By Sheila Julson

Until the mid-century, many people died at home in familiar, comforting settings. Through medical advances and changing family structures, dying at institutions such as hospitals and nursing facilities became commonplace. However, the pendulum is swinging back, thanks to strides in hospice and palliative care—an offshoot of the hospice model designed for those with acute long-term illness. Through efforts by organizations such as Hospice of North Idaho, patients can stay in their homes as death nears or illness looms, while receiving psychological and spiritual support along the way.

Hospice of North Idaho has served the families of Kootenai, Shoshone and Benewah counties since 1981. As the area’s only nonprofit hospice organization helping people regardless of ability to pay, the organization also operates the six year-old Schneidmiller House. The 14-room inpatient unit facility has private accommodations for patients and their loves ones. Licensed social workers Kelly Rey and Kelly Hurt both have extensive careers working with people in end-of-life situations, and they were drawn to Hospice of North Idaho’s nonprofit model.

“Our hospice program is 36 years old, and our palliative care program serves acute chronically ill patients in the community,” says Rey. “Palliative Care is a community-based program, so we do not bill any insurance. It’s a free service where we have a nurse and social worker go out to visit with clients.”

The organization balances nursing care with spiritual and holistic aspects related to dying. Spiritual Care Coordinator Jennifer Hackenbruch begins the process by informing clients of the organization’s services and offering spiritual and emotional support. If clients are part of a faith-based organization, Hackenbruch reaches out to leaders of those groups to arrange a visit for the patient.

“My main role is to visit patients and listen and talk about the end of life process,” Hackenbruch explains. “I ask them if they said all of their ‘I love you’s’ and ‘good-byes,’ or if there anything left unsaid that needs to be said. I also offer support to the families. It’s different with every patient, and I meet them where they’re at. I do not bring my own spiritual beliefs into the room.”

Rey notes a societal shift in how people handle discussion about end-of-life care, as well as differences between rural and urban dwellers. “Those who live far into the woods or mountains are more apt to have the attitude that they’re okay with everything, and that nature brought them peace. In populated areas, I didn’t hear that as much.”

Building trusting relationships can open the door to honest conversations about dying and finding spiritual peace. Hurt observes that once a comfort level is reached between patients and their social workers and health care providers, patients and their families soon discover they’re not alone on the difficult journey. “Everyone I’ve worked with who is dying is always thinking about it, but not everyone wants to talk about it,” she says. “Sometimes patients wants to talk about it but don’t, because they don’t want to hurt their families. It can be very difficult to get that dialogue going, but our team brings in different personalities that offer different aspects of death and dying—the physical, the spiritual the emotional—and as a team, we’re all there.”

Hospice of North Idaho’s pool of 200 volunteers offers support such as sitting with patients at bedside and reading to them, running errands, or bringing in pets for companionship. “It’s building a healing connection,” Rey says. “When you’re dying, you’re so vulnerable and everything is coming to a head—your fears, your uncertainties—but our staff comes in to let people know that we’re in this together.”

A comprehensive bereavement department at Hospice of North Idaho offers support groups and services for adults and children, their families and the community. At the Schneidmiller House, people can enjoy soup, cookies or coffee and find solstice in the meditation room, library or the outdoor waterfall. Construction is underway for a new building on the Schneidmiller House campus that will serve as a resource center with spiritual education programs, bereavement groups, caregiver support and more.

A ticketed black tie fundraising gala takes place February 3, featuring local food, hundreds of wines and a live auction. “Most people who come have a hospice connection or a story to share,” says Director of Communication Denna Grangaard. “The room is filled with love and appreciation about human connection. It’s beautiful energy.”

Hospice of North Idaho is located at 9493 N. Government Way, Hayden. For more information, call 208-772-7994 or visit HospiceOfNorthIdaho.org.

Sheila Julson is a Milwaukee-based freelance writer and contributor to Natural Awakenings magazines throughout the country.