Skip to content
March 29, 2024

“Now That’s Teamwork!”: Listening to Patients, Plants and Each Member of the Team

February 28, 2023

When the Brooklyn West Hospice team first came to care for Kathy*, they could see her life stories evident in every inch of her walk-up apartment. Plants abounded, including a bougainvillea lacing the walls of her bedroom. Driftwood was perched everywhere. Soon-to-hatch pigeon eggs nested inside the window. As the team would soon learn, their care of Kathy would be guided by lessons inherent in the nature that was very much on view.

Listen to the plants,” said Anna Jenkins, a Hospice Spiritual Care Counselor, quoting Kathy. “They will tell you what they need. Trust their communication.” And the VNS Health Hospice Care team listened – each taking guidance from their patient on how she wanted to receive care as she lived her final chapter with her illness and its debilitating physical and behavioral symptoms.

Kathy with Hannah Schwartz and
Anna Jenkins

“Through her telling us how to be a gardener, she taught me how to help care for her,” said Anna. When VNS Health team members asked Kathy a standard question, “Are you in pain?” she replied, “That’s the wrong question.” By listening closely, by giving her the space and time to guide them, the hospice team was able to deliver the care and support Kathy most wanted and needed. A patient who used to be resistant came to regularly tell her caregivers, “I love you.” “She’s let us love her,” said Anna.

Seamless Team Care

Anna often saw Kathy together with social worker Leslie Marseglia. The two were also in constant touch with nurse Hannah Schwartz, who visited Kathy weekly to monitor clinical symptoms and report back on her condition to hospice physician Samuel Weisblatt.

“We do everything as a team,” said Hannah. “I look at the patient medically, and update Dr. Weisblatt after nearly every visit. I might text him that Kathy’s symptoms are better managed since we increased the dosage of a certain medicine, but she’s nauseous or her mood is affected. When Leslie and Anna are there, I might get a text: she didn’t get a medical supply yet, or hasn’t received meds that were ordered.”

While Samuel’s home visits were less frequent than the rest of the team’s, he worked closely by phone with Hannah, Leslie and Anna. “We recognize that there are different domains where people express suffering: physical, psychological, suffering,” he said. “At the core of hospice care is working to address all of those domains.”

Pamela Bernardo

Pamela Bernardo, team manager for Brooklyn West Hospice, agrees. “Working collaboratively as a team gives our patients a unique opportunity to benefit from interdisciplinary care in the home, much as they would in a hospital or other large facility,” she explained. Pamela emphasized that hospice team care, as with Kathy, is always highly individualized, with each caregiver “putting themselves in the patient’s shoes and allowing the patient to show us what they need in this last phase of their life.”

Using Silence to Ensure Dignity

It is all too common for people at end of life to feel a profound loss of control over their lives and their options. Following the patient’s lead is central to hospice care.

Leslie Marseglia

“It’s really important for Kathy to have a say in what her process looks like,” said Anna, noting that Kathy lived alone, was fiercely independent, and was struggling in the face of increasing physical limitations. “She’s spent her life being in charge. It was really important for her to have us receive with seriousness and care the things she cares about.”

“With Kathy, it was helpful to employ the use of silence,” added Leslie. “It gave her space to talk about what she wanted to talk about. We didn’t try to jump in with another question or a band-aid to try to fix things.”

Tracy Scott

Kathy made a list of things she wanted to attend to before the end of her life, including going through her collection of record albums from the 50s and 60s. Here, hospice volunteer Tracy Scott sat with Kathy, evaluating albums and playing songs on the iPhone (there was no record player). “We’d listen, reminisce, and put the albums into keep or donate piles,” said Tracy. “She has a connection to them, and the process was important in giving her agency.”

The Power of Home

Over the course of the team’s care, the pigeon eggs inside the apartment hatched, providing a deep connection to the natural world at a time when Kathy—who recently received a lifetime achievement award from New York City for her volunteer gardening work—was unable to get outside.

Dr. Samuel Weisblatt

“She can’t get to the garden like she used to,” said Samuel, “but the birds helped maintain a sense of normalcy, something enjoyable to enhance her quality of life, bring meaning, and help sustain her through continued loss of functioning.”

“There’s such an energy to her apartment,” said Anna. “It calls out, I am alive.”

* The patient’s name has been changed for privacy