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Community Builder: No unfinished business

Editor’s note: Community Builder is a periodic Q & A series providing perspectives from local people who have been involved in significant change in Southern Oregon. Today’s conversation is with Susan Hearn, of Southern Oregon Friends of Hospice.

Q: You recently retired as executive director of Southern Oregon Friends of Hospice. Describe the work of hospice.

Susan: Hospice provides all-encompassing care for individuals who are dying. Hospice treats their symptoms and keeps them comfortable, but also provides mental stimulation and emotional and spiritual support. Their family also receives support. We strive for a life lived to the fullest, so the last days are as positive as they can be.

Q: Celia’s House is a local residential hospice house. What part does it play in hospice care?

Susan: A visiting hospice program provides the nurse, the social worker and the chaplain during regular visits to the patient’s home under the direction of a trained physician. Typical hospice care in a home relies on caregivers, who are most often family members. Family caregivers might have to work, or they might be elderly themselves. Many hospice patients live alone. Sometimes, care in their home is not a safe or practical option. So, Celia’s House embraces the hospice philosophy of care in a beautiful home-like atmosphere. Families can visit, so they can just be the daughter, the husband or the parent. They don’t have to take on the added stress as a care provider.

Q: How has palliative care changed in the past 30 years?

Susan: Like much of modern medicine; new treatments in palliative care evolved in the last 30 years. To palliate is to relieve from suffering. Palliative care doctors are trained in pain and symptom management. A palliative doctor, nurse, social worker and chaplain focus on relieving physical, emotional and spiritual suffering. Hospice is really palliative care in the last few months of life. Caregivers are taught to look for nonmedical causes of discomfort and anxiety. Having loved ones nearby providing a listening ear and human touch relieves stress. People live longer and better with good symptom management.

Q: You’ve spent most of your professional life supporting people and families in end-of-life care. Why is that important to you?

Susan: My love for elders is based on my relationships with four loving grandparents. Helping people have meaningful conversations is very rewarding. As a young person I was interested in medicine and caring for people. Working with the AIDS population in the late ’80s in the L.A. area, I became familiar with the hospice model of caring for the whole person as opposed to specifically being disease-oriented. Treating the whole person really appealed to me. My first job in the region was at Rogue Valley Medical Center, where I worked for home health as the community liaison. Through those positions I helped start the hospice program in 1993.

Q: You’ve helped bring seminars about end-of-life to the region. How was that received?

Susan: There’s an enthusiastic audience for conversations about death and dying. I worked on the COHO (Choosing Options, Honoring Options) project, which fosters conversations about death and dying. The seminar audiences were very large. The hope is to talk about what matters most: to say, “thank you,” “I love you” or “I forgive you.” If you recognize and talk about end-of-life wishes in advance, your time can be less about medical treatment and more focused on what brings joy.

Q: Was there an event that moved you to focus on end-of-life care?

Susan: I worked briefly for GlaxoSmithKline. GSK wanted me to spend a day with a pulmonologist to see what infections their new antibiotic might treat. I witnessed a hospital admission of an older gentleman who had end-stage lung disease and a pneumonia that resulted in him being intubated and put on life support. I asked the doctor if he ever talked to his patients about the POLST (Physician Orders for Life-Sustaining Treatment) form or end-of-life care. The doctor admitted he rarely had enough time to talk to his patients about their end-of-life wishes. I realized that this conversation and counseling couldn’t be entirely the doctor’s responsibility.

Q: What was next in your journey?

Susan: I stayed home with our young children for several years and then supported Ashland Community Hospital’s marketing and community education for six years. In 2009, I went back to college and got a master’s in management with an aging services certificate at Southern Oregon University. My master’s thesis was integrating palliative care with social workers, nurses and doctors to support conversations with family about end-of-life wishes. I interviewed dozens of ER, internal medicine and family practice doctors. Those interviews identified a need that resulted in a Cambia Health Foundation grant that funded COHO for six years. We integrated palliative care in the internal medicine office at Providence Medical Group. Patients and doctors really appreciated the program. Patients had meaningful conversations with their family so they would know and agree with the care mom wanted at the end of her life.

Q: What does it mean to have a good death?

Susan: Just as every birth is unique and different, so too is every death. Recently, we cared for a Holocaust survivor at Celia’s House. She was a lovely woman with a devoted daughter. She was in a beautiful room with open French doors that looked out over the Rogue Valley. The sun was shining on her face. Her daughter stroked her hair and sang to her while her dear friend rubbed her feet. There are many, many beautiful end-of-life stories. For me, music and nature are key with hands-on loved ones nearby. It’s peaceful. There is a sense that there’s no unfinished business; what needs to be said has been said. Having seen many deaths, it’s not something I fear. I trust hospice providers’ expertise and the process, the natural process of dying.

Q: How did you end up in Southern Oregon?

Susan: I’m an Oregon girl. I was raised in Portland. After graduating from University of Oregon, I went backpacking in Europe and met my future husband, who’s from Southern California. Chris visited Ashland as a kid because his parents, who were both professors, loved the Shakespeare Festival. Chris worked for a law firm in L.A. Oregon was tugging at me, and I convinced him to take the Oregon Bar. Four years later, we were ready to start a family, and I really didn’t want to raise children in Southern California. So, in 1992, Chris interviewed and accepted a job at the Ashland law firm where he has been a partner for 28 years.

Q: Who is an inspiration to you?

Susan: I’ve had two of the greatest mentors: Carolyn Johnson and John Forsyth. Carolyn is the founding executive director for Southern Oregon Friends of Hospice and was my boss at Ashland Community Hospital. She’s quiet, but very tenacious pursuing what she believes in. She started Meals on Wheels and several other health care programs locally. Carolyn is wise, incredibly capable, insightful and has a big heart.

Dr. John Forsyth has been a long-time inspiration. I met John in 1996 when we organized a medical ethics conference with Dr. Ira Byock about end-of-life care. Together we led the COHO project for six years. After realizing the former home of Harry and Eleanor Holmes could be converted into a hospice care facility, we toured thousands through the home sharing about hospice care and the importance of a comforting setting for those at the end of their life. With Dr. Forsyth and many other inspired volunteers, the Celia’s House culture of mindful caregiving was developed.

Q: What do you love about Southern Oregon?

Susan: During the pandemic I thought, “If people can live anywhere because they’re working from home, why wouldn’t they live in Southern Oregon?” I think smaller communities allow for a greater sense of connection. City living can be hard and lonely. It’s reassuring to know the families your kids are going to school and playing soccer with. The value systems of Southern Oregonians seem to be less materialistic and more grounded in family and community. From a professional perspective, the local medical community is the right size to do something innovative like COHO or Celia’s House. And I love to hike. The trails are right out my back door.

Q: What’s clearer to you at this point in your life?

Susan: I’ve been looking for clarity about what open door to head through next. I recently spent time at our cabin at Odell Lake, just myself and the snow, to reflect and read the book “Socrates Express” given to me by John Forsyth. The book shares the wisdom of many great philosophers and focuses on how pure attention is the best way to love people. At Celia’s House we refer to it as mindful caregiving. It’s clear to me that asking questions, listening intently and creating trust are important elements of love.

Q: What’s next for you?

Susan: I have accepted a consulting position to assist the oldest hospice house in Oregon reopen using the residential care hospice model. I’m interested in health policy and continuing to develop innovative models of care that are more effective and save costs. Both COHO’s work on expanding palliative care and Celia’s House’s model could be replicated in other parts of the state and country. That’s the big next step.

Q: Why is Celia’s House special?

Susan: There are about 200 Friends of Hospice volunteers and over 1,000 donors to Celia’s House. Many foundations and the hospitals all came together to support it. Being the home of Harry and Eleanor Holmes of Harry and David and designed by the famous African American architect Paul R. Williams makes it special. A National Historic Registry application is in process. The original architectural plans are held in the Getty Museum archives. Like family birth centers that emerged in the 1980s to welcome new life, Celia’s House is a hospice center where people say goodbye. Celia’s House is a perfect example of a community-wide project that has developed into a Southern Oregon treasure.

Steve Boyarsky is a retired educator and longtime resident of the Rogue Valley. He continues to be involved in educational and youth programs.

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Susan Hearn bio

A fourth-generation Oregonian, Susan Hearn was raised in Milwaukie. She graduated from University of Oregon with a degree in marketing and communications. A life-changing European backpacking trip resulted in the chance meeting of her husband, Chris, in Switzerland.

Chris and Susan married and started their life in Santa Monica, California. They moved to Ashland in 1992, where they have enjoyed being active in the community while raising their three children (Annika, Joseph and Ava). Personal joys include hiking in the woods with their three Icelandic sheepdogs, traveling the world, singing and cooking for family.

A love of seniors, local history and a passion for hospice have influenced Susan’s 28-year career in Southern Oregon. Susan recently retired as executive director of Southern Oregon Friends of Hospice and Celia’s House. In 2011, Susan earned a master’s in management with a certificate in aging services from Southern Oregon University, receiving the Guanajuato Most Outstanding Graduate Student Award.

Susan has volunteered for numerous clubs and nonprofit boards including PTA, soccer and football clubs, and Ashland Family YMCA board. Host mom to several Rotary International Exchange students, Susan currently serves as the scholarship chair for Ashland Rotary Foundation.

Susan Hearn at Lithia Park in Ashland. Andy Atkinson / Mail Tribune