Hospice Mazatlán IAP is a non-profit community based healthcare organization.
It has been more than two years since I talked about the challenged charity Hospice Mazatlán. I say “challenged” because when a group of people decide to create a charity in a given city they and the citizens see an unfulfilled need. It is just that fulfilling the need does not generate a sufficient profit, if one at all, to entice a for profit organization to step in and fill the void. We can see that here in Mazatlán with charities for animals and children, just to name a couple.
But, when Lois Croly decided Mazatlán needed a hospice, the citizenry didn’t even know what that was. The term “palliative care” was not in their vocabulary. I have not asked her, but I have wondered whether Lois, like Kevin Costner in the movie Field of Dreams, one evening heard a voice saying, “Build it they will come.”
But, whether she heard a voice or not, she built it. It is now led by a Board of Directors comprised of Amaya Peña de Cevallos (President), Luis Cabellero, Hector Treviño, Silvas Casas, Gordon Wainwright, Alicia Vasquez, and, of course, Lois Croly.
The staff is directed by Dr. Levid Torres Guzman, Medical Director and Adriana Carrillo Paredes, Director of Operations.
Yes, she built it and they certainly came!
Through the first of this week, Hospice Mazatlán has provided palliative care to 160 terminally ill patients this year. This compares to the 112 patients served last year; a 43 percent increase! As of the end of October, Hospice Mazatlán’s nurses had made 2,703 individual nursing visits, compared to 1,614 for all of 2013. Doctor visits and visits by social workers were also up dramatically, 53 percent and 74 percent, respectively.
Although palliative care was unheard of in Mazatlán when Hospice Mazatlán began in 2007, Mexicans comprised all but three of the charity’s patients this year. Through the efforts of Hospice Mazatlán, its board of directors and staff many Mexicans in Mazatlán now acknowledge that often there comes a time when medicine can longer heal and all we can do is make our loved ones comfortable until it is time for their life to end.
But, unlike what expatriates would envision during this time of waiting and reflection, it is quite different in the culture of México. Last time I wrote about Día de los Muertos, the Day of the Dead. This Mexican festival celebrates the fact that death is not the end of a story, but the beginning of a new paragraph in it. Life merely continues on another plane and death is a time for celebration, not mourning.
That may have been true centuries ago, but it is not now. Today the Day of the Dead is pure symbolism. Although I cannot say Mexicans fear death, I can say they do not talk about it. When I wrote about Hospice Mazatlán in 2012 I mentioned that it was only in 2008 that the law was changed so that a physician was obliged to obey the wishes of a terminally ill patient who wants to suspend life-prolonging treatment, leave the hospital, and return home for their final days.
Obviously under this law the doctor must tell his patient their prognosis, so the terminally ill can make a decision. However, over six years later, few physicians have found a way to tell a patient he or she will not survive. Today that is just not the Mexican culture. It seems as if a Mexican acknowledges that death is the only option, they permit death to come. Relatives often fear that if their loved one accepts their own death, they will give up and die sooner. It is almost like silence will keep the grim reaper at bay; to me an odd fact when the Day of the Dead celebrates death.
So in almost every instance, those receiving palliative care from Hospice Mazatlán have not been told their time on earth is short and death is inevitable. The physician may have told the family, but certainly not the patient.
So how does the family, who knows their loved one will be gone in a matter of a few months, talk to their dying relative? In the United States and Canada the conversations runs the gamut, but they are basically what people appreciate hearing at any time of life: words of candor, reassurance, and love.
Ira Byock, a palliative-care physician, says dying people want to hear four very specific messages from their loved ones: “Please forgive me.” “I forgive you.” “Thank you.” “I love you.”
Unfortunately, Mexican family members never have these types of conversations with their dying loved ones. Culture leads them to avoid the subject of death and when death does come the opportunity to ask for forgiveness, to let the dying loved one know they are forgiven, and to say that last “thank you” and “I love you” is lost forever.
Putting off these meaningful conversations is perhaps the number one source of regret and only intensifies the grief we all experience when a loved one dies. Open expressions of grief are acceptable for females in this culture, but for many the lost opportunity to say “goodbye” only increases the grief one would expect. For men, breaking down after a death is not the norm. They are expected to be strong and keep their emotions in check.
Lois and the Hospice team encourage the bereaved to share the many intense and frightening emotions, including depression, anger, and guilt that are part of the grieving process. Often, the one left behind feels isolated and alone in his or her grief, but having someone to lean on can help him or her through the grieving process.
Unfortunately, most members of the family refused to accept the proffered help; not knowing how to accept it. Seeing a need Lois began offering the services of a local psychologist, Octavio Robledo León. Often Hospice Mazatlán would pay him to visit a specific family member when it was painfully obvious they were unable to deal with their grief.
As time progressed he established bi-weekly meetings for grieving family members. Initially the meetings were not well attended. But, as time passed more family members came, as well as some people whose deceased family member had not been helped by Hospice Mazatlán. They had just heard of the program, including men whose mother, father or other loved one had passed away several years before. They just never had anyone to help them through their grieving process.
The fortnightly meetings are now held at the offices of Hospice Mazatlán and are regularly attended by around 12 people going through the grieving process.
Hospice Mazatlán is going beyond providing palliative care and this month celebrated the first anniversary of the Grief Group. Hospice Mazatlán is once again providing a service to Mazatlán; the citizenry did not know was needed.
Next time I want to talk about how Hospice Mazatlán is providing an additional needed service to the community that also goes beyond what one would expect from a hospice organization.
No comments:
Post a Comment