But for Minerva , it took a VITAS team to help her die.

Minerva was admitted to the VITAS program through a referral from a social worker at Northwest Memorial Hospital where she had gone in crisis to the ER just a few days before. She had been diagnosed several months previously with diabetes, but during her ER admission she received much more serious news: she had metastasized pancreatic cancer. This terrifying diagnosis was truly a bolt out of the blue.

Minerva was only 38 years old. She and her husband Moises - who had been rendered a paraplegic in a motorcycle accident 12 years before - were a quiet, unassuming couple who had been together since high school. Proudly independent, they lived on Moises’ $500-a-month disability income. They had never tapped into any of the service networks for additional benefits, and help from their extended families had fallen away over the years.

But now, frightened, anxious, and in considerable pain, Minerva, known as “Minnie,” agreed to be admitted to VITAS so that she could remain at home with her husband. She was admitted with what is known in the VITAS vocabulary as “no payer source” - no insurance or other money to pay for hospice services. But it didn’t matter. The VITAS team went to work.

The first thing her VITAS nurse did was to help control her pain. Once that was accomplished, the VITAS social worker began exploring how to handle the couple’s other needs - there were so many of them, it was almost overwhelming.

Minnie and Moises’ home was in poor condition and, in the blistering heat of the Texas summer, air conditioned in only one room. Because their finances were so stretched, they ran short of food every month. Moises had not been in the bathroom of his house since his accident because his second-hand wheelchair would not fit through the door. They both needed attentive medical care - including access to supplies, occupational therapy, and
physical therapy - and a daily caregiver. They needed help to cope with the future in general. Minnie had no funeral plans, and no money to make them. She and Moises were simply praying for a miracle to make the cancer go away.

The cancer did not go away, but for the next five months, the VITAS team pitched in to make Minnie and Moises’ lives better, in both practical and spiritual ways.

The VITAS chaplains helped Moises get the materials to build a wheelchair ramp for his van. The VITAS social worker, physician and chaplains worked with a local medical equipment dealer to secure a new motorized wheelchair to help Moises get around more easily not only around the house but also to run errands for Minnie. These priceless gestures of assistance, together with the VITAS team’s emphasis on controlling Minerva’s pain, helped the couple gain more confidence and trust with their hospice team.

As Minnie got sicker and sicker, and moved in and out of Crisis Care, Moises’ energy, too, began to flag. Unfortunately, it was not the only thing beginning to show wear and tear. The couple’s ancient air conditioner, working overtime, quickly caused the family utility bill to explode. The VITAS worker got Minnie an emergency provider to relieve the pressure on Moises, and paid the utility bill to keep the couple’s electricity from being shut off. The team supplied them with everything from groceries for themselves to pet food for their dogs. And then, just a week before Minnie died, the air conditioner broke for good.

Minnie was moved to the VITAS inpatient unit, and although the staff was attentive and efficient, she cried every day to go home. Hot as her house was without the A/C, she wanted to be home with Moises when she died. After five days of anxious waiting, the VITAS worker finally got a new air conditioner delivered and installed. And it was just in time. Discharged to her (now) cooler house, Minnie died the next day. She was home, with her husband beside her, just as she wanted.

The story does not end there. The VITAS social worker talked a local funeral home into providing a full-service funeral and burial plot for Minnie - free of charge.

The story of Minerva and Moises is an amazing tale of generosity and teamwork. It is the kind of service VITAS provides regardless of a patient’s ability to pay. Whenever a crisis in Minnie and Moises’ lives seemed to overwhelm them - and it happened frequently - a member of the team would step in and fill the gap.

Perhaps one of Minnie’s nurses said it best when she told Moises that she would “pray for 1,000 angels to surround him and Minnie” and help them through this extraordinarily difficult time. Well, there may not have been a thousand of them - but there were the nurses, the chaplains, the social workers, the aides, the inpatient staff, the crisis care staff, and many other people beyond hospice who helped Minnie die in comfort and peace.