As our society changes, health-care workers and counselors become the extended family and neighbors of yesteryear.
By JoANNE VIVIANO
VINDICATOR STAFF WRITER
WARREN -- John J. Lazor was at the mall, bending over to tie a loose shoelace.
Betty bumped into him.
"I said, 'I have to marry this woman,'" Lazor said. "... We was two, but now we're one."
John, a widower, married Betty, who was also widowed.
That was eight years ago. A year later, Betty was diagnosed with ovarian cancer.
Now, after six years of on-and-off chemotherapy and four surgeries, the disease has progressed to her liver. The couple awaits her coming death.
Their focus remains not on their losses but on each other.
Holding her hand, John, 79, calls Betty, 77, his "Poody Doo." He is her Sweet Pea.
Betty cried when she was diagnosed. She knew John's first wife had died of cancer. How could she tell him? "I felt very bad," she said. "He said, 'I love you, baby. I'll take care of you.'"
Now, he still dotes on her. He makes jokes so she will smile.
But his eyes well with tears and his voice falters when asked about life after Betty dies.
How will he get by? "Not so good."
But for now they are managing. They know what to expect. They are getting help. And they try to live each day.
How it's changed: Betty said dying today is much different from what it was more than a decade ago, when she watched her mother, father and first husband die. Back then, she said, health-care workers tried to keep news of a terminal disease from patients.
"I think it's better that they know and can think about the rest of their life," she said.
She refuses to give up, rises each day, dresses and does her hair. She recently had her nails manicured. The couple bakes, they still make visits to the mall and recently went on a lunch date, with the help of volunteers from Hospice of Northeast Ohio. They build their faith by attending church and getting visits from Betty's minister.
Betty has also been able to plan. She's given savings to her five grown children. She's distributed cherished antiques among them. She's written each a goodbye letter. An executor has been chosen. And John carries phone numbers of all the kids -- and Betty's minister -- for the day when her last breath is imminent.
A decade ago, Betty was responsible for caring for her dying loved ones. Today, she and her family get support from hospice, a network of healthcare workers and voluteers who provide in-home care to terminally ill patients. Today, John said, medical professionals are better equipped to medicate patients and keep them from pain. He calls hospice nurse Louise Simpson "a miracle woman."
Living longer: Those who work with the sick and dying and the bereaved have also noticed changes in the way this time in life is handled.
A newer issue is an older population, said Susan Matwich, director of Hospice of Northeast Ohio. With more people living longer, it has become difficult to find caretakers. Sometimes a spouse is gone or unable to provide adequate care; grown children are unavailable.
"People are out in the work force," Matwich said. "No one is as available to take care of the elderly or sick and dying, as they used to be."
As a result, hospice care in America has grown, Matwich said. Workers from hospice, funded through Medicare, have attempted to fill that role with nurses and volunteers who help patients and their families, teach relatives how to care for loved ones, link them with other resources and let them know what to expect. Once a death occurs, workers continue to assist the bereaved and offer counseling and support groups.
Sister Pauline Dalpe said another complication of living longer is that we experience more grief in our lifetimes. We see more loved ones die; parents more often grieve for their children.
Dalpe, an Ursuline nun and professional counselor, said grieving has also changed, with medication keeping people alive through extended illnesses and new ailments, such as AIDS.
In the 21st century, families are dealing with gender issues, family secrets. Further, she said, rising crimes, especially murder, mean more people must mourn sudden, traumatic losses.
She said grief support groups through the Catholic Charities Regional Agency have been growing. Specific groups are established for widows, survivors of murder, even for mothers grieving an aborted child.
Because families don't live close anymore, and neighborhoods are less intact, counseling programs become an extended family for those in grief.
Handling pain: Matwich said the medical field is now much more aware of end-of-life pain than in years past, with the American Medical Association terming it the "fifth vital sign."
In response to this awareness, many medical centers are adopting care programs to manage patient pain. One such program began in March at Humility of Mary Health Partners hospitals, said Stephnie Darby, coordinator of the new program.
Through a program funded by local foundation grants, practitioners treat pain in patients with chronic and terminal illnesses. The program addresses practical as well as spiritual and emotional issues. Dying patients, Darby said, live life up until their last day.
"They live in the face of death, and people are still giving and learning and experiencing and having positive life experiences in the end of life," she said.
Many of Darby's patients hope for recovery; many learn they won't recover. She has watched patients and their families wrestle with the notion of death, and the fear of a painful one.
Changes she's seen over the past five years as a care provider include an increased awareness of medical issues. People are becoming educated about living wills, medical power of attorney and do-not-resuscitate orders.
Most don't fear dying itself.
"I don't think there's fear of death itself. It's a fear of leaving loved ones behind," Darby said. "People fight to the bitter end because they don't want to leave loved ones behind."
Lessons learned: Betty's not afraid to die. She hopes she'll be at home. And she wants her children close by. And she's pictured her funeral. It's been planned, right down to the music. Her favorite music minister will sing "How Great Thou Art."
Through her struggle, Betty said she has learned a valuable lesson: "You should live every day for the day."
And she's not the only one learning.
"They're enjoying every moment, like we should," Simpson said. "But we think we have tomorrow."
For Betty, getting by without fear means "faith is No. 1." She believes in a peaceful and happy afterlife. A family that stands behind you also makes the difference.
John says he accepts their fate, also through faith and the support of others.
"Yesterday's gone. Tomorrow's not here. Live for today," he said. "I try to keep Poody Doo happy as much as I can."