December 14, 2018

A journey of dignity: Combined effort promotes palliative and hospice care as ‘embodying Catholic teaching’

Comfortable rooms decorated with family photos and meaningful mementos—such as this room of a war veteran at Franciscan Hospice House in Indianapolis—are typical of hospice care homes. Hospice care, which falls under the umbrella of palliative care, seeks to help terminally ill patients live out their final days in comfort and peace. (Photo by Natalie Hoefer)

Comfortable rooms decorated with family photos and meaningful mementos—such as this room of a war veteran at Franciscan Hospice House in Indianapolis—are typical of hospice care homes. Hospice care, which falls under the umbrella of palliative care, seeks to help terminally ill patients live out their final days in comfort and peace. (Photo by Natalie Hoefer)

(Editor’s note: The Criterion is running a series of articles on senior-related issues through the lens of the Catholic faith. This final installment will focus on the new Hospice and Palliative Care Initiative, a collaborative effort of the Archdiocese of Indianapolis, Ascension St. Vincent and Franciscan Health to support, raise awareness of and educate on palliative care and hospice care. Read part one, part two and part three of this four-part series.)

By Natalie Hoefer

On Jan. 6, 2016, archdiocesan chancellor Annette “Mickey” Lentz was present in an official capacity for the blessing of a new building conducted by then-Indianapolis Archbishop Joseph W. Tobin. She’d been to many such events before.

But this one was different.

“I was so impressed,” she says emphatically. “It felt like a sacred place.”

The building being blessed was not a church, chapel or shrine. It was Franciscan Hospice House, a 12- (soon to be 16-) bed medical facility of Franciscan Health on the south side of Indianapolis. There, the terminally ill can receive around-the-clock care with the primary goal being the comfort and dignity of the person and their family.

“As we took the tour and learned about hospice care,” says Lentz, “I thought, ‘I don’t know any of this, and I’ve been a caregiver three times. If I don’t know this, what do my kids know, what does my staff know? What are the right ethical things to say? We need to arm people with this information.’ ”

A year and a half later, the Hospice and Palliative Care Initiative was under way.

‘Spirited vision and energy’

After the eye-opening blessing, Lentz shared her thoughts with John Short, director of development for the Franciscan Health Foundation in central Indiana.

“He suggested we talk about Franciscan Health, St. Vincent [now Ascension St. Vincent] and the archdiocese coming together to do some fundraising,” says Lentz. “Not an event, but something to draw attention to the challenges [of raising awareness of hospice and palliative care] and how we might meet them.”

Short recalls dinner conversations with friends about the subject, including with Archbishop Tobin, who conveyed “his spirited energy and vision for our Roman Catholic archdiocese, wishing we could bring together the two [hospitals] for a project with the archdiocese.”

A plan began to develop. It was based on a vision of “programs of education and parish resources in hospice and palliative ministry, drawing upon the notion that every family in support of their loved ones’ end-of-life [journey] or serious illness seeks the wisdom and prayers of their parish priest or neighborhood minister,” says Short.

Lentz knew such an effort “was going to take a lot of time, a lot of work and a lot of money,” she says.

She, Short, Archbishop Tobin and others conducted a private fundraising event. Nearly $150,000 was raised to launch the initiative, with the majority of funds donated by Michael Browning of Browning Investments construction firm in Indianapolis. He is a member of St. Luke the Evangelist Parish in Indianapolis.

‘There is a battle being fought’

The enthusiasm around the topic stemmed from one key principle: the dignity for the sick and the dying that hospice and palliative care offer, and how such care embodies the Church’s teaching on respect for all life.

“There is a battle being fought in our culture of death,” says Brie Anne Varick, coordinator of the archdiocesan Office of Human Life and Dignity. “Our vulnerable sick, suffering and elderly are being fed the lies that they are a burden.

“Many are afraid of death and the dying process. Many are afraid of being a burden to our loved ones. They are afraid of intolerable pain and suffering, losing their freedom with loss of control over their bodies, a fear of being abandoned and alone, or there is a fear of lingering in a state of limbo with Alzheimer’s disease or dementia.”

Society’s answer to such thoughts and fears, says Varick, is physician-assisted suicide. It has been spun as “death with dignity” and “mercy killing,” and it has already been legalized in three countries and seven states, plus the District of Columbia.

The Church’s response to physician‑assisted suicide is an approach of “love, support and companionship.” The United States Conference of Catholic Bishops wrote on the subject in their 2011 statement “To Live Each Day”:

“Our society should embrace what Pope John Paul II called ‘the way of love and true mercy”—a readiness to surround patients with love, support and companionship, providing the assistance needed to ease their physical, emotional and spiritual suffering. This approach must be anchored in unconditional respect for their human dignity, beginning with respect for the inherent value of their lives.”

It is just such an approach that hospice and palliative care offer—in personal residences, nursing and assisted living facilities, in hospitals or in specialized facilities run by hospitals.

But not all people are aware of this approach, or if they are, “their knowledge is based on misconceptions and misinformation,” says Dr. David Mandelbaum. He is medical director for palliative care services at Franciscan Hospice House in Indianapolis, and co-director of Franciscan Visiting Nurse Service Hospice.

“The problem facing hospice and palliative care today is that people don’t understand the difference between hospice and palliative care, so they use the terms interchangeably,” he says.

Same approach, but ‘two populations’

Mandelbaum defines palliative care as an approach that “provides collaboration of the patient’s doctor with other physicians, nurses, social workers, the chaplain and caregivers. The same approach is used to serve two populations.”

The first population are those who receive palliative care, which he defines as “an umbrella of care that is all about quality of life and team support of patients and their families through a serious or life-threatening—but not necessarily terminal—illness.”

Such patients are “undergoing curative therapy,” he says. “They’re not terminal, but they may still benefit from the input of a palliative care team giving spiritual [from a chaplain] or psychological support [from a counselor], or symptom management” from a pain specialist, such as easing pain while receiving chemotherapy or radiation for cancer.

The second population are the terminally ill. They receive a subset of palliative care called hospice.

With hospice care, Mandelbaum says, “The illness is incurable or the patient is no longer pursuing a cure. It’s all about the patient’s comfort and dignity and quality of life for however many days they have left.”

Mandelbaum, who represents Franciscan Health in the joint initiative to support, raise awareness of and educate others on palliative and hospice care, is excited about the effort.

“How appropriate that such a collaborative form of health care is being promoted by the joint efforts of the archdiocese and two health care systems—in a world where hospitals are in competition for business,” he notes.

‘Foundational elements of Catholic health care’

Elliott Bedford, director of ethics integration for Ascension St. Vincent, is the initiative’s representative for the hospital. He, too, is enthusiastic about the effort.

“As an ethicist, I want to help people to know God and go to heaven,” he says. “To do this, they need to make good choices, and I want to help by offering good ethical counsel. If people don’t know the good choices they have available, like palliative care or hospice, that’s a disservice.”

Palliative and hospice care are “foundational elements” of the Catholic philosophy of medical care, he explains.

“They recognize human beings in both their wholeness—body, mind, spirit, relationships—and their limitations and frailty. They meet people where they are in their journey, and they try to help the patient and their family have life to its fullest in their particular situation.

“When given the chance and done in the appropriate way, it can be downright beautiful in how they ensure the suffering person is respected and cared for.”

Bedford describes the initiative’s goals as “awareness, collaboration and promotion of the Church’s support for palliative care, advance care planning and living well. (See related article.)

“It’s time people in the pew really understand these things,” he adds.

‘An overwhelming desire for more’

The initiative’s first official event was a free, half-day palliative care and hospice care conference, held at Marian University in Indianapolis in June. It was open to “all those in the community who are interested in learning more” about the topic, says Varick.

In support of the initiative, Archbishop Charles C. Thompson opened the conference with prayer.

“Feedback from the conference indicated there was an overwhelming desire for more,” says Varick. Consequently, the same conference will be offered again on March 11 at St. Paul Catholic Center in Bloomington.

She is also pursuing the creation of videos “to promote the truth, beauty and goodness of hospice and palliative care,” she says.

The initiative is in its infancy stage. But as Varick notes, “The threat to the dignity of our vulnerable, our elderly, our disabled, mentally ill, sick and suffering is not going away anytime soon.

“Our families, community and medical professionals need to rise up and support those who are sick and suffering. Hospice and palliative care does this.”

(For more information on palliative care and hospice care, or to donate funds toward the initiative to raise awareness of and educate about palliative care and hospice care, go to [case sensitive]. To register for the free palliative care and hospice care conference at St. Paul Catholic Center in Bloomington on March 11, go to [case sensitive].)


Related: Topics and goals of palliative care and hospice care initiative

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