Christmas time is an especially difficult and lonely time for people who are confined to their beds and have been told they are going to die soon. Imagine lying in bed, being ill and knowing you won't get better and being all alone on Christmas. The people of Legacy Hospice of North Arkansas, however, are there to help and care for those who are dying or terminally ill 24-7.
Through all the chaos of Christmas sales and bargains and shoppers frantically scampering through stores and shopping malls for gifts, people often forget what the season is about. Somehow, in the back of their minds, the meaning is still there -- the night a bright star in the sky led three wise men to Bethlehem to bring their gifts to the savior of the world.
People often forget these men were bringing gifts to a small helpless baby in a manger, a baby which they barely knew and was born to a family of meager means and was going to die a painful death.
This fact seems to be forgotten amongst all the gift-giving and holiday cheer, but for those working at Legacy Hospice the meaning of Christmas and of Jesus' life means a lot to them.
Legacy Hospice patients are always in hospice workers' hearts and minds, and workers give gifts of kindness and care to their patients and their patients' families throughout the time they are with them.
According to Community Education Director Trena Spears, the philosophy of Legacy Hospice is as follows: "Hospice affirms life and focuses on the quality of life. Hospice exists to provide support and care for persons in the last phases of incurable illnesses so that they might live as fully and comfortable as possible. Hospice recognizes dying as a normal process whether or not resulting from disease. Hospice neither hastens nor postpones death. Hospice exists in the hope and belief that through appropriate care and the support of a caring community sensitive to their needs, patients and families may be free to attain a degree of mental and spiritual preparation for death that is satisfactory to them."
Their philosophy does a good job of accurately portraying what volunteers, nurses, doctors, chaplains and all hospice employees do for their patients.
"We are there at the end of someone's life to care for them and provide them with all the comfort that we can, with all their families and care givers, to make sure their dying process goes as it should," Spears said.
Medicare, Medicaid and private insurance pays for hospice care according to Spears. They also accept patients who don't have insurance. Spears said all the patients involved with indigent care receive hospice for free. Spears said last year, hospice offered indigent care in the amount of $80,000 to those who did not have medical insurance to pay for hospice.
Spears said Legacy Hospice is a free-standing hospice that does not accept donations. "Any donations we do get, goes directly back to the patients," Spears said.
During the care of a hospice patient, Spears said hospice provides patients with pain medications, all medications related with diagnosis, medical supplies and nutritional supplements.
According to Legacy Hospice, they receive patients who are literally at the end of the road in life. For many patients, the end of the road can be when they are 90-years-old to 9-months-old. Legacy Hospice serves patients in all age ranges and from all walks of life.
Hospice often steps in when taking care of a terminally ill or dying family member or friend becomes too difficult for care givers who are, most of the time, family or friends. Hospitals are usually not an option for these patients because there is nothing more they can do to make the patient better or more comfortable.
"Patients are referred by their physicians, however, a hospice patient can be referred by anyone," Spears said. However, a physician has to provide proof that patient is terminally ill.
"Basically, hospice patients are picked up when they have six months or less to live, but that only applies if their disease follows a normal progression," Spears said. "We've got hospice patients we've had for two years. As long as they continue to show decline, we can continue to have them on hospice care."
But perhaps the most important thing about hospice, besides the care it offers, is the people who dedicate their time and services to be with these patients and their families during this rough turning point in their lives.
Bonnie Hayes, the Legacy Hospice volunteer coordinator, said she couldn't say enough about the 34 volunteers who put in hours of their free time volunteering with hospice.
"I try to send them (the volunteers) to Salem if they live in Salem and Cherokee Village if they live in Cherokee Village. And at Christmas time they're very busy and they're all retired people, usually," Hayes said. "And they have limited hours they can work, so I always run out of volunteers. We always have a need for volunteers. Because they are unpaid Hospice Hearts, we call them, and they do things that go above and beyond the call because we aren't able to pay them."
Hayes said Legacy Hospice does background checks on potential volunteers. She then tries to place them with an appropriate patient by matching up the patient's and volunteer's likes and dislikes and their hobbies.
At Legacy Hospice's Salem and Walnut Ridge offices, Hayes said the volunteers, or Hospice Hearts, worked a total of 2,146 hours in the past year and traveled about 5,000 miles just in October.
Hospice also helps patients with the spiritual side of their illness and coming to terms with death for both the patients and their families. Gene Gardner is the corporate chaplain for both Legacy Hospice in Arkansas and Hospice Inc. in Missouri. He has a doctorate in theology, a master's in administration and supervision and a B.A. in sociology. Gardner is also on the Arkansas State Hospice Palliative Care Association board and has served with hospice since its inception about 20 years ago.
Gardner said he was in the Civil Air Patrol United States Air Force for 20 years as a lieutenant colonel and a command chaplain. During his Air Force time, he said he traveled around the world and experienced many different religions including Buddhism. "(Hospice) is a continuation of my ministry," Gardner said. "I have been in the ministry since I was in my middle teens. This is just a continuation of my ministry. It is my ministry to help people."
"I've worked with all the major denominations of the United States where members are allowed to salute the flag," Gardner said. "I can work with any patient in hospice who has a belief. Our goal is to work in harmony with the patient's belief system."
"We make it easy for that person (the patient) to share with us their beliefs, and often by the time they come to that place, we've gotten acquainted with them and they have gotten acquainted with us enough that there is a sharing because of trust," Gardner said. "And we give them the help they request and we contact their pastor and their church, and this is for the purpose of, we're not trying to separate them from their church (or) from their peers. We are a service to them to help them in the whole ballgame of spirituality. If they have no church and if they have no pastor, and they tell us what kind they want, we will help them to find that. Nearly everybody has, because of their upbringing, a favoritism in which church they have."
Gardner can even perform communion or final rites for those who ask for it or he can contact an appropriate pastor, as he said he did in the case of an elderly couple in Cherokee Village who were terminally ill and wanted to take communion.
As one can imagine, working with terminally ill patients can be a very emotional job, especially if a patient dies. Gardner said, the hospice team works together and feeds off each other to make a plan for a patient's care. The team also knows how each member of the team feels towards any particular patient, and they are all there for each other when things turn bad.
Still, hospice's main goal is the comfort of their patients. "I have been with them (patients) literally when they drew their last breath," Gardner said. "I've been with them when it lead up to their last breath, and our (greatest) goal is to comfort them in any possible way for their individual peace."
Gardner said the holidays are a very difficult time for the terminally ill and their families and loved ones. "This is the most crucial time of the year, the special holidays," Gardner said. "They're the most lonely then than any other time in their lives. Our policy is to give them all the comforts that a human being can have or give to another at that time, and often it's the family who needs the comfort, because we lose so many people to death from Thanksgiving through Christmas is when people, they really die. They've reached that goal and then they feel like it's time to turn loose and let go, and it leaves the family lonely because next Christmas they'll remember the same thing (the death)."
Gardner also said he helps families in the bereavement department of hospice who have lost loved ones and are struggling with the loss. He said hospice normally keeps up with a family that has suffered the loss for about 13 months after the death to help with any emotional issues.
For those who are in need of terminal or end of life care or for anyone who might have a loved one who could benefit from hospice care, the Legacy Hospice of North Arkansas' Salem office can be reached at 895-2651.