To Salute My Grandson & Be Baptized

When we shared the story of Mr. Ramirez’s very special wish on our Facebook page, it reached nearly 400,000 people. Later, we made this simple video to use as part of our 2016 Bucket-List Challenge. Special thanks to his family, and especially his granddaughter, Blue, for sharing their memories and photos with us, and with you.

To Make Sure Sue Keeps Dancing

Charlie Conner and his wife Sue spent the winter at their Florida home for 17 years.  He loved the warm weather, dancing with his love of 52 years, and listening to her sing.

But when Charlie was diagnosed with cancer, everything changed. Winters in Florida seemed impossible.  Instead, they stayed closer to home, where Sue took wonderful care of him.  She didn’t leave Charlie’s side for four years.

As his condition worsened, Charlie told Sue he wanted to spend one more winter in

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Charlie with Sue, the love of his life.

Florida.  It wouldn’t be an easy trip, and it would take a lot of planning, but Charlie wanted to see Sue dance and sing in the Florida sun again, so they made the arrangements. In November, they returned to their Florida home and were able to stay until April.

Not long after returning to Kentucky, Charlie’s physician suggested they look into hospice care.  He was admitted to Hospice Care Plus and his hospice team began to care for him. They quickly learned that he had another wish. He and Sue had always attended both of their family reunions in the summers.  Charlie wanted to attend one more reunion.

As the July reunion drew near, Charlie’s condition worsened again.  Knowing how important it was to him to make it to the reunion, the hospice team worked diligently to bring pain and symptoms under control, making frequent visits, adjusting medications, and collaborating with his physicians. When the big day approached, Charlie felt well enough to go. He wasn’t able to stay the entire day, but he did get to make that last trip to see his family.

A month later, Charlie passed away.

That’s when Sue told us that he had one more wish, and this one only Sue could help him with.

Sue was the love of Charlie’s life.  Throughout his illness, he worked hard to prepare her for his leaving.  His final wish to Sue was that she go on living.

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Sue and Charlie surrounded by all the littles ones they love.

“He told me, ‘you love to dance and you love to sing.  When I’m gone, you go on living. Find someone to dance with and keep on singing,’” remembers Sue.

Hospice’s bereavement program stayed in touch with Sue to offer support. They were delighted to learn that Sue would, in fact, honor Charlie’s last wish.

“It’s only been a few months since Charlie passed, but I went to Florida this winter, because that’s what he would have wanted.  I’m continuing to live, just like he asked me to do.”

To Taste Home Once More

It’s not surprising many hospice patients turn their thoughts to family, family traditions, and even childhood.

That was the case for Alejo Ramirez, a Texas native who lived in Kentucky for more than 30 years. His thoughts often turned to his birthplace and to family traditions. In particular, he told his Hospice Care Plus team about the authentic, homemade, corn-husk tamales

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Mr. Ramirez looks over old photos after his special meal.

his mother used to make.

“Mr. Ramirez talked about these tamales regularly,” says Jackie McGee, his hospice social worker. “He was looking for a way to find them locally, but, living in far southeastern Kentucky, it was a challenge. He even called to ask different companies in other states if they could ship them to him, but he had no luck. Everyone said that tamales would deteriorate long before they arrived.”

Jackie and the rest of the hospice team, including Jodi Neal, the primary nurse, and Sally Iseral-Shepherd, his chaplain, had a feeling that what Mr. Ramirez really wanted was to “taste home again.”

“It seemed very important to him,” says Jodi. “And we felt it was a quality of life issue. It was about so much more than tamales; it was about remembering his childhood, missing his birthplace and his culture. We felt he needed this.”

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Giving a big thumbs-up after eating nearly every bite.

Mr. Ramirez never asked the team to find him these tamales, of course.  He just told us stories about trying to locate them.  But the team, always reading between the lines for ways to make quality of life better, wanted to help.

Jackie, Jodi, Sally and the entire team went to work. They heard of a Mexico native now living in Berea, Ky., who could make the authentic tamale meal Mr. Ramirez craved so deeply.  Her English was very limited, so a staff member’s friend volunteered to translate.  Once the translator explained the situation, she agreed to shop for the ingredients and make a meal—enough for four people—so Mr. Ramirez could share it with others. The team all pitched in to fund the ingredients, gave the funds to the volunteer, and the meal was prepared.  As soon as it was ready, the team loaded the food into their cars and drove it to his home in Booneville, just over an hour away.

The team spread the feast out onto the kitchen table and made a plate for Mr. Ramirez.  Everything was lovingly made from scratch: the colorful guacamole; the rich, black refried beans; true Mexican rice boiled in tomato juice; and, of course, the pork-filled tamales wrapped in corn husks.

His wife had mentioned that Mr. Ramirez had eaten not long before we came, and that he

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A young Mr. Ramirez during his years of military service.

probably wasn’t hungry. It went slowly at first—we asked if we could take a picture of him with his full plate, even if he didn’t want to eat just yet. He agreed. But, gradually, as the team filled their plates and sampled the wonderful food, Mr. Ramirez began to eat, too. He was so quiet as he did so, as if he wanted to carefully consider every bite. He barely said a word until the last bit of food was gone from his plate. Then the magic happened.

The familiar tastes and smells of his childhood brought back his loved ones—mother, father, brothers and sisters—and his memories. He spoke of watching his mother when she made tamales, more than 50 years ago. He described the sights and sounds as she ground the spices in a lava-rock bowl, or steamed the husks over a bucket full of boiling water. His wife brought photo albums to the table, and he told us more stories from his youth.

The team had been right. It wasn’t possible for Mr. Ramirez to physically get to Texas at this point in his life. Nor, of course, could he see his mother or father—both long gone. But he could get there and be able to be with them again through his senses—taste, smell, feel. And that was exactly what he needed to do….one more time.

“It was beautiful,” said Brenna Wallhausser, a hospice staff member who came along to take photos. “To see the food take him back that way, and to share this meal with him—it felt like a true honor. It felt like a celebration of him, his culture, and his life.”

To Find a Home for A Navy Veteran

One afternoon, our hospice, Hospice Care Plus, was called to see if we could help a young Navy veteran, Mr. Jones (name changed), who was essentially homeless.

He had been living in a home with some family members, but difficult family dynamics led to it being a very unsafe environment for him, especially since he was coping with an end-stage disease.

One of our nurses was sent to evaluate Mr. Jones, and found that he was appropriate for hospice care. The challenge, though, was where we would care for him. He had no home.

After making several calls, it was clear there was no way to find an immediate home situation for the veteran patient. The Hospice Care Plus team met and made a suggestion: what if we housed him at our Compassionate Care Center in Richmond, so at least he could live in peace and comfort while we continued trying to find a safe and welcome living situation for him.

It was a big decision. We are reimbursed about $600 per day for patients who need inpatient care at our Center, as determined by Medicare guidelines. Unfortunately, though, it looked as if Mr. Jones might not meet those Medicare guidelines for inpatient care—just for hospice home care. In order to let him stay at the Center, then, we’d have to be prepared to accept the home care reimbursement rate of $130 per day instead of the inpatient reimbursement of $600 per day. If he stayed two weeks, and if he never met those inpatient Medicare guidelines, we stood to lose about $6,580. If he stayed more than two weeks, it could add up to an enormous amount of lost funds.

But, we all felt there wasn’t a choice, really. We had a bed, and a dying veteran needed a home. How could we not invite him to stay? If anyone deserves compassion and dignity at the end of life, it’s our veterans.

He came to the Center and was given a room of his own. When he was well enough to eat, our dietary staff loved to cook for him and bring him meals. Our We Honor Veterans program presented him with a framed certificate, thanking him for his service.

He also got to enjoy some of the things that meant a lot to him throughout his life. An avid guitarist, Mr. Jones loved rock music. His favorite times in life were spent going to various music venues, watching bands he loved, and joining them on stage to jam along with them.

Since he couldn’t do that anymore, he did the next best thing—he brought his guitar with him to our Center.

“I think it helped him remember really happy times of playing with his favorite bands,” says Diana Bond, the social worker at the Compassionate Care Center. “You could always tell when he was feeling well, because that’s when he’d pick up the guitar and strum for a while.”

Diana worked to find Mr. Jones permanent placement at a VA facility in Kentucky, but he deteriorated so quickly that it wasn’t possible to transfer him anywhere else. So, the Center was his home until the end. He died peacefully a few weeks after coming to us for a safe, caring home.

Mr. Jones never said to us, “My bucket-list wish is to live out my last days in a safe place, under a roof, in a warm bed, with homemade food and loving people around me—not on the streets.” He didn’t have to. It was unexpressed but clear as a bell. Who doesn’t want that? It’s incredibly tragic that such a basic human need became a bucket-list wish for him. But, it did.

We’re not sure how we’ll recover the losses from that stay, but we still feel we did what we had to do. Twenty-five percent of dying Americans are veterans. They gave us their all. They deserve no less from us.

To Visit My Favorite Fishing Hole

Mr. Smith (name changed) loved to fish. Every weekend for most of his life, he managed to fit in a time to fish for a while at his favorite fishing hole. His wife, Mary, often told us that his fishing spot was like his second home.

When we admitted Mr. Smith to our hospice home program, he had recently been hospitalized for several weeks. His energy was low and he was weak. He still loved to talk, though. Every time his Hospice Care Plus team visited, he regaled them with fishing stories.

One afternoon, when the nurse aid was visiting, he told her a story that struck a nerve with her.

“One Saturday a long time ago,” he told her, “I got up early and went to the fishing hole. It was the first real Spring day, and that fishing hole was calling to me. Mary usually made me breakfast biscuits on Friday nights, so I could take them with me if I went fishing the next morning. I grabbed those biscuits and my fishing pole, and off I went.”

He paused at this point, remembering that warm, sunny morning. The nurse aid saw that his eyes were a little misty.

“That morning was the last time I got to go there, and I was just thinking that I wish I’d known it. I wish I’d known it was the last time.”

The nurse aid asked what he’d have done differently if he’d known it was the last time.

“Honestly, I think I just would’ve sat there and soaked it up. I’d have thanked God for the time I was able to spend there over the years. It was my quiet spot, you know—a place where I could get away from everything.”

“Mr. Smith,” the nurse aid said, “If it’s okay with you, I’m going to take this back to the whole hospice team. I bet they’ll want to find a way to help with that.”

For the next two weeks, the team worked hard to help Mr. Smith strengthen his legs a bit. They walked arm-in-arm with him around the house, reviewed his medications, and came up with a plan. By the end of those two weeks, one sunny summer morning, three team members showed up to go fishing.

It wasn’t easy—Mr. Smith’s mobility was still pretty limited—but those three team members were able to get him to the car with his fishing gear. They drove to his favorite fishing hole, helped him out of the car and into a special chair, put a pole in his hand, and left him alone for several minutes.

The team eventually returned and sat next to him in silence, taking in the beautiful view. After about 10 minutes with him, Mr. Smith said, “It’s time to go, ladies.”

They helped him back into the car and took him home. After they settled him into his favorite chair at home, he looked up at them and smiled.

“What you just did…that meant the world to me,” he told them. “I needed to say good-bye to that place. I have a peace about everything now that I didn’t have before. Thank you for that.”

A Last Christmas with Sara

This bucket-list story is about sweet young Sara (name changed). We had the honor of caring for Sara, and of working with her family to help prepare them for life without her.

One of their bucket-list wishes was to make sure they had one more Christmas together before losing Sara. Unfortunately, it wasn’t going to be easy. Her medical care up to that point had been intense, and it wiped out nearly all they had. They weren’t sure how they would truly make it Christmas, since gifts for Sara and her siblings seemed out of the question. Plus, her Hospice Care Plus team was fairly sure Sara wouldn’t be with them by Christmas.

But, as always, the hospice team met to come up with a plan. They worked closely with Sara’s family to see if they were open to having Christmas a little early. Not only were they willing to do it, they embraced the idea. Together, Sara’s parents, siblings, and the hospice team planned a family Christmas celebration to remember.

Everyone at Hospice Care Plus pitched in to find a Santa Claus, a very kind gentleman from Mt. Vernon, Ky., who agreed to volunteer his services, including traveling to Sara’s home in Jackson County, Ky. There were no extra funds at our hospice to purchase gifts for all the children, so the hospice team and other staff used their own money to make sure every child had a few gifts. The family and the team also worked together to decorate the house.

When the day finally arrived, it was as authentic as any Christmas we’ve seen. There were gifts, trees, decorations, and an entire family gathered together to celebrate.

The highlight of the day was seeing sweet Sara rest so peacefully on Santa’s lap and in his arms. She was so content and comfortable, she fell asleep in his lap as Christmas went on around her.

Bucket-list wishes like these aren’t just for patients, although it was definitely a memorable day for Sara. They are for the families, too. It is a gift to Sara’s parents that, even in the midst of the unfathomable pain of losing a child, they have this special day to remember—a magical Christmas together, complete with their own Santa Claus and gifts for everyone.

To Make Thanksgiving Dressing One More Time

LeAndra Sullivan, 57, a bubbly, irrepressible optimist with a heart of gold, refused to let cancer keep her from living. In fact, that’s why she chose hospice care—she had too much left to do, and she needed help making sure she could do it.

Junie Barclay, her primary hospice nurse, also full of spirit, was the perfect partner in crime for LeAndra.

“The first few times Junie was here, we cried together,” LeAndra told us. “But on that third visit, we both said, ‘That’s enough. Now we’re going to laugh.’ And we did! We’ve laughed and laughed together.”

They also planned. LeAndra came home from the hospital with hospice on October 28, 2014. On her first visit with LeAndra, Junie asked what was most important to her.
“I want to be here, at home, enjoying the little things,” LeAndra told her. “I want to spend time with my grandbaby, Blane, because he is my light.”

Then she added a milestone she wanted to meet–her bucket-list wish: be alive and at home at Thanksgiving, and be well enough to make her beloved dressing one more time, so Karen, her daughter, could learn to make it herself.

“Hers is better than anyone’s,” says Karen. “I wanted her to make it and I wanted to watch, write down the ingredients, and learn.”

Junie immediately worked with LeAndra and Karen to develop a plan of care centered on helping her meet her goals. They plotted out what had to happen in order for LeAndra, who was mostly bedbound, to be able to sit or stand at a kitchen counter long enough to make the dressing.

It would be a challenge. LeAndra’s cancer had metastasized to several parts of her body. Massive pain crippled her, and she had been in a coma for months after having a bad response to chemotherapy treatments.
“We had to get her pain under control, re-educate LeAndra and Karen on how to take the medications, and develop enough strength and good body mechanics for her to be able to leave the bed,” says Junie.

The Hospice Care Plus team scheduled extra visits to give their plan the best chance of working in time for Thanksgiving. Within a few weeks, they had success. On Thanksgiving Day, using a special chair that helped lift LeAndra to the counter, she made the dressing one last time, with Karen at her side.

Passing on the traditional dressing recipe to her daughter meant the world to LeAndra.

“We had the most beautiful day I’ve ever had in my life that Thanksgiving,” LeAndra said.

LeAndra died on March 15, 2015, after a five-year battle with cancer and five wonderful months at home with hospice care. Her daughter, Karen, has so many memories from her mom’s time at home—memories that will be especially poignant each Thanksgiving, when she makes her mother’s dressing.

“Leandra had the best outlook on life,” says Junie. “She was full of life and determined to live it—truly live it—until her last breath. I’m very proud to have been a part of that.”