The Nagel’s Family Story

Linda Nagels couldn’t have planned a more storybook ending than the one her family and the staff at McNally House still love to talk about. Linda’s story is the second in a three-part series on living, loss and learning to heal, and the special role that McNally House Hospice plays in our community.

It was late afternoon on Monday, August 22 as her family – husband Derek, two sons Jason and Craig and devoted daughter Melanie – gathered around. The sun shone down on the Niagara escarpment that day, imparting a warm, summer glow as big, puffy clouds rolled by. A stream that runs the periphery of the residential hospice in Grimsby trickled by, just steps away. A soft breeze could be felt as birds sang their ode to the season providing Linda and her family with a beautiful, comforting backdrop.

The garden outside of her room at McNally House was Linda’s favourite spot during her five month stay at the free, 24-hour facility that serves the terminally ill. She loved the outdoors and told staff that if she had her druthers she’d prefer to die outside.

With her three-year-old granddaughter’s voice in the background, the 66-year-old, who had fought a seven-year battle with ovarian cancer, got her wish, passing away peacefully held and caressed by her family just after 4 p.m.

“If you had written a book about how a person should pass away it would be her story,” says Linda’s husband Derek Nagels. “All of her family was there and Sophie’s voice trailed away on the speaker phone.”

Linda’s journey to McNally House had been a lengthy one. Knowing that her condition would progress, this open and proactive extrovert first connected with hospice staff a full year-and-a-half earlier. McNally’s partner, the Niagara West Palliative Care team, led by Dr. Denise Marshall, began visiting Linda in her Vineland home more than a year before her death to assess her physical condition and to offer counselling.

As Linda’s health worsened, members of the team would recommend various medical aids such as a walker or a wheelchair, devices that made her more comfortable at home. But her eyesight and balance deteriorated and she grew more dependent on her daughter and husband to make her way from one room to the next. Linda was growing increasingly uncomfortable so when the palliative care team paid its visit in early April of 2011, they were escorted into Linda’s bedroom. What happened next touched the family irrevocably.

“Dr. Marshall got down on her hands and knees beside my mother’s bed,” recalls Melanie, who by then had quit her job to care for her mother in the family’s Vineland condo, “She said, ‘Linda, you’ve done really well here and if you’d like a break and a rest we have a room available for you at McNally. It’s your decision, if you choose to accept it.”  “When my mom said yes, I started crying. I found that really touching that Dr. Marshall made sure she was talking directly to my mom and that my mom was the one to make the decision.”

That kind of exemplary, personalized care which highlights an interprofessional, collaborative practice is one of the reasons why Niagara West is recognized as one of the top 3 communities in Canada for palliative care. This shared care model exemplified by McNally House and the Niagara West Palliative Care Team has been held up as a gold standard within the international palliative care community.

In addition, McNally House also holds the distinction of being Ontario’s only rural teaching hospice, lending students a first-rate facility in which to hone their specialties. The hospice has provided nearly 16,000 teaching hours to students in such disciplines as medicine, nursing, personal support worker, social work, occupational therapy, medical records and for those in high school co-op programs.

“What’s unique is that it’s family-doctor run and led,” says Dr. Marshall, a Grimsby-based palliative care physician and McMaster University professor who spearheaded the community drive for a hospice “We’re very proud of the fact that it’s primary care driven. We’re there to be the second line of support. Capacity building care like this is sustainable, cost effective and it’s what people want.”

An avid gardener, who loved colour, interior decorating and jewelry, Linda and her husband moved to Vineland from Gilford, Ont. in 2006, two years after she had underwent surgery, chemotherapy and radiation. Described by Melanie as the heart of the Nagels family, Linda was a caring soul whose genuine interest and curiosity in humanity automatically drew people to her.

A music lover who adored Elvis, Motown and Leonard Cohen, Linda loved listening to the playlists her son made for her or singing along with guitarists who visited and played songs for her while at McNally House. She also enjoyed visits from therapy dogs and liked to fuss over a pet goat that one of the personal support workers brought in. These experiences allowed Linda to live her remaining days in full – enjoying the things she loved, and allowing her family to make new memories with her.   “We’d be in the worst state and she’d say something that would just lighten the mood and make us all laugh,” recalls daughter Melanie.

Melanie took the unusual step of moving in with her mother while Linda was at McNally. She slept on a pull-out couch in Linda’s room. Often, the two shared stories and many laughs late into the night or they listened to music and watched television. They made a point of getting up early to watch the wedding of Prince William and Kate Middleton. It’s these types of memories that McNally House allows families to create and cherish – living memories with their loved ones.

“When I went to the hospice it changed my whole idea of what a hospice was,” says Melanie. “It put your faith back in the healthcare system. That’s why funding and donations are so important. You really don’t know till you’ve gone through it, how important a place like McNally really is.”