Walking through the park, up the sidewalk from West 231st Street and Riverdale Avenue in the Bronx, I take solace in the fragile beauty of the autumn morning. The gray sky and the rust and gold of maple and oak are harbingers of the coming New York winter. Already there has been a flurry of snow in the air. The changing seasons complement our family’s present experience.

 For some time now we have been saying a long goodbye to a dear member of the family. Most aunts are not as important to most nephews as this one is to me. Both my parents died many years ago, and my Aunt Grace—my mother’s only sibling, who never married—has taken on the role of parent throughout my adult life.

 Beloved by the whole family, she has been strong, brilliant, witty, and nurturing. For years the head of the social services department of a children’s hospital on the outskirts of New York City, she matched wits with physicians, professional colleagues, and state politicians in advocating for the needs of disabled children. She managed a large staff at the hospital, and was founding co-editor of an international professional journal. But that was in the summer of her life. Now, after a long and productive autumn of retirement, in her ninety-first year, winter is arriving.

 The leaves have been turning and falling for several years as Alzheimer’s Disease has taken its inexorable toll. She is bed-ridden now—resisting it until just a couple weeks ago. Brief flashes of recognition are fewer and farther between. Mostly she sleeps. When her eyes are open they stare. Yesterday, the hospice nurse, Karen, described the likely progression in what we expect will be Grace’s last few days. We are caring for her in her own home.

 Keeping my aunt at home has been made possible by a wonderful organization, Calvary Hospital Hospice. Before Karen’s visit yesterday, Kate, a hospice social worker, also stopped for a visit. They both offered expert practical advice—what signs to look for, how to administer medications, how to care for bodily needs. But Karen and Kate were not concerned only about my aunt’s wellbeing. They took time to focus their full attention on our needs as well. They probed gently to find out how we are holding up, made insightful suggestions, drew out healthy expressions of emotion, and used gentle humor as a counterpoint to somber moments.

 “You do important work,” I said to Kate as she was preparing to leave.

 “Oh,” she said, a little surprised. “It is nice to hear that. Thank you.”

 These women, and many more like them, should hear such words often.

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 When I looked into it, I was surprised to find that hospice care is a relatively recent development in the healthcare world. Care for the dying at Calvary Hospital actually predates the worldwide hospice movement by several decades.

 The impetus for the larger movement came from British physician Dame Cicely Saunders and American psychologist Elisabeth Kubler-Ross. Dr. Saunders, who began working with dying patients in the 1940s, founded the first modern hospice—St. Christopher’s Hospice in London—in the 1960s. Dr. Saunders came to believe and to teach, "We do not have to cure to heal." In 1964, she began teaching at Yale University School of Nursing about holistic hospice care and how it enhances the quality of life of terminally ill patients.

Several years later, Dr. Kubler-Ross published her book On Death and Dying. Based on interviews with dying patients, she identified five stages of grief—denial, anger, depression, bargaining and acceptance. The book, which became a bestseller, did a great deal to bring death out of the shadows. In the years to follow, the hospice movement gained broad support—and also funding from government and other sources. Today there are more than 3,200 hospice organizations in the United States.

Before all of this took place, however, Calvary Hospital in New York City—the organization we are so fortunate to have supporting our family—was providing care to the dying. In 1899, a small group of widows in New York, inspired by the work of a group in France called Women of Calvary, began caring for destitute women with terminal diseases. They took care of the women first in their own homes, then in two brownstone houses in Greenwich Village. The House of Calvary moved to the Bronx in 1915, became fully accredited in 1965, and officially changed its name to Calvary Hospital in 1969.

Several orders of nuns contributed to the organization’s work over the years. These include the Dominican Sisters of Blauvelt, the Dominican Sisters of the Sick Poor, and The Little Company of Mary. Today the hospital continues as a not-for-profit agency operated by a lay administration in connection with the Roman Catholic Archdiocese of New York. People from many faiths now contribute to the hospital’s work. We are so grateful for their contribution to our family in our time of need.

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 I guess for some, the winter of old age and death appears to be the final season—the end. But as I walked among autumn leaves in the park this morning, I had no sense of approaching finality. I’ve lived considerably more than 50 years, and I have yet to experience an eternal winter. Long though some winters may have seemed, every single one has been followed by springtime. So it will be for my Aunt Grace, whose winter will one day be suddenly interrupted by springtime resurrection!

 “The Lord himself will come down from heaven, with a loud command,” wrote Paul, “. . . and the dead in Christ will rise first. After that, we who are still alive and are left will be caught up with them in the clouds to meet the Lord in the air. And so we will be with the Lord forever. Therefore encourage each other with these words” (1 Thessalonians 4:16-18). 

 Yes, I am encouraged! It is now winter for my Aunt Grace, but springtime is coming.

 B.W.

For more information about hospice care, visit:
www.caringinfo.org
www.calvaryhospital.org

 Addendum: Grace Fields died at home, surrounded by her family, at noon on November 25.