When Dr. Laura Ferguson was a child, her grandmother suffered from progressive dementia and had an agonizingly slow journey to death.
She watched her grandmother slip away day by day and little by little.
“We knew she was never going to get better,” Dr. Ferguson said.
Near the end of her life, her grandmother needed constant help and the family struggled with how to care for her.
They had few options to turn for help, relief or comfort.
“That was a big part of my childhood,” she said. “I knew there had to be a better way.”
The experience made her determined to devote her life to providing medical care to the elderly.
Dr. Ferguson is one of four full-time doctors at The Hospice of East Texas. Her job is to make sure those with terminal illnesses are as comfortable as possible and help their families face the emotions and difficult choices that come with end-of-life care.
Her patients have only months - sometimes only minutes - left to live.
A hospice originally was a place where weary or ill travelers could find rest during long journeys. Dr. Cicely Saunders, who worked with terminally ill patients in London, England, beginning in the 1940s, is credited with establishing hospice as a specialty branch of care.
She was concerned with how to better control pain and help families deal with grief, according to the National Hospice and Palliative Care Organization.
Dr. Saunders helped to introduce hospice in the United States when she spoke at Yale University in 1963. The hospice movement gained momentum in 1969 when “On Death and Dying” became a bestseller. The book made the case that the terminally ill were better off receiving care at home and should have a greater say in end-of-life decisions.
In 1980, the Joint Commission on the Accreditation of Hospitals began developing standards that hospice care organizations must meet and in 1982 Congress approved hospice as a service covered by Medicare.
Hospice includes medical treatments, pain management and emotional and spiritual support for patients and their families provided by a team that can include doctors, nurses, aides, therapists, social workers and bereavement counselors.
Patients usually stay at home but can receive care in a hospice center, hospital or a long-term care facility.
In the United States, nearly 2 million people are receiving hospice care, according to estimates from the National Hospice and Palliative Care Organization. The number has increased each year since 2010, a report commissioned by the organization shows.
The Hospice of East Texas was chartered in 1982 and began with 20 patients. Today it provides medical care to about 2,200 patients annually and support and counseling to every patient’s family, Marji Ream, the organization’s president, said.
After visiting a friend in Arizona receiving hospice care, the late Evelyn Lake of Tyler convinced The Junior League of Tyler to provide funding and volunteer support to help establish a hospice here.
In 1993, the nonprofit bought 23 acres in southeast Tyler that now houses The Robert M. Rogers Hospice Center. The campus has administrative offices, a 28-bed inpatient unit called HomePlace and the Pat Oge Center for Living, a bereavement and support center.
The founders “had a dream of bringing the very best end-of-life care to their friends, families and neighbors,” Marji Ream, the organization’s president, said in its newsletter. “Today that dream is a reality for thousands of patients and their families who are cared for every day in a 23-county area.”
The organization serves “every patient who needs our care, regardless of their financial circumstances or the complexity of their case,” she said.
Hospice of Texas will use its anniversary to launch a new campaign seeking continued financial support.
As a hospice care doctor, Laura Ferguson helps patients and their loved ones understand that she is not there to heal.
She administers painkillers and performs other medical interventions to keep her patients comfortable.
“In medical school you are taught to cure everyone,” she said. “With palliative care your approach is that people die and that death does not mean failure.”
A bigger issue is getting the patient and the family to accept the reality of impending death.
“Death is going to happen,” Dr. Ferguson said. “It’s going to happen to all of us. We want to make sure the patient passes peacefully and comfortably … without suffering.”
Ms. Ream said that when hospice provides end-of-of life care and emotional support, families have more quality time together as death approaches.
“It allows them to concentrate on what matters most,” she said.
'A BEAUTIFUL JOURNEY'
Dr. Ferguson began working with the family of Gary Ferguson when he decided to end treatments for a brain tumor.
Jan Thedford knew something was wrong go her husband, Gary, began to display strange behavior.
He had always loved playing golf and being with friends. “And then his personality changed. He became very depressed,” she said.
She didn’t know what to do when Gary suffered bouts of depression and then bursts of hyperactivity characterized by almost non-stop talking.
Mrs. Thedford grew more concerned when the muscles around Gary’s mouth suddenly started drooping.
During a holiday celebration, he was cut accidentally and needed emergency care. After learning of his other problems, the doctor ordered a CT scan, which led to more testing.
Images showed a brain tumor.
“The doctor looked at me and said, ‘It’s bad,’” Mrs. Thedford said.
The tumor was large and inoperable. Radiation and chemotherapy were the only options.
“Gary said, “I want to fight this,”’ his wife recalled.
The cancer treatments made Gary sick. He lost his appetite and became weak.
“He was getting progressively worse,” Mrs. Thedford said. “I climbed up in bed with him and lay there beside him. I said, ‘Gary, it’s not going to get any better. You don’t have to live like this.’”
With his family at his bedside, Thedford decided to end treatment.
That very day, they made arrangements to move him into HomePlace, Mrs. Thedford said
Theola Thedford, his mother, knew that was a good decision. She was a volunteer at HomePlace.
“I knew he would be taken care of,” Theola Thedford said. “They provide the care that you can’t give.”
Mrs. Thedford said they never regretted the decision. “Gary just fell in love with all of his nurses. They were all so wonderful to us.”
The Thedfords’ minister from Green Acres Baptist Church and friends came to visit. The staff kept him comfortable.
Thedford decided to spend his last days at a friend’s ranch home that offered a more intimate and peaceful setting for the family to experience his death together.
“They (hospice staff) made it happen,” Mrs. Thedford said. “They came out there with us.”
Her husband died a short time later at age 61.
“It was the most beautiful journey into death,” she said. “It was so beautiful.”
Since losing her husband, Mrs. Thedford also has become a volunteer at The Hospice of East Texas.
She works with people in the final stages of Alzheimer’s disease and their families.
“I just visit with them and talk with them … do whatever it takes to comfort them,” she said. “I like to think that I didn’t choose this, it chose me.”
IF YOU GO:
What: Hospice of East Texas 35th anniversary luncheon
When: 11:30 a.m. Thursday
Where: Green Acres Baptist Church’s CrossWalk Conference Center, 1607 Troup Highway