Franciscan St. Francis Health’s Palliative and Geriatric Care

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Franciscan St. Francis Health, Indianapolis Campus, 8111 South Emerson Avenue.

As I stood in front of the bed, I watched the busy, but efficient nurse gently remove the oxygen strap from my mother’s face. Just for a moment, Mom’s cloudy blue eyes opened. She whispered, “Don’t leave.” “I won’t, Mom.” Tears streamed as I tasted fear. For three days in October, Franciscan St. Francis Hospital’s fifth floor Center for Geriatric Care had been my 87-year-old mother’s home. There, she was treated for pneumonia and complications from a malfunctioning aortic valve. Two aspirations in less than 48 hours required honoring her living will and Do Not Resuscitate (DNR) order.

The transfer to the rolling bed with the foam waffle mattress caused Mom to groan. My sister-in-law, Pam, and I followed the bed and the “get well” balloon bouquet to Palliative Care, approximately a hundred feet and two automatic doors away.

As I watched the day nurse, Mary, tend to my mother’s new needs – primarily to slow the frantic breathing and make her comfortable – Mother Teresa’s life mission of caring for the dying came to mind. Providing free hospice for the “poorest of the poor” in Calcutta, she once said, “A beautiful death is for people who lived like animals to die like angels — loved and wanted.”

Dr. Nicolas Priscu and Monica Magna_5.1
Director of Franciscan St. Francis Health’s Geriatric Care unit Dr. Nicolas Priscu and Day Nurse Monica Magna.

Later that night when Center Grove resident Teresa Bowman walked into the room, I knew God was in control. A friend from church, Teresa and I reconnected in just a matter of minutes. When she converted the window loveseat into a trundle bed with crisp white sheets, I knew the night would have some peace and rest. Teresa, a 1988 University of Evansville nursing graduate, knew when she was five years old her life’s work would be nursing. Years later when her stepfather lay dying in the hospital of kidney and esophageal cancer with no emotional support for their family, she felt the need for focused end-of-life care. Even though there is an emotional toll in caring for the dying, Teresa notes, “You do get invested in the families. You feel blessed that they allow you into their lives for that brief period of time.”

Teresa’s faith, along with her mother’s example of caring for her own 99-year-old mother, motivates her. In addition, she appreciates that at Franciscan St. Francis, nurses can pray with their patients.

“Before I go in there, I pray so much for them to see God in me, for Him to use my hands and feet.”

Day nurse Monica Magna, a former Greenwood City Council member, sees wisdom in palliative care, a six-bed unit that officially opened in August, 2012. Its full-time and part-time staff includes Director Dr. Nicolas Priscu along with administrative staff, social workers, nurses, nurse practitioners, doctors, and chaplains. “It’s a wonderful idea to have a dedicated unit to take care of the sick and dying, removing them from the busy floors.”

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Franciscan St. Francis offers palliative care to those diagnosed with a life-limiting disease such as COPD, cancer, dementia, or severe cardiac disease. Patients who have experienced a serious medical event such as heart attack, respiratory failure, or stroke may also receive it. Regardless of the stage of disease or the need for other therapies, palliative care can be provided concurrently to prolong life or as the main focus of care.

Julie Saunders, nurse, Center for Geriatric Care_1
Julie Saunders, nurse in the Center for Geriatric Care.

Dr. Priscu, who oversees both palliative care and hospice, first saw the need for intentional end-of-life care when his 81-year-old father was dying in 2004. His father, who was suffering with congestive heart failure complicated by an acute rupture of his Mitral valve, grew weary from the frequent “revolving door” hospital trips and wished for home. Hospice became the answer. “I was very impressed by the compassion and savvy of the hospice RN who showed up at my parents’ home around midnight, about 12 hours before he died, two months before his 82nd birthday.”

From that personal and emotional experience, Dr. Priscu asked his father’s doctor to mentor him and then later took the first ABIM-recognized palliative/hospice board exam, receiving certification. What he enjoys most about his role as director is giving patients and families new goals and targets inpatient care, where traditionally doctors just “give up hope” when no further curative attempts are indicated or desired.

“Death is inevitable for all of us, and there should always be a goal, whether it is a comfortable death, or just relief from constant trips to the ER, or relief of one or more particularly frustrating symptoms.”

According to Priscu, “Staff is everything.” He sees them as “a special group of people who are dedicated to their patients and who never seem to run out of energy. It is not an easy job to be involved with high numbers of patients that will most likely die in a relatively short period of time.”

Like my mom, palliative care patients may begin their hospital stay in the state’s only Center for Geriatric Care, focusing on patients 65 years and older. Center Grove residents Julie Saunders and Tamara Crowder find their nursing duties there both challenging and rewarding. Because of serious medical issues and failing physical abilities, 5-West patients require constant care. However, the rewards, according to Tamara, outweigh the workload. “The older people are very kind, loving, like to talk, share stories about their families, and appreciate what you do for them. They often give me hugs at the end of my shift when I come in to tell them goodbye.”

Julie mentions the challenge of keeping up with the patients’ needs, saying, “Think roller skates!” The staff must daily provide treatments, medications, exercise, nutrition (which may include spoon-feeding), emotional support, and home care planning. She, like Teresa and Tamara, depends upon her faith. “I have prayed and asked God to help me make good decisions, to know who to ask to help me make those decisions, and the strength to meet the physical, emotional, and spiritual needs of my patients. He has never let me down!” cg

 


 

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Joyce Long, Greenwood Middle School language arts teacher from 1992-2000, has called Center Grove home for the past 25 years. Currently Joyce works as the communications coordinator for Center for Global Impact and is passionate about engaging people to empower the poor.

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