Eight years ago when my mother came under hospice care in Jefferson County, I experienced first hand what Kathie Campbell of Hospice of the Eastern Panhandle, refers to as the “end of life tool kit:” the guidance, support, and information for patients and their families that hospice provides. Hospice workers know what is in store for terminally ill patients and their families, and, at the same time, are open to the unique unfolding of someone’s life. My mother, diagnosed with lung cancer, moved in with us too weak to take care of herself.

Hospice’s first and foremost mission is to make sure the terminally ill patient is given adequate routine home care. Hospice provided, and Medicaid paid for, everything she needed to be comfortable and free of physical suffering—equipment (hospital bed, oxygen, shower stool, wheel chair,), palliative medicine, supplies, a weekly nurse’s visit, and other staff as needed. It also offered a variety of therapies, volunteer relief for me, her primary caregiver, and 24-hour online support.

As the chemicals from the chemotherapy treatments left her system, my mother grew stronger. She was discharged from hospice and spent 14 months in relative good health. Four months before her death, she returned to hospice. As my mother faced dying, and I and my husband our loss, we relied on both medical and more subtle benefits of hospice.

Campbell says that calling hospice is opening the door. Hospice staff—nurses, social workers, chaplains, a variety of therapists—are experienced at helping patients and families find their way during the patient’s decline and dying. They help patients maintain dignity as they weaken and need more and more care. They support caregivers so they don’t burn out. They help the patient and family come to terms with their losses. It becomes an opportunity to soften, to let go of whatever needs to be freed, to say what needs to be said, to acknowledge the impending losses. As Dr. Ira Byock puts it in Dying Well, the terminally ill patient has to go through the taskwork, the stages of discovery, insight, and adjustment that are unique for each person and that are important to complete one’s life.

My mother spent her last four months accepting her death. A stream of family visitors came to say goodbye, local friends frequently visited, and occasionally she was well enough to go out for lunch or to run errands. The pain medication, oxygen, and medical advice made these months rich with laughter as well as with sadness. A social worker visited to help my mother work through whatever she needed to complete her life. A chaplain visited, too.

Where did this wonderful medical agency begin? Hospice began in the early 1970s, founded by Dame Cicely Saunders in London. A doctor, nurse, and social worker, she advocated better treatment for the dying, treatment that controlled pain, involved the family, and helped the patient and loved ones cope with their loss.

Hospice of the Panhandle was created in 1980 as a grassroots, all-volunteer organization. Ten years later it had grown to a Medicare-certified, nonprofit medical agency. It now serves anyone who is medically referred to hospice care. Eighty percent of its patients are in Medicare; 15 percent are on Medicaid. It has a $12-million budget, but nearly a million dollars of service each year is provided without compensation. Hospice relies on community support to provide its service.

In the Eastern Panhandle nearly half of people who die do so under hospice care. In addition, the bereavement team works with anyone in the community coping with the death of a loved one, in or out of hospice.

In many ways, hospice is a model for medical care for our society. It provides the patient and family with what is needed. It treats the patient as a whole person with body, mind, and spirit taskwork to do. And it recognizes the interrelatedness of the terminally ill patient to family and the community.

My mother-in-law understood this. She was the primary caregiver for her husband during his illness 12 years ago. After his death she became a hospice volunteer, winning the hospice of the year award in 2006. She died, under hospice care, earlier this year.