• Sharing Mayo Clinic

    Palliative and Hospice Care Ease Difficult Transitions

As they've faced the realities of a terminal illness, Jim and Nancy Moessner appreciate the support and assistance they've received from Mayo experts in palliative care and hospice care.

Nancy Moessner smiles affectionately when reflecting on the happy memories she and her husband, Jim, have shared through the years: the two sons they raised together, the weekend excursions they took, the train trips they enjoyed as a family.

Jim, an Eau Claire, Wisconsin, resident and former real estate appraiser, was diagnosed with multiple sclerosis — a disease of the brain and spinal cord — in 1980. The condition was mild in the beginning, and Jim was able to manage it well for decades. But that changed in fall 2006.

"Lesions all over his brain, right-side weakness — it just exploded and never relented," Nancy says. The disease led to so much cognitive impairment that Jim had to stop working in December 2006.

Today, Jim is unable to walk or speak, and he requires complete care by family and the hospice team from Mayo Clinic Health System in Eau Claire. As hard as the changes in Jim's health have been, having access to palliative care and now hospice services has helped lighten the load.

"Hospice has provided an amazing amount of support," Nancy says. "All of the staff at Mayo Clinic Health System — not just in the hospice program but even prior to hospice — have been so good with Jim and so knowledgeable about what services are available for treating and helping him. It just has made this whole transition easier."

Welcome support

Janna Baker, a nurse practitioner in Palliative Care, worked with the Moessners frequently over the course of a year before Jim transitioned to another nurse practitioner and then to hospice. Baker remembers the couple fondly and recalls having several conversations with them about tests and treatments.

"Nancy is doting and so attentive to Jim," Baker says. "She has given him such good care and was open to our discussions about goals of care and end-of-life because they hadn't really talked about those topics prior to going on palliative care. I feel like it was really helpful to her."

"They're all so good with him. It's just amazing to watch them."

Nancy Moessner

Baker outlined the differences between palliative care and hospice care. She explained that palliative care is intended for anyone with a serious illness. It comes before hospice care, and its focus is on symptom management rather than aggressive treatment. The switch to hospice typically happens when the focus changes from active treatment and management to more comfort-based care.

"The other part of palliative care is discussing goals for the future as things change and bumps in the road come up with health — talking about those things ahead of time, so patients and families have time to think about how they would approach them, and what they want for tests and treatments," Baker says. "It really comes down to giving them all the information they need to be able to make a decision for themselves when the time comes."

Comforting benefits

The Moessners' goals are to be together for their 46th wedding anniversary next year and to be at home feeling comfortable and safe. But even if that isn't possible, they take comfort knowing there is a plan in place and support for the difficult times ahead.

"To know that we've helped with symptom management and helped people live out their days the best they can — it definitely makes you feel good about what you do on a day-to-day basis."

Janna Baker

Nancy says she can't say enough about the benefits of the hospice program — from the respite visits she's offered to the equipment recommendations she's been given to the physical health examinations the team provides to Jim.

"They're all so good with him," she says. "It's just amazing to watch them. It's really been good."

Hearing comments like that warms Baker's heart. "It's really wonderful when we can see the impact of these services and help give people all the information they need to make decisions going forward," she says. "To know that we've helped with symptom management and helped people live out their days the best they can — it definitely makes you feel good about what you do on a day-to-day basis."

Note: A version of this story previously was published in Hometown Health.



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