As a physician in the Navy in the mid 1970s, I was caring for a retired gentleman who had pancreatic cancer. He really wanted to stay at home but there was no one who could provide professional help or support to his wife and sons who were trying to care for him themselves. Moreover, the hospital was the only place in which he could receive injected narcotics. Even after I went all the way up the chain of command to provide pain medication at home, his son had to drive up here two to three times a week for the medications.

That entire experience just made clear to me the need for something like hospice. When Gene Lewis invited me to join the effort and I started reading about the philosophy of care, the light went on and I realized this is what he needed.

So along with my “day” job, I began as a volunteer medical director working with the nurses – Gene, Jackie Aquino, Trudy Harris – doing what I knew needed to be done. What I felt was the right thing to do for patients.

Because we were pioneering a new philosophy of care, we had some initial difficulty convincing physicians, who maybe didn’t understand what we were trying to do or were afraid of losing control. Most of the early referrals came from nurses or from patient families who had heard about hospice as an alternative.

At first there weren’t great numbers of patients. After office hours at the end of the day, Jackie and I would meet in the hospital cafeteria to review the charts of hospice patients. The hospice movement grew until it got so big I couldn’t devote my time to both my practice and my hospice patients.

Now, it is a very important organization for the community. Whether giving time, giving money or doing things for the organization, it’s important for the community to support this organization because it’s important for the patients and families to have an organization like this.

Dr. Matthew Becker, volunteer medical director

I knew about hospice because my husband was in a nursing home toward the end of his life and he had hospice care. I had heard nothing but good things about Community Hospice.

So in March, after talking with my doctor, I contacted them. I like my independence so at first the nursing assistant came to my apartment three times a week to help me bathe. The nurse and social worker also came to check on me regularly.

I didn’t have any pain and I have been able to care for myself. But then I started feeling short of breath more often and I fell down. I really didn’t realize how sick I had become until I came to Community Hospice’s Acosta-Rua Center for Caring. They got my breathing stabilized and I felt better right away.

Everybody at the inpatient center is so nice – they immediately made me feel welcome. I don’t feel as if I’m imposing or that caring for me is just their nine-to-five job. I’ve had plenty of visitors – not just my kids and grandkids. The volunteers come by to see if I need anything and I spoke with the chaplain.

Now that I've got the care I needed, I’ll be able to go home. I feel so good I imagine saying “Lord, I’ve changed my mind. Let’s wait awhile.”

Mary Croasdell, Community Hospice patient

In the early days money was very, very tight. We didn’t have any money to rent a facility. The American Red Cross gave us a little space. Then, Dr. Day gave us a little cubicle in his office for a while. As we grew a little bit more, Dr. Max Karrer let us use a four-room suite adjacent to Memorial Hospital, and that was sheer luxury.

We finally became a United Way agency, which gave us a little money, and then Prudential gave us money. We’d almost run out of money and just at the last minute, someone would come and rescue us. Eventually, the law passed in Washington and we were able to get Medicare reimbursement for our hospice care. We grew like topsy after that!

My wife was involved with hospice first. She had been a counselor for caregivers at a naval hospital. When I retired from the Navy, I was drifting around and wanted to do something meaningful so she got me involved.

I was on the board in 1980 and president of the board in 1982. Our biggest job was trying to get a Florida hospice statute that we could live with. The law at that time was that we had to have an inpatient facility to be a hospice care provider. As we were at that time, we couldn’t exist under this law. We wanted to provide hospice in the home. And all these other hospices in Florida were just like we were—little, broke, with no place to call home. So we ended up going to Tallahassee frequently. Dottie Dorion and Lois Graessle helped us get that law changed.

My greatest reward has been the personal satisfaction to see Community Hospice grow as much as it has. It is also very rewarding to see family members after their loved one has died, and how appreciative they are for Community Hospice’s help. I stay involved by going to events and asking others to donate to the Foundation. It’s very important that we continue to raise funds so it will continue to exist.

Community Hospice is a close-knit organization. It’s a part of me. My wife was a patient and died in their program. They were perfect when caring for her.

Phaon Derr, Jr., co-founder, 1982 board member, volunteer

A handful of professional and nonprofessional volunteers who understood and believed that death could be peaceful and pain-free came together in 1979 to create a hospice for Northeast Florida.  We "Do Gooders" fought mentally, physically and spiritually every day to keep an unknown hospice concept alive.

Folks called it "Ho-Spice"; doctors thought we were trying to take their patients away.  All of us were working and on-call 24/7.  Our first year's budget was $500 with no idea where it would come from.  Beezie Towers donated and saved us from going out of business.

Our humble beginnings were a desk and chair under the stairs of the Red Cross. Then began our journey to find homes: Sam Day's exam rooms, the Wells Complex, Prudential building and beyond. Paul Brenner, the father of "our hospice," inspired us and spread the word throughout Florida.  Phaon Derr, Lois Graessle, and I took a year out of our lives to lobby in Tallahassee and change the original hospice law, which said in order to be a hospice you had to own a hospital bed. That would have put all grass roots, home care hospices out of business.  We later testified in Washington, D.C., to get hospice care into the reimbursement system.

We persevered. We should never forget these humble beginnings and truly appreciate where we are today. This celebration is a reality because of the original pioneers and the continuing generosity of donors for more than three decades. Community Hospice can be proud of the loving care and comfort given to patients and families for 30 years.

Dottie Dorion, RN, MS, 1979-1982 Community Hospice volunteer nurse, board director, legislative advocate, donor and volunteer.

During Thanksgiving with Rev. Paul Brenner in the late 1970s, I was lamenting how as a hemodialysis nurse caring for people whose kidneys were failing, it was troubling that I had no language for dying patients and no system to support them in the dying process. The patients didn’t have a way of communicating their fears and what they wanted even when they knew they were dying.

Paul and I discussed this and the need for an alternative to dying in the hospital. We had heard about a hospice program out in Marin County, California, that was inviting people to come and learn more about it. So after serving as part of the team that cared for Paul’s parishioner, I traveled to Marin County to spend a week learning about hospice and how to bring the concept to Jacksonville.

Back home, at the town meeting Paul organized, I shared what I had learned and that’s where it all started. It was a grass roots endeavor, among a tight-knit group of people who shared our feelings and supported each other.

It was challenging and sometimes sad – but also very rewarding to help people spend their last days the way they wanted. One of our earliest patients was a little boy, six years old, who had cystic fibrosis. The day we thought for sure he was going to take his last breath, he sat up and said, “Mommy, I want to go to Wal-Mart and get a Legos set.” So we hooked up the portable oxygen, loaded up a wagon and went to Wal-Mart. I don’t think he actually even played with the Legos – he was too sick. But he was so thrilled. Because we helped make his last moments happy and talked with him about heaven, he was so ready and unafraid because he knew where he was going. He died the next day.

And in my own experience, my mother-in-law was in a nursing home, and when we knew that she didn’t have much longer to live we brought her home with hospice help. It was wonderful. She loved coffee so we were able to put some on her lips. We were able to play her favorite songs. It was a very good experience for all of us.

That’s why I tell people, even if you never become a volunteer, you should get the training. Learning more about hospice is invaluable because the end of life is something that affects us all.

Shirley Doyle served as a founder, volunteer nurse and the first full-time director of the organization that today is Community Hospice of Northeast Florida.

There’s a long, funny-sounding name for what I have. But it just means it’s hard for me to breathe sometimes, and I get sick a lot and I have to go to the hospital. Once, right before Christmas, I was in the hospital for 27 days – I couldn’t even count that high.

I don’t really like going to the hospital – sometimes the tubes and needles hurt. I can't go to school because there are too many germs and being in the hospital makes it hard for me to learn.

But Miss Danielle and the team from Community PedsCare have been coming to see me for a while. We read, do art, and even “paint” the patio with sidewalk chalk. My mom says the games I play with Miss Danielle have helped me learn so now I know my numbers and my letters like other five-year-olds. I just like playing.

One of my favorite games is when Miss Danielle lets me dress up like a doctor so I won’t be afraid of the hospital. I like shining the light and pretending to give the shots. It’s better than getting shots.

The other thing I like about Community PedsCare is the fun places we get to go with my family. We have gone on picnics at the Diamond D Ranch and I got to play golf at The Players’ Championship where a really tall man helped me swing the golf club. My picture was in the newspaper.

I guess these events raise money to help pay for Community Pedscare services. I just like going to these events.

Samantha Fross, Community PedsCare patient

My wife, Mary, was sick for five years with breast cancer, and we never, never spoke about her death. We were optimistic to the very end. We were trying to care for her ourselves but we were struggling. Then people at my church said, “You need to call hospice.”

Right away, the Community Hospice doctor and the nurses were able to provide care and support. Her room at the inpatient center was home-like and peaceful, like a sanctuary. Mary was much more relaxed and comfortable. That gave us real peace of mind. Even my 15-year-old son could tell. He told me,“This is better for Mom.”

Mary passed away in my arms the next day. Her favorite CDs were playing and the room was filled with friends, family and pastors from our church. We truly had an extraordinary experience.

But Community Hospice’s care didn’t end there. My family benefited from the outstanding bereavement support. I attended their spouse loss support group and scheduled individual counseling. Both made a tremendous difference for me.

My son attended Community Hospice’s weekend bereavement camp, Camp Healing Powers, where he learned how to cope with his feelings among other kids who were grieving.

Not only did Community Hospice’s care make it possible for my wife to have a comfortable, peaceful death, it has helped my son and me to heal.

Tony Kronenburg, family survivor

I was a nurse and president of the board of the Visiting Nurses Association when I attended a meeting at St. John’s Episcopal Cathedral in June 1978. Rev. Paul Brenner was there discussing hospice as an alternative to care for the terminally ill. Two months later I became the first president of “Friends of Hospice,” the organization formed to further this concept in Jacksonville.

God guided us and we learned a lot of things as we went. We were fortunate to have a doctor on the team and that helped us overcome reluctance from the medical community. We were blessed to have so many good people come forward to help -- the president of Prudential donated one year of rent-free office space; others worked to get laws changed to recognize hospice. And the nurses in particular volunteered their time for no pay because they really cared about helping people.

I hope people will educate themselves to know what hospice is about and how it can help. Most people don’t know how hospice is paid for so they think they can’t afford it. But hospice can make such a difference – not just because it manages the pain and symptoms and keeps the patient comfortable – but because hospice makes it possible for the patients to review their life and how they lived and not have any regrets so they are able to have a peaceful death.

Gene Lewis, founder, Community Hospice board member, volunteer and donor.

On a professional level, I first became involved with Community Hospice about 12 years ago when I was chief operating officer with Baptist/St. Vincent. Community Hospice approached us about working together in providing hospice care to hospital patients, and it made a lot of sense. It has been a very productive partnership and a useful response to a community need.

From my own personal experience – having lost a child without the support of hospice – I know what a painful and difficult situation the end of life can be. So when I encountered this well-run organization that is so skilled in providing comprehensive end-of-life care and support and extending its services to all populations – adults, children, veterans – I wanted to be involved and contribute my service.

One of the most remarkable things about this organization is how the community supports it, especially through its board of trustees. I think it says a lot that every major local healthcare provider has been represented on this board, and the trustees are very collaborative and devoted to Community Hospice’s mission and success.

The result is a responsive, innovative hospice program that meets the needs of its community, whether they have a need for inpatient hospice care, grief counseling, children’s bereavement camp or any other similar services.

John "Jack" Logue, donor and board member of both Community Hospice of Northeast Florida and Community Hospice Foundation.

I first got involved with Community Hospice when I attended a lecture given to our residents by Dr. Paul Borgman, an associate medical director of Community Hospice. He is a dynamic speaker, and he stressed the importance of emergency department physicians and staff to consider the needs of patients who are in their last chapter of life.

After that encounter, I was recruited to take part in the organization's Emergency Department (ED) focused care program. This program is a collaboration between Community Hospice and the University of Florida-Shands Jacksonville, where patients who’ve come to the ED with end-of-life illnesses will get care to meet all their needs—mind, body and spirit.

Specifically, Community Hospice nurses work with us to train our medical residents on how to communicate end-of-life “news” to our patients and their families. When we tell family members that their loved one has a limited time to live or has died, they will remember every single word we say for months, perhaps years. So it’s extremely important for us to communicate very clearly and in a professional manner. With help from Community Hospice, we are taught how to do just that. And if we’re able to communicate well with the family, it helps them during the grieving process.

Our population is aging. During the next 20 to 30 years, we’re going to see baby boomer patients who may have a lot of chronic illnesses and need to make decisions concerning the end-of-life. Many of these decisions will have to made in the ED. Therefore, our residents and attending physicians will need to clearly describe the services that a hospice provider can offer.

Physicians have often thought of hospice as the time to give up. But, it's not that at all. Actually, when we give patients access to Community Hospice care, many of them do not return to the ED because they have so many more resources. We know that they’re getting much better care now than we could have offered them in the ED before this program.

Dr. Mark McIntosh, clinical assistant professor, UF-Shands Jacksonville Department of Emergency Medicine, lead physician liaison for Community Hospice's Emergency Department (ED) focused care program.

About eight years ago, a good friend of mine, who had lost her daughter, asked me to join the Community Hospice board of directors.

Through that experience, I’ve learned more about the wonderful things that Community Hospice does—not only by providing compassionate end-of-life care in people's homes but through their four inpatient care centers. Many friends tell me about the good experience and wonderful care they've had at these centers.

I also learned about their specialized services like Community PedsCare, the pediatric palliative and hospice program that cares for children with life-threatening conditions.

This is one program not covered by insurance. So when my friend said we need to do something to raise money for Community PedsCare, I said let’s just each call a few people and see what we can do.

That’s how Halloween Doors & More got started. You just need energetic, smart people in the community who are willing to work to make a difference.

There will always be the end of life. We’re very lucky to have Community Hospice—with its dedicated inpatient care centers and its specialized programs—as a unique community resource.

Marcia Morales has served on the board of directors for both Community Hospice and Community Hospice Foundation.  She was instrumental in the launch of the annual Halloween Doors & More gala, which to date has raised more than $1.2 million in support of Community PedsCare.

There's a common bond that I share with my fellow employees of Community Hospice.  We believe in our mission.  We truly strive to improve the quality of life for patients and families with advanced illnesses.  It's not just words.  I know that it's true because I have experienced our care, too.

Like me, my mother worked for Community Hospice for many years. She was an administrative assistant in the nursing department. More than 20 years ago, she helped me get my job at Community Hospice. She was also a patient who was cared for in one of our inpatient centers. It was the best decision our family ever made. Once she was admitted to our care, it was the first time I had seen her peaceful in months.  The care provided and the love shown to my mom, to me and my whole family was extraordinary.  Before and after her death.

As a bereavement coordinator, I see firsthand that same kind of care for our family survivors.  They come to us for grief counseling sometimes distraught and in a lot of emotional pain.  They feel alone.  After just a few sessions, I can actually see a difference—in their face, their whole body.  They learn the skills that they need to cope, realize that they're not alone, and begin to heal.

How wonderful that we have made a difference for so many people throughout the years.  I'm grateful to Community Hospice for being here for our community, for me and my family.

Marci Moss, 20-year Community Hospice employee

For me, becoming involved with Community Hospice at the beginning was God’s will. Before I became a physician, my early experiences with a friend and his wife during her last days enlightened me about hospice care. It was a moving experience to see loved ones care for someone in their home, and I believed everyone deserved that same attentive, compassionate care.

So in 1977, when my pastor Paul Brenner took a fellow parishioner who was dying into his home and asked me—a resident physician at the time—with Shirley Doyle and Sue Meehan—volunteer nurses—to provide care to her, I knew what that meant, and I was eager to help.

Little did I know then that I would come to rely on Community Hospice for the loving care of both my dear mother-in-law and mother. Both received care in their homes as well as at the Earl B. Hadlow Center for Caring, one of four Community Hospice inpatient centers.

I’m proud to have played a part in the founding of such a valuable community asset that continues to provide excellent end-of-life care for us all. For these reasons and many more, my family and I will continue to support Community Hospice.

Since the first “Friends of Hospice” meeting in 1978, Dr. Frederick Schert has passionately given in support of Community Hospice. He is a past board member, fundraiser, donor and referring physician.

When my young niece was terminally ill, my family turned to Community Hospice. They made such a difference in her life and in my family’s life. Now, I’m giving back and letting people know about the excellent care that they provide.

I love getting to know patients, caregivers and their families. I read to them, listen to their stories or play cards with them. Sometimes, I’ll give a hand massage at the end of the visit. As one patient’s husband said to me, “She loves when you come to see her because she enjoys talking to you and it relaxes her. When you leave, she’s ready for a good nap.”

Volunteering is so rewarding—I get so much more out of it than I give. I tell people there are lots of other ways to give their time, too. For instance, there is Camp Healing Powers, Community Hospice’s weekend grief camp where children get to spend time with other children who have experienced similar losses. They receive specialized bereavement support from mental health professionals who lead camp activities that help them express their feelings. It’s wonderful to witness a weight that’s been lifted from children as they begin to heal.

Whether spending time with patients, helping with Camp Healing Powers or assisting at a Community Hospice event, I have found it is always time well spent.

Ellen Vargas, six-year volunteer in St. Augustine

As a chaplain for Community Hospice, I am privileged to walk on, what I believe to be, sacred ground when I visit our patients. I’m welcomed into their “inner circle” to help reassure and put them at ease. Dealing with the unknown is always scary—for patients and their family members. Spiritual concerns can surface during life’s transitions. It’s natural to question the meaning of our circumstances, or for patients to ask, “Why me? Has my life made a difference? Can I be at peace with my memories and my loved ones?” My role is to help them work through these questions in their own way and time so they can reach a new sense of meaning, purpose and wholeness. I’m there to listen, to comfort.

We all are spiritual beings with a need to understand ourselves in relation to the larger world and to appreciate the meaning of life. I’m not there to take the place of their pastor. I am there to help and to be an asset to clergy of all faiths. The specialized training that all Community Hospice chaplains receive qualifies us for providing this much needed, end-of-life spiritual care. Regardless of your beliefs or non-beliefs, we walk the journey with you and your loved ones.

It’s an honor to make a difference in someone’s life. I am blessed to work side by side with the many other dedicated Community Hospice employees who believe this as well.

James “Pop” Williams, Jr., Community Hospice chaplain

I was pastor of Grace Lutheran Church in Riverside from 1966 to 1984. In 1977, we had a long-time, elderly member of the church named Ora, who was dying. She didn't have any family here or anywhere to go except the hospital and she didn’t want to stay there. So I moved her into my home and persuaded some people from my church to help care for her.

The hospice concept was still in its infancy so we (Dr. Frederick Schert, and nurses Shirley Doyle and Sue Meehan) were unprepared by any formal training to truly deal with what people at the end of life are going through. We had to learn by the seat of our pants. What we did know was that we wanted to give her – and other dying people -- some control over their life when it came to their death.

That experience helped all of us realize that something needed to be done about end-of-life care options, and we continued to talk and learn about hospice after Ora died. By the beginning of the next year, I actually sat down and began making lists of what needed to be done

From the start, the organization that became Community Hospice was blessed to have the guidance and contributions of many creative and generous people. At the first organizational meeting at St. John’s Episcopal Church we assembled a board of directors from the community who were able to see what could be done.

As an all-volunteer organization, we managed to survive because some person or some group of people would come through just when we needed something. We used to run things out of my house until we were given a wall plug and a chair in the hallway of the Red Cross building as our first “office."

We paid our expenses through donations, fundraisers and formal grants. When we realized that the financial stability of the organization depended on reimbursement, a group of us worked to help structure hospice as a Medicare benefit, including crafting and rewriting laws.

Because we were pioneering this new concept, there wasn’t the paperwork or the job descriptions you have today. We all did a little bit of everything, which was wonderful because we all learned so much. We took turns carrying beepers. We had to make our own forms. And we did things hospice workers today aren’t allowed to do.

But even though the organization and the hospice philosophy behind it have come a long way from where we began, the basic premise is the same. When people are dying they often feel cut off from the community at the very time they need the community the most. But they know that hospice people will be there to care for them.

Many talented individuals worked tirelessly to help us develop and launch Community Hospice’s 30th anniversary online gallery and 2009 Community Report. We appreciate their creative expertise and thank them for their dedicated help.

Suzanne Hendrix, Suzanne Hendrix Design
Ingrid Damiani, Ingrid Damiani Photography
Keith Storm, Computer Solutions of SC
David Smith, The Hartley Press, Inc.

Thank you to our founders and friends who contributed to this project and told their touching “Why” stories.

Dr. Matthew Becker, Paul Brenner, Mary Croasdell, Phaon Derr, Jr., Dottie Dorion, Shirley Doyle, Samantha Fross, Tony Kronenburg, Gene Lewis, John “Jack” Logue, Dr. Mark McIntosh, Marcia Morales, Marci Moss, Dr. Frederick Schert, Ellen Vargas, James “Pop” Williams, Jr.

To our community of patients, families, volunteers, employees, healthcare professionals and donors, thank you for making it possible for us to help families live better with advanced illness.