Hospice Beginnings... recorded June 2001 by Jean Moulthrop Hoogstra
A newspaper article regarding St. Christopher's hospice in London, England, was the first I had ever heard of this concept of care for the dying. It made a tremendous impression on me and stimulated the idea of finding out more about this subject. Immaculate Conception Church was looking for an outreach program at that time and the thought of pursuing this idea came to mind. We were told that Sister Therese Galligan was in the process of trying to form a hospice for Buncombe County. We were fortunate enough to contact Sister Therese and she graciously agreed to come to Immaculate Conception Church one evening and tell us all about the program. At that meeting, Sr. Therese invited us to attend a Speakers' Workshop to be held on May 11th, 1979 in Asheville. That was the very beginning!
Dr. John Esse, a Hendersonville psychologist, and I went to this really wonderful workshop, and we were truly inspired by the concept of this program. John said he would help organize some folks who might be interested in such a venture. Then, that is what he did, very successfully. Because it would be a community program, and necessarily funded by the community, he covered as many bases as possible in his choice of people to be contacted.
Hopefully, these folks would be organized as an Ad Hoc Steering Committee. We had a doctor, a lawyer, a representative from the Rest Home Advisory Committee, two nurses from the Henderson County Health Department, a member of the clergy, a geriatric specialist from Trend Community Health Services, a member of the Council on Aging and several community representatives.
Early in June, John sent out a letter regarding a meeting to be held for all who felt they might be interested in knowing more about hospice, and might be interested in pursuing the matter further. That letter was dated June 6, 1979. This meeting, and successive meetings, were held at the home of Dick and Jean Moulthrop on Springside Drive, in Hendersonville. That would continue until we found office space. That meeting covered many subjects such as, Introduction of each person and why hospice was of interest to them; How did each individual feel about death and dying; Brainstorming as to the critical elements we would want to see incorporated in this program; Organizational framework; how we might go about solving problems. We spoke of the work assignments necessary to accomplish these steps. This was very basic and that was understandable, because hospice was so new that it was still in its "infancy." None could yet stand alone. All through this period, people were very interested in anything regarding this concept of caring for the terminally ill with compassion and care and with an outlook that the last of life should be as happy and fulfilling as possible.
At that time there were only two hospices actually working in our nation. The first was established in about 1975 in New Haven, Connecticut, by a Reverend Edward Dobihal. The second, clear across the country, was in Marin County, California. This was established, or was being established by Dr. William Lammers.
By July 1979, we were preparing our first draft proposal, in which we defined the hospice Mission, policies of admission, personnel, fiscal polices and quality assurance of patient care. In December 1979, Lex Veazey, our hospice lawyer, had submitted copies of our Articles of Incorporation and By-Laws to the State of North Carolina and requested a non-profit status for our hospice. Also our Agreement of Affiliation with the North Carolina State hospice Association was completed, and in early March (3/80) Claire Burson and Jean and Dick Moulthrop attended the hospice State Board Meeting in Winston-Salem.
A hospice of Henderson County Board meeting in February, 1980, reported that we had $543 in our checking account and we were rich enough to have $200 in our savings account. At this time I should mention that Wachovia Bank was very good to us for they did not charge us a service charge. R.E. Harmon was responsible for this "bonus."
The minutes also stated that we were organizing a Speaker's Bureau, developing a newsletter, outlining a training program for volunteers and scheduling a program on Pain Control given by Dr. Jerald Pyles. The budget for the year was a hopeful $47,000.
We entered a marvelously exciting period in the development of our wonderful new program. We sent out surveys to the doctors, nurses, churches, and any organization or group that might be affected or involved, or interested in this concept. We eagerly scheduled speaking engagements for any group that indicated any interest at all-no matter how near or far!
The surveys confirmed the need for, and the interest in the development of our hospice. We received letters of support from the Mental Health Association and the Retired Teachers group. We also received "seed money" from Immaculate Conception Church and from St. John in the Wilderness Church. Upon the invitation from Reverend Walter Roberts, and then word from the Bishop of the Episcopal Diocese for their "Venture in Mission", which granted funding for certain designated community endeavors.
At this point, I would like to tell you how this came about. We were at the very beginning point of our project when I received a telephone call from Lyn Fozzard, the daughter of Melvin and Georgiana Lane, the folks who were responsible for the Lane Wing at Pardee Memorial Hospital.
Lyn phoned one night and asked, "Are you the folks who are interested in the establishment of a hospice program here?" I said we certainly were the folks. She told us her father would like to talk to us. I asked if we should come right over, because there was no time that was not a proper time to talk about hospice! "No, come over tomorrow afternoon," she said. So, the next day we went over, and of course, Mr. Lane knew all about hospice because Lyn was involved in the formation of their Chicago hospice.
Mr. Lane told us that he was interested in helping us get started. I really think that Lyn was the one who told him he was interested in helping us. Mr. Lane said, "I will be happy to have you figure out the amount of money that you would need to start with patient care, to open your doors. Now right after you do open your doors and accept patients, you are on your own. I mean that my part is all finished." Then he said, "The way I would like to work this, if you don't mind, is this: The Bishop of the Episcopal Church as asked me for a donation, and I am going to donate $30,000 to the 'Venture in Mission.' Now, tell me what portion of that money you will need, and that will be yours."
Dick Moulthrop had figured out what he thought we would need to get our doors open, and he thought that it would come to about $7500. However, he felt there were so many unexpected expenses that might come up, that maybe we should double that amount to $15,000. So we told Mr. Lane that we would really, really appreciate $15,000, and that would be it! Mr. Lane agreed that that would be fine. He was giving the money to the man who would be in charge of grants. Mr. Lane would stipulate that at least 50% of that money must go to hospice of Henderson County. But, if more were needed, our hospice could take up to the $30,000 point. What we would not require would go to any other North Carolina hospice that had also applied for the grant. That is how we got our first real big donation that made us feel that we were really going to make it!
In the following months, many meetings were held as more detailed plans were made. In November of 1980, 10 of our hospice group attended the 3rd annual NC State Conference at Lenoir Rhyne College. It was a most wonderful, exciting experience, and served to inspire our whole group.
In order to more easily recognize each other in such a crowd, I made each one a cut-out of an apple, made of red felt and marked with the letters HHC on each one, indicating hospice of Henderson County, of course. It proved to be a great conversation piece and led to interesting conversations with so many others. This gave us an opportunity to exchange information and ideas. It really was great fun!
Dr. William Lammers was the principal speaker at the conference. He was in the process of establishing a hospice in Marin County, California. That, I believe, was about the second one in the United States at that point.
All information about the hospice concept was knowledge obtained from St. Christopher's hospice in London, England, which was established through the efforts of Dame Siscely Saunders. The program was then brought to the United States by Reverend Edward Dogihal, who founded the hospice of New Haven.
Everyone attending that conference was most eager to learn more about this concept of care, and all were very enthusiastic. We thoroughly enjoyed Dr. Lammer's speech, but we had an even greater treat in store for us at the luncheon which would close the conference. At that luncheon, the guest speaker was the author of one of the first and best books explaining the hospice concept. Her name was Sandol Stoddard, and I don't believe that anyone hearing her that day will ever forget the impact her presentation made on each one of us.
The history she gave, the cases she reported, the compassion and real dedication Ms. Stoddard exhibited was very, very impressive. She showed such enthusiasm as she expressed the main purpose of this endeavor, defining it as a "Ministry." It was at that point that we recognized that what we were embarking on was just that-a ministry of care and compassion for terminally ill patients and families!
As I try to gather thoughts about our beginning, I realize that dates and figures could never give you the basic facts of this "brand new" project without telling you of the emotional, very warm heartfelt side. For instance: we had no office as such, so, from the first day, the Moulthrop house on Springside Drive in Hendersonville was the center of all our meetings and our "brainstorming" sessions. In making arrangements for a dinner sponsored by Trend, some time before, I met Mary Sue Anders, the Hostess at the First Presbyterian Church, and we became very good friends. Mary heard all about our need for office space, and she spoke to John Clay, a member of the church. Mr. Clay proposed the idea of allowing hospice the use of a room that had been designated for a Nursery, but was not being used or needed then. John interviewed the Moulthrops and gained permission for hospice to use that room as our office. Few announcements could not have been more joyously received!
The First Presbyterian Church housed us for about six years, asking only that we pay for the phone (which we had installed with the proper wiring, etc). Their support was so all encompassing and gracious, that we could never adequately thank them! We not only had our office there, but we held all training sessions there in the classrooms, as well as having the Fellowship Room for any pot-luck dinners, etc. Now, of course, we had little or no money. So, we also had no furniture for the office. I was told that Steelcase sometimes provided desks for nonprofit endeavors if they felt the cause was worthwhile. These desks were supposedly "damaged" or "rejects," but if that were true, the flaws were hard to find for the desks were "magnificent"!
I contacted the comptroller of the Steelcase plant in our area, told him about our project and asked him to come to lunch and listen to what we hoped to do. His name was Max Price and he was one very fine person. He approved our request for furniture and he had two desks sent to us. (As a footnote-Max Price and Steelcase provided many non-profit agencies and some churches with needed desks, etc.) They were always gracious about it. So when I recall our first office, I remember with grateful thanks, Mary Anders, John Clay, and Max Price. Without their support, I am not sure things could have gone as smoothly. Right after we moved into the office, we had a picture taken of Max Price, John Clay, Dr. Pyles and me, and I am glad to have it, for it marked a milestone.
If I could tell you truly of the dedication and emotional side of this period, I might be able to make you understand how "engrossing" it was for all of us. We were filled with expectation, enthusiasm and high ideals about this ministry, as well as being a little scared. Every step forward brought us just one step closer to accomplishment. But the steps had to be taken with thought and care.
Volunteers were, of course, absolutely necessary to the entire program. At first, we had no "paid staff." I made sure the office was attended each morning from 9am till 1pm. If I were to be away, for any reason, we asked someone to cover this time for us. Our training program for volunteers lasted 10 weeks and was held one evening a week. Response to this training program was really surprising. We had about 25 or more for each session. Thankfully, ever since that time, hospice has always had wonderful people who are willing to give of their time and effort to continue this ministry.
Miriam Kussrow was our first "Home Care Coordinator" and she was simply "outstanding" for she was there for anyone who needed her. Her manner with patients and families cannot adequately be described. She has (please note that I use the present tense) the most compassionate, most sincere manner of helping people through traumatic times that I have ever know anyone to have.
Van Kussrow, Miriam's husband, was kind enough to teach a class for us in Public Speaking at Blue Ridge Community College. We needed some skill in that facet of Public Relations in order to present our ministry in the community. We received certificates when we completed the course.
When we finally opened for patient care, we entered a new phase of communication, for we had weekly team meetings where patient care was reviewed and discussed to make sure of each step taken. Since this whole idea was new, it was like teaching a child to walk. These meetings were held at Pardee Hospital and were very confidential in nature. That was completely understood and accepted in its full sense.
Team meetings were another thing that brought us closer and closer as a family. We supported hospices with our finances, if possible, and we gave enthusiastically of our time and effort as well, as we all had the same goal-to see hospice of Henderson County a firmly established ministry for those in our community faced with a terminal illness. We never forgot that hospice care meant both patient and family.
For those fortunate enough to have taken part in the formative months and years of our hospice, it is a memory that would not easily fade. We had such hopes and plans and togetherness, that it was a joyous time as well as a time of praying that this was just the beginning, and that others would continue to feel as we did about this endeavor and work toward its future success.
Now, some twenty years later, we do sincerely thank the Lord for all the folks that, through the years have continued not only to support this program, but have been responsible for making it grow-and grow! We are pleased and grateful to everyone who has had any part of this wonderful ministry. But the greatest privilege and joy was being involved in the struggle at the very, very beginning.
Jean Moulthrop Hoogstra
Co-Creating The Care Experience