Invited into a family's final goodbye, Mark Patinkin sees the power of hospice

It is part of my work to come into people’s lives at difficult times, but this is among the more sensitive moments I’ve been invited to observe.

I am getting off the elevator on the third floor of the HopeHealth Hulitar Hospice Center in Providence, being escorted to an end-of-life vigil in room 302.

Not that 302 is special. Such vigils are taking place in all 30 of the private rooms here. That is the mission of this extraordinary place – to help patients, and loved ones, through life’s final goodbye.

I use the word “extraordinary” because of the feeling one gets here. Although there are nurses’ stations and medical infrastructure, this is an unexpected world, just off the bustle of North Main Street, where, unlike most hospitals, the main thing one senses is peace.

I am joining Elizabeth Ruest, 69, whose elderly mom, Annemarie Minicucci, is marking her final days here. It strikes me as an act of grace for Elizabeth to share this, offering a glimpse into a part of life – its end – that we don’t like to face, or talk about.

Indeed, Virginia Magnan, HopeHealth’s clinical director, will tell you that those who founded the state’s hospice movement 50 years ago were almost vilified. How dare they think hospital patients should spend their final days elsewhere, such as home, or a building like this.

Yet today, there are perhaps 10 hospice companies in the state, HopeHealth being the biggest, with 650 or so staff members. They have around 700 folks under care, most in their homes, where they remain until the end, but for a few dozen, the medical needs are demanding enough for higher-level maintenance, and here on North Main, this lovely building is the place many come.

Annemarie is such a patient, failing from pancreatic cancer and 89 the day I visited last week. She is bedridden and unresponsive, but, unexpectedly, I sense a spirit of life in the room. A half dozen family members are here, and all will tell you that Annemarie, their matriarch, would want her loved ones to be upbeat around her, even now.

Medicine is often able to closely predict the end of life, so most who check into the HopeHealth building are there for just three to five days before passing on, though by my mid-morning visit here, Annemarie is marking day six.

“She’s stubborn,” jokes Elizabeth, adding that her mom was healthy and energetic until the illness.

Annemarie was diagnosed in June after pain in her back and abdomen brought her for an exam and scans. They tried cancer treatments through the summer, but it became clear this was terminal, so they stopped.

Annemarie’s faith is profound, and she felt if this was her time, she would soon be joining her parents, her husband, John, who died at 89 a year ago March, and many others she'd loved and lost.

As is common, Annemarie began this final chapter at home, with frequent visits by a HopeHealth nurse named Michel Anne Thorpe. That extended the gift of independence, but last Friday, Annemarie was unable to get out of bed, her sudden decline requiring more than home care, so by Saturday morning, an ambulance brought her here.

There are two recliners in the room, and every night since, Annemarie’s daughter Elizabeth and son Steve Minicucci have slept here to remain with their mom, only leaving a few hours each day.

Steve is among those who are here when I visit. He’s 67 and has an interesting career track – he retired from being a financial manager but grew bored, so he now runs a power-washing company.

As they hold court, Annemarie lies asleep, with hydrangeas brought in from Elizabeth’s garden on the bedside table, next to a framed photo of her husband, John.

Steve’s wife, Kathy, is also in the room, as is Annemarie’s sister-in-law Theresa Daigle. So is Elizabeth’s husband, Tom, a retired middle school teacher. The two were both educators, Elizabeth having been an elementary reading specialist in Cranston.

Sometimes, the mood in this room is, of course, somber. But often not.

“We laugh a lot and tell stories,” says Elizabeth.

She shares how her mom was 15 and dad 17 when they met around 1950 at Mount Pleasant High. John, everyone says, was a renaissance man, a pharmacist and science teacher who built a summer home for the family in Truro, Massachusetts, and bought a condo in Naples, Florida. That’s where he passed on in 2022 from congestive heart disease.

That was after 68 years of marriage, and it occurs to Elizabeth that she and her own husband have now reached 41 years.

“Time goes by so fast,” she says. “I’m only 20 years younger than my mom. You think about that – how much time you have left.”

And now, for her mom, Annemarie, the time remaining is measured in days.

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But Virginia Magnan, HopeHealth’s clinical director, tells me such is the purpose of hospice, helping folks through that passage, and it's her own purpose, too.

Virginia became a nurse later in life, at 49, after both her parents went through hospice at their home – her dad from colon cancer 20 years ago, at age 78, and her mom five years later from lung illness at 83. The hospice folks, she says, provided extraordinary help guiding the family through it.

Virginia has been in hospice work now for more than a decade, finding it, paradoxically, life-affirming as they help families find dignity and peace during the time of transition. She considers it an honor to play such a role.

Sometimes, there are even rich end-of-life memories. She tells of a male patient here, only in his 40s, who married his lifelong girlfriend in the facility. He passed on the next day. In another touching moment, the staff arranged for a small school ceremony in the building so that a mom near her end could be present for her son’s high school graduation.

As we sit, Elizabeth talks about her mother, how she worked for decades as secretary to the dean at Rhode Island College. That’s where Elizabeth went to school, she and her friends sometimes hanging out at her mom’s office.

“They loved her,” says Elizabeth. “I was always so proud of her; I had the youngest and prettiest mom.”

She speaks also of memorable mornings at the family's Truro house, Annemarie asking everyone for their breakfast orders as soon as they woke – pancakes or eggs? By midday, there would be the smell of garlic as she moved on to dinner, lasagna and manicotti among her signature dishes.

During more recent years, Annemarie’s focus was on her four grandchildren and six greats. All of them knew, at each visit to “Mema’s” house, that her candy pantry would be supplied with Reeses, Kit Kats, peppermint patties and more – take your pick, two allowed for each.

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That is how it goes here in this room, where space is given to focus on good memories. And I realize this is the gift of hospice, the peace that comes from accepting the end of life’s circle instead of fighting it.

As I get up to leave, around noon on Thursday, I ask if Elizabeth and Steve plan to spend another night here.

Of course.

“She was there for us our entire life,” says Elizabeth. “How could we leave her?”

Indeed, they are there until Annemarie Minicucci’s transition, which I hear the next day arrived 15 hours after I left, at 3:08 a.m. Friday, in the presence of her daughter and son, who loved her deeply and always will.

mpatinki@providencejournal.com

This article originally appeared on The Providence Journal: HopeHealth hospice an extraordinary place to view life's final goodbye