Hospice NewsW I N T E R 2 0 1 4

Grief vs. DepressionNoticing the differences

Hospice Team SpotlightLisa Malone, Registered Nurse

Balancing Faith and HopeHow the two impact end-of-life

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Brookings Health System Hospice would like to acknowledge with appreciation the following donations (received through 9/30/13):

In Memory of Dick FergenDick Fergen familySusan BerrySusan & David KarolczakBrad & Kim DahlWink’s JewelryRoger & Lois TealKevin & Erin TetzlaffDorothy HainesRick & Kristi LeeJim & Reyna MartinLionel & Fran TorgrudeRichard & Theanne PetersonAnne WestbrookScott & Nancy HodgesJames & Joanne SkybergSteve FoeresterStuart WebsterPowershop GymBarbara NelsonCarl RosePatricia BergeD/M ChicoineJeff LeeConnie KupecMark & Anita HandburyDean or Leona KrogmannLL Berry, LTDRenaldus & Carol Wentz

In Memory of Leo OsebyLeo Oseby familyNorman & Charlotte Zafft

In Memory of Kay BaumanRoger Bauman

In Memory of Bill KuechenmeisterRoger Teal

In Memory of Gussie FriedrichJohn & Kristin MorseM.E. McCannNancy Gries

In Memory of Leonard HuffmanBlanche ScheiRobert & Cindy Dezeeuw

In Memory of Evalynn SpildeJoann Wilgohs

Donation fromArlene (Susie) Hendrickson

Donation from Rudes Loft on the Level

Donation from Kathryn & James Berreth

David & Patricia MeyerMr. & Mrs. James BerginMary TofteTim & Brenda BjorklundLynne StarkJim & Molly YungingerAlan GreggJohn & Charlene KainVan & Barb Fishback

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V O L U N T E E R S P O T L I G H T : MeghanI have been a hospice volunteer for a little over a year.

I grew up on a farm east of Brookings with my mother, Lisa; father, Lynn; and my brother, Derk. On our farm we raised chickens, rabbits, cows, ducks, turkeys, and pigs. We also grow corn and soybeans. I was an active 4-H member for 12 years. While in 4-H I was involved in community service. During Achievement Days I brought fresh vegetables from our garden, canned vegetables, breads, and crafts for judging. In 2009 I graduated from Brookings High School and I am now in my fourth semester in nursing at South Dakota State University. I will graduate December 2014.

After my experience in 4-H with community service, I felt the need to keep volunteering. When I heard about the hospice volunteer program, I thought it would be a good fit for me because it would give me an experience that would be helpful to me as a nurse. I also thought it was a good fit because I love working with people. I am always interested in hearing about their life stories. I almost always take something important from them that I can apply to my own life. I also enjoy doing activities with the clients and being there for support.

There are many things I enjoy about working with hospice clients. They include interacting with the client and providing support for them. I also enjoy doing

activities with them and seeing them smile. I find it gratifying to be a part of their life and to hear about life events that were important to them.

Some thing I enjoy doing in my spare time is going to the lake. I love to fish, boat, or just relax on the shore. I also enjoy rollerblading or ice skating. Going to movies and hanging out with my friends are two other favorite activities.

H O S P I C E T E A M S P O T L I G H T : Lisa MaloneFor the past five years Lisa Malone, RN, has been a case manager for hospice.

LIsa fInds enjoyment in the one-to-one connection she is able to make with hospice clients and their families. She also enjoys helping them manage effectively whether they are in their home or a setting such as a nursing home.

Lisa received her bachelor of science in nursing from Missouri Western State University in St. Joseph, Missouri.

She is an experienced nurse who has worked in a variety of settings within the areas of St. Joseph and Kansas City, Missouri. For eight years she worked with patients in oncology/hematology. Another eight years was spent caring for pre- and post-operative cardiac patients. Lisa also worked in a home health care setting for three years. She brings a wide range of experiences to her care for hospice clients.

Lisa is married to Mitch, who is retiring from the military after seven overseas tours. He is currently the education supervisor at the Disciplinary Barracks, Fort Leavenworth, Kansas. They have two children. Jennifer is 14 and is active in the music program at Deubrook School. Charles is a Mite player for the Brookings Rangers Hockey.

Lisa enjoys gardening and also likes to sew. She likes to do sewing machine embroidery and makes quilts from old military uniforms. The latter started as a fund raising project for her husband’s unit and has since expanded with numerous requests. “The biggest challenge has been a uniform from the Korean War era. The fabric has begun to deteriorate and is fragile.” Lisa includes arm patches and other decorations from the uniform. Recipients find these to be an important and decorative way to remember their service.

Are you interested in becoming a Hospice Volunteer?We would like to have you join us! Our hospice program utilizes volunteers in a variety of ways at all levels of skill, from providing companionship to a hospice patient and their family, to assisting with meals, to doing administrative work in our office. We are in need of more compassionate and caring men and women. If you’re interested in volunteering, call Mavis at (605) 696-7700 for more information.

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Sadness, of course, is a consuming part of grieving. In fact grief is defined in Webster’s dictionary as “deep sorrow.” We often float about the word depressed when we talk about sadness. “I’m feeling so depressed about that! Boy, does she look depressed. This weather is depressing me.” Turning to Webster, one finds depressed defined as “saddened, dispirited.”

grIef, sorrow, feeLIng dIspIrIted, feeLIng depressed. Those of us who have lost a loved one would readily identify all of those as good descriptions of what we are experiencing. Those feelings and more are part of the usual grieving process.

What about depression? There is depression, as we frequently talk about it, as described above. There is also the depression as defined by those in the mental health field. This is Major Depressive Disorder (MDD) and is one of many mental health problems defined in the Diagnostic and Statistical Manual used by mental health professionals to help diagnose a mental health problem in the people they see as clients.

Sometimes those who grieve can slip into a depression defined as MDD. It’s important to point out, however, that this is certainly the exception and is more apt to happen if one has already experienced an episode of MDD. Though one may feel overwhelmed by grief at times, this is not the same as having MDD.

So what’s the difference? MDD is defined by a specific set of symptoms which some one has been experiencing for a specific period of time. That time period is “almost every day for the past two weeks.” Here are the symptoms:

1. Difficulty sleeping, characterized by difficulty falling asleep or awakening too early (say 3 a.m.) and not being able to return to sleep OR sleeping much more than usual – sleeping late in the morning, taking naps during the day and still being tired

Is it Grief or Depression?

Mavis GehantHospice Social Worker

Those who grieve have moments and even days when they feel “pretty good.” Those with depression feel down most of the time.

2. Loss of appetite or eating much more than usual

3. Excessive weight loss or weight gain

4. Feeling down, depressed or hopeless

5. Trouble concentrating on things such as reading or watching TV

6. Recurring thoughts of death, of harming ones self or thoughts of suicide

7. Feelings of worthlessness

8. Difficulty concentrating

9. Loss of pleasure in usual activities

Admittedly some of these symptoms are also experienced by those who grieve, especially the sleep disturbance, appetite changes and difficulty concentrating. There are, however, significant differences. Grieving has more of a roller coaster aspect to the emotional component whereas MDD is persistent. Those who grieve have moments and even days when they feel “pretty good”. Those with depression feel down most of the time. Grieving individuals experience moments of pleasure whereas those with MDD frequently do not. And grief rarely results in the feelings of worthlessness and low self-esteem characteristic of MDD.

Sometimes the differences may be difficult to distinguish. The bottom line is that if one’s sadness is interfering with one’s ability to function at home or at work and has been persistent for some time, it is wise to seek out professional help. That does not necessarily mean also needing to take an antidepressant medication. Many people with depression have a good outcome through increased self care such as paying attention to good nutrition, sleep hygiene and exercise (the latter alone can significantly improve mild to moderate depression). It may also be important to see a therapist to talk about one’s situation and gain a more helpful perspective. Addressing depression is important so that one may move on in a more satisfying way with one’s life.

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Faith and ResignationOne of the things I enjoy about being a hospice chaplain is the privilege of accompanying the dying through their death experiences. Being part of such a sacred and personal time is an honor. The dying process is somewhat of a mystery to me.

I don’t know how I will be when my time comes. Will I be at peace? Will I be afraid? I simply cannot say. All I can do at this point is learn from those who are actively dying. They teach me about what death is and what it means to die. And I am indebted to them.

Many of the dying I see have strong faith connections and religious beliefs. I enjoy listening to their faith stories. Many times I hear them say, “Faith helps me to cope with my illness. I know I’m going to heaven when I die. This is my hope.” Faith and hope are amazing qualities. The writer of Hebrews wrote, “Faith is the assurance of things hoped for, the conviction of things not seen.” Faith and hope are similar and yet dissimilar. Faith is about believing. Hope is about expecting and believing. More precisely, “hope” is a confident expectation. It’s the belief that what God has promised will most certainly come to pass. It takes great faith to believe in what we cannot see. It takes even more faith to hope in promises made yet unfulfilled. And yet there is hope. People expressing faith and hope through death experiences inspire me.

There is a difference between worldly hope and the Book of Hebrews kind of hope. A worldly hope, for example, might say, “I hope the Twins win the World Series this year. I doubt they will. But I hope they do.” Realistically, I’m sad to say that without divine intervention the Twins probably won’t win the World Series this year. Worldly hope is a feeling or wish that something might happen. Worldly hope isn’t necessarily wrong. There’s just no certainty behind it.

One thing I have learned as a hospice chaplain: the will to live is strong. Sometimes I hear patients say, “I’m not giving up. I’m fighting this cancer. I hope to get better.” That is a noble desire. My humanity identifies with it. But the reality is that depending on the cancer, getting better might not happen. In fact, in many cases it certainly will not happen. Acceptance can be a difficult thing. For some acceptance is synonymous with defeat. It means giving up.

I have learned from patients that there can be a balance between faith and hope. When asked about hope I have heard them say, “Sure, I hope to get better. I’m hoping for a miracle. But it’s okay if there isn’t one. I have accepted whatever happens.” And that’s the key. Illnesses and disease are not necessarily messages from God or tests of faith. They just happen. I wonder if accepting whatever happens is what faith is really all about. Accepting illness and death isn’t about giving up and shutting down. It’s not about dying, but living. It is about pursuing -- not a cure necessarily, but those things that are truly meaningful. Acceptance -- faith gives the time and the energy to live and to love and to reflect with the time that is given. I wonder. Aren’t those the things that are truly worth pursuing?

“I’m not giving up. I’m fighting this cancer. I hope to get better.” That is a noble desire. My humanity identifies with it. But the reality is that depending on the cancer, getting better might not happen.

Gregg TeBeestChaplain

As 2013 comes to a close, we look back upon a successful year and we are very grateful for your support.

you heLped make a home for 79 people when The Neighborhoods at Brookview opened in June. Thanks to your participation in our sporting clay event, a portion of the former Brookview Manor was repurposed and remodeled to establish an outreach specialty clinic allowing patients to see medical specialists here at home.

Dear Foundation Friends,

together we Launched PINKAP, the Tough Enough to Wear Pink assistance program to help uninsured and underinsured patients purchase post-mastectomy products from the Brookings Health System/Avera Home Medical Equipment store. PINKAP funds may also be applied to the cost of breast biopsies and lymphedema therapy from Brookings Health System.

foundatIon funds supported health and wellness education including training for Hospice and Home Health employees as well as a free program for area nurses featuring the author of Chicken Soup for the Nurses Soul. Your donations provide full scholarships for children attending the Brookings Health System “Let’s Go 5-2-1-0” program to fight childhood obesity. This year, the program was expanded to the Brookings Boys and Girls Club, and to the communities of White and Arlington.

BrookIngs heaLth system is focused on providing superior health care for our community having a direct impact on our quality of life and economy. These efforts result in ratings above state and national performance averages as seen on www.medicare.gov Hospital Compare. In August, The Neighborhoods at Brookview earned the coveted 5-star rating via Nursing Home Compare.

BrookIngs heaLth system foundatIon enables you to participate in healthcare philanthropy to rally round Brookings Health System. Next year, we will work to support expansion of the ambulance fleet as well as the next phase of the master campus plan including renovations to the existing hospital. As you prepare your giving plans for 2014, please remember to include Brookings Health System Foundation. For more information please call (605) 696-8855 or email foundation@brookingshealth.org.

Sincerely,

Roberta Olson—Foundation Board Chair Ardelle Roberts—Foundation Board Vice-chair Bruce Lushbough—Foundation Board Secretary/Treasurer David Kneip—Foundation Board member Jason Merkley—Foundation Board member Barb Anderson—Foundation Development Officer

Thank You!

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Hospice News is published by Brookings Health System. This publication in no way seeks to serve as substitute for professional medical care. Consult your physician before undertaking any form of medical treatment or adopting any exercise program or dietary guidelines.

300 Twenty-Second AvenueBrookings, SD 57006

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We Extend Sympathy to the families of patients lost through December 2013:

Ida Kay Bauman 4/25/46–11/3/13

Myrl Bruemmer 11/9/24–11/2/13

Richard Fergen 1/21/42–10/11/13

Naomi Gilkerson 1/19/26–12/25/13

Robert Henninger 1/5/33–11/16/13

Leonard Huffman 9/6/36–10/24/13

Lois Jorenby 4/1/36–10/17/13

Howard Kjellsen 12/22/27–10/5/13

William Kuechenmeister 10/29/25–11/17/13

William Murfield 7/20/42–12/31/13

Doris Newman 5/13/58–12/14/13

Leo Oseby 3/4/16–10/27/13

Edna Reed 1/1/15–10/8/13

Verda Schulz 6/15/24–10/22/13

Evalynn Spilde 12/20/10–12/12/13

Sheryl Ulrich 10/5/60–11/8/13

Jeannette Waage 11/15/14–12/26/13