Palliative Staff as a whole does a wonderful job making sure that all of our Veterans' needs are met when they are on the Palliative Care Unit and they always go "above and beyond". The following is such an example.
A Veteran was admitted to the Palliative Care Unit for end of life care, his wife was still living at home even though she also had been diagnosed with a terminal illness and was also at end of life. She and the Veteran would often visit in Veteran's room, hold hands, reminisce and plan to join one another in Heaven. During the Veteran's admission, one of their son's tragically committed suicide. The Palliative Care Staff did all they could to support the family during this very difficult time.
Eventually, the Veteran's wife was no longer able to come to the VA to visit her husband due to her own terminal illness. Staff was told that she would soon be admitted to Zilber Hospice and had a prognosis of days to weeks to live. The Palliative Care Staff were very aware of how difficult this separation was for the Veteran, his wife, and their entire family. The Palliative Care Nursing Staff started to think about and review options of how they could facilitate the Veteran visiting his wife one last time in their home. The Nursing Staff spent a great deal of time and effort to coordinate with the Palliative Care Social Worker, VA Travel staff, Medical Staff, and Management to work together to make this very complex and complicated last visit happen even though something like this had never been accomplished before and at times it seemed to be like a Herculean undertaking. Through their unrelenting efforts, they were able to arrange for a one-time travel via ambulance with a Palliative Care RN who volunteered to accompany the Veteran on this last home visit.
Palliative Care RN wrote a Summary of their experience:
"Today the Palliative Care Team was able to complete the last wish of a patient in our care on Heroes' Corner. The Veteran was diagnosed with renal cancer 4 years ago. He received chemo and radiation therapy and was diagnosed with bone cancer this year. He was being cared for by his wife in their home. Unfortunately, she was diagnosed with pancreatic cancer in March of this year and due to declining health for both of them, she was unable to continue to care for him in their home when he became too weak to walk. At that point, he was admitted to our care on Heroes' Corner. She and their family have been frequent visitors to the Veteran during his stay. Recently, the family experienced another tragedy when their adult son, committed suicide and left a wife and young daughter. The Veteran's wife's health has continued to deteriorate after his death and she has recently been admitted to home hospice. The Palliative Care Team has continued to provide emotional and spiritual support during their complicated grieving process.
Kaz, RN and I discussed how we could do something positive for this family that is experiencing so much loss. We brought an idea forward to Kim Melton the CNL of Heroes' Corner to investigate if there was a way to bring him home to have a last visit with his wife and their family. Kim further discussed this with Don Weir SW, Patty Starr NP, and our unit nursing managers Joan Koehn-Fogl and Bobbie Glaser. Together we were able to create a plan for him to go on a trip pass for 2 and a half hours to visit his wife and family in their home. Kaz consulted with PT to confirm that his Broda chair would have the proper cushion to provide him comfort and measurements were taken to confirm it would fit in the van and through the doors to his home. Today we were able to make his final wishes a reality. At 0930 Veteran and I left Heroes' Corner for his final trip home. The Vet asked the driver, Marianna, to take National Ave "so I can see some of my favorite spots one last time." He pointed out a favorite pub and a Wok restaurant that used to be a drive-in where the waitresses served the food on roller skates. He arrived at home at 1000. Marianna assisted him into his home via the garage entry. His wife, her 2 sons and her daughter were present. The Vet was positioned beside his wife in her recliner. He stated he was comfortable. The Vet enjoyed time spent at home holding his wife's hands, watching cooking shows on TV and sharing stories of their joy of cooking together. He snacked on a ham and cheese sandwich, chicken broth, pumpkin bread, chips and soda with his family. At noon I provided the Veteran with his pain medication in anticipation of our ride back to the VA. I then informed the family I would provide them private time and would be immediately available on the porch if he needed any assistance. The driver returned at 1220, I entered the room and the Veteran asked that his Broda chair be turned around so he could face his wife. He leaned over and hugged his and wife stated to her, "I'll see you in heaven", he stated, "it won't be long." The family said their goodbyes and we returned to the van for the ride back to the VA. He and the family thanked me and the team multiple times for this final opportunity."
The Veteran died soon after this visit, and his wife died just a week after that. The family had a Joint Funeral for both the Veteran and his wife. The family thanked the VA staff for all that they did to provide him with excellent care and especially remembered the staff for taking the extra special effort to make sure that the Veteran and his wife were given a last chance to be together at the home that they shared for so many years. I think that the Palliative Care Nursing Staff had a vision and worked with the Palliative Care Team to make this miracle happen due to the trust and confidence that they had built up while working with the Veteran, wife and their family. I think that the Palliative Care Staff showed how dedicated they are to serve the Veterans and honor the VA Mission in this example and in so many small ways every hour of the day. The Palliative Care Staff provided Veteran and his wife/family dignity and respect in this example and really, in each and every interaction. Palliative Care Staff always strive for the highest quality of care and are always looking for ways to provide the best care possible for the Veterans with whom they serve. I truly believe that the Palliative Care Team deserves to be recognized for all of their efforts in this case and so many more.