Tsering Sangpo, HHA

February 2011

Akiyli Tiger, one of Mission Hospice & Home Care’s four home health aides (HHAs), remembers the first time she saw a patient die. “That was when reality hit,” she recalled. “I told a nurse then that I couldn’t do hospice work, but she told me that that’s what would make me good – that I cared enough to be upset.”

Although Tiger only joined Mission Hospice in October, the former emergency medical technician (EMT) has been working in hospice programs for the past eight years. She joins a loyal group of longtime Mission Hospice HHAs: Olga Donis, who joined in 2002; Tsering Dolma, 2005; and Cris Pratt, 2007.

HHAs help patients with personal care such as bathing, walking, feeding and oral hygiene. Sometimes, they will also provide light housekeeping and meal preparation. They typically spend about an hour with each patient and see three to five patients a day. The four women all said it is satisfying work because these are often services that give patients a lot of comfort.

“I had a patient this morning who was so grateful just to be bathed,” said Donis.

For some caregivers, assisting with personal hygiene is either uncomfortable, or because of their own physical limitations, impossible. “Providing personal care is one of the simplest ways that we can help restore comfort and dignity to our patients, and also support their families,” said Barbara Feduska, director of patient services and supervisor of the four HHAs.

Pratt added that sometimes the most important service is just being there. “I’ve had patients who were in pain and very weak, and they just wanted me to sit beside them and hold their hands,” she said. “Sometimes, the best thing I can do is keep them company.”

Often, their work consists of hard physical labor. Donis says she goes to a gym to keep in shape, but the aides also rely on the body mechanics they learned during their training. California requires HHAs to have 120 hours of training and certified nursing assistant credentials.

Although the women seldom see each other during the workday, they keep in touch with each other and the rest of the hospice care team. Each also comes from a different ethnic background, which has proven invaluable in serving Mission Hospice’s diverse patient population. Tiger, who is African American, says she may call Donis, who hails from Guatemala, for advice on dealing with an Hispanic patient. Dolma was born in India but is of Tibetan descent, and Pratt is a Filipina.

All of the women say the most difficult part of their job is caring for younger patients, especially patients who have children at home. “We had one patient who was only 23 years old,” said Pratt. “It’s emotional because you can’t stop them from dying.”

“And some people are just very brave,” said Tiger. “You draw your strength from that.”

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