Matthew Strother email@example.com
January 31, 2014
It’s been a long and emotional road for Cathy Wiggins since she took the helm of the fledgling West Georgia Hospice program at West Georgia Health more than 30 years ago, but she said it was worth the 24-hour days and emotional trials of caring for the dying to know she gave them and their families comfort over the years.
Wiggins retires today as director of West Georgia Hospice. She began at West Georgia Health in 1976 fresh out of nursing school, then worked for local oncologist Julian Duttera, who would go on to serve as the hospice’s medical director. She came back to the hospital in 1980 as a part-time neonatal nurse.
When the hospital began looking at creating a hospice program in 1980, it was uncharted territory. It would be the first in the area, and only the seventh in the entire state, to offer such a program, and there were very few regulations to go by.
“At the time they had three or four books and a stack of articles that Charis Acree had pulled together to do her thesis on the feasibility of a hospice here,” Wiggins said.
Acree, now the hospital’s senior vice president of operations, who would later go on to help open Florence Hand Home.
“When she first came here, she came as an intern working on her administration master’s study, and there just wasn’t enough information to do a thesis on it,” Wiggins said.
However, Acree didn’t want to let the thesis go, and it became the backbone of policy for the West Georgia Hospice. She and Wiggins would eventually write the hospice’s mission, which has largely remained unchanged despite continuous changes to federal and state legislation.
“Nobody knew anything about it,” Wiggins said about hospice in the early years. “You had a definition, and that’s about all you had.”
At the time, “99.9 percent” of hospice patients suffered from cancer, Wiggins said, which had limited treatment options.
“Because you could determine a statistical prognosis if you treated, done everything you could for the patient, and there was no more treatment, they were going to die eventually,” Wiggins said. “So, for years, probably up until the early 90s, that was trend at hospitals everywhere.”
Wiggins was recommended for the job, but unsure if she wanted to do it because meant being on call 24 hours a day and knew it would take an emotional toll. However, her experience in oncology, which she said had a holistic approach to treating patients, made her a front runner for leading the program and she was hired for it in 1981.
The program began seeing patients in 1982. Based out of the basement of the Enoch Callaway Cancer Clinic, the program saw patients in area hospitals, nursing homes and at their homes in Troup, Heard, Harris, Meriwether and Coweta counties.
“We were working out of a little exam room,” Wiggins said. “… I had a tape dispenser, a pen and a pad, and a telephone. … That was it. We didn’t have computers or anything. Everything was done manually - all your clinical notes, all your admissions, everything.”
Wiggins said the hospital supported the hospice program despite it being an expected “money-loser,” with no reimbursement from patients until 1986 with hospice medicare benefit.
“So the hospital really stuck their neck out for us,” Wiggins said.
Wiggins said even with medicare reimbursement, community support was necessary to the operation of the program.
In its first year, the hospice saw about 20 patients. Now it annually sees about 400, Wiggins said.
One of first in area, she helped other hospices in the area get started over the years. Acree said she and Wiggins were helping shape hospice programs in the state. Wiggins noted that they served on an interdisciplinary team for the house committee that wrote legislature on hospice laws for the state.
Wiggins recalls in the early years having to carry a pager at all times in case of any of the families in hospice care had to contact her. The pager only worked inside Troup County, though, so if she left to visit somewhere like Callaway Gardens, she had to occasionally go to a pay phone and check in with the families to ensure they didn’t need anything.
Even in town, being on call for the families of hospice patients meant having to take some extraordinary steps. Going to Callaway Stadium to watch her daughter cheer meant if her pager went off, she would have to go to the press box and crawl under the announcers’ feet to reach the one public phone and call them back. Later, she was able to bring a portable “bag phone, which weighed 30 pounds,” with her.
One of the challenges of hospice is making sure patients are comfortable to enter the program in the first place. A lot of people are afraid to sign on for services because they think they’ll die sooner, Wiggins said.
Most patients are actually likely to actually live a little longer, she said, and hospice’s mission is to improve their and their families’ quality of life.
“It’s not a depressing thing, because when that person knows that they’re going to die, you’re not going to change that,” Wiggins said about the philosophy of hospice. “But you can certainly change how you get to that point, and how that family gets to that point. That’s what you try to turn around and think positive for the quality of life for family, too.”
However, the type of patients she sees has changed over the years.
Now, with more treatment options, the cancer patients, who account 38 to 40 percent, end up in hospice sicker because they have exhausted all treatments. Also, there are many patients who are older with types of dimentias and congestive heart failure.
Wiggins said rules and regulations have made the process more complicated for determining who is eligible for hospice and what kind of care they can provide.
However, despite the regulations, Wiggins said the staff always strives to go above and beyond for patients. One time, when an 8-year-old child was in hospice and became too sick to go to school, and wanted to go to the petting zoo. One of the hospice’s social workers then arranged for a petting zoo and the child’s class to come to his house.
“That’s the kind of thing that keep me going, those things that my staff makes happen even with all the regulations,” she said. “Those are just some of the things that we doggone do.”
Wiggins said caring for children is one of the hardest things she and her staff deals with.
One of the programs that has come from hospice is Camp Dogwood, a grief camp for children who have lost loved ones, now in its 16th year.
“It is absolutely phenomenal,” Wiggins said. “And that started with 16 kids the first year, and we can take up to 60” now.
She also praised the more than 100 people who volunteer their time to hospice, many family members of former hospice patients, and those who donate are vital to the hospice’s operation. Wiggins said longtime volunteer coordinator Joyce Wood and current coordinator Tammy Forbus also contribute so much to the operation and have been inspirational to her for their and other volunteers’ constant willingness to help.
Wiggins said as hard as it can be to get a call in the middle of the night and make a long drive out to a patients’ home to talk to a grieving family, she knew it was the right thing. Reassuring families that they had done all they could to make their loved one comfortable was sometimes the most important part of her service.
“You have to be very knowledgeable, clinically, and procedurally,” Wiggins said. “… But then emotionally, you know that patient’s family is going through something they’ve never been through in their lives and you are trying support them and to hold them up emotionally with what they’re going through.”
Wiggins said following each patient and their family for months makes the workers almost like a member of the family. However, they have to be able to disassociate enough to be helpful and therapeutic as well.
Wiggins said she has no qualms about handing off the program because it has “a really strong team on board now to take things to the next level, and I feel really good about that.”
Acree said Wiggins has done an exceptional job building up the program to its current point since she was first hired in 1982. She said her rapport with patients, families and physicians has contributed to much of its success and Acree has no doubt she was the perfect person to put in charge.
Duttera, former medical director of the hospice program, agreed.
“I can’t think of anyone who could have done a better job than she has over the last 30 years,” Duttera said. … Hospice LaGrange is “one of finest hospice facilities you’ll find in the area, and Cathy has done a superb job with it.”
Wiggins said the building of Hospice LaGrange, the hospice house at West Georgia Health - even though the name of the building sometimes causes confusion - was possibly the most significant thing to happen under her tenure. Built through the contribution of Ely Callaway, Wiggins noted most towns the size of LaGrange don’t have a hospice house.
“Opening this building was just such a phenomenal gift, something in my wildest dreams I never imagined possible,” Wiggins said. “But we served so many people over the years that we wouldn’t have touched so many without it.”
With the house also came an expansion of employees. From the early days of Wiggins being its sole employee, the hospice now employs 58.
“It’s been a special gift, and it’s been a challenge,” Wiggins said. “Sometimes you see someone come in the front door and see they’re afraid that they or their loved one is going to die and they don’t know what to do … and we greet them and help them get settled in, and you can see them relax a little bit and hopefully they see they will be cared for.”