Goodbye SxSW - Goodbye Texas!

We met yesterday with Austin’s only not-for-profit in-patient hospice, Christopher House. It’s a gentle, harmonious place with large rooms for patients and families, a garden, a retreat room, a piano and music filling the wide entrance hall. Nurse Mandy Malcomson from Strathcarron and the director, Holly Eades sat down to find out how different life is for hospice patients in the US and the UK.

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As they went through the team they bring together – social worker, complementary therapists, chaplain, nurse, doctors, we saw it was the same experience. As Holly explained “We meet the whole family wherever they are, and walk down that path with them, whether it’s a family who are not accepting a terminal diagnosis or a family who want access to the hospice straight away.”

Some challenges are the same – the struggle to accept our mortality is universal. But Holly has a few extra challenges thrown her way. Hospice is big business in the US, with most hospices run for profit. They don’t like the ‘expensive’ patients: the children, the cancer patients, anyone whose needs are complex and require a team of care-givers. This eats into the shareholder’s profits. So these patients are politely declined.

It’s terrifying.

As Holly explained, the US is a nation of ‘fixers’: “we feel we can fix just about anything”. That’s an extra pressure on doctors, and failure to cure a terminally ill patient can be felt as a personal slight. So patients can fail to be cured, disappointing the doctors, then fail to get into their most local hospice care. Small wonder the US has a culture of seeing death as failure.

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Holly came to our last screening here at SXSW. She loved the nurses, the hairdresser, the hand-massages, the music, the way Strathcarron is embedded in the local community and answerable to it, the range of services and the huge number of volunteers and the humour. We have started planning on ways to collaborate, using the film in Texas and further afield to support their aims: “treating each patient as an individual, respecting and honouring their personal wishes”.

And I love that includes their pets too – even miniature horses. Because this is, after all, Texas!

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