Hospice NewsS U M M E R 2 0 1 4

Hospice WorkBlessings in disguise

Not Sleeping Well? 10 steps to get the

sleep you need

Out of SyncThe struggles of a disturbed rhythm of life

Brookings Health System Hospice would like to acknowledge with appreciation the following donations (received through 6/30/14):

In Memory of John Unruh Norman and Catherine Allmer John W Allmer Dennis Lang

In Memory of Chris Moller Florence Moller

In Memory of LaValle Holter Gregg TeBeest

In Memory of Mary Ann Schultz Richard/Evon Rasmussen

It was descrIbed as a “living wake.” So often, friends and family gather only after a loved one dies to say a final goodbye. Thanks to the help of Community Hospice (Washington, D.C.), Arthur LeVan had the opportunity to savor two things he cherished—opera music and sharing it with people he loved.

“The opera performance turned out to be kind of the grand finale,” explained his daughter Lisa LeVan Haarman.

“Two weeks before it, the staff at Community Hospice made it possible to have his grandson christened at the hospice facility so he could attend. Then a week later, they arranged a piano recital. Even though my dad was dying, he was literally asking me, ‘So, what are we doing this weekend?’”

One of the lasting memories for Lisa is how the opera performance ended. “It was really unplanned when the concert concluded,” she recalled. “My dad had been in a reclining chair on wheels to be comfortable during the concert, and when it was over my sister turned him around and said, ‘Dad, I want you to look around the room and see everyone who loves you.’

“The room gathered and sort of made a line on either side as we exited the atrium where the performance was, and people were able to give him a handshake or lean over to give him a hug or a kiss, or to smile and say goodbye. I’m sure my dad didn’t necessarily think of it as saying goodbye to people because his spirits were so high the rest of that day, and he felt really loved.”

Arthur died three days later.

“I think to be able to die with dignity, and to be comfortable, is what we should all have the opportunity for,” Lisa said. “He enjoyed music his whole life, right to the end, and that was really a gift. Hospice made that moment possible. He was able to live his life to the end with great grace and great dignity.”

To watch Arthur’s story, visit www.momentsoflife.org/AConcertforArthur or scan the QR code below with your tablet or phone. To learn more about hospice services at Brookings Health System, visit www.brookingshealth.org/hospice or call (605) 696-7700.

A Concert for Arthur

brookingshealth.org2

Getting a Good Night’s Sleep

However If tHe problem is difficulty falling asleep or staying asleep, the following tips may help. These tips are from the June 28, 2014 Healthbeat newsletter published by Harvard Medical School.Volunteers receive training and learn how to be present with clients without feeling the need to interact or be “doing something” with clients. They learn about hospice philosophy, their role as part of the hospice team and how to be with our clients in a professional capacity.

Tips to promote a good night’s sleep:

1 Maintain a consistent schedule. Setting a routine time to go to bed and to get up (even on weekends when possible) “trains” one to fall asleep and wake up more easily.

2 Use your bed for sleep, not for sitting and doing projects, paying bills, completing work for your job or using it as a place for long or difficult phone conversations.

3 Cut down on caffeine. Caffeine is a stimulant and for some even a small amount early in the day can lead to difficulty falling asleep. Caffeine may also increase the need to urinate during the night.

4 Get involved in physical activity. Regular aerobic exercise such as walking, swimming or biking helps one to fall asleep faster, have more restorative deep sleep and helps one awaken less often during the night.

5 Limit day time naps.

6 Quit smoking. Nicotine makes it harder to fall asleep.

7 Use alcohol cautiously. Alcohol depresses the nervous system so a drink at night helps people fall asleep. However the effect wears off after a few hours and may lead to waking up throughout the night. Alcohol can worsen snoring and other sleep breathing problems.

8 Improve sleep surroundings. Remove the TV, office equipment and telephone (unless required for safety

reasons) from the bedroom. This reinforces the idea that this room is meant for sleeping. The ideal sleep environment is quiet, dark, cool with a comfortable bed and little clutter.

9 If you are still awake after 20 minutes or you awaken at night and are awake for 20 minutes, get up and read to relax. If you don’t, you may just toss and turn and increase your frustration about not falling asleep. Do not watch TV. It tends to be too stimulating and the light can send a message to your brain that is time to be awake.

10 Try to avoid sleeping pills. If you do take prescription sleep medication, work with you doctor to use it effectively and take it for as short a time as possible.

Here are a couple of other tips:

A Try some deep breathing/relaxation techniques. A simple one is to breathe in deeply and as you breathe out, relax you tongue. Breathe in deeply again and as you breathe out let your shoulders drop. Breathe in again and relax your entire body. Then breathe normally, paying attention to your breathing and the relaxed state of your body.

B Tell yourself (even though this may seem silly), “This bed is for sleeping, not for thinking.” Say it to yourself as many times as you need to. Say it several times coordinating the words rhythmically with your breathing. Often when we are unable to fall asleep, it’s because we are thinking about so many things. The thoughts may not be causing us to feel anxious, but they are certainly keeping our brain active.

C If you are having difficulty sleeping, tell yourself that at least you are resting. Then try the deep breathing/relaxation exercise again.

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Mavis GehantHospice Social Worker

When we are grieving or worried or are very busy, it may be difficult to get a good

night’s sleep. Yet adequate sleep is essential for our good health. If there is a

problem with sleep apnea, that is a condition which requires medical attention.

He was a perfect specimen of health, physically fit in his mid-fifties because his

work and all his hunting and fishing involved a significant amount of physical

activity. But this early morning he awoke with an uncomfortable chest pressure

going into his neck and jaw.

He arose to find no relief with stretching, a glass of milk or anything. Finally after awakening his wife, they made their way to an emergency room where he was given merciful pain relief, and immediately tested to define if it was his heart that was causing the pain.

Not long after arriving, waiting for test results, as his wife was talking with him, he suddenly slipped into unconsciousness. It was there on that cold, South Dakota mid-winter, before-dawn-hour that he died, despite all the best resuscitation efforts of the emergency room team. Likely due to arterial blockage and irritable heart muscle, the symmetry of his heart rhythm had changed into one of pure chaos that wasn’t effectively pumping blood, and the rhythm could not be stabilized despite every effort. The value of rhythm is never more evident than during cardiac arrest.

The definition of rhythm comes from Greek roots of rhuthmos (to flow) and rhyme; meaning any regular, recurring, pulsing; a succession of contrasting elements occurring over various periods of time. Think of the rhythmic experience from some speech and verse, rhyme

and song, drum, and dance. There is something about rhythm that calls for symmetry, and when it is out of sync, there is a part of us that becomes uncomfortable and we are left wanting to make it right again.

It is interesting that the rhythm of walking-running gait, of waves breaking on a beach, or of heart-beat-pulse, all commonly match musical sounds of Beach Boys, Beatles, Blake Shelton, Beyonce and B. B. King, or of Simon and Garfinkel, Smokey Robinson, Stan Getz, the Su-premes and Taylor Swift.

The rhythm of life is regular, recurring and pulsing; a succession of elements over time like the flow of seawater, fish, and animals meeting shore on a tide; the seasonal salmon in a freshwater river swimming hard for a place to spawn; the birth of lambs and calves, bursting forth on an early springtime prairie pasture; or even the 80 to 90 year life-cycle of humans, moving with joy, sorrow, and grace, from birth to natural death.

When a man dies too early, the rhythm is disturbed, the symmetry is out of sync, and we are left wanting to make it right again.

The of Lifeis a Thing

Richard P. HolmMD

brookingshealth.org4

Hospice Care:Burden or Blessing?People often ask me how I cope with being a hospice chaplain. They say, “It must

be really hard dealing with death all the time. It seems like a burden to me. I don’t

know how you do it.”

I’ll be Honest. There are times when it is difficult. Watching families struggle as their loved one is dying can be stressful for care providers. But what people don’t realize is that providing end-of-life care can also be very rewarding. The following story illustrates why I feel blessed in providing spiritual care to our patients and their families.

One of our long time nursing home residents had suddenly declined with a respiratory issue. I was called by staff who told me of his illness and requested a visit for spiritual care to his room at Brookview Manor. I visited the resident and found that he was struggling to breathe. When I called his name he opened his eyes and smiled,

recognizing me, but he was non-verbal. He denied being afraid and acknowledged that his wife, who had preceded him in death, was waiting for him in heaven. I didn’t expect him to continue very long, perhaps days or only hours. So I sat with him for awhile, prayed with him, and gave him drinks from his cup. After sitting for a while longer we said our goodbyes.

Later in the day while rounding on hospital patients, I got a call from the family who said they were at Brookview and would like me to stop by for a visit. When I arrived, a daughter, grandson, granddaughter and her toddler aged children were all in the room. The grandson asked me to take a seat against the wall. As I took my seat he put

his chair between mine and the door. I then realized that this family was serious about my visit and that I would probably be there for awhile.

After introductions the family explained much of their history sharing that an estrangement had taken place among the family involving the resident. The daughter told me she hadn’t spoken to her father for quite a few years over an issue between them. The grandson shared that the resident’s decline provided the opportunity for family members to speak with the resident about love and forgiveness. Ultimately, the daughter and her father reconciled. Through their tears the family expressed happiness with being able to heal and look to the future. As the visit came to a close the grandson, apologizing for “barricading me in the room” as he put it, requested prayer. With my hand on the resident’s shoulder, I prayed for the family. Each family member then shared a personal prayer as we gathered around their loved one. After prayer the resident opened his eyes but was unable to speak. He then closed his eyes, became unresponsive again, and lingered for another day before passing away. After his death I spoke with staff at Brookview who said that this resident had “nine lives.” He had come close to death many times before. Evidently he wasn’t ready to die, until now.

I believe the reconciliation that took place within this family provided the resident with the peace he needed to leave this earth and enter eternity. Though I feel any good listener could have provided this family with the care they needed that day, they apparently felt the need for a minister. Their time of confession seemed to provide healing at a crucial moment in time.

Can hospice work be difficult? Yes it can be. But it’s also very humbling. I am honored every time a family invites me, a stranger, in to share such sacred moments. Providing spiritual care to our patients and their families is no burden to me. In fact, it’s a blessing, my calling. And I love what I do!

““I believe the reconciliation that took place within this family provided the resident with the peace he needed to leave this earth and enter eternity.

Gregg TeBeestChaplain

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brookingshealth.org6

Team Isaac Raises $10,361 for SIDS AwarenesstHe fIrst annual team Isaac golf tournament was held Saturday, July 26 at the Meadow Creek Golf Course in Volga. Proceeds totalling $10,361 benefitted the Team Isaac “Safe to Sleep Gift Pack” project.

In 2008, Amber and Jason Hemmestad of Volga lost their 7½ month-old son Isaac Scot to Sudden Infant Death Syndrome (SIDS).They later co-founded Team Isaac, a local organization working to raise awareness of infant loss and to promote safe-sleep education.

With funds raised at this event, Team Isaac gift packs will be provided to the family of every baby born at Brookings

Health System. Each pack will contain a HALO SleepSack swaddle, a Charlie’s Kids Sleep Baby Safe and Snug board book and other information about the risk of SIDS.

HALO SleepSacks replace loose blankets in the crib that can cover a baby’s face and interfere with breathing. It’s a warm, cuddly blanket the baby can’t kick off, helping to ensure they sleep soundly throughout the night.

Individuals who wish to support Team Isaac may donate on-line at

www.brookingshealth.org/foundation. More information about Team Isaac can be found on their Facebook page www.facebook.com/TeamIsaacScot.

Brookings Health System Foundation to Hold 5th Annual Aiming to Inspire Health FundraiserbrookIngs HealtH system foundatIon will hold the fifth annual Aiming to Inspire Health sporting clays fundraiser on Thursday, Aug. 14 from 2 to 8 p.m. at Medary Creek Hunt Club, rural Aurora, S.D., presented by First Bank & Trust.

Proceeds from the 2014 event will help fund a new Type III ambulance at Brookings Health System. The ambulance will replace an older Type III vehicle as part of a fleet of five offering the only Advanced Life Support (ALS) service in Brookings County. It will be built and stocked as an ALS unit and will be the primary 911 response unit.

“Brookings Health System and its ambulance department is 100% self-supported,” said Foundation Development Officer Barb Anderson. “In other towns, the ambulance system is often operated and maintained by the city and new ambulances are often paid for through tax revenue. We don’t do that in Brookings, so the Foundation is reaching out to the community for support of a new ambulance.”

Volga, Bruce and Aurora each have a city-funded volunteer fire department with first responders and no ambulance. Brookings Health System’s ambulance responds to 911 calls in these communities. In addition, the ambulance often receives requests to assist from the city-funded, volunteer Basic Life Support (BLS) ambulance services based in White, Arlington and Elkton.

The participant roster for the event is full, however, activities open to the public include free hunting dog demonstrations by dog breeder Rod Brandenburger at 5:00 and 6:45pm and on-going ambulance tours conducted by ambulance staff. Raffle tickets are available for a facility wide family membership at the Outdoor Adventure Center valued at over $500, a $200 package of hunting gear and a facility/equipment rental from Dakota Nature Park valued at $125. Ticket holders need not be present to win.

Individuals who would like to contribute may purchase sponsorships or raffle tickets by contacting Barb Anderson at the Foundation office at 605-696-8855 or email foundation@brookingshealth.org.

Facts about Hospice Care Everyone Should KnowHospIce Isn’t a place. It’s a type of care that focuses on living …living as fully as possible, up until the end of life. Hospice brings comfort, love and respect to the patients and families they care for.

Considered to be the model for high-quality, compassionate care at the end of life, hospice care involves a team-oriented approach to care that includes expert medical care, pain-and-symptom management and emotional and spiritual support. All care is expressly tailored to the patient’s needs and wishes.

Hospice offers the services and support that Americans want when coping with a serious or life-limiting illness.

The goal of this type of care is to treat the person instead of the disease, and focus on the family caregivers, not just the individual. The quality of life is emphasized, not its duration.

Just tHe facts: natIonal HospIce and pallIatIve care organIzatIon reports:

• Hospice usage in the U.S. is growing. Every year, more than 1.65 million Americans with life-limiting illness are cared for by the nation’s 5,100 hospice providers.

• The median length of service for hospice patients is 19.1 days (half of patients receive care for more days, half of patients receive care for fewer days). Yet, more than 35% of patients die or are discharged in seven days or less—too short a time to benefit from the full ranges of services a hospice can offer.

• Cancer accounts for less than 38% of hospice patients—which surprises many people who mistakenly think hospice only serves cancer patients. The five other leading diagnoses are: heart disease, debility, dementia (this includes Alzheimer’s disease), lung disease, and stroke.

• Hospice is covered under Medicare, Medicaid, most private insurance plans, HMOs and other managed care organizations.

• An estimated 450,000 trained volunteers contribute more than 21 million hours of service every year.

• Research shows that 8 out of 10 Americans would want to stay in their homes surrounded by family and loved ones if they were faced with a life-limiting illness. Hospice makes this happen.

For more information, contact Brookings Health System Home Health at (605) 696-7700 or visit www.brookingshealth.org/Hospice.

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This is arecyclable product.

Hospice News is published by Brookings Health System. This publication in no way seeks to serve as substitute for professional medical care. Consult your physician before undertaking any form of medical treatment or adopting any exercise program or dietary guidelines.

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We Extend Sympathy to the families of patients lost through June 2014:

Lyle Bennett 4/8/18–4/13/14

Boyd Bruse 3/20/31–6/13/14

Robert Drewes 8/11/34–5/3/14

Edna Gums 2/14/25–4/10/14

Patricia Halliday 5/5/30–5/30/14

Lyle Heesch 10/5/28–4/9/14

Lawrence Holmes 3/4/41–4/9/14

Lavalle Holter 9/29/35–5/31/14

Robert Langner 10/19/24–6/21/14

Christopher Moller 6/3/31–5/7/14

Leila Moser 2/14/31–5/21/14

Dale E. Nelson 6/16/28–5/23/14

Ronald Rottluff 4/21/45–5/25/14

Mary Ann Schultz 2/7/22–5/28/14

Violet Smith 7/30/15–5/3/14

Michelle Spencer 4/5/65–6/28/14

Bernice Swanson 7/17/14–4/23/14

Norbert Syrstad 7/24/26–4/21/14

John Unruh 2/11/15–4/23/14