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Saying goodbye with grace and dignity

For some people, death is scary and depressing subject.

The fear of the unknown is paralyzing.

As a registered nurse, Julie Ostling has seen her fair share of death. Some men and women have died of old age after living life to its fullest; others have died of cancer or illness decades before their "time."

Nonetheless, death isn't sad or intimidating at all, Ostling said. It's a time to reflect on life and love in a positive light - a lesson she learned as an Assured Hospice employee of 12 years, caring for people nearing the end of life.

Now, as the community education coordinator and liaison for Assured Hospice of Clallam and Jefferson Counties, Ostling shares her hospice experience with others.

Hospice care is focused on patient comfort and pain management. Together, a team of RNs, CNAs, therapists, counselors and trained volunteers works to provide the highest quality of life for people with terminal illnesses.

Though they have the least amount of professional training, volunteers are perhaps the most important piece of the hospice puzzle, according to

Ostling. "We always say the heart of our hospice team are our volunteers," she said. "(And) they are just 'regular' people who want to give back."

Nationally, about 100,000 people serve as hospice volunteers and give millions of hours of time to terminally ill patients and families.

No task is too big or too small for a hospice volunteer. Volunteers offer companionship, share hobbies and special interests and help with household chores. Sometimes a volunteer might just sit with the patient, lending a shoulder to cry on or an ear to listen or simply serve as a warm, caring presence in the room.

Specific activities might include sharing favorite childhood memories, looking through family albums, helping write a personal memoir or perhaps talking about deeper issues such as death. Other volunteer opportunities include helping with special projects, mailings, planning a reception, clerical support and fundraising.

Volunteers aren't paid. Not monetarily at least.

"You become a part of the family and they become part of yours," Ostling said from experience. "The patients I have worked for, there are a few where I am still in contact with their family members. We are friends."

Terry Segal, comfort therapy coordinator for Clallam and Jefferson counties, said being a hospice volunteer permanently changed her life - for the better.

"I was transformed by my encounter with him and his family," Segal said, recounting her friendship with a man who suffered from Lou Gehrig's disease and ultimately convinced her to transition from practicing massage therapy privately to hospice care before he died. "They completely changed my life on every level possible," she said about the man and his family.

It's not easy work but the personal rewards are enormous, Segal continued about hospice care, describing the volunteer experience as an honor. "They allow this support to come into their lives and build relationships ... I am always awed by that," she said. "Time is so precious and they let us into their lives and share what limited time they have left."

The hardest part, Ostling jumped in, is knowing from the beginning that the patient is going to die. It might not happen that day, or the next week or even that year, but the person will die. Despite that knowledge, it's not a "sad" experience, she reiterated firmly. "It's not sitting around talking about death and doom - it's about talking, sharing and helping each other. We know the patients are going to die but that's not what hospice is about. Hospice is about how you live and what we can do to make their time alive more peaceful and comfortable."

Ostling and Segal are working together to recruit hospice volunteers. Assured Hospice of Clallam and Jefferson Counties is offering a free hospice volunteer and comfort therapist training series Oct. 9-24. Participants must complete 24 hours of extensive training over a period of four days before being eligible to work with a patient.

And then, Ostling said, be prepared for a life-changing experience. "You will never be the same. It is very meaningful," she said. "You don't realize how much you will learn from each patient and their family. We go in and think we are helping them but the truth is we gain so much from seeing the strength they have and learn so much from them as they walk that final walk."

New research finds that patients live longer under hospice care. A study published recently in the Journal of Pain and Symptom Management reported that hospice care actually might prolong the lives of some terminally ill patients. Among the patient populations studied, the average survival rate was 29 days longer for hospice patients than nonhospice patients, the study concluded.

"It's not uncommon for patients to start doing better once they start getting hospice care," Ostling backed up. "We see it happen all the time."

Potential volunteers who are unable to attend the October training dates are encouraged to contact Assured Hospice for more information about upcoming training opportunities. Call 582-3796 or go online to www.assured.org.



'When home is where you want to be'

Hospice is a special way of caring for people who are dying from a terminal illness. Patients are referred to hospice care when they no longer want aggressive curative therapies and seek palliative or "comfort" care. Hospice addresses physical, emotional, spiritual and financial needs of patients and families. Teams are available 24 hours a day, seven days a week. Medicare and Medicaid offer full hospice benefits, as well as some private insurance programs. For more information about hospice care or to see if a patient is eligible, call 800-833-9404 and ask to speak with an intake coordinator.



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