Having a good life and good death
Mary Ellen Rigby is in the business of ensuring people experience “good death,” and she could not be more passionate about having such a job.
It is exactly what her work entails as part of United Hospital District’s Home Health and Hospice program, which she has overseen as director since 2003.
And it derives from both personal encounters with lost loved ones and the life-changing imprint that has come with caring for as many as 2,000 patients between Martin and Faribault counties over more than a decade of Hospice service.
“Every single person we care for, we want them to have the same level of care my family has,” says Rigby, who recalls her own father’s passing as the type of “peaceful, quiet” death she and her Hospice team seek to aid in offering. “Our No. 1 concern is to make sure that until you take that last breath, you’re comfortable and you and your family are in a good place.”
It is a noteworthy mission, perhaps not so much for its intent as much as the sensitivity surrounding it. But it is also what Hospice is all about.
Tailored for those who have been medically determined to have a terminal illness and prognosis of six months or less to live, the service is meant to help patients “continue an alert, pain-free life and to manage other symptoms so that their last days may be spent with dignity and quality,” according to UHD.
Fueled by a wide-ranging team that features contributions from nurses, chaplains, home health aides and a social worker among others, it includes everything from 24/7 nursing assistance to personally requested emotional, spiritual and physical support.
“And it starts, No. 1, with a conversation,” says Rigby, who previously worked as an agency nurse and immersed herself in Hospice when she joined UHD as a case manager in 2000. “A tough conversation.”
In society, Rigby continues, people often spend absorbent amounts of time preparing for “big events” like weddings, birthdays and anniversaries.
“But we don’t really talk about the end-of-life situations,” she says. “It’s a scary concept, but every single day, we as people reorganize our hopes and goals, and as people get to the end of life, we want to help them do some of the reorganizing.”
That reorganizing, Rigby says, is driven by a willingness to prepare for the passing of a loved one, and it can equate to providing just about anything a person desires. Anything to make their journey to the end of life or their relative’s as comforting as possible.
“We want people to reach that stage of acceptance, that they can know their family members left this world in a peaceful, gentle way,” Rigby says. “There are people who have sought just emotional or spiritual support, but we’re also here for physical assistance.”
In the latter case, Rigby says that as a Hospice patient’s condition changes, staff involvement often increases, usually under the watch of Dr. Aaron Johnson, the program’s medical director. But even with each patient carrying a terminal prognosis, there are instances of lives being extended, perhaps in part due to Hospice care.
“There is research that shows that patients with similar diagnoses live 45 days longer when they’re in hospice,” Rigby says. “And we’re very clear in our understanding that sickness doesn’t stop at 5 o’clock.”
As director of the Hospice program, which currently serves between 15 and 20 patients across Martin and Faribault Counties as well as part of Northern Iowa, Rigby knows that is the truth.
She is responsible for all the administrative duties of Hospice, like paying the bills and securing donations to keep program offices afloat on Main Street in both Blue Earth and Fairmont. But she also prides herself in paying patients personal visits, understanding those patients’ needs and sometimes even examining those patients herself.
“I forget to take off my stethoscope,” she says. “I’m a working manager, and I love to do evaluations. It gives me an image of what the patients need.”
When she is not bouncing between the two offices, then, Rigby can be found visiting patient houses, hospitals, nursing homes and assisted living centers wherever she can be to help further the Hospice mission, which was once volunteer-based but is now Medicare-certified.
The ambition to physically be in the presence of the patients, to serve their every need, is one that she says is replicated throughout the Hospice staff, too.
“The criteria for working here includes having that passion,” Rigby notes. “You have to have that drive.”
She is referencing the kind of hunger to help people that, for example, has her hoping to one day raise enough support to construct an actual Hospice house. The kind of hunger that has helped craft the last decade of a program nearing 30 years of local service. The kind of hunger that, above all, prepares people for one of the most avoided, albeit important, times of their lives.
“We see a lot of death in its natural setting, and it allows people to die with comfort,” Rigby says. “When a person dies, that counts for almost no part of the care, but our focus is on the preparation, and no one gets refused.”
Rigby knows, of course, that death is still and may always be a touchy topic.
“When someone tells you that someone you love has a life-limiting illness, it’s hard not to be scared,” she admits. “It’s hard not to be sad.”
But she also knows that, if she or her team have any say in the matter, any impending death is going to be as “good” as it can get, not only for Hospice patients but for all of the loved ones by their side.