From Hospice Director to Author: Maureen Groden ’77 Discusses End-of-Life Care in New Book

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Maureen Groden ’77 is on a mission to educate the public about dying.

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"When a Loved One is Dying" by Maureen Groden is out now.

A longtime nurse, hospice leader, and nurse educator—and now, published author— Groden drew over 70 attendees from the Elaine Marieb College of Nursing (EMCON) community to a virtual talk about her new book, “When a Loved One Is Dying," on April 1. She read excerpts from the book and offered practical guidance on supporting people and families through serious illness and the end of life. Clinical faculty member Cheryl Sabola moderated the evening.

Groden urged the audience to learn about end-of-life services before they are needed. “I feel really strongly that, if people learn about end-of-life services ahead of time, people will have a much better experience when the time comes," she said, adding, “We’re all in the position where a phone call could change your life.”

Groden did not shy away from systemic critique. “One of the reasons I wrote this book for the public is because I question whether hospitals consistently and thoroughly educate families about palliative and hospice options, or leave them to research care on their own," Groden explained. She said the sector has "not fully recovered" from the effects of the COVID-19 pandemic, during which she served as a director of hospice services. Groden advocates for the healthcare system to do a better job at communicating and coordinating healthcare. "That means having really good leaders who set the bar and strive to create healthy work cultures," she said.

“You're only as healthy as the culture you're in.”

—Maureen Groden '77, author of 'When a Loved One is Dying'

A throughline of Groden’s remarks was the humanizing principle that should guide care. “We have to get better at seeing people for who they’ve always been... We have to value people and look at people deeper.” To that extent, Groden also offered concrete advice for loved ones of caregivers: don’t withdraw; acknowledge the sorrowful situation; and offer tangible help such as grocery shopping, childcare, or sitting with a dying family member so caregivers can rest.

Hospice Care Versus Palliative Care

In her talk, Groden clarified the distinction between palliative and hospice care. 

Palliative care, Groden said, began in oncology units in Canada in the late 1970s and supports symptom management for patients receiving treatments such as chemotherapy or living with chronic heart or lung disease. Palliative care patients are often still opting for curative treatment. 

Hospice care, she explained, is intended for people expected to have six months or less to live and are electing "comfort care." The median length of stay in a hospice program is 21 days, Gorden said, citing the National Alliance for Care at Home. She noted that some recent studies are showing that electing palliative care or hospice care earlier may improve quality of life— and may even increase length of life.

Groden urged families to consider nonprofit hospice providers, noting that 84 percent of hospice programs are for-profit. Nonprofit programs generally have higher ratings of care, she said. Hospice ratings can be found on Medicare.gov.

Three Key Legal Care-Planning Documents

Groden outlined three key legal and care-planning documents used in Massachusetts that are helpful to have completed before end-of-life care is necessary. She informed listeners that a “living will” is not legally binding and is not generally one of the health care directives that medical providers focus on. "My mom taught me about the importance of palliative care and quality of life. Being her health care proxy, and walking that walk with her, [was very powerful]," Groden said.

Health Care Proxy

Everyone over 18 should appoint a health care proxy after a conversation with the person they choose, Groden advises. 

MOLST Form

A MOLST (Medical Orders for Life-Sustaining Treatment) form currently governs specific procedures. According to Mass.gov, MOLST "is intended for people with serious illness to document their treatment choices in the event of a medical emergency. MOLST is voluntary and should be completed by a medical provider after discussion with the patient." This form will transition to the National POLST model in April 2027; all MOLST forms are currently valid.

POLST Form

Beginning April 2027, Massachusetts will move to a POLST (Portable Orders for Life-Sustaining Treatment) form that can travel across state lines and focuses on direction of care across a spectrum of scenarios. All MOLST forms will still be valid, but providers will begin using the POLST forms in 2027. According to the National POLST Collaborative, "POLST is part of advance care planning intended for people who are seriously ill or who have advanced frailty due to aging. It starts with a talk between the person and their health care team and can lead to a portable medical order, or POLST form."

Learn More and Buy the Book

Visit the author’s website to learn more about Groden, "When a Loved One is Dying," and upcoming author talks. Use the code "HWTN" at checkout for 30 percent off your purchase on https://press.jhu.edu/.