The Violet Hour: Great Writers at the End by Katie Roiphe review – how to cope with death

This study of Susan Sontag, Sigmund Freud, John Updike, and how they coped with the mystery of extinction, is also a memoir about brushes with mortality

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Katie Roiphe: ‘I think if I can capture death on the page, I’ll repair or heal something. I’ll feel better.’

Katie Roiphe begins her study of writers in their last hours with the story of a near-death experience: her own. At the age of 12 she began coughing up blood, but decided not to tell anyone – not her parents, or sisters, or doctor. She had in fact developed acute pneumonia, and after an operation that removed half of a lung she came out of hospital weighing 60lb, “too weak to open a door”. Ever since that narrow escape, death became her obsession, but one that continued to defy understanding or articulation. Who could make sense of such a thing? Her answer: great writers, specifically great writers as they approached death’s door. “I think if I can capture death on the page, I’ll repair or heal something. I’ll feel better. It comes down to that.” This mini-memoir, and a coda, are the most compelling parts of The Violet Hour. They bookend a sequence of five case studies of writers whose thoughts on mortality are often arresting, sometimes moving, yet never add up to a coherent vision of what Henry James called “the distinguished thing”.

Roiphe (above), an essayist, teacher and contrarian, is a woman up for a challenge. Her most recent books – a study of literary unions, Uncommon Arrangements, andIn Praise of Messy Lives, a scattershot broadside against the way we live now – reveal her tough, unbiddable, non-ingratiating character. Fittingly, her first subject is Susan Sontag, a writer whose personal and intellectual fierceness could be Roiphe’s model. Sontag’s determination to outface death became part of her legend. She had already survived cancer, twice, when she was diagnosed with leukaemia in 2004. Believing herself to be “exceptional”, she rejected the evidence, adopting a get-well-or-die-trying attitude that caused intense anguish among the people who cared for her – her son David, friends, nurses, hired hands. She took up cudgels once again, enduring chemo and the dangerous procedure of a bone marrow transplant. The treatment caused her shocking physical agony. At this point I couldn’t help thinking of Woody Allen’s line: “I don’t want to achieve immortality through my work. I want to achieve it through not dying.”

Susan Sontag with her son. David, in 1967.
Susan Sontag with her son. David, in 1967.

Sontag is an extreme case – and the only woman – in this book. Her example is unlikely to make Roiphe, or anyone, “feel better” about death. Sigmund Freud, on the other hand, adopted the opposite approach. Even as a young man he disliked the idea of “prolonging life at all costs”. Stricken by an inoperable cancer of the jaw, he refused any painkillers other than aspirin. “I prefer to think in torment than not to be able to think clearly,” he said. Was his stoicism a better, braver way to face the end? As Larkin wrote in “Aubade”, “Death is no different whined at than withstood”. His disciples believed that Freud had no terror of the end, but Roiphe wonders if he protested his indifference too much: he may have been trying to persuade himself that he didn’t care.

Shadowing Roiphe’s book is a tentative desire to find something consolatory – a truth, a meaning – in death. Can writers teach us how to die? The uncertain, provisional nature of her project is evident. Instead of a continuous narrative, she writes in discrete floating paragraphs, as if conducting a philosophical investigation. Either that, or she doesn’t quite know how to structure her argument. Maurice Sendak, a writer and illustrator she has revered from childhood, described death “as if it is a friend who is waiting for him”. He suffered a heart attack at 39, but lived on till his 80s. He owned Keats’s original death mask and would take it out “to stroke the smooth white forehead”. When his lover died, Sendak drew his corpse, obeying the creative instinct “to turn something terrible into art”. Here Roiphe does get at something useful, which is the consolation of work: “For the time it takes to draw what is in front of you, you are not helpless or a bystander or bereft: You are doing your job.” (I would take “or bereft” out of that sentence.)

John Updike, characteristically, worked unto the last, writing some of his most poignant poems (in Endpoint) from his hospital bed. Like Freud, he cleaved to stoicism in considering death, but unlike him had sought comfort in religious faith and sexual adventure, the latter his way – or at least his characters’ way – of cheating mortality: “If you have a secret, submerged, second life, you have somehow transcended or outwitted the confines of a single life.” In an almost too-perfect illustration of his twin drives we learn that Updike plotted Couples, his great novel of adultery, while in church – “little shivers and urgencies I would jot down on the program”. The oddness of this chapter, however, concerns what happened between Updike’s family during his last illness. His first wife Mary and their four grown-up children seem to have come a cropper under the Cerberus-like vigilance of his second wife Martha. The children felt that Martha, perhaps with her husband’s tacit agreement, restricted their “alone-time” with Updike. This is interesting as gossip, but I can’t see how it enlarges our understanding of the writer or his work.

Dylan Thomas in 1946.
Dylan Thomas in 1946.

Even less illuminating is the record of Dylan Thomas’s bibulous last days in New York, swaggering – or staggering – from hotel to pub to hospital and thence into a coma. Roiphe notes that myths have clustered around his death, and the causes of it. Some still argue that he “wasn’t an alcoholic”. Seriously? Put it this way: if Dylan Thomas was not an alcoholic then his was an even more horrifying personality than at first appears. Addiction would at least explain, if not excuse, his lechery, his flakiness, his self-pity, his self-loathing, his tendency to steal from his friends, and the fact that he had written only six poems in his last six years. At 39, Thomas is the youngest to go of this small assembly and the one whose death I felt least inclined to lament.

The Violet Hour does, however, rally at the end. For reasons the author doesn’t entirely understand she seeks an interview with James Salter, then 89 years old, and nearly the last Great American Novelist. To her surprise he agrees to talk. Perhaps it is her contact with a living subject, perhaps it is Salter’s wry, Delphic way with words, or the fact that he came close to death as a fighter pilot in Korea, but something is unlocked by their encounter and Roiphe at last identifies what her quest has been about – not death but the fear of death: “The knowing you are about to die. The panic of its approach … That’s what I’ve been trying to write my way through.” It returns her to another formative moment in her life, the sudden collapse of her father – a heart attack in the lobby of his building – and her belated realisation that he must have felt pain in the minutes before he died. She is excruciated by the idea of his pain, and that he may have panicked. “The idea that he didn’t have time to be afraid had consoled me.”

This book is Roiphe’s haunting but muddled attempt to come to terms with the mystery of extinction. Her father died, and she will never know what he was going through. Salter, who died last year, knew best: “Don’t dwell on it.”

Complete Article HERE!

The 11 qualities of a good death, according to research

BY Jordan Rosenfeld

The 11 qualities of a good death, according to research

Nearly nine years ago, I received a call from my stepmother summoning me to my grandmother’s house. At 92 years old, my Oma had lost most of her sight and hearing, and with it the joy she took in reading and listening to music. She spent most of her time in a wheelchair because small strokes had left her prone to falling, and she was never comfortable in bed. Now she had told her caregiver that she was “ready to die,” and our family believed she meant it.

I made it to my grandmother in time to spend an entire day at her bedside, along with other members of our family. We told her she was free to go, and she quietly slipped away that night. It was, I thought, a good death. But beyond that experience, I haven’t had much insight into what it would look like to make peace with the end of one’s life.

A recent study published in the American Journal of Geriatric Psychiatry, which gathered data from terminal patients, family members and health care providers, aims to clarify what a good death looks like. The literature review identifies 11 core themes associated with dying well, culled from 36 studies:

  • Having control over the specific dying process
  • Pain-free status
  • Engagement with religion or spirituality
  • Experiencing emotional well-being
  • Having a sense of life completion or legacy
  • Having a choice in treatment preferences
  • Experiencing dignity in the dying process
  • Having family present and saying goodbye
  • Quality of life during the dying process
  • A good relationship with health care providers
  • A miscellaneous “other” category (cultural specifics, having pets nearby, health care costs, etc.)

In laying out the factors that tend to be associated with a peaceful dying process, this research has the potential to help us better prepare for the deaths of our loved ones—and for our own.

Choosing the way we die

Americans don’t like to talk about death. But having tough conversations about end-of-life care well in advance can help dying people cope later on, according to Emily Meier, lead author of the study and a psychologist who worked in palliative care at the University of California San Diego’s Morris Cancer Center. Her research suggests that people who put their wishes in writing and talk to their loved ones about how they want to die can retain some sense of agency in the face of the inevitable, and even find meaning in the dying process.

Natasha Billawala, a writer in Los Angeles, had many conversations with her mother before she passed away from complications of the neurodegenerative disease ALS (amytropic lateral sclerosis) in December 2015. Both of her parents had put their advanced directivesinto writing years before their deaths, noting procedures they did and didn’t want and what kinds of decisions their children could make on their behalf. “When the end came it was immensely helpful to know what she wanted,” Billawala says.

When asked if her mother had a “good death,” according to the UCSD study’s criteria, Billawalla says, “Yes and no. It’s complicated because she didn’t want to go. Because she lost the ability to swallow, the opportunity to make the last decision was taken from her.” Her mother might have been able to make more choices about how she died if her loss of functions had not hastened her demise. And yet Billawalla calls witnessing her mother’s death “a gift,” because “there was so much love and a focus on her that was beautiful, that I can carry with me forever.”

Pain-free status

Dying can take a long time—which sometimes means that patients opt for pain medication or removing life-support systems in order to ease suffering. Billawala’s mother spent her final days on morphine to keep her comfortable. My Oma, too, had opiate pain relief for chronic pain.

Her death wasn’t exactly easy. At the end of her life, her lungs were working hard, her limbs twitching, her eyes rolling behind lids like an active dreamer. But I do think it’s safe to say that she was as comfortable as she could possibly be—far more so than if she’d been rushed to the hospital and hooked up to machines. It’s no surprise that many people, at the end, eschew interventions and simply wish to go in peace.

Emotional well-being

Author and physician Atul Gwande summarizes well-being as “the reasons one wishes to be alive” in his recent book Being Mortal. This may involve simple pleasures like going to the symphony, taking vigorous hikes or reading books He adds: “Whenever serious sickness or injury strikes and your body or mind breaks down … What are the trade-offs you are willing to make and not willing to make?”

Kriss Kevorkian, an expert in grief, death and dying, encourages those she educates to write advance directives with the following question in mind: “What do you want your quality of life to be?”

The hospital setting alone can create anxiety or negative feelings in an ill or dying person, so Kevorkian suggests family members try to create a familiar ambience through music, favorite scents, or conversation, among other options, or consider whether it’s better to bring the dying person home instead. Billawalla says that the most important thing to her mother was to have her children with her at the end. For many dying people, having family around can provide a sense of peace.

Opening up about death and dying

People who openly talk about death when they are in good health have a greater chance of facing their own deaths with equanimity. To that end, Meier is a fan of death cafés, which have sprung up around the nation. These informal discussion groups aim to help people get more comfortable talking about dying, normalizing such discussions over tea or cake. It’s a platform where people can chat about everything from the afterlife (or lack thereof) to cremation to mourning rituals.

Doctors and nurses must also confront their own resistance to openly discussing death, according to Dilip Jeste, a coauthor of the study and pediatric psychiatrist with the University of California San Diego Stein Institute for Research on Aging. “As physicians we are taught to think about how to prolong life,” he says. That’s why death becomes [seen as] a failure on our part.” While doctors overwhelmingly believe in the importance of end-of-life conversations, a recent US poll found that nearly half (46%) of doctors and specialists feel unsure about how to broach the subject with their own patients. Perhaps, in coming to a better understanding of what a good death looks like, both doctors and laypeople will be better prepared to help people through this final, natural transition.

Complete Article HERE!

Life’s Too Short to Wear Beige

I was a closeted gay woman surrounded by white-hued walls and yearning for my own colorful world. My sister’s death changed everything.

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too_short_for_beige

All my life, my walls have been painted different shades of white, and beige. Ordinary, predictable hues, “normal” and controllable in feel.

My childhood bedroom was a cool shade of white, with Tiger Beat pull-out posters and a 1978 World Champions Yankees poster from Burger King thumbtacked to my bulletin board. My college dorm room walls were made of cinder block with the gum-tacked picture collages I had made of my family, high school and camp friends. My first New York City apartment was a rental — with eggshell painted walls. The Georgia O’Keefe print I had picked up at Bed and Bath, added some warmth, the pastel palette calming. But the walls around me, I always kept those in tones of white, off-white, and beige.

When I got married to my boyfriend of four years, and a year later gave birth to our beautiful son, we moved to the New Jersey suburbs. And yes, we painted our walls different shades of white and beige in our new home.

In 2004, the oldest of my two sisters needed me. She’d been battling stage 4 ovarian cancer for seven years, and we’d learned I was a stem cell donor match, and her best chance to beat her cancer. So, I took time off from my job, and brought my two-year-old-son back and forth for each of my sister’s two-week long treatments at M.D. Anderson in Houston.

A few months before her treatments began, my sister was still living back in Atlanta, at home with her husband and two daughters. “What’s this?” her husband asked after work one night, upon seeing the scattered paintbrushes and Benjamin Moore color wheel. “Life’s too short for beige,” my sister said. It only took a week for every room in their house to get a fresh coat of paint. From rooms of white and off white to bold and bright-colored walls.

As my sister fought her battle, I fought my own. Like the tick of a kaleidoscope, my entire world of control tumbled and rotated; suddenly, my life of white walls felt unstable and discomforting.

Perhaps it was also when I began to realize that my sister’s doctor, the one I had first laid eyes on during round one of the stem cell transplant, was my perfect match. She explained how my blood and stem cells could save my sister, but she also opened my eyes to understanding how my sister’s “you can’t control what life will throw at you, but you can control how you deal with it” philosophy directly related to the safe and normal box I had created for myself all those years, and the reality I had been trying to shove away.

My big sister, who walked the hallways of the MD Anderson Cancer Center in her Fresh Produce clothes and her bald head held high with a Life is Good baseball hat covering it, even during a time of grave uncertainty, with her cross body canvas handbag adorned with different sized John Kerry for President buttons — in Texas, aka Bush country.

The truth is, I was a gay woman trying to convince myself it would be easier to live surrounded by safe, white hued walls rather than within my own colorful world.

My sister knew of my decision to live my truth before she passed away, a year after her transplant. Her doctor, today my wife, and I live together in our suburban New Jersey colonial. We have three children, two of whom are named after my beautiful and brave sister. And our walls? All of them are painted the brightest and boldest colors of the Crayola box. Just how we like it.

Complete Article HERE!

Maori Digital Stories about whanau caregiving

Today’s posting comes to us via Clare O’Leary | Palliative Care Educator | Mary Potter Hospice | Wellington, New Zealand

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Maori digital stories about caring for kaumatua (elders) at the end of life. Teaching resource for nursing students, nurses and other health professionals who want to know more about Maori whanau (family) end of life needs and priorities.

 

More information:  https://www.fmhs.auckland.ac.nz/en/so…

Powerful Advice From A Dying Man

By Houston Barber

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Life is all a matter of perspective. We may look at someone and think they’ve got the perfect life and everything figured out, but we never know what that person is really going through. At the same time, we spend countless amounts of energy struggling and stressing over the small stuff in life, and unfortunately, it’s not usually until something traumatic happens that we realize this.

Recently, a young man in California was face to face with a life-threatening illness, and his prognosis did not look good. His cancer was diagnosed too late and doctors only gave him months to live. This is the sort of thing that will put your life into a harsh perspective, and the 24-year-old wanted to share his new outlook on life with those he would be leaving behind.

So, the young man began to write a letter and addressed it to anyone who would take the time to read it. In the letter, he wrote the things he wished he would have done, and some pieces of advice to those who would be willing to listen. Read the full letter below and take the dying man’s words to heart as you go about your life.

“I am only 24 years old, yet I have actually already chosen my last tie. It’s the one that I will wear on my funeral a few months from now. It may not match my suit, but I think it’s perfect for the occasion.

The cancer diagnosis came too late to give me at least a tenuous hope for a long life, but I realized that the most important thing about death is to ensure that you leave this world a little better than it was before you existed with your contributions. The way I’ve lived my life so far, my existence or more precisely the loss of it, will not matter because I have lived without doing anything impactful.

dying_man

Before, there were so many things that occupied my mind. When I learned how much time I had left, however, it became clear which things are really important. So, I am writing to you for a selfish reason. I want to give meaning to my life by sharing with you what I have realized:

  • Don’t waste your time on work that you don’t enjoy. It is obvious that you cannot succeed in something that you don’t like. Patience, passion, and dedication come easily only when you love what you do.
  • It’s stupid to be afraid of others’ opinions. Fear weakens and paralyzes you. If you let it, it can grow worse and worse every day until there is nothing left of you, but a shell of yourself. Listen to your inner voice and go with it. Some people may call you crazy, but some may even think you’re a legend.
  • Take control of your life. Take full responsibility for the things that happen to you. Limit bad habits and try to lead a healthier life. Find a sport that makes you happy. Most of all, don’t procrastinate. Let your life be shaped by decisions you made, not by the ones you didn’t.
  • Appreciate the people around you. Your friends and relatives will always be an infinite source of strength and love. That is why you shouldn’t take them for granted.

It is difficult for me to fully express my feelings about the importance of these simple realizations, but I hope that you will listen to someone who has experienced how valuable time is.

I’m not upset because I understand that the last days of my life have become meaningful. I only regret that I will not be able to see a lot of cool stuff that should happen soon like the creation of AI, or Elon Musk’s next awesome project. I also hope that the war in Syria and Ukraine will end soon.

We care so much about the health and integrity of our body that until death, we don’t notice that the body is nothing more than a box – a parcel for delivering our personality, thoughts, beliefs and intentions to this world. If there is nothing in this box that can change the world, then it doesn’t matter if it disappears. I believe that we all have potential, but it also takes a lot of courage to realize it.

You can float through a life created by circumstances, missing day after day, hour after hour. Or, you can fight for what you believe in and write the great story of your life. I hope you will make the right choice.

Leave a mark in this world. Have a meaningful life, whatever definition it has for you. Go towards it. The place we are leaving is a beautiful playground, where everything is possible. Yet, we are not here forever. Our life is a short spark in this beautiful little planet that flies with incredible speed to the endless darkness of the unknown universe. So, enjoy your time here with passion. Make it interesting. Make it count!

Thank you!”

Complete Article HERE!

5 Tips for Choosing a Hospice Provider

Proximity is key

By Angela Morrow, RN

Choosing a Hospice Provider

When a patient is initially referred to hospice care, usually by their physician or a case worker within the hospital, they are usually given a list of hospice agencies in their area to choose from. Sometimes these referral sources have a particular agency that they prefer and their recommendations shouldn’t be taken lightly; they are in position to see how well a particular agency cares for their patients.

However, as with any health care decision, you should be as informed as possible in order to know that you are making the best decision for you and your loved ones.

Why Choosing the Right Provider Matters

All hospice agencies work within the guidelines set forth by Medicare. The basic services they provide are the same across the board. This may leave you wondering why it would even matter which hospice agency you choose. There are differences, however, and they’re often tucked away in the small details.

It’s important to do a little research from the start to find where those differences lie.

To find out what services hospice agencies provide, see What is Hospice Care?

Your first interaction with a hospice agency may happen over the phone after they receive your referral information and call you to set up an appointment. It may happen in the hospital setting when a representative from the agency comes to evaluate your loved one and offer information.

It may be initiated by you. Regardless of how your initial interaction takes place, there are some important facts to gather from the start.

The 5 Things to Consider When Choosing a Hospice Provider

  • First, the location of the staff is important. More on that below.

Location, Location, Location

Hospice care can take place in the home, in a nursing home or in a hospital. Very few hospices have inpatient facilities, which means that most people receive hospice care via an independent agency. So, probably the most important question you can ask a hospice facility is related to the location of their nurses.

Just to clarify, it really makes no difference where the agency’s office is located, but it makes a huge difference where the nurses are located. I used to work on-call for a large hospice agency that covered three counties, over 200 square miles. On weekends, I covered the entire area with only the help of one LVN (licensed vocational nurse). Consequently, I would sometimes be with a patient in one county and get a call from another patient who had a crisis in another county who then had to wait two hours or more until I was able to get there.

Knowing how far away the on-call nurses live from you and how large of an area the nurses cover is essential to knowing how responsive they will be to your urgent needs. Keep in mind that some hospice agencies have multiple branch offices that could be 50 miles or more apart from each other. Make sure that if the agency your looking at has multiple branch offices that they also have a separate on-call nurse covering each one, and that the on-call nurse covering your area also lives in your area. If you have a crisis in the middle of the night or on the weekend, the last thing you want to do is wait two or more hours for help.

Complete Article HERE!

Allina program offers life lessons for end-of-life patients

The LifeCourse program educates patients on how to write a medical directive, how to care for themselves, and even how to make the best of their remaining time — and has achieved striking results in the way people use medical care in their final months.

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Bob DeMarce made a living as a funeral director, but he didn’t think much about his own mortality until he developed cancer. He soon learned it took more than being sick to prepare him for death.

DeMarce became one of hundreds of Minnesotans enrolled in a research program that prepares patients and families for the end of life. Conducted by Allina Health, the LifeCourse program educates patients on how to write a medical directive, how to care for themselves, and even how to make the best of their remaining time — and has achieved striking results in the way people use medical care in their final months.

DeMarce already had plenty of doctors, care coordinators and rehab specialists to attend to his medical needs. LifeCourse gave him a “care guide” — a nonmedical counselor — who met with him and his family to help them set goals and provide support.

“Most people would hesitate to talk about this sort of thing,” said the 75-year-old DeMarce, who has had two bouts of lung cancer in addition to colon cancer. “With the different scares I had with cancer … We did want to get things straightened out.”

One goal of the program is to increase the number of patients with advance care directives, which research has shown can reduce the amount of unnecessary and often unwanted care at the end of life.

And the results were dramatic: Patients in the LifeCourse intervention group had fewer hospital inpatient days, fewer emergency room visits and less intensive care, compared with a control group that was tracked but did not work with care guides. About 85 percent completed a living will, compared with 30 percent in the control group.

But the program also aims to improve the quality of life at a time when chronically ill patients and their families often feel overwhelmed.

“The model we chose was one that would be very personal,” said Dr. Eric Anderson, a palliative care physician at Allina’s United Hospital and one of the LifeCourse leaders. “There is an intimate connection between talking about what matters most and having effective advanced directives.”life-lessons

In some ways, the program turns the patient’s focus away from the end of life to the life that can be lived.

“People want to have meaning in their lives, that is more important than anything else,” said Anderson.

“The lived experience for these patients and for their families is simply better. In a number of ways they feel more holistically supported, less anxious and they are using services in a more rational and effective way.”

Minneapolis-based Allina is so encouraged by the program that it plans to develop it beyond the research phase and make it available to patients at eight Allina clinics by the end of this year. It is also talking with other organizations that might adopt the LifeCourse model.

“We’ve got such a large number of people who will be over the age of 65 who will face serious illness,” said Heather Britt, Allina’s director of applied research, who also worked on the project. “Systems like ours have to figure out what to do differently.”

Setting a course

LifeCourse began in 2012, targeting patients with heart failure, advanced cancers and dementia using Allina’s electronic medical record.

“We figured out who was sick enough with those diagnoses, and that took a fair amount of tweaking,” Anderson said.

Eventually, 450 patients were enrolled in the intervention group and about an equal number in a control group.

Care guides meet with patients and their families monthly.
“I am helping them identify what their goals would be and what resources that they might need,” said Judi Blomberg, an Allina care guide since 2013. A lawyer by training, Blomberg was drawn to a health care job because she wanted to help people dealing with crises and trauma.

“Feeling overwhelmed is something that happens when we hit those crisis points,” said Blomberg. “One of my jobs is to help people anticipate what is to come.”

Using a set of questionnaires and assessment tools, care guides help patients set a course to achieve what matters to them.

For some patients, it could be medical goals such as staying out of the nursing home, controlling blood sugar, walking without a cane or losing weight. But many patients also set goals outside the medical realm: doing volunteer work, spending more time with relatives or putting together photo albums.

Toes in the ocean

Bob DeMarce and his wife, Marilyn, who were among Blomberg’s first clients, decided their initial goal was to develop a living will.

“One thing that we were bringing to them was a framework where they can talk about difficult things together that had been hard for them to talk with each other about,” Blomberg said.

“It felt very natural,” said Marilyn DeMarce. “They made it not hard to sit down and have a conversation.”

“She kept us on point and made sure we got it done,” said Bob DeMarce, who does not want any extraordinary measures to prolong his life.

In addition to completing a living will, the DeMarces resumed traveling, a favorite pastime, last November with a trip to Palm Springs, Calif., including a side trip so Bob could stand in the ocean.

“That was big on my bucket list,” he said.

Although Bob DeMarce is now cancer-free, he did fall and break his femur about two years ago. The DeMarces were able to rely on their care guide for help.

“It really provides extra support. When you are in crisis you need as much help as you can [get],” said Marilyn DeMarce. “When you are living with this type of illness you know that at any moment your life could just change.”

“The interest they have shown in my health for whatever reason has been beneficial to me,” Bob DeMarce said. “It prepares you to live with being sick but it also helps you to get ready to die.”

Complete Article HERE!