From the Rocky Mountain News February 20, 2001 by Rebecca Jones, News Staff Writer.

Freeing spirits

Anam Chara focuses on making death a calm passage

Boulder – Ninety-three-year-old Winnie Kline lay in her bed, immobile and silent, save for an occasional fidget of her hands. Next to her bed a tape played softly, a soothing voice whose words were aimed at the old woman's fleeting consciousness.

“You are going home,” the voice on the tape said, “You are letting go of these denser energies of the Earth plane as you move up to the light about you, to your soul, to the oneness with all that is. Call the light. Move into it. Feel our energy lifting you. Feel the soul light touching you. You have come here often in your dreams. You know the way. You are not alone as you make this journey.”

For weeks, Winnie's tough old bull of a spirit had been struggling to remain in the land of the living. Several times, just when her caregivers thought she couldn't possibly last much longer, she'd fight back, emerge from her coma and demand a trip to the Jacuzzi and her favorite drink, three tablespoons of lemon juice in hot water.

But this time, it seemed different. The fight was slowly leaving Winnie. Her friends, family and caregivers at Anam Chara, a holistic personal care facility where she'd lived since March 1999, were preparing to help Winnie through her “death passage,” to reassure her it was OK to let go and move on. One by one, they came to her bedside, keeping nearly a round-the-clock vigil, reading her favorite stories and prayers to her, saying their goodbyes, easing her into the next world.

For Anam Chara founder Peggy Quinn, Winnie's death was approximately the 40 th death passage she had assisted, both at the Boulder home, open for three years, and at the original Anam Chara home, which has been open for 13 years in Denver's Skyland neighborhood just north of City Park.

Anam Chara is an old Gaelic term meaning “soul Friend.” In ancient Celtic tradition, and anam chara was a sort of midwife who helped others through all life's major passages, including birth and death. Quinn, a former medical technologist with a background in holistic health care, was introduce to the concept in 1987, when she attended an International Conference on Healing through Illness and Death on the island of Iona in northern Scotland. That was also where she met Elisabeth Kubler-Ross, internationally renowned author of on Death and Dying and the woman who popularized the notion of the five stages of dying and loss.

With Kubler-Ross' backing, she launched the nonprofit Anam Chara Home as a place where elders could live out their last days in a homelike environment, a place where children and neighbors would feel welcome to drop in and visit, where residents could putter in the garden or the kitchen, a place where life – and death – would not take on an institutional feel. In short, she wants it to be kike it was before nursing homes and hospitals took over the roles of primary caretakers for frail elders.

“What we want is a fundamental paradigm shift, to emphasize what we've lost in just two generations,” Quinn says. “Once, there was a cycle of birthing and dying in the home, and aging and dying were thought of as just part of life, not pushed into institutions where people have to be afraid of them.”

So far, Anam Chara has logged one birth. A staff member gave birth in a bedroom at the Denver home. Quinn recalls one 97-year-old resident cradling the newborn moments after its birth and saying, “You've just come from where I'm going to.”

It's this sort of intergenerational passage-mixing that Quinn hopes to see spread: elders there at the birth of babies, young people sitting beside elders as they die. “This is the continuum of life in its purest form,” she says.

Quinn walked into Winnie's sunlit yellow room, noticed her fidgeting hands and headed for the oxygen pump located at the foor of the woman's bed. “Here, sweetheart,” she said, gently placing an oxygen tube in Winnie's nostrils, Then taking the older woman's hands into her own and rubbing them. “This will keep you comfortable. I love you.”

Quinn lingered a couple of moments a Winnie's bedside, stroking her hair, then sat down a few feet away. “Last night, she definitely knew I was here,” she says. “I think she certainly knows it's me here, knows my voice.”

It's hard for Quinn to see Winnie this way – Winnie, always so feisty, so stubborn. “She's definitely a Taurus,” says Quinn, recounting the older woman's legendary acts of misbehavior around the home. Winnie could be volatile, at times shouting and swinging her cane at others. It was these anger outbursts that forced her from one care facility to another during her last years. She'd moved five times before frantic family members got her into Anam Chara.

“Every time they'd say, “We can no longer care for her because she's doing this or doing that or the other thing.'” Says Winnie's daughter, Betty Payte of Golden. Anam Chara promised her a home for life, no matter how unruly or difficult she became.

“I knew we weren't going to change the anger that Winnie has, the guilt she feels,” Quinn says. “All we can do is love her through it, let her know we will be there for her.”

Quinn proceeds to tell Winnie's story: how her mother died when she was a little girl, and how her stepmother was abusive; how Winnie and her husband, Bill, moved to Colorado during World War II, and how she had to raise the children by herself while he was gone for several years working in Alaska. She tells how Bill died in 1986, and about Winnie's brief marriage to a fellow retirement home resident, who lived just eight months after the Wedding. She tells about Winnie's heartbreak at the death of her son in 1997.

Quinn knows Winnie's story by heart. She knows the stories of all the residents – eight in Boulder, 10 in Denver. She never wants them to be just “residents”; she wants them to b e family. And Family members know each other's stories, warts and all.

“We know the reason her anger is there,” Quinn says. “That gives us a place to serve her from, a sense of compassion. Winnie's got a wonderful heart. And on the days she gets angry, well, the next day we don't treat her with any shame.”

Even when relying on volunteers and student interns to provide some of the care for residents, taking care of frail elders is expensive, and Medicaid payments -$1,400 a month – don't always cover their expenses. Private-pay patients pay $3,500 a month. Lately, Anam Chara has teetered on the edge of insolvency.

Just 10 days ago, the foundation's board of directors ousted Quinn as executive director, installing in her place a professional hospice organization, Namaste, to manage the homes until a permanent executive director is hired.

“I think, organizationally, the approach to care will be the same. There will be the same philosophy, the same vision,” says Anam Chara board Chairman James Wall. “But how Anam Chara deals with regulatory agencies, how financially the organization is run, the communication between the board and the executive director – these things will change. The essential outlook will not change.”

Up to now, Anam Chara has not limited the number of Medicaid patients it would accept. Wall says that policy is likely to end. “You'll see the ratio (of Medicaid to private pay patients) changing,” he says. “We'll see what Anam Chara can afford to do, within the parameters of various budgets, in that regard.”

Quinn, who was asked to stay on the board and continue working at the homes, is contesting her ouster.

Winnie has been surrounded by family and friends, even in her difficult times. Besides her daughter, who visits almost daily, her grand-daughter, Amy Clark, lives nearby and her great-grandchildren, Kelly, 6, and Jamie, 11, are frequent visitors. Kelly likes to play cards with her great-grandma, and Jamie is a favorite of all the residents. Winnie is also a frequent church-goer. Though raised Episcopalian, she's been attending the Baptist Church just a block away.

Having people like that, involved in an elder's life is very often positive and life-sustaining. But sometimes, Quinn acknowledges, concern for those they would leave behind keeps people fighting to live, even when death would be a release.

She believes concern about her daughter's recent health problems may be motivating Winnie to hang on.

She has watched Winnie's family members come to grips with their own emotions about her impending death. “Her daughter, Betty, has gone from saying, 'Don't go!' to, ‘It's OK to leave, Mom' ” Quinn says.

Even so, Payte has her own dilemma to deal with. She'd due to leave town for a month for a long-planned retreat with other family members in Arizona. Yet she has no idea how long her mother will linger. “My mother's middle name must be Lazarus,” Payte jokes. “She's been dying since October, but she just keeps coming back. The last time, we were certain she wouldn't make it through the night, and the next morning she was up eating corn-flakes.”

Quinn advises Payte to say her goodbyes to her mother and go on her trip. Quinn is pretty sure that as soon as Payte leaves town, Winnie will let go. “I feel comfortable with that,” Payte says, after her final visit to her mother. “And I feel like she couldn't be in a better place.”

Death came quietly to Winnie Klein on Jan. 17, shortly after Payte left town, as predicted. A three-day wake followed, throughout which Winnie's body remained in the house, in her bed, cooled by dry ice. Friends came to her room and sat next to her body, sang to her, shared their favorite memories of her. Two days later, friends gathered in the home for a memorial service. Only afterward was Winnie's body removed from the place she'd called home for the final two years of her life.

While the memorial service was going on at Anam Chara, Winnie's family members were conducting rites of their own. At her grand-daughter's house, just a mile away, the family lighted candles and shared stories of Winnie. In Arizona, Betty Payte and her sister, Nancy, held a candlelight service for their mother, with anecdotes, laughter and tears. Another family member in Hawaii, at that moment, got out a picture of Winnie, lighted candles and read from the Bible. At the same moment, a grandchild in Philadelphia lighted candles and baked a cherry pie in Winnie's honor. “We all did our own form of toasting Grandma and acknowledging her passage,” Amy Clark says.

Peggy Quinn was pleased with how Winnie's death passage went. “It was simple and beautiful,” she says. “All the mythology around death was totally dispelled, in the way we've seen happen over and over. This is the way it was done when our grandparents lost a loved one. All the grieving was done right here, in her home.”

In the past, Quinn has had to fight state officials for the right to keep the body in the home for so long. The usual procedure when someone dies is to get the body out of the home and off to the mortuary as quickly as possible. “We went through quite a long process,” Quinn says. “We went to the very top of the state health department and proved to hem this was not against the law.”

Health department regulations require that the body be properly cooled, and will not allow it to remain in the home beyond 72 hours.

Clark admits she was uncertain about Anam Chara's approach to death, but once she become convinced that her grandmother accepted it, she grew more comfortable with it. “Would that there were an Anam Chara on every fifth block, and all our parents could be in a place line Anam Chara,” she says. “The caregivers are there as students and the residents are the teachers."