At 77, Chatham county resident Alan Murray (not his real name) needed a few weeks of extended health care following a surgical operation. But his son, Jeff, and daughter-in-law, Abby, living a busy life in Portland, Ore. with two young sons, weren’t sure how to go about arranging it from across the country.

A North Carolina friend suggested they get in touch with Duke HomeCare & Hospice (DHCH), which quickly arranged for in-home infusion and nursing services for Murray. “They provided just what my father-in-law needed,” says Abby. “Being able to tap into that level of service with one phone call was just what we needed, too.”

For millions of “sandwich-generation” Americans, juggling the demands of nuclear and extended family members is a day-to-day adventure. Add a health crisis that requires extra attention and care, and it can throw a real curve ball into people’s lives.

To help families feeling the sandwich squeeze, DHCH links a continuum of services -- home nursing, home infusion, hospice, and bereavement -- that provide comprehensive care for issues ranging from temporary disability to terminal illness. DHCH’s multidisciplinary team includes doctors, nurses, pharmacists, social workers, physical therapists, and other professionals and draws on more than 20 years of collective experience.

“Our team includes not only professional caregivers but dedicated volunteers,” says Toni Cutson, MD, the program’s medical director. “That means we not only provide medical care, but offer caregiver support -- such as help with all those domestic and personal care tasks that can sometimes become overwhelming.”

DHCH Home Health nurse Jodie Gulker, RN, says she and her colleagues work closely with patients on preventive medicine, with diet and appropriate exercise being the most important components. Program nurses often assist with locating additional community resources to help with cooking or cleaning needs.

Because many infusion patients have to be on intravenous medications for months or even years, DHCH infusion nurse Leigh Garmhausen, RN, says that teaching is her single most important function. "Our goal is to give patients and their caregivers the knowledge to perform daily maintenance and treatments on their own," Garmhausen says. "We try to be very sensitive to their state of mind, as we understand that people have varying comfort levels about what’s involved.”

Along the continuum of services provided by DHCH, hospice -- palliative and emotional support for terminally ill people with less than six months to live -- is associated with some of the most intense emotions. DHCH’s Hospice Program is a descendant of Triangle Hospice, founded some 25 years ago and the only one in the Triangle with a freestanding inpatient hospice facility, located at the Meadowlands in Hillsborough.

"The dying process is scary for both the patient and family," says DHCH Hospice nurse Carolyn Casey. "As the patient declines, the family needs more and more support. A lot of what we do is relationship building -- establishing trust and friendship with patients and families. That’s just as important a part of care as the medical therapies."

“During the course of their care, our patients often move through a variety of settings, such as hospital, hospice, home, and nursing home,” says Cutson. “So our team provides continuity of care through all those stages. In fact, I often serve as a primary care physician for hospice patients, making sure that they and their families have what they need, and being available to help them address any questions or concerns.

“It’s challenging, certainly, but also very rewarding. Each patient and family teaches us something about this most profound transition, which we will all someday face.”

Sharing the tranquil, pastoral Meadowlands setting with hospice is the Unicorn Bereavement Center. Within the historic brick home, DHCH’s Bereavement Services provide succor and support for family members of all ages mourning the loss of a loved one, whether or not they have previously been served by hospice or other DHCH services.

When Kay Gundlach's husband, Bob, was dying of cancer, the couple spent their final days together at the Meadowlands. "Being there was a real gift," says Kay. "The setting is serene and magnificent, and the rooms have sliding glass doors and terraces so patients can enjoy the outdoors. It doesn't feel clinical at all. And the staff were extraordinary -- so kind, caring, and considerate.

"One of the saddest times in my life became also one of the most beautiful, because of the care Bob received. I think the word for what I found during that experience is 'peace.'"

What Is DHCH?

• Home health services for adult patients needing nursing, rehabilitation, social work services, and home health aides; pediatric services including rehabilitation and social work services. These services are offered to patients within a 60-mile radius of Durham, including parts or all of Alamance, Chatham, Durham, Granville, Orange, Person, Vance, Wake, Warren, and Franklin counties.
• Infusion services for patients needing intravenous medications at home in North and South Carolina, and Virginia.
• Hospice care in private homes, long-term care facilities, and a six-bed inpatient care facility in Hillsborough. Hospice care is provided to patients in Durham, Orange, Granville, Wake, eastern Alamance, northern Chatham, and southern Person counties.
• Bereavement services to anyone in the community who has suffered a loss due to death or who requires critical incident debriefing.