Making Things the Way They Should Be
By Rebecca Spencer McCurdy
Some years ago now I was privileged to attend a performance of the very popular musical, Hamilton, at Playhouse Square in Cleveland. I expected to be impressed and entertained, most of the reviews for the show had been glowing. What I was surprised by was how moved I was by it. There were certainly some depictions of grief and loss that were deeply moving, but there were also some aspects of the development of American democracy that touched me deeply. For example, when George Washington asks Alexander Hamilton to help him write his Farewell Address, he talks about the necessity of teaching the people how to say good-bye. I found it moving to think about how essential this act of a peaceful transfer of power was to the future of our country.
On the other hand, there were some things that could have gone better. If Alexander Hamilton had gotten his way, slavery would have been abolished in the Constitution. However, Southern, slave-holding leaders such as James Madison and Thomas Jefferson wielded more influence, so it took another 90 years and a terrible Civil War to rid our country of the curse of human bondage.
I’m especially struck by all this because I’ve been thinking recently about the fact that hospice is still really in its formative years. The hospice where I served for 30 years has been serving its community in Ohio since 1982. Internationally, Dame Cicely Saunders served her first patient in the first modern hospice outside London almost 60 years ago.
As hospice care has become more mainstream and accepted as a regular part of the continuum of care, some elements that were not a part of the original vision of hospice care have been added. Some of those “new” things have been great. For example, when I first started with hospice, we could not serve patients who lived in nursing homes. Now we understand that regardless of where a patient lives, as they approach the end of life, a patient will need the kind holistic support hospice provides.
At our local hospice we have also been able to add some expanded services in response to the needs of our communities. Things like dietary services, our Loess Life Legacy Project, pet therapy and Pet Peace of Mind, massage therapy, music sharing and a hearing aid program are just a few examples. This growth in the breadth and depth of services has been remarkable and joyful.
At the same time, there have also been some “new” things that are not so good. For example now, nationwide, about 75% of hospice care is provided by large corporate hospices that have no local connection to the people they “serve.” Some of those hospices still do a good job, and some don’t. My prejudice is that a hospice which is local and not-for profit is the best way to do end-of-life care. It is also my prejudice, because I’ve seen what a difference it can make, that volunteer services provided by well-vetted and well-trained volunteers… i.e., local people serving local people… can make all the difference in the world as to how truly responsive a hospice can be to the needs of the patients and families they serve.
I feel like I learned a lot in my decades of hospice work about what a community needs in order to do a good job for its members in the poignant last season life. I have also learned that the principles that make hospice work best for patients and families, are basically the same principles that allow families and friends be a good support to those they love when they face terminal illness. I hope to keep supporting those principles until it’s my turn to be supported in my last season of my life.