Casey House: An Important View
by Grace Brooke Huffman, MD, CMD
Associate Medical Director, Montgomery Hospice
When I was asked to write about the work done at Casey House, I first considered telling you about some of the regulations governing the use of in-patient hospice care. That seemed dry (even to me as a physician dealing daily with those constraints), so I thought of telling you about how we – the physicians and nurse practitioners at Casey House – expertly treat pain, shortness of breath, anxiety, agitation, nausea and other symptoms that might occur as someone approaches death. We have advanced training and interest in serving those at this point in their journey.
However, that might leave you thinking that Casey House is about our expertise and knowledge. We certainly do provide medications, and listening ears, and a variety of complementary and non-pharmacologic therapies, and we try to skillfully choose which ones are most appropriate at the right time for each particular patient. So Casey House is about our expertise, but not just that.
I then thought of writing about the superb staff at Casey House who work tirelessly, patiently and collaboratively to mitigate suffering that can occur when a loved one has received an upsetting prognosis, or developed a new pain, or is struggling to find meaning in their situation.
The work our excellent staff does is hard, but they do it without complaint and without wearying. You might wonder and ask (as many do), “How can you work day in and day out with people who are suffering?” Our work at Casey House might even make you more thankful for the work you do in your own daily life! Casey House is about our staff, but not just that.
I could talk about the patients we care for: those ill with cancer, heart disease, dementia, and hundreds of other diagnoses; young, middle-aged, elderly; males, females; African-American, Asian, Caucasian, and every race in-between; agnostic, atheist, Buddhist, Christian, Hindu, Jewish, Muslim and all other faith traditions; the poor, the rich, the solidly middle-class; and those from the Western hemisphere or from lands distant from Montgomery County, Maryland. We serve anyone who needs the help we can provide. The stories of their lives and illnesses might bow your shoulders or bring tears to your eyes, but we all consider it a privilege to care for them as they are.
That realization—that the lives of the people we serve are what matters—made me think of this quote from Harper Lee’s To Kill a Mockingbird where Scout’s father offers the following wisdom:
“First of all,” he said, “if you can learn a simple trick, Scout, you’ll get along a lot better with all kinds of folks. You never really understand a person until you consider things from his point of view….”
So here is what I want you to know about the care we are honored to provide at Casey House. Although we usually have only a short time to get to know our patients, and the circumstances might be challenging, we try, as best and quickly as possible, to see things from our patients’ points of view. It is a truism in hospice that we “meet people where they are,” and those who work at Casey House are exceptionally good at this. We want to know the lives and the goals of our patients – even when those lives and goals might be more limited than any of us would hope.
- A middle-aged woman weakened with lung cancer wants to feel the snow on her face. The nurse and nursing assistant cover her with blankets and wheel her bed outside to the courtyard.
Casey House is a place where goals are achieved.
- A young boy skips into Casey House to visit his mother—our patient—proclaiming that he is four years old and today is his birthday. Staff members buy cupcakes and balloons and sing Happy Birthday in a celebration that will be remembered by many for a long time.
Casey House is a place where life and joy occur.
- Furniture is rearranged so that a soon-to-be family member can play the cello for her fiancé’s mother, who will not be able to see the growth of this new family.
Casey House is a place where sustaining memories are made.
- One newly-retired husband has tired of endless tests and procedures in the hospital. After a professional life spent travelling abroad, he looks forward to finally getting to spend time with his children. Although he is not able to have that future that he imagined, his wife tells me that Casey House is a “refuge,” truly a place of calm for the entire family to hold him and let him know that he is adored.
Casey House is a place of love and peace.
Yes, there are many regulations, there is difficult medical care requiring our expertise, and there are hard conversations. But please remember this: while we unflinchingly and daily deal with all of those issues, Casey House is most of all about discerning how life looks from the eyes of patients and their families and about helping them find the meaning which enables this portion of their journey to be gentle, dignified and valuable.