By Chris Valley

“Life looks different to a dying person,” comments Arlene Patton, a Hospice Atlanta volunteer. “Limited time forces a choice about what really matters to the person. Someone who is dying sees priorities differently.” Over the past two and a half years, Mrs. Patton has served five terminally ill people and their families as a hospice volunteer.

Founded eight years ago, Hospice Atlanta Inc. is a home care service which concentrates on helping dying patients and their families through emotional support, medication in cooperation with the patient’s physician, and assistance with errands and personal care. Begun by members of the Unitarian Universalist Congregation of Atlanta in response to needs of one of their members, Hospice Atlanta Inc. is a non-sectarian organization housed in donated offices at St. Joseph’s Hospital in northeast Atlanta.

“In medieval times,” notes Nancy Parish, director of Hospice Atlanta, “a hospice was a way station for travelers and pilgrims. It was a place to stay the night before going on with their journey.”

In current usage a hospice is a general term used to describe a program organized to care for a person near the end of life’s journey.

The first modern hospice was founded in London in 1967 and is a free-standing facility where those who are dying may stay and receive special care. However, “hospice” is a description not of a particular facility, but of a concept of care for terminally ill patients and their families in which help is given to alleviate pain and to support the patient and the family, often in their own home, during the last weeks or months of the patient’s life.

At present there are approximately 1,200 programs in various parts of the United States. Eleven of them are in Georgia.

Mrs. Parish, whose background includes hospital administration and patient advocacy, heads a small staff

consisting of herself, an office manager/volunteer coordinator, and a half-time nurse. The primary providers of direct service are trained hospice volunteers.

“We make what we have go a long way through use of volunteers,” comments Mrs. Parish. “Volunteers maintain weekly contact with the patient or family members. We look at the patient and the family as one unit of service and care. If we really support the family, then they can better care for the patient.”

“Volunteers run errands, contact agencies, provide a listening ear and help provide extra emotional support to patients and families,” she explains.

Hospice Atlanta serves from 20 to 25 patients and their families at any one time. Approximately 125 to 150 are served in a year. Patients have ranged in age from 13 months to 90 years old. The vast majority of these have cancer.

Patients may request hospice service if potential life expectancy has been defined in terms of weeks or months, if the attending physician approves and will continue participation with the patient, and if there is a responsible person to assist in the care of the patient at home. Funded by voluntary contributions, Hospice Atlanta charges no fees for service.

Currently, there are 55 hospice volunteers. Each makes a minimum commitment of six months. Most are active for a year to 18 months. Twenty percent of the volunteers are professionals in fields such as psychology, social work, ministry, financial planning, dietetics, pharmacy, and physical therapy. No particular professional background is required. All volunteers go through 20 hours of hospice training.

Hospice volunteer Arlene Patton lost a good friend to cancer four years ago. Her friend was able to remain at home, in familiar surroundings, until two days before her death. A year later Mrs. Patton heard of Hospice Atlanta. Now, she goes shopping and runs errands for the patients assigned to her care. Mostly she listens to them and their families. “We try to help them express their feelings,” she says.

Dr. John Burns, of the DeKalb Center for Psychotherapy, is a volunteer who acts as psychological consultant to Hospice Atlanta. His first hospice patient was a 12 year-old girl dying of brain cancer. Dr. Burns sees the hospice program as an example of caring for the whole person, with body-mind-spirit interrelated. This wholeness of the person is emphasized in hospice volunteer training, which Dr. Burns developed.

During the initial training, volunteers are introduced to the psychology of family dynamics, different religious beliefs and spiritual concerns of the dying, patient care and pain treatment, the ethics of confidentiality and other community agencies available to help patients. A major focus is on communication skills needed to work with dying patients and their families. After initial training, a bi-weekly meeting of volunteers provides ongoing assistance in their work.

While the primary purpose of the hospice program is to support people who want to die at home among familiar surroundings, service to the family is not ended upon death of the patient. If the family chooses, hospice volunteers will maintain contact for up to a year after the patient’s death.

Families may choose to become involved in a mutual support group known as “Bereaved Partners.” This group is directed by trained volunteers. It provides family or friends the opportunity to share their feelings of loss. The group meets twice a month and is open to spouses, parents, children, brothers or sisters, and friends.

Other functioning hospice programs in Georgia include two affiliated with hospitals, Kennestone Hospital and Grady Memorial; one affiliated with Wesley Woods; and one operated by a group of physicians in Decatur for care for their own patients.

“Death is a normal part of living,” notes Hospice director Paris. “When there is no prognosis for improvement, we support people who want to die at home, among familiar surroundings.”