Seventy-six-year-old Rowena Blizzard had always been there for her kids. As she aged, all 10 of her children were there for her. Even as adults now with families of their own, one was always dropping by and checking in on their mom. It was just an hour after her daughter had left, having spent a lovely afternoon together, that the accident happened. A lit cigarette fell from Rowena's hand into her lap. She used a walker and had limited mobility due to arthritis, so before she could stand up to dislodge the cigarette or move her hand to brush it aside, her clothes caught fire and completely burned away. With burns over 60% of her body, Rowena still managed to call 911. Paramedics were there within five minutes and rushed her to the Miami Valley Hospital (MVH) Emergency Room.
From places as far away as New York and California, all her children came to be with their mom in the MVH Burn Unit. And all 10 met the next day with Trauma Surgeon Mbaga Walusimbi and Deb Bentley, RN, a member of the MVH Palliative Care team. Dr. Walusimbi was open and explained that recovery chances for their mother were poor, only 2% to 5%. It was agreed, however, that surgeons should proceed with surgery to remove the dead skin, which would be Rowena’s only chance for survival.
The MVH Palliative Care team is called in when a patient’s condition is critical. Their role is to assist the family on many levels. They act as advocates and coordinators for the patient’s care, help arrange for the family to use the extensive medical library at MVH to better understand conditions, and aid with legal issues, like medical power of attorney. When needed, the MVH Palliative Care team is also available for assisting with end-of-life care and is there if requested when patients pass on. The Palliative Care staff provides a bridge between medicine and emotion for patient and family.
Rowena’s children set up camp in the MVH Burn Unit waiting room, and she had three surgeries over the next four days. Another surgery was planned for the next week, but there were complications. Dr. Mary McCarthy, head of the MVH Trauma Center, and Dr. Walusimbi met with the family to explain that Rowena's rising white cell count was a sign that her body couldn’t fight off infection and that antibiotics weren’t working. The surgery would have to be cancelled. More meetings were set up with family members and staff, including Palliative Care’s Program Director, Beth Delaney, to discuss Rowena's condition. With Rowena’s chances for recovery fading, the family made the tough decision to allow Rowena to pass on with dignity.
From this point, care centered on relieving Rowena’s pain and allowing her passing to be as natural as possible. The family credits Deb and Beth of the Palliative Care team for their patience in pursuing every option for their mother’s comfort, addressing the family’s needs, and guiding the process of getting affairs in order. It was important to the family that their mom not be alone when she passed, so the Palliative Care team helped them to understand what signs would indicate that the end was near.
While it didn’t seem that Rowena was conscious to hear them, Palliative Care staff explained that hearing is often the last sense to go, and though Rowena may not be able to respond, she most likely could hear what was said. Family members, including in-laws and grandkids, wanted to say a private goodbye. Subtle changes in Rowena's body movement and twitches in her finger indicated that she was hearing them. At one moment, Rowena opened her eyes and a tear ran down her cheek.
Over a period of six days, Rowena sank deeper into sleep. On her last day, she was bathed and freshly bandaged by Latisha, an MVH Burn Unit nurse, and other caring nurses in the Burn Unit. Family really felt that Latisha took care of Rowena as if she were her own mother and helped maintain an air of optimism in the room. That evening, family members gathered in the room, reminiscing about old times through laughter and tears. No one wanted to leave, but slowly they did. The two remaining sisters started to comb their mother's hair when they saw Rowena’s heartbeat slowly start to fade on the monitor and noticed her breaths becoming shallow. As the medical staff responded, one daughter called family to alert them. Just before midnight, Rowena passed on. A few moments later, two brothers rushed in to say final goodbyes.
It had been 18 days since the accident. Throughout that time, dozens of Rowena's extended family members and close friends had been to the hospital, gathered in the waiting room, sat at Rowena’s bedside, and conferred with staff. Rowena’s family felt they put a lot of demands on the nurses and Palliative Care team at MVH. And at these times of high emotion, the family was grateful for a staff that remained calm and cared for Rowena’s needs as well as theirs during such a trying time.