ‘I know how to help you.’”

As an interfaith organization, Emmanuel Hospice meets the spiritual needs of all individuals, guiding patients and their loved ones in finding solace and strength through a peaceful life transition.

Over the years, Thompson says she’s discovered “we all express ourselves and our spirituality in different, creative ways.”

She notes the more she exposes herself to opportunities for more learning, the better she’ll be prepared to nurture that spiritual side.

“I like to assume we’re all interconnected and interested in one another’s stories,” she says. “I find solace in building on that base of love and understanding.”

For more information, visit EmmanuelHospice.org/holistic-care.

 

 

The human body’s most complex organ?

The brain, teeming with some 86 billion neurons, all of which are in use and communicating with other neurons to form circuits and share information along myriad pathways.

That is exactly why healthcare providers like Emmanuel Hospice pay special attention not only to a patient’s physical needs, but to the mind – a growing trend among medical professionals in general, who are embracing this holistic approach more than ever before.

“The traditional medical mindset has been to focus in on what is going on with the body,” notes Lauren Enos, a social worker at Emmanuel Hospice who has been a healthcare worker 16 years. “What we’re learning, though, is that things occurring medically can be the result of external stressors and events. When we pay attention to that as well, we gain a more accurate picture of causes and circumstances surrounding what a patient is going through.”

Because providing comfort is a primary goal of hospice programs, it’s important to know a patient’s history so that they can receive the best care possible.

“A person’s life is steeped in history, culture and habit,” Enos says. “They’re a product of the people who came before them, and it can inform their qualities and characteristics – anything from education to spending habits to relationships.”

Learning about how a person thinks and acts – especially in a singular situation like dying – can help caregivers approach that patient and their friends and family in more sensitive ways.

“Each patient could be someone who perhaps is carrying five generations of history with any particular issue,” Enos says. “It’s important we know as much as we can.”

As a social worker, Enos says it’s especially important to be an active listener. The rewards will manifest themselves in the patient’s story, which will provide cues as to what they’re thinking and why they react the way they do. They will also serve as a springboard for developing strategies to effectively navigate end-of-life needs.

“We want to decrease the patient’s tension, and maybe that’s achievable in having someone play music for them and sing hymns,” Enos says. “Maybe it’s through massage therapy or acupuncture or just practicing deep breathing.”

At Emmanuel Hospice, a full slate of complementary therapies is available to patients and their families, including journaling, which can take multiple forms. While some patients make daily diary-like entries, others might simply write a letter or two that helps them internalize feelings that are tough to verbally express.

Another program offered is Art Legacy, which gives patients the opportunity to create and leave behind legacy artwork for their loved ones. Patients can use anything from crayon to watercolor paint, fabrics and more for self-expression.

“All of these activities allow the mind to relax and let creative energy flow,” Enos says. “It can bring emotions to the front.

“Supporting our patients’ minds culminates in some very powerful moments. It begins with having a respect for the entire person and all the systems they might be in – home environment, community, school, family origins. It’s a privilege to be part of a team which honors that process.”

Grand Rapids, Michigan, Jan. 3, 2023 – Emmanuel Hospice has been awarded a $5,000 grant from the Kenneth A. Scott Charitable Trust, a KeyBank Trust, to support its growing pet visitors program.

One of the nonprofit’s most popular programs, pet visitors help hospice patients reduce feelings of

loneliness, depression and anxiety with visits from comforting, engaging and playful pets. The grant will help cover program expenses, enabling the organization to provide more comfort, care and joyful opportunities to ensure patients’ final days are lived as fully as possible.

Emmanuel Hospice provided almost 300 pet visits last year. The organization currently has seven active pet visitor teams and is looking to add several more in 2023.

Pet visitors and their human companions are specially trained and selected to match each patient’s specific needs, energy level and abilities. Emmanuel Hospice makes all the arrangements needed for a pet to become certified as a pet visitor on the volunteer’s behalf and covers the certification cost through grant funding and donations.

The process involves documentation of current wellness exams and vaccinations as well as three observation visits. Those interested in joining the volunteer program can find more information and register at EmmanuelHospice.org/volunteer.

Scott Trust’s goal is to provide excellent care and support for domestic animals throughout their lives, especially those in underserved areas. Many of the pets participating in Emmanuel’s volunteer program are older or adopted from shelters and have been able to find new lives of meaningful service and connection volunteering as pet visitors to people in end-of-life treatment.

Emmanuel’s application for the grant read in part: Emmanuel Hospice hopes to highlight that every life has worth. Even older pets who are in shelters can have meaningful work and make a significant positive contribution to a person’s end-of-life care.

Services like Emmanuel’s pet visitor program exist in both hospice and hospital settings, though less than 5% of local hospice patients have access to these programs outside of Emmanuel’s services. The organization shares its policies and program successes with other nonprofit hospice organizations to promote the best patient care and animal stewardship practices.

Emmanuel’s pet visitors program is one of many complementary offerings the nonprofit provides as part of its holistic approach for caring for the mind, body and spirit. Complementary programs can be used alongside pharmaceutical approaches or as an alternative. Other offerings include massage therapy, music therapy, virtual reality, essential oils, acupuncture and more.

Complementary services are not covered by traditional insurances, but provided at no cost to patients through the support of volunteers and donations. To learn more, visit EmmanuelHospice.org/holistic-care.

About Emmanuel Hospice

Emmanuel Hospice is an interfaith provider of compassionate, person-centered hospice care to patients and their loved ones in West Michigan. Serving the community since 2013, the nonprofit draws on a team approach that focuses holistically on mind, body and spirit, working to enhance each patient’s life with a combination of expert medical care, spiritual counseling and complementary therapies. Emmanuel Hospice has expanded to serve all of Kent and Ottawa counties and portions of Allegan, Barry, Newaygo, Ionia, Montcalm and Muskegon counties. For more information, visit EmmanuelHospice.org.