I was five years old when my family had the good fortune of being visited for the first time by Visiting Nurse & Hospice Care. I was raised in Goleta, and my parents were immigrant farm workers from Mexico. As the oldest, I would go out to the fields with my mother and help her take care of my little brothers.

Nurse Brown was tall and slender, with dark brown hair gathered in a neat bun. What fascinated me most was the way she entered our home wearing her nurse’s cap and navy blue uniform, carrying a little case with her instruments. I was especially impressed by the way she took care of her instruments, spreading out a piece of newspaper on the table and then carefully placing the instruments on top of it.

From that very first visit I decided that I, too, was going to be a nurse someday. I saw Nurse Brown as a heroine, someone who was from outside my culture but who understood us. She would always compliment my mother on how well my brothers and I looked, and for years she helped us take good care of our health.

She was also the school nurse, another program started by the Visiting Nurses. She knew all the kids at school by name because she’d known us all since birth. She would come to school and check us for things like whether we had nutritional deficiencies. And she always encouraged us to continue our education.

Over the years Nurse Brown’s hair turned to silver, and I kept my desire to become a registered nurse. When I was 16 I heard about a scholarship for a 3-year RN program, but I didn’t know how to apply. My parents didn’t know, either, so I asked the counselor at my school.

Without even looking at my grades or the courses I’d taken, he told me I couldn’t enroll in an RN program, and that I had to enroll in an LVN program instead. I found out later that what he told me was wrong, but I believed him and entered the LVN program at SBCC. My first nursing job was at Goleta Valley Community Hospital. I finally did become an RN, but three years after I would have through the other program.

I then got a job with the public health department and started working at a free clinic on Milpas Street. It was one of the highlights of my life when my heroine, Nurse Brown, came and visited me there and told me how proud she was of me.

I loved working in public health, but decided to earn my Bachelor’s Degree in Nursing. At Cal State Long Beach one of my teachers, another nurse, encouraged me to keep studying, and I eventually earned my Master’s Degree in Nursing Administration from Cal State Los Angeles. For many years I worked with the Visiting Nurse Service of Los Angeles. Now I was the one who went into families’ homes to provide health care and teach them how to live a healthier life.

I always wanted to go back to Santa Barbara, though, and eventually I returned to work with the county public health department. Over time I saw problems related to obesity and diabetes develop in the Latino population, and I decided to get my Diabetes Education Certificate. A few years later VNHC asked me to join the team to educate Spanish-speaking diabetics. Working here, where my heroine used to work, I feel like I’ve come full circle.

There’s a big need for bilingual nurses and diabetes educators. I’m happy to know that because of my cultural heritage and my education I’m better able to help the people of my roots, the people of my heart.

Nonprofit since 1908, Visiting Nurse & Hospice Care provides high quality, comprehensive home health, hospice and related services necessary to promote the health and well-being of all community residents, including those unable to pay. Serving all of Santa Barbara including Santa Ynez and Lompoc Valleys. For more information, call (805) 965-5555 or visit www.vnhcsb.org.

His daughter, who lived out of state, was worried about him. She knew he was declining, but being so far away she was unable to see for herself.

Hospice received a telephone call and, through many subsequent phone conversations, it became clear he could no longer manage at home. Serenity House was offered as an option. Of course an independent man would not hear of a 24-hour-care facility for himself. Home was where he was and where he wanted to stay. In reviewing options with the hospice medical social worker, the daughter decided Serenity House was the best place for her father. She asked him to please try it.

A neighbor, who brought him, was very nervous for the gentleman. This was a big change. The Serenity House staff worked hard to meet his needs and to make him comfortable.  We kept his room dark as he requested. We spoke quietly. Over the next 24 hours we got to know him better and allowed him to be as independent as possible.

The next day he picked up the phone and called his daughter. His words to her were “Thank you for doing what you did. These people are angels.” She shared this story with me when I made the call to let her know her father had died peacefully.

All this took place at the old Serenity House. I told her we were moving to our new Serenity House in a couple of days.  She said she would be out to pick up her father’s belongings before we moved.

Monday, was the last day at the old house. All the patients had been transferred and only two of us remained, gathering a few items.  The daughter arrived.  We spent time talking about her dad, and about his time at Serenity House.

Again, she expressed her relief and gratitude – relief that we were able to provide him with loving care and gratitude to be able to hear in his voice that he was comfortable and pain free in his final days. She said he was afraid to die in pain, and Serenity House took his pain away.

To me this is what Serenity House is all about. We are able to help families in times of crisis, and establish relationships no matter the physical distance.

To be there for a patient and to be there for a family member is what is so meaningful.

I know in my soul that the heart of Serenity House has moved on to the new House and that no matter what size or shape the building, the heart beats on.

Nonprofit since 1908, Visiting Nurse & Hospice Care provides high quality, comprehensive home health, hospice and related services necessary to promote the health and well-being of all community residents, including those unable to pay. Serving all of Santa Barbara including Santa Ynez and Lompoc Valleys. For more information, call (805) 965-5555 or visit www.vnhcsb.org.

Countless families across the country have found themselves in similar situations, burdened with making difficult end-of-life health care decisions for loved ones of all ages. Much of this could be prevented if people let their loved ones know their wishes in an advance directive, also known as a “living will” or health care power of attorney.

On Saturday, April 16, Santa Barbara joins the rest of the country in celebrating National Healthcare Decisions Day. The annual observance is aimed at increasing the number of Americans who have completed an advance directive in which they name the person who will make medical decisions for them in the event they are seriously ill and can’t speak for themselves.

“It’s understandable that people would put off discussing the topic of serious illness and death, but it’s essential to have this family conversation in advance,” said Lynda Tanner, president and chief executive officer of Visiting Nurse & Hospice Care (VNHC) which encourages patients and families to have a conversation about end-of-life decisions before it’s too late.

“It’s a discussion that should take place in the living room, not in the hospital waiting room when a patient is no longer in a position to make decisions on their own,” she said.

To help patients and families navigate the end-of-life care decision making process, VNHC uses Aging with Dignity’s Five Wishes® advance directive program, America’s most popular living will with more than 14 million copies in national circulation.  The 12-page document is easy to use and deals with personal, family and spiritual matters in addition to medical and legal concerns.

“The Five Wishes booklet was given to our daughter by the Palliative Care team at Santa Barbara Cottage Hospital. It was a tremendous help to confirm what her wishes were in terms of care and comfort measures as she went onto Hospice Care,” said a patient from Santa Ynez, CA.

“It was invaluable for us as a family to discuss some sensitive areas as well as joyful for the opportunity to share with each other how she would want to be remembered.”

To receive a copy of the Five Wishes advance directive booklet, please contact VNHC at (805) 965-5555 or visit www.agingwithdignity.org to create your advance directive online.

Nonprofit since 1908, Visiting Nurse & Hospice Care provides high quality, comprehensive home health, hospice and related services necessary to promote the health and well-being of all community residents, including those unable to pay. Serving all of Santa Barbara County including Santa Ynez and Lompoc Valleys. For more information, call (805) 965-5555 or visit www.vnhcsb.org.

Despite its many connotations, hospice offers patients and their families a range of unique opportunities for saying goodbye as comfortably and peacefully as possible. Local attorney Steve Yungling, said hospice meant “options” as his mother faced death following a long battle with cancer.

Diagnosed with breast cancer at 39, Yungling’s mother Darlene had only one wish – to watch her sons grow up. Over the next 18 years, she would battle cancer 6 times in a courageous effort to see that wish fulfilled. Finally in 2008, Darlene’s cancer had metastasized to her brain and she could fight no longer. However, in her final days, she experienced an overwhelming sense of peace and comfort knowing that she was surrounded by family, friends and most importantly, her “grown-up” sons.

During their mother’s last few weeks, the Yungling family agreed that it was time to consider hospice. They called Visiting Nurse & Hospice Care (VNHC) to help them navigate the end-of-life process and cope with the many decisions that needed to be made in the coming weeks. The family worked closely with Barbara Irvine, RN, a hospice nurse at VNHC, who offered compassion and support every step of the way.

“Even though we were facing the most difficult and challenging times you could ever imagine; even though it was very difficult to realize my mom wasn’t going to make it to age 60; it provided tremendous support to have Barbara and her team there showing my mom compassion, support and love in her final moments,” Yungling said.

“It was very important to Steve and his family that every effort be made to ensure Darlene was comfortable, lucid and pain free so she could enjoy her remaining time with family and friends as much as possible,” said Irvine.

Most patients come to hospice at the end of their lives after all available medical treatments have been exhausted and the reality of dying finally sets in. For this reason, hospice is sometimes viewed as conceding failure or “giving up.” While it’s true hospice does not function to prolong life or cure disease, it does everything but give up on patients.

“Hospice delivers compassionate end-of-life care through an integrated team of doctors, nurses, social workers & spiritual counselors who work around the clock to support a patient and family through the dying and grieving process,” said Lynda Tanner, President and CEO of Visiting Nurse & Hospice Care.

For the Yunglings, hospice allowed them to bring their mother to Santa Barbara to be near them, confident that they had enough support from VNHC to care for her properly at home. For their mother, it allowed her to spend quality time with her two granddaughters.

“One of my favorite pictures was the three of them wearing fairy wings and running around the house playing fairies and princesses.  My mom loved it because she only had boys and it was her chance to engage with girls and be ‘girly-girls’ if you will. Just being around to watch them grow, because at that age they change on a daily basis, it was really important to her to be able to watch those changes as long as possible,” Yungling said of his mother’s last moments with her grandchildren.

Each person you ask will define hospice in their own, unique way. Each family will have had a different experience and their own story to tell. As Steve Yungling so eloquently expressed, the heart of hospice for him truly lies in providing options.  And where there are options, there is hope. Hope not always for recovery, but for the possibility of peace and happiness at the end, even as we take that one last breath.

Nonprofit since 1908, Visiting Nurse & Hospice Care provides high quality, comprehensive home health, hospice and related services necessary to promote the health and well-being of all community residents, including those unable to pay. Serving all of Santa Barbara County including Santa Ynez and Lompoc Valleys. For more information, call (805) 965-5555 or visit www.vnhcsb.org.

On paper most outsiders would immediately consider David Eden a hero. He was a man of many accomplishments as a firefighter, a mentor and a community activist. His family will probably not remember these things first. David’s wife Lorie will remember their first date–the movie Beetlejuice–over 21 years ago. His kids will remember the big smile on his face whenever they did anything outdoors. They will remember his soft words when mending bumps and bruises. They will remember the ineffable him.

David and Lorie Eden were both raised in Lompoc. They met at work and started dating two weeks later. Love and marriage soon followed. They had two children, Tricia and Alex, to whom David was a doting father. David gave daughter Tricia her first bottle, and was just as attentive when son Alex was born. David loved his job as a supervisor for the Santa Barbara “Hot Shots” crew – a group of firefighters specially trained in the handling of wildfires. During his free time he loved camping with his family and mapping rural areas. He created an address system for the Cuyama and Sisquoc areas which helped the fire department during wildfires. The family lived the closest thing to a real life fairytale until 2005 when David was diagnosed with a brain tumor.

He suffered a grand mal seizure during a morning jog that led to its discovery. Before the incident he had no other symptoms. And yet many more would come. He endured chemotherapy, radiation and surgery. Eventually his condition deteriorated to the point that it was unsafe for him to be cared for at home. With a terminal diagnosis David faced the unthinkable. He had to leave his wife, two teenage children, and his hometown to live in a board & care facility in Montecito. David’s diagnosis and the uncharted territory to follow was, as Lorie described it, “the hardest experience I have ever had.”

David and Lorie’s long journey would eventually lead them to Visiting Nurse & Hospice Care. After living at the board and care for several years, David began to require 24 hour nursing assistance that they could not provide. The family was referred to Serenity House, a fully licensed inpatient hospice facility operated by VNHC.

Upon arrival, Lorie said she was struck by the “overwhelming graciousness of the staff, how attentive and kind they were.” They set up David’s room in a way that Lorie said was like “your own bedroom – homey, clean & pleasing.” By encouraging patients to bring in mementos, families to stay overnight, and visitors to discard the idea of special “visiting” hours Serenity House hopes to give patients and families the anchored feeling of personal freedom that can really only be experienced from being at home.

For David, home was filled with activity. Even after having to leave his 27 year career as a firefighter due to his diagnosis, proof of David’s heroism was brought forth daily. It came streaming through the front door of Serenity House—the consistent flow of friends, family, and fellow firefighters were living evidence that this man had touched so many. They ushered into his room, all decked out in firefighter posters and family photos, to support a man who had supported them all at one time or another.

Many told stories of his bravery, some told anecdotes, but surprisingly few held a somber note. David was amidst all else, a funny man and an avid practical joker. One morning his friend visited while David was sleeping and saw an opportunity. “His mouth is open! I wish I had some shaving cream. I would put it right in his mouth. It would be so funny, because I know he would do the same to me!” For Lorie these visitors, with their fond memories and love, were an important source of support. They helped her find a “strength she didn’t even know she had” and kept her going for her kids.

In addition to the strength found in friends and family, Lorie was greatly helped by the gentle guidance of the staff at Serenity House. “It was wonderful, they explained everything to me. They kept me informed and prepared us for what was going to happen. Initially I was afraid of the word ‘hospice’ but it’s not scary. They are like angels that come in and help you,” Lorie said.

David Eden died on August 21, 2010 at 51 years old. In death he was given a hero’s honor, as his body was escorted by fire trucks on its journey back to Lompoc. He was met along the way by other fire brigades, some who knew him personally and others who knew of his reputation. Their sirens rang out as he passed by, recognizing his many contributions to the force during his lifetime. As he drove up the 101 he took the Lompoc exit, the road he had followed so many times before. The road he had missed for so long. The road home.

Visiting Nurse & Hospice Care provides licensed hospice throughout Santa Barbara County including Santa Ynez and Lompoc Valleys. If you would like to learn more about Serenity House or our home hospice program, please contact Visiting Nurse & Hospice Care at (805) 965-5555 or visit us online at www.vnhcsb.org.

Each day Jim’s wife, Rose, patiently and lovingly assists him with the most fundamental and often personal of tasks. From shaving his stubbly face with that fancy new electric razor he got for Father’s Day, to slowly buttoning up the front of his cozy flannel shirt, Rose remains a steadfast and compassionate caregiver despite often feeling like a stranger.

On this particular day, Jim isn’t doing so well. After a very long morning, he’s escorted to the living room where he’ll stare blankly at the television for a couple hours while Rose recovers from the A.M. grind. She’s feeling a bit more exhausted than usual, longing for the companionship and affection her husband was once able to provide. Willing to try anything at this point to connect with him again, on any level, Rose decides to add something new to Jim’s afternoon agenda – music therapy.

Days later, Rose eagerly answers a knock at the front door, welcoming Stefana Dadas, a board-certified music therapist with Visiting Nurse & Hospice Care, into her quaint Santa Barbara home. After a candid discussion about Jim’s condition and history, Stefana pulls an acoustic guitar from its case and begins serenading him with the WWII classic, White Cliffs of Dover. Jim studies her fingers intently as they dance across the bronze strings. And then it happens. Something Rose hasn’t seen her husband do in quite some time. Jim smiles.

Imagine not being able to remember your spouse’s name, perhaps even your own name, but with little effort could hum note-for-note, a song your grandmother used to sing to you as a young child. Can you imagine the excitement, the relief, you might find in being able to identify with something from the past and for a brief moment, feel like you had some sense of who you are or where you came from?

People with Alzheimer’s often lose the ability to speak or recognize loved ones as the disease progresses, but many retain the capacity to remember songs from long ago. It isn’t suggested that music can reverse the effects of Alzheimer’s, but studies have shown music therapy can complement other forms of treatment and offer substantial long-term health benefits and comfort.

Following the success of their initial session, Stefana developed a music therapy schedule with specific goals for Jim based on his condition and personal history. In the weeks that followed, he not only continued to smile, but actually began singing along with Stefana who shared dozens of songs she thought might spark some memory of days long forgotten. Jim’s response to the therapy was remarkable and Rose found great respite in knowing her husband, at least for a few hours a week, was able to find joy and peace through music.

“While all of the hospice services are unbelievably marvelous, Stefana is among the best.  It’s the one time a week that Jim and I are able to connect and share memories through the music.  It is the highlight of our week,” said Mrs. Summers.

Through the generosity of local philanthropists Jack and Julie Nadel, Visiting Nurse & Hospice Care is able to offer music therapy to Jim as part of its ongoing hospice services.  Jack and Julie started the Elly Nadel Music Therapy Program in 2008 as a tribute to Jack’s late wife who benefited from the healing power of music during her battle with cancer.

“Bringing Elly’s favorite music to her during those final days dramatically improved the quality of her life. We’re thrilled the Elly Nadel Music Therapy Program will bring comfort and peace to hospice patients in their last days,” said Mr. Nadel.

Stefana and VNHC’s Elly Nadel Music Therapy Program serves dozens of patients who receive treatment on a regular basis.  The program is of particular benefit to hospice patients, bringing relief from physical symptoms like pain or discomfort and reducing psychological symptoms like anxiety, depression, or isolation commonly associated with end-of-life care. Stefana finds music therapy also of great benefit to family members and friends navigating the grief process.

Visiting Nurse & Hospice Care provides licensed music therapy to hospice patients like Jim throughout Santa Barbara County including Santa Ynez and Lompoc Valleys. If you would like to learn more about the Elly Nadel Music Therapy Program, please contact Visiting Nurse & Hospice Care at (805) 965-5555 or visit us online at www.vnhcsb.org.

Patient names in this story have been changed to protect their privacy in accordance with the Health Insurance Portability and Accountability Act (HIPAA).

Seniors today have a vast number of health resources available, many of which enable them to maintain healthy, independent lifestyles from the comforts of home. One of these resources is called geriatric care management – a comprehensive program where individuals and family members work with a health professional to develop a complete care plan addressing a person’s physical, social and emotional needs.

Geriatric care managers work closely with doctors, specialists and other long-term care professionals to help make sure a patient is being properly cared for after leaving a physician’s office or medical facility.

Maurine Atkins, a 92 year-old Santa Barbara resident and active community member, recently hired a geriatric care manager after being diagnosed with congestive heart disease – a serious condition common in old age and often marked by painful swelling, difficulty breathing and in some cases, organ failure. Although Atkins receives full-time care from a close family friend, treatment of her condition is challenging and includes a strict diet, complex medication regimen and daily exercise.

Because of her ongoing health requirements, Atkins and her family felt she would benefit from the services of a health professional who could help assess and manage the quality of her in-home care. After some research and guidance from her doctor, Atkins found the help she needed in Kathleen Smith, a registered nurse (RN) and geriatric care manager with Visiting Nurse & Hospice Care in Santa Barbara.

“If you didn’t have people like Kathleen, life would be awful for old people,” said Atkins, who looks forward to her weekly visits from Smith. “Kathleen knows all the kinds of things I should or shouldn’t do and she tells me. You know, when you have that much confidence in the people that are taking care of you, you have nothing to worry about.”

The first step in assisting Atkins was conducting a thorough assessment of her state of care and well being. Smith reviewed her physical and emotional condition, living environment and daily routine – noting any areas of concern like difficulty bathing, dressing or preparing meals. She also identified any safety hazards or injury risks in the home and recommended ways to address these issues.

“Often, simple measures such as removing clutter and throw rugs, improving the lighting or installing grab bars in the bathroom and shower can greatly reduce the risk of an accident and enable someone to live safely and independently in their home,” said Smith who has over 20 years of experience working with seniors and aging issues.

Following the initial evaluation, Smith worked with Atkins and her doctors, family and caregiver to develop a personalized care plan incorporating each of her unique health and personal needs. In addition, Smith supervised the installation of new safety equipment and provided Atkins’ family with information about helpful community resources such as personal care, legal and financial services, meal delivery and adult day care programs.

“Geriatric care managers support patients and their loved ones during all phases of the decision-making process — from liaising with existing doctors and specialists to recommending and overseeing additional in-home services like cleaning and laundry,” said Lynda Tanner, president and CEO of Visiting Nurse & Hospice Care, which provides geriatric and personal care services to more than 400 local residents each year.

“Things like dietary requirements, new medications or even medical bills can be confusing and often overwhelming for someone new to long-term care,” she said. “These qualified and well-trained health professionals work within a patient’s existing continuum of care — advocating on the patient’s behalf and helping coordinate every aspect of their care regimen.”

Atkins’ full-time caregiver, who is not a trained professional, finds Smith’s assistance very reassuring and acknowledges that because of her additional support and expertise, he is able to provide better care to his dear friend while allowing more time for his own needs.

Smith currently visits Atkins every Thursday in her East Mesa home which she and her husband built by hand in the early 1960’s. Following a quick check of her vitals and review of the weekly routine, Atkins can’t wait to share with Smith, stories of passion and adventure – like how she piloted one of the first post-revolution flights to Cuba in her own plane, protested the Vietnam War in animated State Street demonstrations as a member of the Grey Panther Party or coped with her husband’s severe bipolar disorder.

No matter how vivid or epic her adventures, or what corners of the earth she explored – Atkins’ first love was and will always be, her family and her Santa Barbara home. Thanks to the compassionate care she receives from her friends, family and dedicated professionals like Smith, Atkins will continue to enjoy the rest of her days in the one place she feels most comfortable and secure.

Visiting Nurse & Hospice Care provides licensed geriatric care management services to people like Atkins throughout Santa Barbara, Santa Ynez Valley and Lompoc Valley. They offer a free in-home assessment where individuals and family members can create a customized home health plan addressing all relevant needs.

If you are a senior who needs care now, the relative of someone who needs assistance, or an older adult preparing for the future, in-home geriatric care may be an ideal solution for getting the help you need. Contact Visiting Nurse & Hospice Care at 805-965-5555 to speak with a licensed care manager or ask your doctor for more information.

With no clinics in Santa Barbara, the women who founded the organization saw the need to provide health care at home for low-income families and patients unable to go to the hospital. Families also needed education to prevent infectious diseases, food poisoning and other life-threatening health problems that were common.

Starting out with one nurse who went to patients’ homes on foot, the founders of the budding non-profit were delighted with the loan of a horse, and even more excited when an automobile was donated in 1915.

That was the year that Josefina Jacobo was born, in Jalisco, Mexico. “My mother was brought to the United States when she was 30 days old,” says Yolanda Marquez, 60, a community college teacher. “Mom lived in Carpinteria when she was young, and married my dad, José Dolores Marquez, in 1930. He worked for 50 years in the lemon groves and became a mayordomo de quadrilla [foreman].”

In the 1940s the Marquez family bought a house in Santa Barbara. “Mom was a musician. She would get her guitar and come out in the parades and sing with Mrs. Castro and the dancers at the courthouse,” remembers Marquez with a grin as she cuddles her toy terrier.

When Josefina was suffering from Alzheimer’s disease at age 90, Visiting Nurse and Hospice Care helped Yolanda care for her mother. VNHC physical therapist Li-Ching helped Josefina become stronger so she could walk better, and Luciana and other trained caregivers assisted her with activities like bathing and dental care, giving Yolanda a break.

“It really helped,” Marquez says, “especially when mom would get scared and temperamental. They gave me time to run errands and do simple things like grocery shopping and paying bills. They made it so you could go have a hamburger and forget about what was going on at the house.” The visiting nurses helped care for Señora de Marquez until she passed away.

Then, the following year, a fairly routine abdominal surgery took an unexpected turn for Yolanda. “I had what was supposed to be a simple surgery. It didn’t turn out that way,” she recalls. Marquez learned that upon returning home her wound dressing would have to be changed twice a day by a professional:

“There was no one in the family who could do the bandage change. Even if they had been able to, they couldn’t have gotten the time off work. It was a very challenging time. I had to walk around the house with a walker, and my family put a day bed in the living room for me to sleep on.”

“The nurses from Visiting Nurse and Hospice Care were a lifesaver to me,” Marquez says. “For two months they were here twice a day. Maureen, Kit-Yee and Lovette were very gentle. And whenever I had any questions they would explain everything to me. I am diabetic and asthmatic, so they had their hands full.”

Looking back, Marquez reflects, “There were times when recovering from my operation was really bad, but I’m up and running again. I’m very thankful, and I have a manda to pay. I’m going to the sanctuary of Our Lady of Guadalupe. That’s my project for next year.”

Having been diagnosed with terminal cancer, it was during a hospital stay that Diego met Mario Cepeda, a spiritual counselor in the Hospice program of Visiting Nurse & Hospice Care. Hospice is a special way of caring for someone who is in the last phase of life. “In Hospice we not only help people prepare for the last phase, we also help them celebrate life,” said Cepeda.

As part of the Hospice program a nurse, a social worker and a spiritual counselor each visit the patient at different times to offer support. “If possible, I help the patient to reflect on his or her life. As part of this process, something important may surface that the patient has always wanted to do, but has not been able to do,” Cepeda explained.

For Diego, it was his dream of marrying Anita, his wife of 47 years, in the Catholic Church. But to reach that happy moment Diego had to face a labyrinth of obstacles.

Diego’s story

As a young man Diego was engaged to be married to a woman from his village, Acuchitlán, in the state of Guerrero, Mexico. To save money for married life Diego enrolled in a work program to harvest crops in the United States. First he went to the lettuce harvest in Camp Verde, Arizona, then to the lemon groves of Santa Paula, and so on, leaving and coming back to his village several times over a period of four years. But when he returned from his last trip he was crushed to learn that his fiancée had been seeing another man, and the wedding was cancelled.

Not long afterwards, Diego met Anita Figueroa, whom he had been acquainted with when she was a young girl. He noticed that Anita had grown to become a kind and beautiful woman, and he fell in love with her. He began to court her and she accepted his proposal of marriage.

It was the custom to be married first by the State and then by the church, and that is what Diego and Anita planned to do. They had their civil ceremony, and their church wedding was to take place a week later. “Everything at home was ready for the reception. All the guests were in the church,” Diego explained. “But when we got up to the altar the priest refused to marry us. We begged him. We had already paid him, and we offered to pay him even more money, but he wouldn’t do it.”

Later Diego realized that the priest’s refusal was related to the fact that he was the uncle of Diego’s first fiancée. Diego’s faith was profoundly shaken. “We were so ashamed. I felt so let down that I stopped believing in priests,” Diego recalled.

After the frustration of the wedding, Diego went back to work. Soon a son was added to the family, and another. With the arrival of their third son, Diego was obliged to find work outside the village to support his family. He worked for years in Acapulco, then Mexico City. After many years he returned to the United States to work. “I dedicated myself to providing for my children,” said Diego. “For many years all my resources went towards that.”

In 1982 Diego filled out the paperwork to bring Anita and their family – which by now included 6 sons — to join him in the United States. In 1986 the family was reunited in California.

Of his spiritual life, Diego related: “When we went to mass everyone would get up to take communion, but not us – we felt that we couldn’t [because of not being married in the church.] … But I always thought, ‘Some day I’m going to get married.’”

In Santa Barbara Diego once again sought to be married in the Catholic Church. “We went a few times to see the priest at Our Lady of Guadalupe. He said that we could get married, but we needed something. Maybe it was a paper… I don’t remember what it was. But we didn’t have it and we stopped pushing to make the wedding happen.”

While in the hospital Diego met Father Ludo DeClerq of Holy Cross Church. “I was very sick when Father Ludo came to visit me. I told him that I wanted to be married in the Church, and he said that, yes, we could make that happen. But between managing my symptoms and the chemotherapy we lost track of him.”

When Diego was admitted into the VNHC Hospice program, Mario Cepeda went to visit him. “Diego and Anita told me they had met Father Ludo, but had lost touch with him. I immediately realized that the wedding was something very significant for them, and that they didn’t have much time. So I did everything I could to make the wedding happen as soon as possible,” said Cepeda.

Cepeda called Father Ludo to arrange the details of the wedding and he also let the nurses at VNHC know about the couple’s needs. One of the nurses provided a suit for Diego, others donated money, and the VNHC Loan Closet provided a cane. The VNHC Foundation provided funding for catering for the reception. The Carachure family and their friends made the other wedding preparations, such as getting the wedding dress, preparing their front yard for the reception, and arranging for a musical group.

The week before the wedding, Diego said, “I feel good. Like something beautiful is going to happen in my life – even if it’s the last day that I’ll be able to really enjoy that happiness – because at last my dream that I have always wished for will become a reality. I want to be able to belong to my God body and soul.”

To Cepeda, Diego said, “God will pay you back for everything you’re doing for me, because I could never truly repay you.”

Diego’s dream finally became reality when he and Anita presented themselves at the altar of Holy Cross Church, in a ceremony presided over by Father Ludo. Most of their children and grandchildren were in attendance, as well as other family members and friends and VNHC staff. During the wedding, due to Diego’s weakened state, he and Anita were seated in chairs.

After the ceremony, as Father Ludo presented them to the congregation as man and wife, Anita was resplendent, her eyes full of emotion. Diego leaned on his cane and wore a solemn expression. Then Diego and Anita kissed and tenderly embraced, surrounded by their grandchildren, who were like beautiful spring flowers.

At the reception, Diego continued to lean on his cane, but then he left it behind to be supported and embraced by his beautiful bride as they danced. Then the couple danced with their guests. In exchange for a dance, guests pinned bills to Diego’s suit and Anita’s shawl – singles, fives, tens, twenties, even a hundred dollar bill.

Later that evening Diego and Anita both took a moment to express their heartfelt gratitude to everyone in attendance, as well as all those who had helped make the wedding happen. They specially thanked Visiting Nurse & Hospice Care for their attentive and caring support. As the sun set, Diego and Anita sat peacefully side by side, watching their guests dance and enjoy themselves. The long awaited blessing of their union had come at last.

Luis Mendoza didn’t get to know his mother until two weeks before she died. Sitting in the garden outside Serenity House on a bright spring morning, 16-year-old Luis confided, “I feel sad about meeting her when things are like this, but at the same time I feel happy, because I didn’t know her before.”

Luis was just six months old the last time his mother, Isabel Mendoza, had held him. Isabel, estranged from her husband, Luis’s father, had not seen Luis or his two brothers for over 15 years. He had no memory of her. That changed in April during Isabel’s final illness, when Luis met his mother again at Serenity House.

A petite brunette who didn’t show her emotions easily, at 45 Isabel was one of the youngest patients the Serenity House team has cared for. She had been diagnosed with cervical cancer, and two years later, after a two-month stay at Cottage Hospital, her prognosis worsened: Isabel’s doctors had exhausted all treatment options. Realizing that Isabel’s sister, Ana, would not be able to give her the specialized care she needed, hospital staff referred Isabel to Serenity House.

Serenity House nurse Jannele Gonzales recalled that Isabel’s younger children, Margarita, Rosa and Tomás, 14, 11 and 9, “would come here every evening to keep the family feeling. They would sit in her room with her and talk to her.” While she was at Serenity House Isabel told the spiritual counselor on her hospice team, Mario Cepeda, that she also had three older sons living in another state.

“It was a surprise to learn about the other children,” he said. “I asked Isabel for permission to let them know that she was dying. When I talked with them on the phone I realized how much pain they felt about not knowing their mother.” Over the course of a week Cepeda and Isabel talked about her estranged family. Eventually she gave him permission to invite them to come to Santa Barbara to see her.

But the family did not have the funds to make the trip from Arkansas. A volunteer at Serenity House with contacts at the Dream Foundation was able to bring in financial help from that organization.

The family was reunited at Isabel’s bedside, surrounded by her beloved images of the Virgin of Guadalupe and the Sacred Heart. Her children saw a mother who, despite her illness, had delicate hands and the complexion of a 20-year-old.

Serenity House staff were touched by the interaction between Isabel and her children.

“The sons were so respectful to her. They were able to come in here and give her the love she was looking for from her children, which was really beautiful. They had the maturity to give her what she needed without holding any grudges,” Gonzales said.

The siblings, who had never met, were keen to get to know one another. “The children clicked from the beginning, as if they’d known each other for a long time. You could tell by the way they were talking to each other,” said José Velazquez, a licensed vocational nurse at Serenity House.

During the ten-day visit the Serenity House team guided the family through a forgiveness process, helping them to talk about “things from the past that have separated them,” Cepeda explained.

Luis and his siblings accompanied their mother for hours on end, occasionally taking breaks on the patio outside her room.

Serenity House nurses and physicians provided the 24-hour medical care Isabel needed.

The older children did not want to go back to Arkansas while their mother was still alive, but she firmly told them that they must. Middle son Adrián, 21, had already given up his job when he was denied time off to come visit his mother.

Once the grown children had returned to Arkansas for work, Babetta Daddino, VNHC’s Hospice Director, suggested that the family stay in contact with the help of a visual computer connection. John Dougherty, VNHC’s Director of Information Technology, installed a laptop and camera in Isabel’s room, and the Arkansas siblings set up a system with the help of neighbors back home.

Through the computer they were able to visit with their mom on her last day.

Four days after her sons had gone home, Isabel slipped into a coma. The next day the two sets of siblings were talking together all afternoon and keeping watch on their mother, the older ones through the computer camera. That evening, against great odds, Isabel passed away surrounded by her family. She had been at Serenity House 31 days.

“I have no words to describe the way my mother has been cared for in this clinic,” said Isabel’s oldest son, Miguel, 26. “It is wonderful that you have something like this. At home we don’t have the medicine or the equipment you need to take care of someone in this situation.”

On the day he was leaving for Arkansas, Adrián said, “Even with things being the way they are, I am grateful that I got to see her. It’s better than never seeing her again. Thank you for helping us fulfill our dream of seeing our mother again.”