Even with a loved one in hospice, the nursing home is off limits to family

Kim Strong
York Daily Record

Hilda Melhorn doesn't know her husband died five years ago.

Her failing mind lost the memory, and her family doesn't know if they should dig it up again.

"We just pretend that he's alive," said her daughter, Vicki Knisely of Dover. When they have tried to tell her in the past, Melhorn reacts with fear: How will she manage, she wonders.

"For that moment, she's alone," her daughter said.

She's alone now, more than ever. Like most nursing home patients, she's caught in the quagmire of the coronavirus pandemic, unable to have visitors despite being in hospice care.

"That can provide a lot of angst, a lot of anxiety to the patient themselves as well as the family, who want to give their loved one one more kiss, to hold their hand one last time, to hear their voice one last time," said Christy Trump, administrator for Heartland Hospice serving Southcentral Pennsylvania. "With patients in isolation, it's more difficult to say that final goodbye."

'She was a dynamo'

Hilda Melhorn had stayed home to raise her only child, while her husband, Kervin, a U.S. Army veteran, worked at the New Cumberland Army Depot. 

"She did all the yardwork. She was a dynamo," Vicki said. She didn't invite neighbors over for coffee or play bridge because her church stood at the center of her social life. "If somebody needed help, she'd be there." 

When Vicki married Gary Knisely, he found a second mother.

"She was extremely loving to me," said Gary, whose own mother died just recently.

With a life-long love of singing, Melhorn has rediscovered that passion through music therapy at her nursing home. 

"We went to a support group and learned that no matter how deep the dementia becomes, whatever they enjoyed in life will be with them until they pass," Vicki said.

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Moving into hospice

Melhorn, now 91, lives in Providence Place Senior Living in Dover. She moved there six years ago after a fall that broke her hip.

Now, she's blind in one eye and deaf in one ear from a tumor in her inner ear. Even worse, she's bedridden because her legs have locked in place from lack of movement. She already had a low threshold for pain, but the dementia heightens that, Vicki said. Because of it, the medical staff doesn't force her into physical therapy, and about 18 months ago, her legs would no longer move. 

The Kniselys typically visit Providence Place at least weekly, always taking fresh flowers to her. Now, with the virus protocol in place, they make do with a phone call. 

But they are fortunate. Beyond the staff at Providence Place, they have help: Heartland Hospice. The hospice agency in York provides comfort and care to end-of-life patients.

"Hospice is not a death sentence. It’s just another set of hands and eyes," Vicki said. "Hospice reads to her, they feed her, they hold her hand. I don’t know what I’d do without them."

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Heartland Hospice has its own medical director, nurse, social worker and other professionals and support staff that build a plan for each patient. Hospice is a Medicare-funded program for patients determined to be at the end of their life.

Vicki Knisely becomes emotional at the thought that she won't see her mother until this virus has passed its critical stage. It's a sadness that folds on top of the fog and loneliness that dementia creates for her mother.

"I was fortunate that my mother was bright until she succumbed to the leukemia," Gary said. "For Vicki, it is so horrible to go in and see someone in a home with dementia and start over again every day. It’s difficult. Your mother is there, but in a way you lost your mother years ago."

Kim Strong can be reached at kstrong@ydr.com.