09.18.2015 | Barbara Darius

The word "HOSPICE" spelled out.It was NEVER about the student loan. I now realize why it is important that at the Interdisciplinary Department Team (IDT) all hospice disciplines provide their input when discussing a patient.  Back in April, when I first began visiting people in the in-patient unit patients at the hospice a regular of mine was Ms.V, a 62 year old white woman from the Southwest.  Ms. V. has a daughter, granddaughter, and great-grand daughter that lives out in the Midwest and a brother that she does not get along with, who still lives in her hometown. She does not get along with her brother because he does not live according to how God says one should live.

Ms. V. arrived to the hospice not because her life expectancy was 6 months or less but because was too ill to go home without some prearranged medical care; she had no insurance and no nursing home would take her because of her inability to pay. (One of the reasons I like this hospice is because they will take in anyone, get them on Medicaid, and, if they are not physically eligible for hospice, get them into a nursing home that accepts Medicaid.)

I would visit her weekly. On one visit, I sorted through all the mail that was delivered to her home while she was in the hospital. Among the bank statements, bills, sales flyers, etc. that I was sorting through, there were many mailings from some ministry that Ms. V. was affiliated with – I mean easily ½ of the mail was from this ministry.  Ms. V. expressed her concern that because she was no longer working, she would not be able to pay her student loan. I told her that “Sallie Mae (the organization that services student loans) could wait, and she really needs to concentrate on her health”.  Still she was bothered about her inability to pay. I suggested that next week I will stop by the post office, purchase some pre-paid post cards and will spend our time with me writing a short note to the creditors about Ms. V’s inability to pay with the hospice’s address and phone number, in the event the creditors need to speak with her.  That plan seemed to bring Ms. V. some comfort.  The following Monday, I show up with my prepaid postcards and Ms. V was really tired. Subsequent visits, Ms. V. would mention her student loans, I would mention I would bring the supplies next time then, I don’t know, it would never happen.

Because of other obligations, I was unable to do my weekly patient visits to the hospice, for about a month. Before a meeting with the AR team, I asked the Chaplain how Ms. V. is doing. The Chaplain told me she was finally able to receive Medicaid, after all her expenses she has $50 remaining per month, but she is stressed out because she is unable to give her ministry more money.  In short, paying money to the ministry was her way of repayment for her previous sins. Ms. V. not paying the ministry could mean she could go to hell.  I could NOT believe I missed that!  At no time did I EVER see a letter from Sallie Mae, but I saw MANY LETTERS from that ministry.  It saddened me that Ms. R. was stressing about being accepted into heaven.

I remember the nurse practitioner once telling me that it really is important to have all the disciplines at the table to get the entire picture of the patient; the patient will tell something to the Nurse, but not the Chaplain, mention something to the Medical Doctor but not the Social Worker.  Ms. V. was mentioning her anxiety to me, but she told the entire story of her source of her anxiety to the Chaplain.