Living History Program brings patients, providers closer together
A 92-year-old man was admitted to the hospital. An ordinary man, one might think. But everyone has a story, and when Christiana Care volunteer Carlene Jackson sat down to talk with him, she learned a lot about his younger days as a country doctor during the pre-antibiotic era.
“He told me how penicillin was discovered,’’ she says, and how “during bad weather he’d make house calls wearing snowshoes.’’ He spoke of selling his blood for cash while a he was a medical intern in Chicago. And he talked about his study of Iroquois history.
“He was just the most fascinating person,’’ Jackson says. “There were times when I’d put a question out there and let him go. I’d be leaning forward, hands on my knees, just enraptured.’’
Jackson is part of the Living History Program at Christiana Care. This team of hospital volunteers interviews patients about the non-medical parts of their lives — their families, careers and interests. The volunteers write short life histories based on what they learn, give a copy to the patient and place another copy in the patient’s file, where doctors, nurses and other members of the health care team can read them.
“The Living History Program is about getting to know the patients and their families in a different way,’’ says Margarita Rodriguez-Duffy, director of Visitor & Volunteer Services at Christiana Care. “It has helped our patients be able to share their lives — their inner, vulnerable places — when they come to us. Patients want to be valued, to be special and appreciated, and this tool gives us the opportunity to do that.’’
The program, still in its pilot phase, has collected about 100 patient stories since it started a year ago at Christiana Hospital’s ACE (Acute Care for the Elderly) unit and a rehabilitation unit at Wilmington Hospital. It’s a perfect fit with Christiana Care’s philosophy of patient and family centered care, says Rodriguez-Duffy.
For volunteers and staff, the program has brought unexpected revelations and deep connections.
“It allows our staff to get to know our patients better. And if you know them better, you can take care of them better,’’ says Linda Sydnor, geriatric clinical nurse specialist. “It gives you more opportunity to talk to patients, helps in their plan of care and makes them more comfortable.’’
Their stories are interesting, she says. For example, one patient spent years volunteering with his wife as Mr. and Mrs. Santa Claus at nursing homes. Another was a former New York City runway model.
“We had a gentleman who was one of the last of the Band of Brothers,’’ the World War II regiment made famous in a book and TV miniseries, she says. “What an honor it was for us to take care of him! We’d never have known, had it not been for the life history.’’
The stories remind staff that health care is not about the machines and the medications, Sydnor says. “This is a person. He’s not ‘the gall bladder in room 25B.’’’
For volunteers, the program allows deeper and more satisfying interaction with patients. Jackson remembers John, a man of 103 years who was born in the coal region of Virginia, into a large family. His mother died when he was 5, and the children survived by trapping squirrels for food and using their fur, wrapped around wood blocks, for shoes. He was unused to speaking about himself, she says.
“It was hard for him to actually look at me; he was very shy,’’ Jackson says. “Imagine Virginia 100 years ago, and he was a black man. He had the most incredible life. He brought me to tears many times.’’
She became especially close to the retired country doctor she interviewed, making regular visits to his bedside to hear engrossing tales of life in rural upstate New York, half a century ago.
When he died last summer, his daughter wrote to Jackson to tell her that the family made copies of Jackson’s written history available at the funeral.
That’s not uncommon, says Sheila Brune, director of Service Excellence at CGH Medical Center in Sterling, Ill., because often the history is the only concise record family members have of their loved one’s life.
Brune created the Living History Program a decade ago while director of case management at a hospital in Iowa. It’s now being used at approximately 50 hospitals and medical schools across the country.
She takes no money for the program. “I’m a nurse, not a business person,’’ she says, “and I want it to be that way. It does my heart good to know people are adopting it.’’
It all started because Brune had a habit of reading obituaries.
“When one of my patients passed away, I’d read the obit, and there was always some bit of information, and I’d think, gosh, I wish I’d known that,’’ she says. “Maybe it was someone they were related to that I knew, or where they were born or some hobby or interest we shared.’’
When that happened, she says, she’d regret that she hadn’t taken time to know the patient better. “And one day I was inspired by a speaker who said something like, ‘lead, follow or get out of the way. Do you want to be part of the problem or of the solution?’’’
She thought about how health professionals can come to know their patients as people, understanding the forces that shape their lives. “I said, how can you have the kind of information you get in an obituary without waiting for someone to die?’’ She began by recruiting high-school students to visit patients and gather histories, for which they received class credit.
One of the first students, a high-school senior named Justin, developed a great friendship with a patient who was an elderly widow, alone in the world. When she left the hospital, Justin began helping her with odd jobs at home. His family got involved, inviting the widow to family events and adopting her as an honorary grandmother. When she died, she left Justin her wedding ring, and he had it remade into an engagement ring for his bride-to-be. Now, says Brune, “she’s going to be part of his life forever, because his new wife will wear her ring.’’
The power of the program is, “just telling the stories,’’ she says. “The more you know about a person, the more goodness you find in them.’’