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Bill & Tomi Gallagher (Photo:  Lou Reuter, Adirondack Daily Enterprise)
Bill & Tomi Gallagher (Photo: Lou Reuter, Adirondack Daily Enterprise)

Hospice Path: Dealing with depression

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This morning we continue our on-going series called the Hospice Path. North Country Public Radio is looking in-depth at the way hospice and palliative care programs can help people at the end of their lives.

We've been profiling Bill Gallagher in Saranac Lake. He's 87 years old and his lungs are slowly failing. With the support of his wife Tomi, he's been able to remain at home with his family. Despite those successes, Bill has struggled at times with depression, loneliness and boredom.

As Brian Mann reports, hospice experts say those experiences are common for hospice patients nearing the end of their lives.

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Reported by

Brian Mann
Adirondack Bureau Chief

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One afternoon when I go by to see Bill and Tomi, he is sitting in his big comfortable chair with a glum look on his face.

Actuality One:  I’m mad cause I fell.  (Tomi) Accidents happen.  For heavens sake, Bill.  You fall… (Bill) I get to get mad at something!

Bill’s taken a nasty fall.  So in addition to the terrible shortness of breath and the weakness and his difficulty sleeping, now he aches all over.

When he talks to his hospice nurse about where this journey goes next, the news is always hard.

Actuality Two:  (Bill) The nurse she just looked at me in the face and said, ‘You’re not getting any better.  (Tomi) It’s a slippery slope.  (Bill) One day to the next, it doesn’t seem much, but when you look back at the week.

Now here’s the thing about Bill and Tomi.  This is a subject – the depression, the loneliness, the sense of isolation that come at the end of life – that I’ve been skirting for months.

It’s uncomfortable.  Especially when you’re talking to a guy like Bill – a decorated World War 2 veteran, a big gruff guy – the idea that he might just be sad is – hard.

But on this day, Tomi pushes me.  She’s been listening to the stories in this series and says she’s worried that we’re sugar-coating their experience. 

Actuality Three:  I hope it does sound pollyanish, or kind of that we’re making it sound that it’s easy, easy, easy.

So this is one of the hardest parts of dying, especially when it happens slowly, over a period of weeks and months.

Actuality Four:  This is not an easy time. 

Ryan Mellon is a social worker who’s part of the High Peaks Hospice team partnering with Bill and Tomi.

Actuality Five:  Even if I think people are theoretically prepared, you know, like a patient says they’re prepared to die, who knows if they really are?  You know, it’s got to be scary.

Ryan says he sees Bill wrestling with this week after week, a desire to live and have more time with his family that’s tangled up with a deep weariness.

Actuality Six:  There’s a part of him that I think is ready to go, like he’s sort of made peace with his maker.  And he’s actually learning to cope with the reality that he really is getting weaker.  He really is not able to do the things that he was able to do even a couple of months ago.

It’s important to remember that Bill Gallagher is an engaged, turned-on, curious man.  He wants to be up and out of that big chair in the worst way – and it eats at him.

Actuality Seven:  (Bill) I was walking down from the garage last night, and I says ‘Here I am, I can hardly walk down here.’  You have that down side of you that’s trying to do a job on you.  I don’t know where it comes from but I have to tell him to shut the hell up and just be as positive as I can.  (Brian)  Given that you can’t move around so much, how do you kind of fill your days?  What are you doing… (Bill) That’s the frustration.  I find that I have difficulty concentrating on reading.  I got a book, I went halfway through.

Here again, Hospice has worked closely with Bill and Tomi, giving them someone to talk to, helping them get out of the house, and helping with medication.

Actuality Eight:  (Tomi) Cause this can be very depressing.  It can really, God!  It’s like walking this path, you can get to the point where… (Bill) I’m on that little pill now, I’m not supposed to be depressed.  (Tomi) No, we call it the happy pill.  (Bill) The little green pill.  (Tomi) The green pill is the happy pill. It started, this is day three.  (Bill) Day three.  (Tomi) You better be grinning all over.  (Brian) Is it helping?  (Bill) I don’t know.  Am I depressed?  I’ve talked to myself about it. 

Actuality Nine:  I think they’re amazingly honest about their feelings.  They’re able to talk about the fact that Bill’s life is getting very small.

That’s Sara Wardner, the Hospice nurse who’s working most closely with Bill and Tomi.

Actuality Ten:  He’s a man that had a very large life.  He lived life in a big way.  And as we see with  many of our hospice patients, their lives become very small. 

Hospice can help, Sara says.  But she too is careful not to sugar-coat this experience.

Actuality Ten:  (Sara) I think he is depressed.  He is taking a very small amount of medication to help him with that.  It takes an enormous amount of energy just to breathe.

(Brian) Sometimes I feel like one of his biggest burdens is boredom.  Waking up in the night and not being able to sleep and just the wheels turning.

(Sara) I think you’re right and I think that’s probably very true for a lot of hospice patients.  Because they lose their strength, they lose their ability to be active, they are faced with just sitting within themselves.  And there’s a lot of time to think.

 Now, just like every other part of the hospice experience, it’s important to see this in context. 

 Spend time with Bill and Tomi and you still hear a lot of laughter, a lot of fun – even if it’s just a very small thing like Bill stealing an extra cookie from the tea tray.

 Actuality Eleven:  (Tomi) I knew you we’re going to (Bill) You don’t see this.  (Tomi) Go, go for it.  You want some grapes?  (Bill) They’re too healthy.

 And here’s the very important consolation.  The thing that’s not small at all. With the help of hospice Bill is able to spend this hard and complicated time in the one place he wants to be, at home, with his family.



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