Unfortunately, the following situation is one that’s far too common and happens every day in Wyoming and all across the country. A family is gathered by the bedside of a loved one who’s been seriously ill, and now is likely near the end of life. Each family member has a different idea of what should be done and what their loved one would have wanted.

Unfortunately, throughout the course of the illness, the family never discussed what the care priorities should be in the final months and weeks of life. When these important decisions go unaddressed, it can leave a dark shadow over the death of a loved one that can linger a long time in the memory of family and friends. No one wants to think they might have done more after a person is already gone.

“It’s important that you don’t wait until you’re in the midst of a healthcare crisis,” said Marilyn Connor, director of Central Wyoming Hospice & Transitions. “It can make an already stressful experience even more trying on both the patient and their family.

“And often when the time comes, the patient isn’t able to speak for him- or herself,” Connor said. “That’s why it’s so important to have the conversation early, before it’s too late.”

Central Wyoming Hospice & Transitions is Casper’s only non-profit hospice facility. It serves patients at the end of life, with both inpatient and outpatient care services. When a family is coping with a serious illness and a cure is no longer possible, Central Wyoming Hospice & Transitions provides the type of care most people say they want at the end of life: comfort and dignity. Considered to be the model for high-quality, compassionate care for people with a life-limiting illness, hospice care includes expert medical care, pain management and emotional and spiritual support. An interdisciplinary team of professionals and trained volunteers provide care. And the wishes of the patient and family are always at the center of care.

Hospice also provides bereavement services to anyone in the community who needs it, regardless of whether their loved one died in hospice services. “We’re here for patients and their family before, during and after the dying process,” Connor said.

Central Wyoming Hospice & Transitions can help you start your end-of-life care conversation. Their new website (www.cwhp.org) has resources for how to start the conversation, how to create a living will, and how to plan for the cost of end-of-life care.

Connor offered some final advice. “One of the best ways to make sure you and your loved ones benefit fully from hospice and palliative care is to talk about it before it becomes an issue.”

Central Wyoming Hospice & Transitions is a non-profit organization. Through the gracious financial support of the community, they never turn away a patient for their inability to pay.

For more information about hospice and how to start the conversation, call 577-4832 or go to www.cwhp.org.

Fundraising experts say that a nonprofit organization should never plan a fundraising event unless the event depicts the agency’s mission. If that is true, then Central Wyoming Hospice and Transitions is right on target with their annual fundraising event, “Roaming Wyoming”.

The premise of hospices across the nation is to provide quality of life when it is not possible to add quantity. Hospice is about making every day count and fulfilling all a person’s goals while you are still able. That is also the premise of Roaming Wyoming! The event offers participants the ability to purchase unique Wyoming adventures that may be on their bucket list. Adventures included a weekend of glamping (gourmet camping) completed with massages and catered food, dinner for eight in the purchaser’s home prepared by a professional chef, a guided fly fishing trip, a backpacking trip, a golfing weekend, an evening of star gazing and much more.

An added feature of the event is the recognition of a True Wyoming Family. The 2011 recipients of the True Wyoming Family award was Susie and Demier True. The event was complimented with music and dancing by the Swings Sounds.

The attendees were given the opportunity to support Central Wyoming Hospice and Transitions charity care program through the purchase of a quilt square for our Quilt of Love. The quilt squares, completed with messages written by the purchaser, will be assembled and hung in one of the hospice homes. The quilt is symbolic of the fact that every bed in the hospice homes is adorned with a handmade quilt.

Proceeds from the event will be used to provide charity care for those individuals in need. The staff and Board of Directors at Central Wyoming Hospice and Transitions sends a sincere thank you to all of the participants and attendees for making the evening a great success!

By Dusty Johnson
Incoming President of the Board

Often, we take services like fireman, policeman, or ER health care providers for granted, until you need their skills. Our family had never thought about end of life care until my father-in-law, Tom, needed care during his last days.

Tom was born, schooled, and raised his own family all within a 2 block radius for the past 91 years. In 2004, he lost his wife and for the next 7 years he lived independently with little help from his immediate family. His family loved and supported Tom, but he was healthy and very independent and made all of his own decisions. A World War Veteran and The Great Depression were major events which forged his strong character.

But, in the winter of 2009, Tom had a fall which left him on the kitchen floor for approximately 24 hours. This fall was the beginning of a year which followed with several emergency trips to Great Falls. Finally Tom’s doctor said enough is enough and directed Tom and the daughters to make arrangements for Hospice care.

Tom could have stayed in Great Falls, but that was not an option for the family. They wanted to be close to him during these final months. I told the family about our wonderful facility in Casper and would consider it a privilege to be with Tom. I remember the California daughter having some skepticism about a small community like Casper having accommodations that would be up to her standards for providing the care her father was so deserving of.

Tom was not an easy man to be around. He like things done a certain way and had no problem of telling you when it was not done right. We all had been on the end of Tom’s disapproval bark more than once and feared for the hospice’s staff.

At first Tom’s days were filled with apologies to the staff from his family. Tom was short and demanding and without a doubt upset that he had been uprooted to come to Wyoming. But, as his stay stretched out from days, and weeks, to months, our apologies were fewer. No matter what Tom threw at the staff, he was treated with dignity and respect during his last four and half months of his life. To our amazement the staff relayed that they enjoyed Tom’s spunk. My wife said it all when she said, “The staff met Dad where HE was. They didn’t try to change him for their convenience.”

Our family could not have imagine what Tom’s final days would have been like had it not been of Central Wyoming Hospice. Words could never express our gratitude to the staff and volunteers for providing a world class facility like Central Wyoming Hospice.

The Central Wyoming Hospice & Transitions Resource Center introduces New Resource Library. This library is open to the community to view or check-out its various resources. The library houses books, videos and other information pertaining to end-of-life issues for adults and children, including: Tips for Caregivers; Advance Directives; Grief and Loss; Self Care; Surviving after the death of a loved one; and Community Resources. For more information on our resource library or how you can support our efforts to provide this service, please contact us at (307) 577-4832 or stop by and see us at 319 S. Wilson in Casper.

The Central Wyoming Hospice & Transitions Resource Center provides you with a professional staff of Speaker’s Bureau members who may share information about our services as well as a variety of end-of-life topics.

We are happy to talk to your company, group, or organization on several end-of-life topics, free of charge and would be happy to tailor a presentation to fit your needs. Topics include but are not limited to:

• An overview of our services
• Advance Directives
• Talking to someone with a terminal illness
• Grief and Loss
• When a co-worker dies
• Transitions: Support for the terminally ill
• Volunteering: Making a difference
• Hospice Finances
• Signs & Symptoms of the dying process
• End of Life Rights
• End of Life & Spirituality

For more information or to schedule a presentation, contact us at (307) 577-4832.

By Amy Fitzpatrick, PCSW
Bereavement Coordinator

Often grief has a tendency to feel isolating and in the midst of our grief we can lose sight of whom or where we can turn to for support. In these times, it can help to have someone to talk to and with whom you can share your thoughts. Please know that it is not uncommon to feel that those you expected to be there seem distant. Sometimes you may need to ask for help. Our supporters at times fear that they will not be able to help, or perhaps, make things worse. So, they might appear hesitant or not there in your time of need. Letting them know that you just need someone to listen to you, someone who will let you cry or someone to help with errands is all that you need.

Some identified support can be found through Friends, Family, Neighbors, Counselors, Doctors, Church, Civic Groups, and Clubs. Remember, you are not alone. If you are looking for individual, family or social support please contact CWHTP at (307) 577-4832.

By Ryan Bair, LCSW
Transitions Coordinator

The Transitions Program focus is to assist clients in having the best quality of life possible through providing case management and volunteer services. Through case management clients receive assistance in reaching community services that may provide support in several aspects of daily living. Volunteer services include: companionship, errand running, transportation, light meal planning and light housekeeping. There is no fee to clients. The only requirement for admission to the Transitions Program is approval from the client’s primary healthcare provider, verifying that the client has a life-limiting illness with an estimated prognosis of two years or less.

Aligned with our philosophy of serving the whole family, Transitions offers a Primary Caregiver Support Group every Thursday from 2pm to 3pm. The support group offers both a safe place to process stressors as well as brief education from Certified Nursing Assistants. Our participants have expressed appreciation for the opportunity to voice concerns and receive professional guidance when taking care of their loved one. Recognizing that being a primary caregiver may be difficult, we work with a team of volunteers as well as clients in finding community support to be with your loved one while you attend. All Primary Caregivers in our community are welcome to attend. If you or someone you know is performing this heroic task please feel free to contact us at (307) 577-4832.

By MARTIN KIDSTON
The Billings Gazette

CODY — Many years ago, Randy Leisey was told that life is learning to deal with a series of losses.

It seemed like a negative outlook when he first heard it said, but as time has gone by, he thinks it’s beginning to make more sense.

Leisey, the spiritual counselor and volunteer coordinator at the Spirit Mountain Hospice Center in Cody, has made a career out of helping people deal with loss.

He spends his days listening to stories of grief and helping patients find a comfortable end to life.

“Sometimes we have to encourage them to let go,” Leisey said as snow fell beyond the vaulted windows of Wyoming’s newest hospice center. “There’s always unfinished business. We have those kinds of conversations, and you never know where they’re going to go.

As the countdown to Christmas was under way, Leisey wandered the halls of Spirit Mountain, waiting to lead a bereavement talk scheduled to begin at 10:30 a.m.

A Christmas tree stood in the foyer, and “love lights” decorated the mantel over the fireplace. Shaped like ornaments, the little placards carry mementos written by family members who recently lost a loved one.

“Generally, hospice care is pain control,” Leisey said. “We enable people to have good quality of life up to the end — up to their capabilities. When they’re here, the decision has already been made that a cure is no longer possible.”

With baby boomers growing older, Wyoming is facing a shortage of hospice centers and the services required to meet the needs of an aging population.

Looking toward the future, West Park Hospital District trustees approved a capital campaign in 2008 to fund Spirit Mountain, and construction began a year ago this month.

The $3.2 million facility opened in October and is the only hospice center within a 100-mile radius. Leisey expects it will fill an important niche in rural Wyoming in the coming years.

“There are only five of these in the whole state,” Leisey said. “The centers in Cheyenne and Riverton were getting patients from this part of the state. Now, we’re getting referrals from Worland and Thermopolis. It really fills a need.”

Adults 65 and older now represent more than 28 percent of the population in Park, Washakie, Hot Springs and Big Horn counties. The Wyoming Division of Economic Analysis predicts that will increase to 35 percent by 2020

Spirit Mountain is ready. Hospital officials expect that the facility will serve 100 patients a year, with an average stay of 29 days. Meals, medical supplies and medications are provided by West Park Hospital.

Aside from offering routine in-home care, Spirit Mountain also offers respite care and general inpatient care, or when additional support is needed in the final weeks of life.

The center’s staff includes nurses, nursing assistants and social workers. Religious support is available as needed.

It’s the spiritual aspect of death and dying that gets Leisey talking. He’s made a career of helping patients and families deal with death.

“Even though people aren’t necessarily church members, they love to see me,” he said. “We just talk about the meaning of life. I love to hear their stories. I don’t have any agenda with them, other than recognizing that we all have a spiritual component, and it’s different for everybody.”

Loss is never easy, but the holiday season can be especially hard, Leisey said. He calls it a poignant time of year, and he talks about grief and its many forms.

Dealing with loss on a daily basis is not easy work, he admits, and the emotional toll can add up, even for a spiritual provider accustomed to the work.

“We grieve about the way we used to feel about Christmas when we were young, the magic of the season,” he said. “We grieve for the people we’ve lost over the years. It’s a matter of asking the creative question, so they continue telling their story and getting it all out. It doesn’t happen in one sitting.”

By Elysia Conner
Casper Journal

With an empty space at the table and a Christmas stocking bearing the name of someone who’ll never open it again, holidays don’t feel the same. Some don’t feel like celebrating at all after losing a loved one. Those reactions are OK, according to Dee Ann Lippincott, clinical therapist at Central Wyoming Counseling Center

“People shouldn’t feel pressured to celebrate if they don’t want to,” Lippincott said. “If you don’t want to and if you don’t have the energy, then don’t. But I would also say, don’t isolate and maybe have a plan for those days like Christmas Eve and Christmas Day.”

Amy Fitzpatrick, a social worker at Central Wyoming Hospice & Transitions, also recommends taking some alone time when needed but to also consider limited socializing too.

“You don’t have to stay for the whole event, and you don’t have to go to every event,” Fitzpatrick said. “But think about accepting a few invites. Don’t isolate and withdraw during the holidays, because there’s a fine line between that and taking your alone time.”

So what if the prospect of the usual holiday celebration is too much? Plan ahead to do something else, those who work with grief say. Some of Lippincott’s clients find comfort in honoring the memory of loved ones through volunteering or donating in that person’s name. Some hospice clients schedule activities that give them pleasure and it doesn’t even have to be about the holidays, according to Fitzpatrick. Taking a trip or spending the day with someone in a similar situation also might be a good option.

The idea is not to avoid grief; expect and accept some sadness

“Of course, allow yourself to cry,” Fitzpatrick said. “It does show strength to be able to cry and it’s very healthy.” Don’t hide your feelings from children, she added, it only teaches them to deny their feelings.

“If you have children and there’s been a loss, there’s going to be happy/sad moments,” Lippincott said. “You’re happy because your children are experiencing the joy of Christmas, but there’s still this huge other piece where you’re so sad.

Joining a grief support group or just knowing others out there are experiencing the same thing can help people feel less alone.

“This time of year, you think that everybody else’s life is great and they’re having this Normal Rockwell Christmas and here you are with this horrible loss,” Lippincott said. “But there are a lot of people experiencing loss.”

Fitzpatrick also recommends people not “catastrophize the holidays.” Don’t expect them to be wholly miserable and be open to the possibility of some happiness. Many people feel up to some celebration, but opt for a smaller, quieter gathering.

“It doesn’t have to be all or nothing,” Lippincott said. “You may just want to do something different this year or even start a new tradition.”

Remember to take care of yourself, Lippincott added. She recommends not stressing over holiday activities, getting exercise, eating healthy and avoiding excessive alcohol.

“Alcohol is a depressant and it doesn’t make anything better,” Lippincott said.

Also account for other grievers’ needs when it comes to traditions, Fitzpatrick suggested. The family all lost the same person but each member misses a different kind of relationship. For instance, one person lost a life partner while another person lost a dad.

“Those losses, those experiences, those memories around the holidays are different so their needs are going to be different,” Fitzpatrick said. “So look for that compromise and a little bit of give-and-take. It’s never an easy task.”

Everyone grieves differently. Some might find comfort in carrying on traditions as before or even cooking favorite foods of the person no longer there. For others, those reminders may be too painful.

Maybe grandpa always carved the turkey or big brother placed the star atop the tree. Families can plan out who will carry on a tradition handled by the person who died. Or maybe it will feel right to modify a tradition or start a new one.

Some like to do something in remembrance, like hang something in the window to honor the loved one, light a candle or make a toast. Some families opt to treat themselves to a dinner out instead of cooking.

Be sure to include everyone, especially children in those decisions, Fitzpatrick suggested.

Gifts are a big part of the holidays, but some clients find going to stores decked out for the holidays is nearly debilitating, Fitzpatrick said. Many have an easier time buying online.

Even years after a death, the holidays can still be a difficult time. It can help to plan ahead for the holidays and other significant days throughout the year. It’s most important to allow yourself to feel what you’re feeling and communicate how you feel to family and friends, Lippincott said.

“There’s no right or wrong in grief and there’s no right or wrong in how we celebrate the holidays when loved ones die,” Fitzpatrick said.

We are very grateful to all of our supporters who have made our Wish List Program successful. We appreciate all that has been donated to our organization. If you would like to donate any of the following items, or make a cash donation to help us purchase some of the larger items, mail them or drop them off at the Administration Building at Central Wyoming Hospice & Transitions, 319 S. Wilson St., Casper, WY 82601.

Direct Patient Care

• Tide Free High Efficiency liquid detergent
• CD Players for patient rooms
• Straight-edge safety razors
• Blood Pressure Cuff
• Sponsors for books and needed publications
• Two over-bed tables
• Finger Oxymizers
• Hair Clippers
• New Digital Camera
• Pull-Up Briefs with elastic waist (L and XL)
• AED Defibulator and AED Trainer
• Postage stamps (first-class)
• Chapman Home Dining Room Chairs ($150 each)
• Staff Education Funds

For the Hospice Home Kitchens

• Water Pitchers
• New Pots & Pans
• BBQ for the Chapman Home
• Kleenex and paper towels
• Folgers coffee (regular and decaf)
• Decorative paper plates and napkins
• Styrofoam or paper cups
• Electric Teapot for Chapman Home
• Lg. Countertop Grill

For the Office

• Lg. Bookshelves for Resource Library
• White and colored printer paper and Cardstock
• New Flat screen Monitors
• Dry erase markers
• Dividers
• New Stand Alone Projector Screen
• Letter-size manila folders and hanging file folders
• Funds for new printers
• Heavy-duty paper shredder
• Avery 5160 Address labels
• Avery 8387 Postcards

For the Recording of Oral Histories

• Dragon Naturally Speaking Premium 11
• Sony ICDUX200 digital voice recorder