Leo Adam Biga's My Inside Stories

 

 

When Omaha Magazine inquired if I would be interested in tackling a story that followed a family’s experience with hospice I immediately jumped on it because both my parents received hospice care in their final days. The Hospice House in Omaha offered their cooperation and identified the family who I profile in the story that follows, the Hummels. The plan was for me to spend an extensive amount of time with the patient, Phil Hummel, and his family and I did at first and then, as things often unfold in such situations, circumstances changed and I was unable to get the same access I had before. But I did get to know Phil, his wife Jo Ann, and their son Al fairly well before Phil passed and then I got to visit with Jo Ann and Al the day of their loss. My piece is the cover story in the November/December issue of the magazine, which is distributed at select sites all over the metro. You can subscribe to the publication. To see the story as it appears in its 12-page spread visit omahapublications.com or http://www.readonlinenow.com.

 

Phil Hummel near the close of his coaching-teaching career

 

 

A Hospice House Story: How Phil Hummel’s End of Life Journey in Hospice Gave His Family Peace of Mind and Granted Him a Gentle, Dignified Death

©by Leo Adam Biga

Published in Omaha Magazine

Even though the end of life comfort care known as hospice is better understood today than decades ago, misconceptions linger. Some mistake it as denying care. Others assume it’s only for special cases. The myths and misapprehensions make sense given how death and dying tend to be topics avoided rather then engaged in America. No two end of life scenarios unfold alike. But charting a real life journey through hospice can remove some of the fear and unknown that follow a terminal prognosis, which is why the Hummel family agreed to share their experience at Hospice House, the Josie Harper Residence. Executive director Gary George welcomed this reporter in to give readers a glimpse at a patient-family-caregiver story. The center, at 7415 Cedar Street. just east of the Bergan Mercy Medical Center, is a collaborative between Alegent Health, Methodist Hospital, the Visiting Nurse Association and the Nebraska Medical Center.

 

 

 

 

 

A Rich Life

Family patriarch Phil Hummel of Woodbine, Iowawas a resident there 10 weeks last summer. Hospice provided a dignified end of life path and offered loved ones peace of mind his every need was met. Hummel, 78, died gently in Room 2 on September. 1. That last day, like each of the 69 preceding it, Phil’s wife JoAnn and son Alan were present. They were with him when he drew his last breath. In the weeks leading up to his death, his daughter Gail was on hand along with other family members and figures from his career as a high school educator and coach.

Married 56 years, JoAnn and Phil met at Tarkio (Mo.) College. She attended on an academic scholarship. He, on an athletic scholarship. Phil, a Riverton, Iowa native, excelled in sports at Sidney High School, where’s he’s a Hall of Fame member. His football-track exploits also earned him a spot in the Tarkio College Athletic Hall of Fame. After the couple married Phil was drafted in the U.S. Army and JoAnn followed him, first to New Jersey, then to Japan.

 

 

JoAnn and Phil in Japan

 

 

Back home, his military hitch over, the couple started their family and taught together at Woodbine High School. Her speciality was business ed. He taught U.S. government and American history. Summers he ran a house painting crew that did work all over western Iowa and the Omaha metro area. He was by all accounts as demanding a boss as he was a coach. During a highly decorated coaching career he led teams in many different sports but mostly made his mark as a cross country and track coach. He won several coach of the years honors and was a longtime Drake Relays official. The Iowa Association of Track Coaches Hall of Fame inductee twice led USA Track and Field youth teams to China. “Sports were a big part of our life, that’s for sure,” said JoAnn. “He was really busy coaching, and then on the side he was an official, and he refereed. He was gone a lot. And then when he wasn’t doing that he was hunting and fishing. It was a good thing I loved sports because that was Phil’s life. I was at all the games.”

 

 

 

 

Her husband, who made his runners take the steep cemetery hills on the west edge of town, was a living legend. “Phil was known all over the state of Iowa,” she said. A measure of the impact he had on young people is the seven pages worth of condolence memories on the Fouts Funeral Home web page after his death. Like any good coach, Hummel was a surrogate father to his athletes. One young man he drew especially close to was Guy Mefferd, who with Phil’s guidance turned his life around and went on to serve as a U.S. Navy SEAL. Jan Sauvain, a family friend Phil coached in basketball, said he could be a strict disciplinarian “but never vindictive or to humiliate you or to demean you, just to give you a little insight into what you did wrong, and he cared about the kids after they graduated.” She said Hummel, unsolicited, recommended her to an AAU basketball coach in Omaha and wrote a glowing reference letter for her brother. “He did care, absolutely,” said JoAnn, who typed her hubby’s correspondence in her unofficial role as “Phil Hummel’s administrative assistant.” She said, “He was always interested to see what happened to students down the line. That’s why so many people came to see him in the Hospice House. Sometimes we had five to ten a day. They came from all over.”

Comfort and Care

When word got out Phil was dying, scores of athletes he coached, along with fellow coaches, even old teammates, came to see him. Each shared a piece of Phil’s end of life journey with him. As did Hospice House staff and volunteers. With its many windows looking out on nature and the great room’s soaring cedar ceiling, there’s a bright, uplifting feel to Hospice House. Also an intimacy and communal aspect quite unlike a hospital. Community meals are convened. Families and volunteers share treats. Musicians come to perform music. Children and therapy pets visit. The emphasis, said Ann Cole, a staff registered nurse, is comfort. ”

Death is really the final stage of growth and dying is a natural part of life and if we have enough time to work with people we can help them and make this really a positive time,” she said. “We can help them to accept what’s going on. First of all, we’re able to control the adverse symptoms that go along with the dying process — things like pain, nausea, vomiting, anxiety, constipation, agitation. Those are all things we often see in varying stages as the dying process progresses. “If we can control those symptoms and the patient knows you’re going to be with them, you’re going to support them, and you have enough time to develop this relationship, then there’s always something we can offer to comfort them. We can control these symptoms, make them the least they can be, so they can live a really comfortable life until death comes naturally. This is our area of expertise.”

Because Phil was alert and active almost his entire stay, he savored many moments with those dear to him and developed rapport with caregivers. He felt well enough most days to relax in the courtyard. He even went on regular outings to favorite haunts, such as the Horseshoe Casino and Olive Garden restaurant. He told stories and shared memories but mostly he listened, laughed and cajoled, holding court on the deck or in his room.

My intro to the Hummels came via a phone call to JoAnn’s cell. She answered from Phil’s room with, “We just got back from the casino with some of Phil’s friends. Phil just ordered Jimmy Johns.'” It’s not what I expected — a dying man living it up, so to speak. I came to see it as his serene surrender to fate — making the most of what time he had and appreciating everybody and everything around him. “He wasn’t scared,” said JoAnn.

Phil loved singing the praises of Hospice House. “Oh, I mean, they are so good it’s unbelievable,” he told me, his voice a heavy rasp from the radiation that seared his mouth and throat tissues. “That doesn’t mean we get everything we want. It’s just — they have a care and a love, and people come in and it doesn’t take long for people to understand that. I don’t know where you can move to a better place. There might be one, but I don’t know of any.”

For those, like Phil, given the opportunity to appreciate the life left to them, hospice is not the dour, bitter end but the last bright stage of things.

Bonds

“People think of hospice as a death sentence so often and it’s really about quality of life,” said Cole. “Hospice is working with the patient and family — supporting, teaching, making that quality of life a real possibility, and I think that’s what we did for Phil. If you can help families know what to expect, what will be done, and follow through on those things, they really learn to trust and the trusting relationship is very important.”

JoAnn and Alan praise the staff for easing the path. “They were wonderful there. It’s just a fantastic place,” she said. When she and her son left to go home at night, she said, they could be assured Phil was in good hands. Said JoAnn, “We knew if he needed any little thing they’d be running right over here because the nurse’s station is just around the corner.”

Alan admits he wasn’t sold on Hospice House before placing his father there. After moving him in though he became a convert. “Looking back now it could have been a cave as long as those people were there. The people that work there make that place what it is. Ninety-nine point nine percent go far beyond the call of duty.” JoAnn, a native Missourian with a show-me attitude, noted the sincere empathy. “When they had kind words to say I never felt they were just making it up to make me feel good. I think they really felt that way. That’s why they’re there.” A little warmth goes a long way. Besides, said Ann Carol, “Who wants a cold nurse?”

 

 

 

 

It wasn’t just healthcare providers who impressed JoAnn either. “The volunteers are fantastic. Like the Cookie Lady. Her husband was a resident there and she wanted to do something for the Hospice House, so she decided she’d bake cookies. Every Thursday she brings them in. It smells so good. Even the cleaning ladies are fantastic. Nice, pleasant, do a beautiful job.”

Gary George, who’s headed the center since its 1998 opening, said everyone who works there embodies “a sense of passion,” adding, “We want to be doing this kind of work.” He describes it as “a calling to be working with people at end of life that then links to an honoring of life and a recognition that end of life is part of life, not something to be feared, not something to be run from. It’s recognizing all the rich…things that can come out of end of life when people are being walked through that journey.”

“Compassion,” is the common denominator said certified nursing assistant Joanne Waltsky, who, like Ann Cole, got close to Phil. “These people are like our family. We get some of the crabbiest people in the world and they always end up loving us — I mean, always. It’s awesome, it just makes us feel good.” The Hummels shared how Waltsky’s habit of singing while making her rounds rubbed Phil the wrong way, at first, before he melted under her buoyant charms.

“The first night I came in here it was a helluva night,” Phil said. “Six o’clock the next morning, somebody came in here singing. Who the hell can be that happy in the morning? I told my wife,’ I don’t think I can put up with that.’ By noon she had me won over. You want to know why? This gal had everything we needed whenever we needed it, before we knew we needed it. That’s not a joke. “And she’s still going, and the others are just like her, just happy as clams, which made us happy of course. I can’t say any more about this place than if I tried, and I’m trying, because they’re good.”

 

 

 

 

Because Phil was there so long and his wife and son there so much, the bonds between caregivers, patient and family had time to to ripen. “Everybody was really attached to him and they were really fond of him,” Alan said. “They want to keep from getting attached but your dad won them over,” JoAnn told Alan. “They won him over,” Alan replied.

Attitude is Everything

Waltsky said in contrast to some patients who sink into despair and wallow there despite her and her workmates’ best efforts, Phil embraced his remaining life. “We try to bring people up but they don’t always want to,” she said, “but Phil every morning got the day planned and told us what he was doing. He touched everybody there. He was so independent. He was everybody’s friend. He had so many visitors. When his coaching friends and past students would come in he’d always introduce me like I was family. I just loved him.”

She said the entire Hummel family made an impression. She was struck by how JoAnn and Alan befriended a woman without any family in the room next to Phil’s, checking in on her, bringing her goodies. “They’re just loving people, you know, and everybody loved that. They were just joy.” JoAnn Hummel returns the compliment by saying she never conceived hospice would be such “a positive thing. I’m so glad we went there. That was the only place for that kind of care. It was either that or go back to Woodbine to a nursing home, and Phil didn’t want to do that. This was just perfect.” She’s certain Hospice House helped extend his life. When he arrived in June, he was given less than a week to live. Ten weeks later, he was still there.

A Life Interrupted

His cancer jolted the couple. They were busy enjoying their hard-earned retirement, traveling to Las Vegas, wintering at a Florida condo, spending time with family and friends. The Council Bluffs casinos were favorite getaways. Phil loved the outdoors. Then, in April, he discovered a large lump on his throat while shaving. After going in for tests at Methodist Hospital, the bleak diagnosis of cancer unsettled his and JoAnn’s world. “The worst you can have,” is how a physician put it. Inoperable. An aggressive regimen of chemo and radiation in Omaha followed. “I truly think the doctors knew it was an impossible slide but worth a shot and I thought it was worth a shot, because the alternative would not be any good if you just left it alone,” said Phil. “I had all the faith in the world the treatments were going to fix it,” said JoAnn.

Only Phil didn’t get better. The tumor didn’t respond as hoped. “I just saw him get sicker and sicker and more miserable,” said JoAnn. Making one-hour drives each way for debilitating treatments took their toll. “We would drive back and forth every day,” she said. “On the weekends he would just go in the bedroom and stay in there in the dark. He couldn’t eat. It was terrible. His neck was getting worse and worse, just burned.” “I couldn’t get anything down,” Phil said. On Mondays it began all over again. “It was a hard time,” said JoAnn. Spring turned into summer when the oncologist reported what the couple already suspected — the tumor wasn’t shrinking. “That was a bad day for me when he said we are going to stop all treatment,” said JoAnn. “I know when it was exactly — the 22nd of June. We came in here (Hospice House) the 24th.”

Phil was precariously near death. “When we came in here the doctor said maybe five days,” JoAnn recalled, “Phil hadn’t had anything to eat or drink for two weeks, only kept alive with hydration. He couldn’t raise his head off his chest.” “I couldn’t move. I was bad,” Phil said to me.

Phil Accepts Impending Death but Continues Embracing Life in Hospice

But then a remarkable thing happened. “When the swelling began to go down from the radiation treatments he began to be able to sip a couple sips of water and eat a little apple sauce,” said JoAnn. “It wasn’t long before he was eating more things.” Alan plied his father with food but Phil could never hold it down. Yet the better Phil felt, the hungrier he got for his favorites, including hamburgers. It’s all he talked about. Alan was reluctant to give him one, until he finally threw caution to the wind. “It took us awhile to figure out it doesn’t matter — give him whatever he wants. I went to Five Guys Burgers and Fries and brought it back. He didn’t eat very much of it but it was the first time in at least a week he was able to hold down food,” recounted Alan. “You would have thought it was the first hamburger, the best hamburger, some kind of divine hamburger. Seriously, the look on his face…That hamburger is when he turned the corner from being where we thought there was no way to maybe there’s some hope he’ll hang in there a little while, and it was.”

Rebounding

Phil gradually regained strength. Not long after his rebound began, tells JoAnn, the doctor that gave Phil precious little time to live stopped by Phil’s room. “He sat down and pulled his chair right up to Phil’s face.” “Nose to nose,” is how Phil put it. “And,” JoAnne continued, “that doctor said, ‘I can’t believe what I’m seeing.’ That he’d come around. And you have to give a lot of credit to this place because it’s a wonderful place.” Phil agreed, saying, “You know, I feel so far from where I was when I came in, but I accepted it (his fate). Maybe it’ll give me some more days down the road, I don’t know.” “It’s a miracle you’re even here,” Alan told him then. Five days turned into 10, 10 into 20…

Certainly no one expected Phil to venture out, albeit confined to a wheelchair, to eateries and attractions, but that’s what he did and if residents get there early enough it’s how hospice ideally transpires.

“The fact he was so positive about going out on his little excursions, and I’m sure he probably didn’t always feel the best, is what hospice is about. It’s to go out and do the things you love to do. You’re not confined to bed in this place. We encourage people to do what they can do. We’ve had people go home and stay overnight a couple days and come back,” said Cole.

The turnaround Phil experienced, said George, “is neither usual nor unusual, it happens sometimes, and for who knows how many reasons.” He added, “Sometimes people do seem to have some spark, some different amount of energy when they get here, and for some people it may be due to more stimulation and activity, for other people it might be a sense of relief — some sort of freeing up and letting go of responsibilities, letting loose of some things.

“Lots of people bring treasures here that mean things to them. For many people that’s photos. For one guy it was a full life-size cutout of John Wayne. For one of our earliest residents, John, it was a little bookshelf filled with these thick novels and I said, ‘Oh, John, you must have brought along your favorite books,’ and he said, ‘Oh, those aren’t my favorites, those are just ones I have left to read.’ I don’t know how many he got to read while he was here but that’s what he planned to do. I thought that was amazing. “People come with a bit of a sense of adventure sometimes. I always admire that attitude of here’s something new and different — kind of leaning into it.”

That same leaning into one’s dying days is what Phil Hummel exemplified. A small bulletin board in his room displayed photos of things and people he cherished: family, friends, track. An American flag emblem. And a hand printed Bible verse from his granddaughter Jessica about the virtues of love. He literally lived for visits by friends and loved ones, former schoolboy tracksters, hunting-fishing cronies, and for those casino-restaurant forays. Not everyone can be so active. For most, their illness is too advanced to allow for much mobility or independence, whereas Phil prided himself on going to the bathroom alone.

“Our residents tend to come to us later in their disease process then they used to, so on the continuum Phil was a little bit more on the active end of things when he came,” said George. “Most of our residents are no longer at a point where they’re any longer coming and going so freely and wanting to do that even. But he also was a person who came, it seems to me, with that drive — this is what I want to do, this is how I want to do this. He kind of made that happen along with his family.”

 

 

 

 

An Unforgettable Character

Phil himself theorized his “cantankerous” spirit may have spurred his comeback. Action follows attitude, even when dying. Phil Hummel’s gregarious, generous attitude set the tone for his end of life experience and everyone around him. “You know, he was one of those patients none of us will ever forget,” said Cole. “He was just a delight, really a people lover. I picked that up. He really, really cared about people. He talked about his coaching days. It was so obvious he cared about everybody. And even the last couple of days, he was not a complainer. “You had to really take a lot of nonverbal cues as to what’s going on, which is something we do all the time. He always thought about other people, never about himself. ‘How was your weekend?’ he’d say.”

Alan Hummel remarked, “I don’t know how he did it. I thought he was in a bad mood for maybe only one day — and that was the first day.”

The Beginning of the End

After thriving for so long, the end came rather abruptly. On Friday, August 26 Phil was, if not a picture of health, a still vital man. He was keen for the college football season to start so he could root on his beloved Iowa Hawkeyes. Still stinging from a “disasterous” day at the casino, he anticipated better-luck-next-time. He played amiable host to two journalists in his room. Small talk came easy to him as he relaxed in the tranquil courtyard. The last image of him was a tired but content man ready to meet whatever life next presented him, even death.

When I called JoAnn Wednesday, August 31about stopping by she informed me in a taught, severe voice, “Phil’s taken a turn for the worse.” The morning after I saw him he’d suffered a bathroom fall, not breaking any bones, but hitting his head and scuffing his arms and legs. He didn’t lose consciousness. JoAnn and Alan were there. Alan was the first one in to help his father. The nurses were soon on the scene to attend to his scrapes and bruises and make him as comfortable as possible in his recliner. The fall precipitated a rather rapid decline.

“Thats what started it. From then on it was down hill all the way,” said JoAnn. “He whacked his head pretty good. I think he might have been a little concussed,” said Alan. “I don’t know he was in a lot of pain, he didn’t talk about pain,” said JoAnn. “He would have never told anybody if he was,” said Alan. “Had to be strong,” added JoAnn.

Acting on cues, the nurses gave him morphine. “We left him in his chair and he slept the whole day, and then that made him sore,” said JoAnn. “He didn’t eat anything. That was Saturday.” “He slept all day Sunday,” said Alan.”He was conscious but he just didn’t want anything to eat, and he really didn’t want to talk,” said JoAnn. Another sign Phil’s body was shutting down and he was slipping away was when he stopped showing interest in the therapy dogs he used to enjoy. Through the weekend and into Monday and Tuesday he was more and more in a somnambulant state. “He’d wake up, talk a little bit, say a few words, and go right back to sleep,” said JoAnn. “He started babbling, too, like talking to someone who wasn’t there, reaching for stuff,” said Alan. “It was the beginning of the end I’m afraid,” said JoAnn.

Into Wednesday though Phil clung on to what he could. “When they tried to put him into bed he absolutely refused,” said Alan. “They had to sedate him to get him out of his recliner into the bed. Mom said he didn’t want to go to the bed because he knew once he did that was it — he wouldn’t come out…” The robust Phil they knew soon disappeared. “That’s the last we heard from him. When his eyes would open it looked like no one was home…they were all glassy,” said Alan. “Usually when I said something he would look toward me,” said JoAnn. No more. “That was extremely hard to watch, extremely,” said Alan.

The Gift of Time

For the family, there was the consolation of two extra months. A true gift. “How many times did I say that today?” Alan said to his mother the day Phil died. Even though they knew it was coming, losing a loved one still hurts. “At the risk of being cliche, and Mom said it this morning, too — you say you’re prepared, you think you’re prepared, and there is no preparing. You just can’t be prepared,” Alan said. “I figured we would have been at this point a long time ago. We knew the outcome was going to be bad, but he had a good couple of months, seriously.”

Sitting at the dining room table in Alan’s home only hours after Phil passed, son and mother recounted the blessing the Hospice House turned out to be. “All those people who came to see him. Dozens and dozens and dozens of people,” JoAnn said. “I should have kept track of the names.” “It’s been really good,” said Alan. “I think he actually had fun.” “He did,” JoAnn confirmed. “It sounds horrible, but it’s true, I think he had a good time,” added Alan. “When all the track people came from eastern Iowa, they stayed five hours. They sat out on the patio and Phil ordered Jimmy Johns. They all had lunch out there. He had a great time. It made him forget what the situation was,” said JoAnn.

If we have the choice, maybe we should all go the way Phil did. “Absolutely,” said Alan. “Millions of people never get that opportunity.” JoAnn said while “it hasn’t been easy” what helped make it more tolerable was the gradual transition Phil made “from one stage to the next stage,” the “wonderful” care he received and his own serene attitude. “Phil was just resigned, too. He didn’t fight it. If this is the way it’s going to be, it’s the way it’s going to be.”

Hospice House became such a routine in the family’s life that being separated from it feels like a loss, too. “I’m going to miss it, I hate to say that. It’s going to be funny not to go there,” said Alan. “We were there a lot of days,” JoAnn said. “It was weird to leave there after cleaning out the room and it was empty. No one there. None of my favorite girls around,” said Alan.

Lasting Impressions and a Request Fulfilled

What workers were present the day Phil died were moved by Phil’s passing. “A lot of tears were shed that day by the staff,” JoAnn said. He seemingly touched everyone there.

“Phil was a leader and teacher all the way to the end of his life,” said Gary George. “I will remember Phil and his family taking every opportunity to continue to come and go from Hospice House to enjoy life to its fullest. On many occasions I saw them heading out the front door for some adventure together.” The same front doors Phil and family came in and out of are the doors Phil exited for the final time after his death. “We do not want to ‘usher death out a side door,’ or make it seem that death is too awful to look at ” George said. “This I believe is an important feature of Hospice House.”

For Ann Cole and Joanne Waltsky, Room 2 will always be Phil’s. Said Cole, “You couldn’t help but love the guy. He was totally about seeking the positive things in people and affirming that and making them better. You would walk away from his room and just feel so good and hope that you had given him half of what he gave you. He was, oh, so gracious.”

George said when a resident dies “families and friends are given the time, space support they need and my co-workers stand by ready to offer whatever they can,” adding, “This may involve tears, hugs, tissues, offers of a beverage, another chair, a shoulder to cry on…silence, storytelling, or tears mixed with laughter.”

The giving goes both ways. JoAnn and Alan brought flowers from Phil’s funeral to Hospice House, where, per tradition, a candle burned in his memory. JoAnn will be back — she has walnuts and gooseberries for the Cookie Lady. The family asked that memorial donations be made to Hospice House and many were made. Typical of the man, Phil Hummel wasn’t interested in how he would be portrayed. But he did request we emphasize the quality caregiving and warm sense of community at Hospice House. “I want you to give as much attention as you can to this facility,” he said.

Related articles

• A Journey’s End Becomes Mainstream Medicine (kitsapsun.com)
• What Is Hospice? (mademan.com)
• A Special Space (psychologytoday.com)
• Book Spotlight: Death with Dignity by Robert Orfali (bookmarketingbuzz.com)