March 29, 2024

Providing comfort and care at the end

Erin Knauer wasn’t comfortable with death and dying when she accepted her first hospice job at Care Initiatives, but she learned to love being able to do little things for the patients to make their last days enjoyable.

“Someone had never had a pomegranate before, so I went to the store and got one,” said Knauer. “I had never had one, so neither one of us knew what we were doing.”

Knauer is the social worker at EveryStep Greater Regional Hospice Home. She started the job in November after leaving Care Initiatives to earn her master’s degree in social work from University of Northern Iowa.

Knauer has also worked as a mental health therapist and said it’s what she would be doing if she wasn’t working for EveryStep.

“When I left hospice to go to grad school, I always thought that if I had the chance to go back, I would” said Knauer. “I got this chance, so I jumped at it.”

The hardest part of her job is helping families navigate through the death and grieving process.

“It’s almost like you’re trying to grieve before someone dies,” said Knauer. “You’re trying to figure out how to navigate through it, and that’s where people sort of struggle the most — that point where they’re coming in here.”

Knauer said it can also be challenging to get the whole family on the same page and help them realize that all the decisions being made are based on what the patient wants.

When she wasn’t sure she wanted to do hospice work, Knauer said it was something her mother said that gave her an extra push to give it a try.

“My mom told me that dying is not the worst thing to happen to a person, and that’s true,” said Knauer. “When you’re working in hospice, you hear people’s stories, and some people have been through the worst situations. They’re ready to go. They’ve made peace with dying.”

Knauer said patients coming into hospice care can be there for a couple hours or a couple months.

Patients in hospice care aren’t treated for their illness. Caregivers provide comfort and pain relief to get them through their last days. However, Knauer said sometimes that is enough to set them on the road to recovery and prolong their life.

“It’s crazy because people think when they go to hospice they’re going to die, and people actually get better sometimes and live longer,” said Knauer. “Sometimes someone will come in and we’ll think they’re not going to make it through the weekend and two months later they’re still with us.”

Knauer added that providing comfort and pain relief is sometimes enough to help them recover to a point where they no longer need the level of care hospice provides.

“I just heard today someone on staff that works in the field — they have a patient they have to discharge from hospice because she’s stable,” said Knauer. “She’s gotten better and they’re no longer saying she’s going to die. [The patient is] so mad about it because she loves the care that she gets and she doesn’t want to give that up, but she’s better.”

EveryStep only has six beds, so if a patient improves to a level where they no longer need the level of care a hospice center provides, they need to be discharged.

When Knauer started working for EveryStep, she didn’t realize how large the organization was.

EveryStep has more than 30 programs and serves more than 60,000 Iowa residents in 47 counties. The organization is involved in every step of life, from infancy to death, and the organization also has a foundation which provides financial assistance for hospice patients with limited funds.

“This has been my favorite job,” said Knauer. “It’s nice because you’re not sitting in an office all day, and it’s very rewarding. Probably more rewarding than people would think.”