Etta's * room was at the back of the nursing home, "all the way to the end, on the left," said the manager coolly. Nursing-home administrators, like some doctors and even family members, aren't always happy to see hospice volunteers, whom they sometimes see as harbingers of surrender.
I unleashed Izzy, my golden-eyed, 5-year-old border collie, rescued from an upstate New York farm. He now lives on my upstate farm, where he's my resident soul mate and shadow. He's what I call a spirit dog—he takes you places you don't necessarily know you're going.
Izzy and I became volunteers together last summer, after weeks of rigorous training by Washington County Hospice. Volunteers are an integral part of the hospice philosophy, but they have to be taught to behave differently than they might normally—to listen rather than give advice, to accept the reality of death rather than cheer everybody up, to be comfortable with the fact that patients will not recover. To never, for example, tell a patient or family to buck up, move on, or cheer up. Generally, things do not get better.
While the hospice workers at the Washington County Hospice and Palliative Care Program are always looking for ways to make patients more comfortable, they weren't immediately certain that a canine would make an appropriate hospice volunteer—they had to ponder the insurance and health implications, and the particular sensitivities of hospice work. What, for instance, would be the consequences if a dog bit a patient or ate his medication? Final moments matter. My vet had to testify to Izzy's temperament, attesting to his gentleness and responsiveness.
As it turned out, he is a natural. I was the one who needed all of the training.
We headed down the corridor, Izzy walking beside me, watching for cues. Etta's room was a large one with a hospital bed, a dresser topped with old photos. She was 86, the last surviving member of a family that had farmed Hartford for 150 years. She'd had dogs on her farm for years and loved them. Now, the hospice report said she was suffering from advanced colon cancer and dementia.
She had outlived all of her friends and had no visitors, apart from the hospice social workers and nurses—and now, Izzy and me. In private homes, I've seen, the dying are often comforted and surrounded by their families. In nursing homes, they are often alone.
Etta sat in a wheelchair, clutching her side, moaning occasionally, saying she was going to the hospital. She barely seemed to notice when I came to her door.
She was nearly phobic about being touched, the nurses reported, making it difficult for the home staff to clean and care for her. She sometimes struck them. Now she was "actively" dying, a term used to warn volunteers she wasn't expected to live long.
I announced cheerfully that we were there, that I had a dog with me. As is often the case in short-staffed nursing homes, there was no one around. The staff didn't have time for social visits, and so I found myself alone with this still-handsome, elderly woman who appeared anxious, uncomfortable, and confused.