In the Face of Death

Kathy had been receiving hospice care in her family home for almost a month when she had an episode that left her unconscious. She has experienced dementia since then.

Pancreatic cancer is difficult to treat. The American Cancer Society estimates that 67,400 people will be diagnosed this year, and 51,980 people will die from it. 

"It really became clear, when talking to the doctors, that she was not healthy enough to survive," Winnie said. "So she decided that she was ready to go on hospice and forgo any type of treatment." 

Kathy wasn’t the same after her episode. 

“It’s like she's there, but she's not really there,” Doris said.

 Winnie has been responsible for decisions regarding her sister and mother's care. She knew that her family needed more support, and soon, Kathy was living at Hopewell House. 

Kathy had experienced the death of a dear friend at Hopewell House. The house aims to deinstitutionalize people's end-of-life experiences by providing care and comfort in a home-like environment. 

“She made it real clear that when the time came,” Winnie said. “This is where she wanted to be.” 

Before the 20th century, Americans nearing the end of their lives would die in their homes, surrounded by family. In the 1950s, as more terminally ill patients spent their final days in hospitals rather than in their homes, American society experienced an institutional shift.

"We lost it in those years that we stopped having people die at home in parlors and started having them die in hospitals.” Claire Turner, a regular volunteer at Hopewell House, said. “The last decades have been about acknowledging and learning and coming to understand that the body knows how to die. We don't have to be afraid."

Their days at Hopewell House have allowed the sisters to be intentional with the time they have left with each other. "To address death as a natural part of life," Claire said. "We are given opportunities to celebrate a life lived while our loved ones are still alive." 

When coming back to Portland last year, Winnie had not expected to put her life in Texas on hold for so long, but she never questioned taking care of her sister. “I never want Kathy to ever feel alone,” Winnie said. 

Winnie’s husband takes care of their two elderly cats at her home in Texas. Meanwhile, Winnie manages her sister’s care and makes plans for her mother’s future care, while helping her daughter prepare for her upcoming wedding from afar. "There are a lot of unknowns at this point." 

Winnie knows that Kathy’s goodbye has been longer than most Hopewell residents. 

“I think my mind works in terms of analogies, right? We've been here a long time, and we’ve seen dozens of families come and go,” Winnie said. “It's almost like you're going on this roller coaster ride. It's up and down, up and down, and then you get to the end of the ride, everybody else is getting off, but you're going for another round."

When Kathy arrived at Hopewell House, she picked out a handmade light green and pink quilt from an array offered to all residents. She will keep the quilt with her — sometimes spread across her bed, sometimes folded neatly nearby — until she dies. 

Then, her sisters and mother will follow her out of the house in a walkout ceremony. Staff, volunteers and visitors will lay flower petals on her as she leaves Hopewell House for the last time. Volunteers will then fold the petals into the quilt before opening it up — allowing the petals to be carried away by the wind. The quilt will then be given to her family. 

"There is beauty in saying goodbye," Winnie said. "To just kind of share that grief with everybody." 

Winnie and Doris participate in as many walkouts as they can.

“You know — my secret wish was I thought when she retired, and I retired, we'd go traveling together. We could be the two old ladies going together, traveling the world, and now that’s never going to happen,” Doris said.

 “I think there's a lot in the world I don't wanna put on the back burner anymore,” Winnie said.

At Hopewell House, Winnie clears her head by walking up a short path to a bench surrounded by trees. She looks for owls in the dense green branches, thinking about Kathy's life and what will come after her death. 

Throughout her life, Kathy was an avid reader and a fan of cooking shows and magazines. She had a passion for recipes and learning about cooking, but never really cooked. "It was her thing," Winnie said.

Kathy never married or had kids of her own, but her sisters often reminisce on her tenderness as an aunt — always doting on her nieces and nephews. 

“She has two close friends,” Doris said. “They still come and visit her.” 

Mementos from Kathy's life decorate her room at Hopewell House, and she frequently wears knit hats made by her friends. A collage of notes and pictures are taped on her wall; a save-the-date for Winnie's daughter's wedding in September hangs there too. 

The windowsill is lined with family photos. A frame of Kathy, Winnie, Doris and Norma when they were young is tucked among them. 

Kathy will  be cremated and, eventually, Winnie and Doris will spread the ashes of their two older sisters along the Oregon Coast. 

“I think they would have loved that,” Winnie said. “They relied on each other.” 

Each morning, Winnie walks through the front doors with her mother and Doris. "My mom's very strong-willed, but this will definitely break her heart," Winnie said. “To lose two daughters, that's really tough.” 

She scribbles their names on a sign-in sheet filled with the signatures of other visitors. She greets staff as she walks through the sunlit corridor that leads to Kathy's room. 

Once in her room, Winnie watches cooking shows with Kathy, while remaining attentive to her needs. Doris knits beside them, always ready to help, while their mother naps on a small couch in the corner of Kathy’s room. 

 “I do want to get back to my life, but not at the expense of shortening Kathy’s,” Winnie said.

For now, Kathy spends her days tearing pages out of old cooking magazines — recipes that her sisters know she will never make.