Monthospice mc090512

n What is hospice?Hospice is care that focuses on medical and personalcomfort for people living with a life-limiting illness.Hospice care helps patients with physical symptomslike pain or nausea. Hospice staff members also comfortpatients, families and friends by helping them feelemotionally and spiritually at peace. They work togetherwith patients and families to bring dignity and well-beingto those affected by serious illness and loss.

n What is Montgomery Hospice?Montgomery Hospice is a nonprofit organization that hasbeen providing hospice care to people in MontgomeryCounty for more than 30 years. We are the largesthospice in the county. Besides hospice services, weprovide professional grief support for anyone who livesin the county. In 2011, Montgomery Hospice cared formore than 2,000 patients and their families, andprovided grief education and support to 8,800Montgomery County residents.

n Who is Montgomery Hospice?The people of Montgomery Hospice are professionalsand volunteers who work together as a team to meetthe needs of our neighbors who are living with a terminalillness. The professionals include doctors, nurses, nursepractitioners, spiritual counselors (chaplains), socialworkers, hospice aides and grief counselors.

n Is Montgomery Hospice a part of theMontgomery County government?No.

n Is Montgomery Hospice affiliated with areligious group?No.

n Is hospice only for people with cancer?No. Montgomery Hospice can help those with any illness(including cancer, dementia, heart disease and others).

n How are hospice services paid for?Hospice services are paid for by:- Medicare (Part A)- Medicaid- Most private insurance companies, or by- Montgomery Hospice. We care for patients who do nothave insurance or any other way to pay.

n Why do patients choose hospice?Patients choose hospice when it becomes clear that acure is no longer likely, and they want comfort care sothey can live as fully as possible until the end of life. Forsome patients, hospice can be an alternative to stayingin—or returning to—a hospital.

n Where do patients receive hospice care?Montgomery Hospice usually cares for patients andfamilies in their own homes, wherever they live. Besideshouses and apartments, we care for patients in assistedliving facilities and nursing homes. Some patients withdifficult symptoms receive care at Casey House, the onlyfacility in Montgomery County exclusively designed forhospice patients.

n What services are provided by MontgomeryHospice?- Expert pain and symptom relief- Medications- Medical equipment, such as oxygen, wheelchairs,walkers and hospital beds- Medical supplies- Nurses available by phone 24 hours a day, 7 days a week- Assistance with patient personal care- Grief support

18205 D Flower Hill WayGaithersburg, MD 20879

500 University Blvd W., Silver Spring, MD 20901-4625301-593-9500www.collinsfuneralhome.com

Francis J. Collins Funeral Home, Inc.A Montgomery Hospice Gold Level Partner since2011, as well as a long-standing donor to otherfunding initiatives for nearly two decades.

Pettit Family Charitable FoundationSupporting Montgomery Hospice as a GoldLevel Corporate Partner since 2008. Donatingto Montgomery Hospice for more than 20years, the Foundation has also provided criticalfunding for the Casey House Clinical ServicesEndowment and other initiatives.

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What we do & how we can help

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Whom does Montgomery Hospice care for?Montgomery Hospice helps our seriously ill neighborsin Montgomery County who have decided (after talkingwith their doctors) to concentrate on living their lives

as fully as possible rather than aggressivelyfighting a disease.

MontgomeryHospice.org 3

11800 New Hampshire Ave.Silver Spring, MD 20904

301-622-2290www.hinesrinaldifuneralhome.com

Hines-Rinaldi Funeral Home, Inc.Supporting Montgomery Hospice as aGold Level Corporate Partner since 2009.The funeral home has supported otherMontgomery Hospice causes since 1991.

Family & Nursing CareA Montgomery Hospice supportersince 1997, and a 5-year SilverLevel Corporate Partner.

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962 Wayne Avenue, Suite 500Silver Spring, MD 20910

301-588-8200www.familynursingcare.com

n Who cares for the patient?The team of people that work together to care for thepatient includes doctors, nurses, hospice aides, socialworkers, spiritual counselors (chaplains) and volunteers.

n Will the Montgomery Hospice doctor visitthe patient?Yes. If necessary, the Montgomery Hospice doctor willvisit a patient’s home.

n What do Montgomery Hospice nurses do?The nurses visit patients regularly to see how they aredoing, teach caregivers how to take care of their lovedones, and coordinate the medical care of the patient.

n What does the hospice aide do?The hospice aides visit patients periodically to help withthings such as bathing and making sure patients canmove around safely. Every hospice aide at MontgomeryHospice is an experienced nursing assistant with a certifi-cation from the state and specialized training in end-of-life care.

n What does the Montgomery Hospice socialworker do?Montgomery Hospice social workers help patients andfamilies learn coping skills and ways to keep patientscomfortable in their homes. They also can help patientsand families with difficult conversations or to work onpractical tasks, such as arranging for help with chores.

n What does a chaplain do?For patients who are interested, Montgomery Hospicespiritual counselors (chaplains) are available to talk aboutspiritual concerns. Our chaplains help people find comfortand answers that fit their own beliefs. Chaplains offerspiritual support to people of any faith background, or nofaith background, and help people find their own answers.

n What do Montgomery Hospice volunteers do?After a thorough three-day training, volunteers help in avariety of ways such as visiting with patients so care-givers can take a break, giving soothing hand massagesto ease stress, running errands or helping patients andfamilies with email, letters or memoirs. Volunteers arerequired to attend ongoing training during the year.

n What are Complementary Therapies?Montgomery Hospice uses Complementary Therapiessuch as massage, music and aromatherapy. For somepatients, these techniques (used along with conventionalmedical care) provide comfort, and ease pain and anxiety.

n How are decisions made about the care ofthe patient?Montgomery Hospice respects and honors the wishes ofour patients. Their priorities guide us.

n Are patients’ family doctors still involved when apatient chooses hospice?Yes. Patients usually keep their own doctors whilereceiving hospice care.

n Do Montgomery Hospice patients have to stopall medications?No.

n What happens if a hospice patient has anaccident and breaks a leg? Would that breakbe treated?Yes.

n Does hospice hasten death?No. In some cases, hospice helps patients live longer.

n What should patients or families do if theyare considering hospice care, or if they havequestions about hospice?- Ask their doctor to discuss all their options, which mayinclude hospice care- Call Montgomery Hospice for information or ask us tovisit them to provide information- Call Montgomery Hospice back with more questions.Montgomery Hospice wants families to fully understandtheir options and will respect any decision made.

n Can patients who sign up for hospice carechange their mind?Yes. Patients can stop hospice care whenever theywant, for whatever reason.

n What is Casey House?Casey House is a peaceful, home-like facility designedfor hospice patients with acute symptoms. Patients maygo to Casey House to get difficult symptoms undercontrol. Casey House also has doctors, nurses, hospiceaides, social workers, chaplains and volunteers. To learnmore, see pages 4 and 12.

n How is Casey House different from other facilities?Casey House has a highly skilled team of professionalswho are experts in end-of-life care. Patients have privatebedrooms with personal bathrooms. Adult, children andpet visitors are welcome 24 hours a day.

n What is grief? What is bereavement? How doesMontgomery Hospice help?Grief is the intense feeling of sadness felt after the deathof a loved one. The word “bereavement” is very similar,referring to that period of sadness. MontgomeryHospice has counselors with advanced professionaldegrees who support families for 13 months after theirloved one dies. This free support includes phonecounseling, group meetings, workshops and mailings.

n How does Montgomery Hospice help thecommunity with grief?Montgomery Hospice support groups and workshopsare free to anyone who lives in Montgomery County.Montgomery Hospice also provides education aboutgrief to community groups, to employees in theworkplace, and to students in high schools.

Do patients ever leave hospice care?Yes. Some patients improve and leave the

hospice program.


Joseph Gawler’s Sons, Inc.Has increasingly supported Montgomery Hospicesince 2009. Now a Gold Level Corporate Partner,Gawler’s has also provided in-kind donations andhas recognized Montgomery Hospice employeeswith their community service award.

611 Rockville PikeRockville, MD 20852301-774-6400 x6728

Sandy Spring BankSupporting several Montgomery Hospicecauses for 21 years, including the annualHearts for Hospice community fundraiser.Has committed funding as a Silver LevelCorporate Partner through 2013.

5130 Wisconsin Ave, NW. Washington, DC 20016202-966-6400

a CASEY HOUSE story

‘‘M Y MOTHER WAS AN INTERESTINGperson. She was a teacher in Baltimore Citypublic schools, mostly the inner city schools,

with many challenging students. She taught reading to poorchildren throughout the 1950s, 60s and 70s.

After retiring for a brief period, she had a whole secondcareer running a day shelter for homeless men in Baltimore.She ran a program where men who lived on the street couldcome and get a meal and some clean clothes or do their laun-dry or get a shower.

She was a very giving, loving person.When she developed dementia-related aspiration pneu-

monia, she ended up in a hospital. The hospital took morethan two weeks to figure out and communicate that she was,in fact, dying.

WHAT A RELIEF FOR MOM TO BE TRANSPORTED TOCasey House! Casey House has such a homelike atmosphere.We were actually startled by how nice it is. The building iswelcoming and there are lovely touches such as the smell ofcookies and coffee, dogs for petting, and a harp. The court-yard is lovely. We would go outside and make calls, and enjoythe view and the birds.

AT CASEY HOUSE, WE FELT WELCOMED AND AThome. We could come and go at any time. We were able totreat the Casey House Great Room as though it was our ownden. Chris’ siblings were there a lot and we were able to betogether very comfortably as a family. Friends came too.The grandchildren were able to play Nintendo on the CaseyHouse TV. Our kids were nervous and anxious about thewhole process and we were able to provide pizza for themat the table. That was so reassuring and helpful.

MOM HAD ALWAYS ENJOYED READING THE GOSPELand listening to jazz. We read to her during her time in the hos-pital, but by the time she got to Casey House she was too tiredto listen to Bible readings. She did still want to listen to hermusic—which she did, a lot of old Duke Ellington tunes. Thesecond day Mom was at Casey House, the family gathered for

her 85th birthday celebration in her room. We sang “HappyBirthday” to her and there was a cupcake with one lit candle.She couldn’t eat but she was happy to have us around her.

THE NURSES WERE VERY ATTENTIVE. AT THE TIMEMom was admitted, the social worker helped us make tenta-tive long-term plans in case Mom needed to leave CaseyHouse if she stabilized. She was good about making clear to

us that Casey House is for short-term hospice care only. Thechaplain helped us connect with clergy. We were pleasantlysurprised to find out the staff wanted to take care of thewhole family, not just Mom.

Casey House is all-embracing and all-enveloping. Wewant to help people learn that Casey House and Mont-gomery Hospice are there to give people the care theyneed at the end of life.”

Montgomery Hospice thanks Lena and Chris for sharing the story of Chris’s mother, Thelma Foreman.

AN INTERVIEW WITHCHRIS FOREMAN AND LENA ZEZULIN

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Robert A. Pumphrey Funeral HomesSince 2004, has been providing essential funding toMontgomery Hospice, including the annualBereavement Conference and Community Workshops.A Silver Level Corporate Partner since 2011.


7557 Wisconsin AvenueBethesda, MD 20814

301-652-2200 Fax 301-656-2210300 W. Montgomery Avenue

Rockville, MD 20850301-762-3939 Fax 301-217-0377

Visiting AngelsA Silver Level Partnersince 2011.

What are normal reactions when someoneyou love dies?

You may feel a variety of emotions:SadnessAnxietyGuiltAngerDenialNumbness and shock

You may experience sensations such as:Tightness in the throatHeaviness in the chestLoss of appetiteMood swingsExtreme forgetfulnessExcessive fatigue

You may act out of character:Crying at unexpected timesOvereatingUndereatingWandering aimlesslyQuestioning spiritual beliefs

These are all natural, normal grief responses.You are not going crazy when you feel them.You are grieving because you loved.

Before my best friend died, I didn’tknow that grief could have a physicalimpact. After her death, I did not under-stand why I was feeling exhausted dayafter day. I had always thought a “lumpin the throat” was a metaphor, until theday I had to stop jogging because thatlump was literally preventing me frombreathing. It took me a while to figureout I still needed to eat, even when notfeeling particularly hungry.

Before she died, I did not know Iwould feel guilty about being sad. I hadlost my friend, but her husband hadlost his wife and her children had losttheir mother. For quite a while, I toldmyself that their loss was so muchgreater than mine and I should quit feeling sorry formyself. I eventually learned that grief is not a com-petition, that I could lean on other friends for sup-port, and that I could help her family by acknowl-edging how much we all loved and missed her.

I learned after her death that grief is messy andconfusing, and doesn’t necessarily follow a set pat-tern, or a specific series of stages. I was surprisedto experience moments of laughter amidst thesadness. Before my friend died, I assumed thatone “got over” a death after some specific period

of time. I did not know I would stillbe hit with pain randomly at oddtimes for quite a while.

Before I worked at Mont-gomery Hospice, I did not knowthat people spend their careersstudying and researching grief.And that others spend their daysworking with people to educatethem on how to move throughgrief in order to heal. I had notknown that although many of usstumble our way through loss,others need more help. I nowknow assistance is availablethrough books, in support

groups, and through one-on-onesessions with trained counselors.

As much as I’ve learned, I do not presumemy experience is identical to any other’s. Dr.Earl Grollman, educator and author, wrote“[everyone] hurts differently. There is no way topredict how you will feel. The reactions of griefare not like recipes, with given ingredients, andcertain results. . . . Grief is universal. At thesame time it is extremely personal. Heal in yourown way.”

–SUSAN BURKET

Gaithersburg, MD301-355-6578Silver Spring, MD301-578-1616

[email protected]

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Grief is universal.At the same time

it is extremelypersonal. Heal in

your own way.–Dr. Earl Grollman

‘‘

What I Didn’t Know

About Grief

MONTGOMERY HOSPICE HELPS THE COMMUNITYMontgomery Hospice professionalbereavement counselors provide freesupport to Montgomery Hospicepatients’ families and also are availableto help others in the community. If youfeel that talking with a counselor might

help you, please call 301-921-4400and ask to speak to a bereavementcounselor. This counselor will listen toyou and suggest resources that maybe helpful, such as the free grief work-shops and grief support groups that

Montgomery Hospice offers.You can always visit our website,www.mont gomeryhospice.org, tolearn about upcoming grief supportgroups and workshops, as well asexplore articles on grief posted there.

What to Expect WhenYou are Grieving

ISTOCKPHOTO/GIZMO

n An Interview with Barry R. Meil,Campaign Chair & Foundation Board Chair

How did you get involved with MontgomeryHospice?

In 2003, my mother, who suffered from emphysema andAlzheimer’s disease, began her end-of-life journey. Her physi-cian recommended that we bring Montgomery Hospice intothe home. My family and I did not have any real understandingof what hospice care was all about. Though the emphasis atMontgomery Hospice is on the patient, their staff membersalso give tremendous support to the family. My mother, in hermoments of lucidity, knew that Montgomery Hospice was thereto help her. After a few weeks of exceptional hospice care, mymother passed peacefully. We were pleased to have bereave-ment support to help ease the pain of our loss.

After my mother died, my father decided to restart his re-tirement by teaching, attending senior education programs andtravelling. Unfortunately, he was only able to do that for a shorttime before developing his own health problems. For our fami-ly, seeing this intelligent, vibrant person fade into a state ofdepression and affliction was extremely tough. In 2009, hisdeterioration began to accelerate, and because of our wonder-ful experience with Montgomery Hospice, we called again forhelp with my father’s end-of-life journey.

Why should the community considersupporting Montgomery Hospice?

I have seen firsthand how Montgomery Hospice shines inthe care of both patient and family. Montgomery Hospice pro-fessionals are adept at dealing with the emotions of spouses,children and other family members, and are skillful with the pa-tients’ medical and emotional needs. I am not sure how ourfamily would have fared in those dark days without the help ofthe Montgomery Hospice staff. They made those days full oflove, dignity and respect.

Each year, more and more families turn to this gem in ourcommunity for help, and the professional medical staff andhighly-trained volunteers quickly respond. They wrap their armsaround an ailing loved one and the family with skill and compas-sion. Montgomery Hospice is a nonprofit organization that has

delivered excellent hospice care and grief counseling to Mont-gomery County for more than 30 years and does so regard-less of one’s ability to pay. I am proud to know that no one isturned away because of a lack of financial resources. Mont-gomery Hospice relies on the generosity of the community todo so. Reimbursement received from Medicare, Medicaid andprivate insurance does not fully cover the cost of care provid-ed, especially at Casey House, the only inpatient facility in thecounty built exclusively for hospice patients.

I am also proud because Montgomery Hospice is onceagain caring for the youngest members of our communitythrough Montgomery Kids, a specialized interdisciplinary teamproviding comfort care to children (infants through youngadults) as they approach the end of life. Professional grief coun-selors are part of this team and are available to support par-

ents and siblings, a support that continues for two years aftertheir loss.

What is the “Gentle the Journey” Campaign?The “Gentle the Journey” Campaign is an $8 million, 3-year

fundraising campaign that began in 2010. Through this cam-paign, Montgomery Hospice is raising critical support for a $4million endowment created to support Casey House NursingServices. An additional $4 million is being raised to supportMontgomery Hospice’s operational and program needs, whichinclude our Hospice at Home teams, Bereavement Care pro-gram (which is one of the largest in the country), Complemen-tary Therapies, and Community Education and Outreach.

As of today, Montgomery Hospice has reached the $5.5million milestone (in gifts and pledges) toward our $8 milliongoal. Montgomery Hospice is deeply grateful to two majorbenefactors of this campaign: the Healthcare Initiative Founda-tion and the Eugene B. Casey Foundation. Special thanks toour Corporate Partners who are recognized throughout thispublication; their support made it possible. We are also deeplygrateful to so many individual members of our community whogenerously support us.

How can you support Montgomery Hospicethrough this campaign?

As Campaign Chair, I invite you to join me in making a dona-tion to Montgomery Hospice today. Your generosity will help toensure that Montgomery Hospice can continue to respond tothe growing demand for services for all who need its care—today and well into the future.

While a donation of any amount is deeply appreciated, weinvite you to consider making a gift at one of our “Gentle theJourney” Campaign levels:n Hearts for Hospice Circle—the community-wide annual giv-ing circle recognizes donors who give from $250 to $9,999

n Gentle the Journey Circle—recognizes donors who pledgeor make outright gifts from $10,000 to $49,999

n Signature Gift Circle—recognizes donors who pledge ormake outright gifts at the $50,000 and above level

Thank you for helping to make a difference!


Frank McGovern, Executive Director9701 Veirs Drive

Rockville, MD 20850301-424-9560

www.thevillageatrockville.org

The Village at Rockville, a National Lutheran Community2nd year as a Diamond Level Corporate Partner

Gentle the Journey:the Campaign for Montgomery Hospice

“As Chair of the Foundation Board and the Gentlethe Journey fundraising campaign, I am honored

to be helping to raise philanthropic support forMontgomery Hospice, an organization that is

very important to me and my family.”

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Montgomery Hospice cares formore than 30% of county residentswho are dealing with life-limitingillnesses.

In 2011, Montgomery Hospicecared for more than 2,000patients and their families.

Montgomery Hospice providescharity care to patients who areuninsured or under-insured, thanksto donations from the community.

Our team of physicians, nursesand counselors serves those withlife-limiting illnesses through ourHospice at Home program and atCasey House, the only medicalfacility in the county dedicated tothe care of hospice patients.

Montgomery Hospice volunteersmake 200 patient visits per week,supporting patients, familymembers and caregivers by doingchores and being friendly visitors.Their generous donation of theirtime eases the burdens of patientsand families.

Montgomery Hospice providesloss and grief counseling atno charge topatients’familiesand any

community member who has suf-fered a loss. Montgomery Hospiceprovides grief support and educa-tion to more than 8,800Montgomery County residentsannually. We depend on communitysupport to provide this help togrieving people.

Complementary therapies, such asComfort Touch® massage,aromatherapy and music-by-the-bedside, increase comfort andreduce anxiety for patients. Theseextra services are made possibleby community contributions.

Montgomery Hospice educatescommunity members and health-care professionals about end-of-lifeissues and care through theMontgomery Hospice Center forLearning.

Your donations allow MontgomeryHospice to provide the best possi-ble care to our neighbors in Mont-gomery County who need our help.Contact the Montgomery HospiceFoundation at 301-921-4400.


Adventist HealthCareGold Level Corporate Partner since 2010, and supporter of manyMontgomery Hospice initiatives over the last eight years.

Barry Meil, Foundation Board Chairman, Ann Mitchell, President & CEO

Adventist HealthCare301-891-7600www.AdventisthealthCare.com

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Montgomery Hospice pro-vides compassionate, pro-fessional care for childrenwho have a life-limiting illness.We care for children of allages, from infants to teen-agers and young adults. Wesupport the children in theirhomes, surrounded by family,friends and the things thatthey love.

The Montgomery Kidsteam is a dedicated, interdis-ciplinary group of trained pro-fessionals who work with thechildren, their families, andtheir doctors or other care-givers. The Montgomery Kidsteam respects the wishes andpriorities of each child and family.

When do families call MontgomeryHospice?

Families often call us after years of treatmentand repeated hospitalizations, when they andtheir child’s doctors feel that the child could bene-fit from the expertise of the Montgomery Kidsteam members.

How does Montgomery Kids work withthe child’s current doctors?

The doctors who have been caring for the childcontinue to be involved, working closely with theMontgomery Kids team. Collaboration with othermedical professionals is crucial.

What medical services are provided byMontgomery Kids?

The hospice physician and nurse closely mon-itor the child, work to alleviate symptoms, man-age medications and equipment, and provide ed-ucation to the family and other caregivers.

Are treatments stopped when a childreceives hospice care?

No. The child’s physician and the hospice

physician, in conjunction withthe child’s family, decide on a“plan of care” that will providecomfort for the child.

What other servicesare provided?

The hospice social workerprovides emotional supportand works to solve practicalissues that arise. If desired, achaplain can visit to explorespiritual concerns. Trainedvolunteers are available toshare music or stories withthe child, help with siblings orrun errands.

The Montgomery Kidsteam strives to support thechild and the entire family, and

to help them deal with this extraordinarily difficulttime. Montgomery Hospice bereavement profes-sionals provide coping tools, tips on creatingmemories, and ongoing education about griefand loss.

How are services paid for?Most private insurance companies cover

hospice care, as does Medicaid. Donations tothe Gentle the Journey campaign allowMontgomery Hospice to provide financialassistance to families without insurance or anyother way to pay.

How can families learn more aboutMontgomery Kids?

A family whose child is struggling with a seri-ous illness can call Montgomery Hospice at anytime to learn more about the Montgomery Kidsprogram and the services provided. Members ofthe Montgomery Kids team are available to meetwith families in a hospital or in a home, at no cost,to provide detailed and specific information.

For more information, call Jim Dent, Mont-gomery Kids Clinical Manager, at 301-921-4400.

Why SupportMontgomery Hospice?How Your Gift Makes a Difference

Montgomery Kids

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T H E I R S T O R Y

In More magazine, the title of this article was “The Caregiver Chronicles” and these words introduced the piece:

ou don’t have to get all gussied up,” I toldher. “He’s a hospice rabbi. He’s used toseeing people in their bathrobes.” Even

though she knew the end was near, my mother wouldnot consider letting herself go—especially whenRabbi Gary Fink from Montgomery Hospice wascoming to call.

“I’m not people,” my mother said, propped up onthe hospital bed that had just replaced the single bedin her apartment. “And I don’t parade around in abathrobe when company comes.” Even now, at 95, im-possibly frail and tethered to an oxygen tank, Irenelooked glamorous in her blue silk nightie with the ivorylace trim.

“He’s not company,” I protested halfheartedly,though really there was no point in arguing. My moth-er, the former belle of Pittsburgh, would die before shelet any man see her undressed without her “face” on.

Which is exactly what would happen, but we didn’tknow that yet.

Two weeks earlier—before the buildup of fluid inher lungs started squeezing the breath out of her—Irene had called me on the phone sounding frantic.Hearing the wheezy panic in her voice, I panicked, too.Could this possibly be it? I wondered. After years of se-rial near-death experiences, could my mother—thewoman who joked that she was too mean to die—beon the brink of disproving her point?

No, she was not. The lady had more importantthings on her mind than life and death.

“Barb, help me, please,” she implored over thephone. “I’m absolutely going out of my mind. You’vegot to tell me: the bronze silk or the leopard chiffon?”

The retirement home where she lived was holdingits annual black-tie ball that night, and Irene was inknots over what to wear. Forget that she was wobbly onher feet, even with the walker. Forget that she had lungcancer. The lady was a coquette—adored by men, en-vied by women—a flirty knockout with a smart mouth.I counseled the leopard chiffon.

Irene’s cancer diagnosis had seemed to come outof nowhere two years earlier. She’d been admitted tothe hospital for chronic, unremitting back pain whena routine chest X-ray revealed a few suspicious-look-ing spots on her right lung. The biopsy confirmedadenocarcinoma.

My mother, then 93, chose not to treat the disease—or think about it. The tumors were small, and she did-n’t have a cough or any other symptoms. “I’m going toput it out of my mind,” she announced, taking theScarlett O’Hara approach. “Then it won’t bother me.”

Other family members—doctors—were less opti-mistic. “Chances are, she won’t make it to 94,” her firstcousin, a Boston internist, told me privately. This man,along with Irene’s nephew, a Pittsburgh doctor, was de-voted to my mother. Both men had been making pil-

grimages to her “deathbed” for years. They came rush-ing to her side after the emergency colostomy, thebleed on her brain, the hip fracture—and always leftastonished by her ability to bounce back.

“I’m afraid this time it’s for real,” Jerry, the Bostoncousin, predicted sadly.

“She doesn’t have long,” Ken, the Pittsburghnephew, agreed.

They should have known better. This was mymother they were talking about.

A CT scan taken six months after the initial diagno-sis revealed no change in the size of the tumors.Another scan taken six months after that was evenmore striking.

“I’ve never seen this before, and I’ll be damned if Ican explain it,” the oncologist said. “The tumorsappear to be shrinking.”

I was stunned. Boston and Pittsburgh werestunned. Irene seemed relieved, but not as surprisedas the rest of us.

MOST PEOPLE—EXCEPT FOR CERTAIN FAMILY MEMBERS

and service professionals trying to please her—foundIrene charming.

It wasn’t her fault, really, that I was impervious toher charms. Or that she, for most of my life, seemedunimpressed by mine. We were so different, bothproducts of our times, as well as our singular quirks

9

The mother: still glamorous and flirty in her nineties. The daughter: loving

but conflicted, convinced she’d been a lifelong disappointment.

What happens when the two women say good-bye...

“Y

BY BARBARA GRAHAM

T H E I R S T O R Y

MontgomeryHospice.org


and talents. I often felt as though we were mismatched,like two landmasses that don’t fit together—say, Green-land and New Jersey. Irene longed for a daughter whowould be just like her: a princess to her glamour queen.But I was an arty, waifish girl who rejected the wholepackage. I shacked up with a stoned cowboy in hippieoutposts from Boulder to British Columbia. When myman and I stayed in one place long enough to have aphone, I kept the number unlisted so she couldn’t calland tell me I was ruining my life.

That was in my twenties. By my midthirties, I haddumped the cowboy, had relocated from the woods toSan Francisco with my young son, was earning a living(more or less) by my pen and had married Hugh, a manmy mother approved of only grudgingly but later grewto adore. My parents were living in Florida then, andwe saw one another infrequently. Within a day or two,Irene and I would start to drive each other crazy, so Ikept our visits brief.

I never dreamed I would become my mother’s care-giver. My mother never dreamed that she would needa caregiver, or that my father would die and leave herto fend for herself—or, worse, leave me to fend for her.

Taking care of a sick, aging parent is not a job youcan train for. The training happens on the job, by theseat of your pants, and you are always one step behind,playing catch-up to the latest crisis. The only pre-dictable thing about the job is its unpredictability. Andin my case, the stubborn resistance of the caretakee.

Irene hollered and called me a bully. She accusedme of turning her into an invalid and fought me overeverything: the aides, the walker, the grab bars in theshower, the little alarm button she promised to weararound her neck but left in the bathroom the night shefell and broke her hip. The clincher was when shemoved, at my insistence, from Florida to a retirementplace in Washington, D.C., where I live now, so thatHugh and I could look after her. Once she arrived, Irenestarted addressing me as Mother in a tone so sarcastic,she sounded like me dissing her when I was a teenager.

My friend Mary Pipher, the author and psycholo-gist, once told me it’s human nature to love what—andwho—we care for, but Irene? I was skeptical, to say theleast. Although I never doubted that I would be a duti-ful daughter, I wasn’t so sure I could let go of the de-fenses that since childhood had been hardening insideme like bad arteries. Compassion, yes, but love? I wasdetermined to ease my mother’s suffering, but could Iunblock my heart? I worried that I’d be an outlier, therare exception to Mary’s Law of Human Nature.

MY MOTHER WAS A PARTY ANIMAL AND HAD BEEN A

celebrated hostess among her set in Pittsburgh, NewYork and Palm Beach. Although for years she’d beenthreatening supernatural retaliation if I dared to in-clude her age in her obituary—if she died—I’d throwna bash for her 93rd birthday. She hadn’t been doing well(this was shortly before the cancer diagnosis), and Iwas afraid that she might not see 94. But by the time 94

rolled around, her force of will seemed to have driventhe cancer into retreat, so I decided to hold off on giv-ing another party until the Big 95.

Plans were under way when the cancer finallycaught up with her. Her right lung filled with fluid, andshe was having trouble breathing. The pulmonologistrecommended draining the fluid so she could make itto the party. The procedure nearly killed her. Shebegged me to cancel the event, but I refused. Familymembers, including my son, Clay, were flying in fromaround the country. Anyhow, this was Herself. Thesmart money said she’d rally, and sure enough, on thenight of the party, the Belle of Pittsburgh showed uplooking like a million bucks in the bronze silk.

I think my mother had the time of her life at thatparty. After the toasts, she confessed that she’d alwaysbeen jealous of her own mother, envious of how mucheveryone who’d known Bessie had adored her. If Irenehad the looks, my grandmother—also a beauty—hadthe charisma.

“I finally know how my mother felt, and it’s wonder-ful,” Irene said, glowing, her paper-thin skin practical-ly translucent. “Because tonight I feel that way, too.”

It occurred to me that this might be the first time inher life that my mother felt worthy. Good. Deserving oflove, just for herself—not for her appearance, her zipcode, her fine antiques, the rich and famous peopleshe met, the five-star hotels she stayed in, her Chanelsuit or any of the rest of it.

I’m pretty sure Irene knew there would be no 96thbirthday fête. Still, she went right on as before: gettingher hair done, complaining about the food at theretirement home, barking at the help for multipleoffenses, agonizing over what to wear to the home’sannual gala. She called me for advice, and this time sheactually took it. She went with the leopard chiffon.

The real clue that she knew she was dying came in theform of a card she gave me on Mother’s Day. On the frontwas a watercolor of children in old-fashioned bathingcostumes splashing in the ocean. Inside, she wrote,

My mother was a party animal and hadbeen a celebrated hostess among her set in

Pittsburgh, New York and Palm Beach.

PERSONAL PHOTOS COURTESY OF BARBARA GRAHAM

“Happy Mother’s Day! I know why Clay has turned out tobe such a wonderful person.You have been a great moth-er. I know this is true because you have been a goodmother to me. I thank you for your caring and helpingme in every way. Thank you, dear Mother.”

This was the first time my mother had addressed meas Mother without a soupçon of sarcasm. It made mewonder if she’d been expressing gratitude, in her back-handed, wisecracking style, all those other times. Or ifsomewhere along the way, her tone had shifted, and Isimply hadn’t noticed.

Six weeks after the debilitating lung procedure—andtwo days after I’d asked the nurse if they were going tokick my mother out of home hospice care because shewas doing so well—the phone rang early one evening. Itwas Irene, sounding scared. “Can you please come overand help me,” she said. “I can’t stand up.”

From that moment on, everything happened sofast. Stepped-up visits by the hospice team, deliveryof the hospital bed, the start of morphine. Irene hatedit all, except when Boston Jerry, Pittsburgh Ken andGary, the rabbi from Montgomery Hospice, appearedat her bedside.

My mother had met with Gary several times before,and she’d grown to rely on him to help soothe her rest-less, fearful mind. (Plus, Gary was young, handsomeand Jewish, so she also liked flirting with him.) One dayI sat in with the two of them for the first time. WhenGary asked her what it was about me that she was mostproud of, she paused. “Who she is,” she said finally.“Just. Who. She. Is.”

A dear friend once wrote, “You learn the world fromyour mother’s face.” That day I learned my goodnessfrom my mother’s face. I told her that I loved her andthat I would miss her. This time there was no holdingback, no going through the motions, no saying thewords I love you with half a heart.

Each day a little more of my mother disappeared.First her sight, then her hearing. She started reachinginto space for things that weren’t there, and one after-noon she fell into my arms, weeping.

“I can’t see. I can’t hear. This is no way to live,” shesobbed as I held her and tried to comfort her. As if in thatmoment she really was my child and I was her mother.

Except, in point of fact, she was still my mother. StillIrene. Still the Belle of Pittsburgh. As soon as the tears haddried, she began fretting over what to wear the followingmorning when Rabbi Gary was due for his next visit.

“He’s a hospice rabbi,” I told her again. “You don’tneed to worry about putting on makeup or gettingdressed.”

But as long as she had a shred of consciousness left,my mother could not let herself go.What’s more, I thinkshe secretly believed that if she had the wherewithal topull herself together, she would be able to, if not outfox(in her case, outdress) death, then at least delay it.

And so the next morning, instead of greeting therabbi in her bathrobe, Irene insisted on getting dolledup. She couldn’t stand or walk on her own, so Dawn,her Jamaican angel aide, carried her to the bathroom

and helped her with her makeup. But that was as far asmy mother got before her energy simply gave out. Shetoppled over into the easy chair by the hospital bed,her mouth slack, eyes shut, softly snoring.

I knew how much she wanted to see Gary again, so Itried to rouse her, without success. The rabbi talked toher, too, and said a blessing, but she didn’t respond tohim either. My mother seemed to have slipped into arealm that was beyond sleep but this side of death. Afterseveral minutes, Hugh, together with Dawn and Gary,lifted her onto the hospital bed. She never awoke again.

In a way, her retreat could not have been more per-fectly Irene. My mother used up every last atom of herawe-inspiring, superhuman energy reserves to makeherself look pretty for the rabbi.

As I kept vigil at her bedside over the next week, Irealized that it didn’t matter anymore what she and Icalled each other. Mother or daughter, those roles weredone. Finished.

She was just Irene, a woman being swept away bythe current that sooner or later takes us all. This washer story, her passage, and I was her witness. It was thefirst time I really saw her as a separate person—ratherthan one who existed only in relation to me—and some-how, during the hours I spent by her side not trying todo anything except be present, something came un-hooked. All the things we fought over—my ripped jeansand wild hair, her ridiculous pretensions, my badboyfriends and so-called irresponsible ways, her yearn-ing for a daughter who would reflect her back to herself,my longing for a mother who would see me as I reallyam—seemed as insubstantial as a wisp of smoke.

Gone.I buried her in the leopard chiffon.

Selection by Barbara Graham, copyright © 2012 byBarbara Graham, which appeared in Exit Laughing:How Humor Takes the Sting Out of Death, edited byVictoria Zackheim, from North Atlantic Books. Adapt-ed and reprinted by permission of the author.

BARBARA GRAHAM is the editor of Eye of My Heart,a collection of essays about the perils and pleasures ofbeing a grandmother. Her articles have appeared inMore, O, National Geographic Traveler and many othermagazines. She is at work on a memoir. Visit her atbarbaragrahamonline.com.


Danzansky-Goldberg Memorial Chapels,Inc./Edward Sagel Funeral Direction, Inc.Silver Level Corporate Partner since 2010, and supporter of theannual Bereavement Conference since 2007. Ed Sagel, General Manager,

Mortician1170 Rockville PikeRockville, MD 20852-1408301-340-1400www.danzanskygoldberg.com

1091 Rockville PikeRockville, MD 20852301- 217-9400www.sagelfuneraldirection.com

PHOTO BY JERRY EISNER

Rabbi Gary Fink, director of

spiritual care at Montgomery

Hospice, helped sooth Irene’s

restless, fearful mind. Her last act

was to get dolled up for his

morning visit.

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