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Providing emotional support for family

Wallowa Memorial Home Health is a comfort to grieving Enterprise family


Nora Stangel runs Wallowa Memorial Hospital’s Home Health and End of Life Care. She said the sprout from the old trunk in the framed photograph represents the assistance she and her team of nurses give to families facing the loss of a loved one. (Katy Nesbitt/For The Observer)

ENTERPRISE — Caring for loved ones at the end of their lives is never easy, but an Enterprise man who was facing the loss of his wife found honest, kind support from Wallowa Memorial’s Home Health Care.

Willy Locke lives just outside of Enterprise on a farm he shared with his wife, Nancy Lincoln. Shortly after he and Nancy were married they began a 15-year journey with a rare form of cancer — adenoid cystic carcinoma.

“Only 500 people in the U.S. have it, and maybe 10,000 in the world,” Locke said.

Lincoln had surgery to have a nerve removed and underwent aggressive radiation. At the time, the cancer was stopped in its tracks, Locke said.

Every year following the cancer treatment Lincoln had an MRI and remained cancer free until last year. When Lincoln was first diagnosed they were told she had 10 years to live, Locke said.

“Nancy was always looking into the possibilities to be cured before her 10 years were up,” Locke said. “All they could treat her with was head and neck cancer treatment,” Locke said. “Nothing is developed for ACC and it is about as different as a broken arm from a gall stone.”

She participated in treatment trials until the cancer had metastasized in her brain, but Locke said after she developed “brain mets” she no longer qualified.

“Between being a trooper and being stubborn she was the perfect lab rat,” Locke said. “She didn’t let any hopelessness affect her.”

On June 15, Locke said, his wife went through her last chemo treatment. Faced with the fact that cancer was winning the battle for Lincoln’s life, a staff member at the University of Washington medical center called in a referral to Wallowa Memorial Home Health Care Director Nora Stangel.

When Locke said he called about home health care a couple weeks earlier he was told that Lincoln didn’t qualify because she wasn’t housebound. The University of Washington referral gave the green light for home visits and within two days Stangel started regular visits, sometimes as many as four a day for the next two weeks.

Locke said he had some medical training as a ski patrolman, a job that required stopping bleeding or bracing a broken bone. In those cases the medical aid is to help the victim get better. With palliative care, or comfort care, all of the rational things to do for a sick person are turned on their head.

“Nora made a reality for us, explaining what we could do and couldn’t do,” Locke said. “Your brain isn’t used to thinking of things that way.”

For instance, Locke said, Stangel showed them how to help Lincoln eat the little food that she could; she was having trouble swallowing. She also explained what medications were still worth taking and which ones were not. She even suggested that after Nancy died Locke should take her medications to the sheriff’s office for proper disposal.

In 1985, Wallowa Memorial Hospital’s Home Health Care arm was a branch of the Grande Ronde Hospital in La Grande. Stangel said she moved to Wallowa County to head up the department, now solely run by Wallowa Memorial, in 1986. The Lakeview native and Oregon Health Sciences University graduate had been working at St. Charles Medical Center in Bend as a surgery nurse.

End of life or hospice-type care comes under Stangel’s department’s responsibility.

“What we want people to understand is we provide end of life nursing just like a hospice,” Stangel said.

Home Health provides 24/7 on-call nursing care, and connects patients to a minister, if requested, and covers medications, like the pain pump. They can even consult with a palliative specialist via video conference at Wallowa Memorial, Stangel said.

“We will keep the patient as comfortable as possible,” Stangel said.

As far as preparing the patient and the family for what to expect, Stangel said compassion is the main thing she and her nurses provide.

“To assist people through this time is our reward,” she said.

Faced with no cure, Stangel said terminally ill patients’ mental status deteriorates.

Instead of curing the patient, hospice-type care is about pain relief and comfort.

Sometimes medications become difficult to swallow, Stangel said, so the nurse will sort out which medications can be administered in a liquid.

“Suffering can be greater than loss,” Locke said, after having to watch his wife in pain for so long. “Nora guided us through this training so we all felt more comfortable helping Nancy. Our family can’t express enough appreciation for having this service for someone so close to us.”