Mopani Pharmacy spoke with Sister Landi Bezuidenhout, CEO of Hospice Nelspruit. In general, topics regarding end-of-life care are morbid, however, Sr Bezuidenhout has a unique perspective to offer.
How does your day start?
“Before we leave for the day, we disinfect all the surfaces in the office and shop. The next morning, we wash everything with soap and water. We then have a staff meeting, to discuss the patients we had the previous day, and who we plan to see that day. Patients are visited at their homes.”
Patients are categorised in three groups.
- Group 1 – Patients that are still mobile and can look after themselves, are visited once a month
- Group 2 – Patients that need a bit more care and aid in terms of assessing their health and adjusting treatment, are visited twice a month
- Group 3 – Patients who need regular care, are immobile or near end-of-life, are visited once a week, or daily, depending on their needs
Do you have a variety of illnesses among your patients?
“Yes, as well as a variety in age. We take care of elderly patients with organ failure, young patients with cancer, or even a child that has cystic fibrosis, a disease of the lungs.”
“Not all of our patients are dying. Their diagnosis might be life-threatening, but they could live a few years, with help and treatment, and still function relatively well.”
How do you communicate with scared patients?
“You speak with your body language, your tone, and your words. Always introduce yourself properly, as some patients might forget who you are between visits. Communicate in their language, and ways they understand. Use the same terminology they would, and not the medical terms.”
“You have to be soothing, friendly, and be on their level. I never tower over a patient. I get down to eye level by sitting on a chair or on their bed. A healing touch is worth so much. They know when you are touching them with care, and when you are just doing it to get the job done. It is important to work gently. This is especially important when you need to help to bathe someone or work near their privates. They deserve their dignity.”
Is there more to a visit than the normal treatment of a condition?
“You need to ask questions, to make note of any new symptoms. I counsel their caregivers, spouses, parents, children. I will train the family of the patient on how to care for their loved-one, give dietary guidelines, how and when to administer medication and how to bathe, turn or dress their loved-one without hurting themselves. Even a small person can be dead-weight on your back.”
“Sometimes, a family member becomes a second patient. I will test their blood pressure or glucose and refer them to a doctor. They often spend so much time caring for their loved-one that they forget about their own health.”
“We sometimes need to ask patients difficult questions, such as signing a living will, to state their medical wishes; what they want done if they are not in a position to speak for themselves. This will prevent family from fighting over whether or not the patient should be kept alive by extraordinary measures or be allowed to die naturally.”
Misconceptions
“We do not act alone. We are not in the business of helping patients die quicker. We are here to help them live their best quality life, until they die. We report to their doctors, and have medication adjusted in accordance with what we see they need, to ensure they experience as little pain as possible. We work as part of the team, where social workers and spiritual leaders play an important role in providing care to ensure quality of life of patients and their families”
“People often believe that morphine kills. It does not. Many patients who are terminally ill but still mobile, gain some freedom due to morphine. At the correct dosage, they are able to sit up, work with their hands, instead of laying in bed all day in pain. The morphine also relaxes tense muscles in the airways that allows for deeper, relaxed breaths.”
“Every journey for each patient is vastly different, and we need to continuously assess, recommend and adjust treatment, in agreement with their doctors and their wishes.”
Does it affect you, to work with patients who are dying?
“After a long day, I need to debrief. I play with my dogs, speak to my husband, I pray. But it is not just death to me. End-of-life periods are very private, to most patients. They are going on a spiritual journey; they make peace with what is happening. Some are in denial about their situation, but it remains a time where they confide in me. I am so very honoured to have the privilege to be part of their last stretch on earth.”
How many patients can you serve at any given time?
“We recently added a new staff member, Sr Lucia Masinga. We serve between 45-50 patients between us, in a 30-kilometre radius from within Nelspruit, from Riverside to Kanyamazane.”
Tree of remembrance
“This tree on our wall was painted with the sole purpose of honouring our patients. We try to go to each funeral, it’s not always possible, but we try. We offer their families the opportunity to have a plaque made and placed upon this wall. Whenever they need to, they can come here, have a cup of coffee and speak to their loved-one.”
“The pandemic did not allow us to have much to do last year, but we have three to four bereavement-group sessions per year. This is to provide counselling for those who are left behind and need to deal with no longer having their loved-one around.”
How can the community help?
“We have 10 to 15 volunteers; however, they are not all, always available. They act as companions to patients, they run errands, do shopping and pick up medications. We are in need of new volunteers, to add to the group.”
“We host fundraising events every so often, please view our Facebook page. We update it regularly with new information. On 9 March, we hosted a patient care day, and invited our patients to have cake and tea with us in the garden. These small events help them to get out, many of them are stuck at home all day. The pandemic isolated them even more, as they are all high-risk.”
“Our second-hand shop has a variety of clothing, books and other household items, for sale to the public. Please visit us.”
“We are an organisation that is from the community, for the community, by the community. We are reliant on public support and donations.”
If you would like to contact hospice on 0137440095.
For donations: Nelspruit Hospice | FNB | Account no: 62093964891 | Branch code: 250016
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