“For the sick, it’s important to have the best.”—Florence Nightingale

May is National Nurses Month, which seems insufficient time to celebrate the skill, compassion, and hard work of nurses all over the world. Although all nurses deserve to be recognized, it takes a special heart to become a hospice nurse and we at Central Wyoming Hospice and Transitions are very grateful for our amazing nurses. They take on myriad roles, from caring for patients and families in their own homes or in our Hospice Homes, to providing answers, education, and leadership.

Hospice nurses are special because they are invited into a person’s life at one of their most vulnerable points. No matter the age, a terminal diagnosis typically comes as unexpected. At CWHT, we too often receive referrals for patients that went to the hospital for something that was thought to be benign and ended up being terminal, according to Michael Steele RN, CWHT Community Nurse Manager.  “Patients and loved ones are attempting to process the news they have been delivered, and the CWHT nurses are there to help direct the medical care and navigate the family through the approaching unknown. The unknown of how this recently diagnosed disease will affect their physical health and possibly mental well-being,” he says. “It’s a vulnerable time for the family, where the nurse isn’t tasked with ‘fixing’ or ‘helping heal’ the patient but rather managing the patient’s symptoms and helping heal the hearts of those who are left behind.”

“Every single nurse who works here at Central Wyoming Hospice and Transitions has made the choice to work here,” Steele points out. “This is not a job, but rather a calling. They all have received extensive and ongoing training in end-of-life care and exemplify what it means to be a nurse at the end of life. Our nurses work hard to build personal relationships, founded in trust, with their patients and their patient’s families so when the nurse is needed, the family knows they are receiving the best care possible.”

The nurses at Central Wyoming Hospice care not only for the patient, but for the whole family, says Steele. “We view the family as important as the patient. We make sure their needs are being met, encouraging them to care for themselves, so they can care for their loved ones.”

We are honored that our CWHT nurses share so much of themselves. It truly is a work of heart.

Let’s call her Ann. Ann is a 64-year-old grandmother who was diagnosed with terminal cancer 6 months ago. Not wanting her final days to be spent sick, in a hospital, without her family, Ann and her loved ones decided to utilize the services of Central Wyoming Hospice and Transitions. Ann will be using these services for 51 days. During this time, Ann will receive 31 nursing visits and 37 home health aide visits. Throughout these visits, Ann will make it a point to learn each of her caregivers’ names and their favorite books. She’ll have her favorite nurse, of course. But she’ll be sure to make each nurse or aide feel like they’re her favorite. Her smile is contagious and, even though she is in pain, that smile never wanes. 

Ann’s cost of direct care – including staff, medication, supplies, and medical equipment – will be about $8,809. And she is just one of the countless patients that has benefitted from the services of Central Wyoming Hospice and Transitions because of people like you.

In 2022, Central Wyoming Hospice and Transitions served 438 patients. 

CWHT serves, on average, 66.2 patients a day. 

The average duration of hospice care for patients was 50.7 days. 

92 veterans were served; 45 of whom received a special ceremony. 

88 volunteers contributed 2,560 hours of their time.

$342,000 in charity care was provided.

It costs approximately $700 a day to offer care to just one patient. 

And all of those numbers prove just how pivotal community donations are to Central Wyoming Hospice and Transitions. 

As a nonprofit organization, CWHT relies on community support in order to sustain the vast and varied services that it offers to the sick, the elderly, and the dying. 

“We have one of the most generous communities in the Rocky Mountain West, if not the entire United States,” said Kilty Brown, the Executive Director of Central Wyoming Hospice and Transitions. “Our donors are incredibly supportive. And it’s not just these big donors who sweep in with a large amount. It’s the smaller individuals, or families, who maybe send in a $25 check every month just because they’re grateful for the care their mom received.” 

The big donations are important; vital even. But so are the smaller donations from the individuals who give what they can. These donations, all of them, large and small, allow CWHT to operate in the way they believe is best for the community in which they serve. They don’t have to answer to a big corporate conglomerate who is more concerned with ‘the bottom line’ than they are with the actual patients. 

“I think that if we were a for-profit hospice, you’d see a totally different type of care,” Brown stated. “I think one of the reasons that we’re nonprofit is because that way, we can offer care that nobody else does, with our hospice home in particular. Our hospice homes are incredibly important to the community. They’re a safety net for the elderly and for the dying. And it’s important for our community to have them.”

Why are they so important? It’s because, for some of these people, Central Wyoming Hospice and Transitions is the only place they have. 

“You have patients like elderly men or women who never got married or who never had children and have nobody to care for them,” Brown said. “Or sometimes we have homeless patients who just don’t have any family around. Sometimes we have ranchers who live out in the middle of the country and, like in winters that we’ve had this past year, you just can’t get to them easily. So, I think we really need these homes, but we just couldn’t do that without donors.” 

Medicare and other forms of insurance help offset some of the costs associated with hospice and transition care for Wyoming patients, but it’s not enough. It’s never enough. 

“Our hospice home for the population in Wyoming is something that we just can’t sustain off of Medicare and insurance alone,” Brown said. “These are money-losing endeavors for us. And that’s why donations are so important. Your money is going towards paying for care in our hospice homes and providing patient care for the dying. It costs us about $700 per day to care for one person. And we only receive payment of $580 per day. So, every day, we’re losing $120 per patient. So, when you’re donating, you’re paying for nurses, you’re paying for aides, you’re paying for the upkeep of the homes. You’re paying for care.” 

You’re paying for care. Every dollar that is given goes towards the care of the sick, the elderly, and the dying. Central Wyoming Hospice and Transitions would simply not exist without donations from community members, and they mean it when they say every dollar counts. Whether it’s $5 or $500. 

“Without your support, we couldn’t be here, period,” Brown said. “We wouldn’t have our doors open. And I think care for the elderly would look very different in Wyoming. I’ve seen homes where there hasn’t been hospice care, and it’s a crisis. It’s not having access to medicine. It’s not having access to comfort. It’s not having access to basic pain control. And I think that, by donating, you become that stop-gap towards allowing our community to have such important access to dignity and comfort at the end of life.” 

Dignity. That is the word that stayed in the back of Ann’s mind throughout her time with Central Wyoming Hospice and Transitions. Dignity for Ann, and dignity for her family. Throughout their time together, neither Ann, nor her family, had to worry about the cost of her care; they just had to be there to hold her hand, to see her smile. Ann’s community took care of her. They allowed her to die with dignity.  

Ann is just one of the hundreds of patients that Central Wyoming Hospice and Transitions provides care for every year. Her story is a familiar one and it demonstrates just how important the power of giving really is.

To make donations and find out more about the types of services that your donations pay for, visit centralwyominghospice.org/donate.

by Allisa Nathan 

Our experience with hospice as we navigated the end of life with my mother-in-law is beautiful, tiring, sad, full of relief and many emotions in between! 

We were so blessed to have CWHT staff, one and all become our guides to travel through the new and unfamiliar territory of Joan’s end of life. They became a collective help for our family as we made decisions and watched the slow decline of our family member. 

We were so grateful for the gentle care provided by the CNA’s, Nurses, and administrators. They do so many thankless tasks, often unseen by anyone and yet they choose to go above and beyond. Some of these noteworthy acts included making sure that facial hair was kept tidied, special aromatherapy scented lotions were used in cares, and night staff took quiet hours to hold Joan’s hand. And milkshake after milkshake was carefully blended with as many calories as could be crammed into a single cup, all to satisfy the sweet tooth she’d developed. 

They wanted to know our Joanie. They encouraged us to share stories of Joan’s life to know her better and interact with in her in ways that she’d have preferred if she’d been more communicative. Birthdays were celebrated, holidays observed, and conversations shared. We learned of talents as personal violin concerts were generously performed. Night or day we witnessed extraordinary care and found community, friendship, compassion, and understanding. 

The kindness was not just for patients, I knew that the mission of hospice was genuinely tailored to care for people and families as they faced the uncertainties of the end-of-life journey. 

Week after week, month after month we were comforted by these many kindnesses. But for me the culmination came in Joan’s final hours. At the sweet suggestion of one of the staff Joan was wheeled out in her bed to enjoy the warm July heat on the patio next to a trickling fountain. For hours we enjoyed that peaceful setting. As our family members sat and visited, we had staff member after staff member come to say their goodbyes. Joan was hugged and kissed and cried over with all the tenderness that two years of care had generated in this loving crew. She was honored in such a personal way. Even employees who were not working that day stopped in to bid her farewell. We were able to visit with and express thanks to each person. And because we were outdoors, for the first time we saw their faces without masks. It was an unforgettable experience. To me it seemed that she was royal- queen for just one day. 

In life Joan had been a social worker, a kind Christian and a selfless human being to family, friends, and strangers alike. That day on the patio I could clearly see that all those seeds of kindness she’d carefully and intentionally sown in her 90 years were returned to her in the final years. She truly reaped what she’d sown. It was a tribute fitting of royalty. 

“How are you?” It’s a simple question (we think). And it usually elicits an equally simple answer. 

“I’m good, you?

“I’m fine.” 

“Not bad, yourself?” 

Many of us – most of us, even – ask this question in passing. It’s our immediate go-to. When we see a neighbor across the fence, or pass somebody in the grocery store, it’s our default question. We don’t mean anything by it. We may even be genuinely interested. But in many cases, if the answer to that question is anything other than “good, you?” we don’t know how to respond. A grieving person is oftentime absolutely clueless about how to answer that question. They just don’t know how they are. Plus, do you really want to know? Because if they tell you, it might be more than what you were asking for.

For a grieving person, This is true all the time, and especially in the months following the holiday season. January through, let’s say, March, are rough months for many people. Seasonal depression is an epidemic during these cold winter months, especially in Wyoming, where the wind constantly feels like a literal slap in the face. 

The elements, the depression, the feelings of hopelessness are even worse for people who are grieving. 

Grief is…complicated. It’s different for everybody. It looks different, it feels different, it presents differently. 

After the holiday season ends, for some, grief is even harder to deal with. 

For these people, there is Central Wyoming Hospice and Transitions. 

“We have a grief support group for people that started in mid-January because we know that it’s a time when  it’s darker outside and there’s the let-down after the holidays,” said Todd Von Gunten, the Grief Care Coordinator with Central Wyoming Hospice and Transitions. “We usually get some of our larger groups in at this time, after the holidays.”

Visiting one of those grief support groups is just one of the ways people may be able to help manage their grief. But even if they don’t join a group, talking about their grief can help ease it, even if only for a little while. 

“That’s one thing you can do,” Von Gunten offered. “Surround yourself with support, whether that be group [support] or just individual counseling. We have that at any time, just in terms of being able to talk about what happened, or to continue the conversation of remembrance of your person.”

Talking is a very good way to help manage grief during the winter months and at any time throughout the year. Individuals living with grief usually have at least one person they can open up to. That person listening could make an enormous difference. 

It’s not just the weather and the shorter days and the longer nights that can exacerbate grief. It’s also everyday stress. 

“Any place where you can lessen the stress is a good thing,” Von Gunten stated. “If I’ve got this deadline coming up or I’ve got this bill to pay, or the mortgage – these stressors, we see coming at us. The stress of death is a 24/7 thing, where you’re just kind of going through your day and you’re going, ‘Okay, wait a second. Something’s wrong. Something’s not quite right. Oh yeah, so-and-so died.’ It’s not like you forgot. It’s just that there’s constantly a pressure that’s gaining on us and pushing in on us. That stress can’t be fixed. It gets lighter over time, but the grief is much greater. Maybe try and lessen some of those basic stressors.” 

How to actually do that depends on the individual and the circumstances of their own lives. But if there’s a way to do that, it might help with the grieving process. 

Another way to help with the grieving process, especially after the holidays, is to exercise. 

“With New Year’s resolutions and the like of starting to go to the gym and getting buff; it’s not like that,” Von Gunten said. “It’s much more just about movement. Go for a walk if you can, if the weather allows it. Or just find some kind of way to get some exercise in. Maybe get back into a good cycle with your eating habits.” 

One of the biggest hardships of living in Wyoming is dealing with the wind. In addition to the everyday cold that goes along with winter, the wind itself makes conditions even harsher. So how do grieving people combat that? 

“Well, other than telling us all to move…” Von Gunten laughed. “In terms of the environment we live in, I think it’s almost as if we have to distract ourselves, or create our own focus. It’s like telling your inner voice, when it’s negative to you ‘Hey, hold on. I’m going through a very hard time right now and I’m doing the best I can and this is temporary.’ So, if the wind is up or anything like that, is there a way to focus on some art or a hobby that you like to do? These are also tips for reducing stress. Because basically, the wind and the weather stress us out. So, we have to find ways to reduce that stress. So, we tell grieving people to focus on what they like to do.” 

This is good advice even when the wind isn’t blowing a hundred miles an hour. When you’re grieving, find something that you like to do, something that is comfortable, something that brings you peace. 

“If there’s something normal that you used to do, try to do that,” Von Gunten suggested. “If you like to bowl, go bowling. If you like to crochet, crochet. If there’s somebody that understands grief and that can be there with you, even if just to help get you there and be with you while you do it, that’s helpful too. But focus on what you like to do. Listen to the music you like, watch the movies you like, eat the food you like, within a balance. Do things that you like to do. Most importantly, be around people that you like to hang around with.”

If you find yourself as one of those people a grieving person chooses to be around, do them a favor – don’t ask them how they’re doing. 

“Grieving people do not like it when you ask ‘How are you?’ Von Gunten said. “Because either, A) they don’t know Or B) Do you really want to know? Because if I told you, you might not want to know. For those of us who are just trying to be supportive, it’s the thing you say. You say ‘How are you,’ they say ‘Fine,’ and you move on.”

Von Gunten shared a story of a support person asking a grieving person how they were. The grieving person said, ‘I hate it when people ask me that’ and the support person said, ‘I’m sorry, what would you like me to say?” 

“And then, the grieving person had to step back and think about what she would like,” Von Gunten reflected. “And what the grieving person finally ended up saying was, ‘Tell me you’re glad to see me.’ Now, whenever I see a grieving person, whether it’s in a group or individually, I always say ‘It’s good to see you.’ It’s a nice thing to feel like someone is happy to see you. Then you don’t have to come up with some kind of answer to ‘How are you?’ So generally speaking, when you see a grieving person and you know they’re grieving, just tell them you’re glad to see them.”  

If you’d like to know more about our free Grief Care Services, please call Central Wyoming Hospice and Transitions at (307) 577-4832.