Image of a medical professional holding an elderly man's hands.

‘A Blessed Experience’: U.P. Retreat Teaches Compassionate End-of-Life Care

Taking care of terminally ill patients requires a softer, slower approach, says a Marquette-based social worker and pastor.

“When you’re providing care to a terminally ill patient, it’s about ‘being with’ an individual as much as providing specific medical intervention,” explained Jon Magnuson, executive director, Cedar Tree Institute.

For 19 years, Magnuson and two hospice medical directors, Michael Grossman, M.D., and Larry Skendzel, M.D., have led innovative end-of-life teaching experiences in the wilds of Michigan’s Upper Peninsula. Called the Janus Project after the Roman god with two faces – one looking forward, one looking back – bi-annual retreats bring physicians, nurses, social workers, clergy, patients, family members and hospice and palliative care professionals and volunteers together.

A group of Janus Project participants embarking on a kayaking trip.

Janus Project participants bond through physical experiences such as kayaking. (Courtesy photo)

This is not your typical continuing education conference. The experience is limited to a small, intimate group by design. Instead of a hotel room, a remote cabin. Participants engage in physical activities such as hiking, tai-chi and kayaking. Everyone pitches in to make the experience work. Participants cook for one another and share in the prep and cleaning work.

Magnuson said the harsh, rugged landscape of the Upper Peninsula, along with the shared physical labor and experiences break down boundaries and encourage bonding. Intense conversation and learning happen as participants hear from patients facing end-of-life conditions or spouses who’ve survived a dying loved one. The retreats equip health care providers and others involved in end-of-life care with the tools they need to provide their patients with a positive transitional experience.

“Hospice and palliative care are frontiers of a new emerging paradigm for modern medicine,” Magnuson says.

Retreats focus on the importance of accepting mortality and navigating that part of life with dignity, courage and hope. Teachings focus on the experiences of patients and how they navigate meaning as they stand on the threshold between life and death. They also provide new strategies for dealing with emotional and physical pain.

“In this case, the patients become our teachers,” Magnuson said.

Two Janus Project participants enjoy a sunset.

Participants experience the beauty of the U.P. during Janus Project retreats focusing on end-of-life care. (Courtesy photo)

Over the years Magnuson has been involved with the retreats he’s learned that spending time with a person at the end of their life is one of the most important things you can do. Being present and breathing in the same room, even if the patient is in a coma, is a gift. At the end of their lives, many patients “move beyond medicine,” as Magnuson puts it.

“Many have found support apart from the medical providers and they are sustained by friends and family and their own faith traditions,” he said.

The work of caring for dying patients isn’t easy, but Magnuson said there can be moments of beauty and a distinct sense of purpose that comes with the work.

“It’s hard, but it is be for many people, a blessed experience,” he said.

The Janus Project was originally funded in 1999 by a Blue Cross Blue Shield of Michigan Foundation grant. Ongoing retreats continue to be designed and offered by The Cedar Tree Institute, a non-profit organization that initiates projects and provides services in the areas of mental health, religion and the environment. One-third of services are provided pro bono. For more information, visit www.cedartreeinstitute.org.

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Main image photo credit: LPETTET

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