Hospice... Improving the final stages of life

BERNIE, Mo. -- Jed McGowan, like many folks, made some poor choices when he was younger. Because of one of those choices, though, he now finds himself in the final stages of life, suffering from COPD, a progressive lung disease.

"I started smoking when I was 13 years old," McGowan related Monday from his home in Bernie. Although the warnings were there, he says that in his teens, it was the "cool" thing to do.

Today, at 56, McGowan is under the care of hospice. He lives with his parents, both in their seventies, and is dependent upon oxygen 24 hours a day to help him breathe. He also has a host of medications and a pair of inhalers.

While Jed McGowan regrets that he ever started smoking, and even more so that he didn't stop smoking when he started having breathing problems in his 40s, he is grateful for the care he's receiving.

It is that care, says Legacy Hospice Community Educator Waynetta Rodgers, that has sustained Jed in his final stages of COPD.

"Not everyone would have done as well as Jed has," says Rodgers of the Bernie native. "But he's in a home that is clean, free of smoke and pets, and that helps in so many ways."

McGowan is a U.S. Army veteran who joined the service following high school. He then spent five years in the National Guard in a unit near St. Louis. He worked in a factory until his health problems became an issue. He has been back in his hometown since June 2014, and has been in hospice care for nearly that long.

November is National Hospice and Palliative Care Month -- a time to heighten awareness of the work of the many hospice organizations in and around Stoddard County.

McGowan is under the care of Legacy Hospice out of Sikeston, but with several patients in Stoddard County. Rodgers is a Bernie native who coincidentally went to Bernie Schools with McGowan and his siblings.

In spite of Jed's prognosis, the McGowan household is a positive environment. Jerry and Shirley McGowan work hard to accommodate the extensive needs of their son. Jed's room is well equipped with a hospital bed, a television, a computer, an overhead fan and all the conveniences to make him as comfortable as possible. And always heard above the sound of the television or the computer is the constant "whoosh" of the oxygen tank that is helping Jed to take each breath, day and night.

Jed receives a number of services from Legacy Hospice, but also receives services from VNA and others.

"A common misconception is that when a patient is with hospice, it negates other services," Rodgers explains. "That's just not true. Jed's a prime example of that. He still receives care from other agencies, and each one is vital to his well being."

While the hospice nurse regularly arrives at the McGowan household to take care of Jed's hygienic needs, the nurse also closely monitors his medications -- what is working and what might not be working as well as hoped.

"For that reason, his medications are prescribed for only a two-week period," Rodgers explains. "That way, if something needs to be altered, we're not wasting medications that were prescribed for a few months."

"Sometimes the nurses come twice a week," says Jed. "Sometimes they're here three times. I'm not having to take as much medication as I was when I was hospitalized."

Jed's comfort is uppermost in the minds of the Legacy hospice organization.

"Jed is fortunate to have the care of loving parents," says Rodgers. "And in truth, he is likely in a lot better shape than most COPD patients at the same progression because of that care. He's in an excellent environment."

COPD, or chronic obstructive pulmonary disease, is a progressive disease that makes it hard to breathe.

COPD can cause coughing that produces large amounts of mucus, wheezing, shortness of breath, chest tightness, and other symptoms. Cigarette smoking is the leading cause of COPD, and Jed smoked most of his life.

"I quite once after my diagnosis, but I started again. Then I quite a second time and I never picked one up again."

Long-term exposure to other lung irritants--such as air pollution, chemical fumes, or dust--also may contribute to COPD. While Jed believe he may have been exposed to other irritants over the years, he knows that his smoking was the primary contributor to his illness, and that illness is progressing.

"The doctors have told us that he is in the final stages of the disease," Shirley McGowan notes. "But those final stages can last even a few years."

Along with the misconception that hospice rules out all other help from outside agencies, another misconception is that hospice only addresses the medical needs of the patient.

"All hospice groups have at least one chaplain," says Rodgers. "And while they address the spiritual side of final stages of illness, they also fulfill the need for social interaction."

McGowan confirms that often the Legacy chaplain comes by to talk or watch a ballgame together.

"That gives a patient an outside source of social-ability," Rodgers explains. "It doesn't always have to be on a spiritual plane. That's a real misconception. You tack on 'chaplain' to a name, and it's automatically assumed that their visits are always on a spiritual scale. That's not always the case. Most people don't realize the scope of a chaplain."

"Having hospice in the home has made such a big difference," Shirley McGowan attests. "Just the physical aspect of taking care of a patient can be overwhelming, but knowing that you're totally responsible for someone's care can really be stressful. It's a lot of work to keep a patient bathed, keep track of his medications, make sure he's comfortable."

Shirley notes that the family receives meals from the Meals on Wheels program through the Dexter Nutrition Center.

"That's one meal that I don't have to worry about, and that helps so much," she says.

In spite of the situation the McGowan family finds themselves in during this holiday season, they are quick to give thanks to the caregivers that bring a sense of relief and comfort to their home and to their son.

Hospice is an idea, not a place. The idea is that if a loved one has an incurable illness, and treatment to prolong life and keep the illness under control no longer works, there is still something that medical science can do. Even if life cannot be prolonged, comfort can always be provided, and it should be provided effectively. Although hospice is an idea not dependent on a particular place or facility, it is delivered to the patient and the family at a place. That place is most often the patient's home because that's where most people would like to be in their final months.

While this article focused on care provided by Legacy Hospice, there are several hospice agencies in the Stoddard County area including VNA, Four Oaks Hospice, Preferred Hospice and Tri-County Hospice. Each is credited locally with providing excellent care and a variety of valued services to their patients.