Lana Adzhigirey, a registered nurse for Virginia Mason Franciscan Health, recently shared this story about her grandmother, Yelena Lobodzinskaya. She had endured a diagnosis of dementia for nearly 10 years, with increasingly debilitating symptoms over the past five years. Yelena suffered a stroke before Christmas. She died peacefully at Franciscan Hospice House. Her passing was an example of the compassion, clarity and advocacy of Yelena’s family. They knew intimately the values important to their grandmother and when Yelena was no longer able to communicate her own wishes about her medical care, her family made sure that the care she received matched her values and the way she had lived her very rich and full 89 years. The care she received during her final days was reflective of what they knew her wishes to be regarding Advanced Directives and Goals of Care.
Growing up in Ukraine during the time of Stalin, Yelena survived the famine and escaped being sent to the factories to work—a common fate for so many young women of her time. Not only did she and her family hide her Jewish neighbors, but occasionally they also had to hide. Yelena married a Protestant leader in the church, who shared her vision for the future while quietly sharing his faith in a time when being “religious” was risky. After World War II, they had a family (see photo; Yelena is on the right with her arm on granddaughter Lana’s shoulder). The United States offered freedom to pursue education for the youngest generation, allowing hope for a brighter future. Lana recalls that her grandfather wanted her to become a nurse. He said, “You go to school and bring that back to us, and when we need to navigate through the health care system, you will be ready.” The family was able to immigrate to the U.S. in 1991.
The year 2005 was marked by family tragedy with the passing of Yelena’s husband, Lana’s grandfather. He suffered an illness and when the dying process began, the family panicked and called an ambulance. He endured painful procedures and died in a hospital. The family was stunned by the experience. They knew they wanted something different when their grandmother faced end of life.
Over the next 10 years, Grandmother Yelena dealt with increasing dementia. She moved into Lana’s parents’ home when her memory began lapsing. The time came when she needed 24-hour care. Her children pulled together and cared for her while they continued to work. Yelena’s mind continued to fail and her body became weaker. She became easily confused, frightened of change and would cry out frequently. She enjoyed the comfort of being surrounded by her family.
In December 2015, Yelena suffered a massive stroke and was hospitalized. After the family’s previous experience with machines and tubing, noise and bright lights in the hospital, they knew the time had come to make important decisions. The family was ready this time. They found the value of comfort care, and with Lana’s help, they were able to understand that standard treatment options were only prolonging a painful and frightening death, and were not truly supportive of what they knew to be the wishes of their dear mother and grandmother. They advocated for palliative medicine and hospice care. They knew their grandmother did not want to endure what their grandfather had in his final days. Yelena was transferred to Franciscan Hospice House and her pain and symptoms were well managed. Her family had a caring team to support them, helping them to understand what was happening each step of the way, helping them to feel prepared.
Yelena died peacefully, surrounded by her loving family.