AMHERST — Before the 1980s, terminally ill patients in the Pioneer Valley had little opportunity for homecare and regular visits from nurses and social workers.
That all changed when Joan Keochakian, the founder of hospice services in the region, helped initiate a process for dying that could be healing for both patients as well as their families.
“It took people like Joan to bring up the subject of making dying better for people,” says Bob Woolrich, who worked with Keochakian for more than 20 years, first meeting her when he was CEO at Western Massachusetts Hospital in Westfield and sought inpatient hospice services for patients.
Woolrich said Keochakian, who died of heart failure at 84 on Aug. 7 and received support from hospice nurses in her final days, was a national leader.
“The whole movement of hospice in western Massachusetts is a product of what she did in her early days,” Woolrich said. “It was very effective and very much needed.”
Keochakian was inspired by the hospice death with dignity movement, completing a 10-day intensive session with Elisabeth Kübler-Ross, a Swiss-American psychiatrist, before coordinating the Amherst Hospice Group in 1978.
As the founding executive director of the Hampshire County Hospice from 1980 to 1997, Keochakian was instrumental in changing the hospice program from a volunteer one to a professional organization that each year would serve around 130 patients and their families. The idea was to have people live fully to the end of their lives and to give their families support and guidance throughout.
Mary Fago, a clinical director for hospice and a nurse practitioner, said that healthcare in Hampshire County and beyond is better because of the work Keochakian did.
“I’m incredibly fond of Joan. I think she was a visionary,” Fago said. “In my view, she changed the end-of-life care in the Pioneer Valley.”
Fago first met Keochakian after leaving the school of public health at the University of Massachusetts. She was then hired to focus on enlarging access to end-of-life care and enlisting as many physicians and healthcare providers as possible.
Hospice developed so nurses, social workers, spiritual counselors and volunteers could be there to talk to patients and work with families.
“It’s an incredible piece of care to offer,” Fago said.
In 1996, the movement Keochakian founded merged with the Visiting Nurses Association. The organization later became programs operated by Cooley Dickinson Hospital.
Woolrich, later the founding executive director at Applewood Retirement Community, turned to hospice as a way to make sure residents wouldn’t have to leave for nursing homes if they became sick. All who wanted to were able to stay in and die in their own homes there, he said.
After years of focus on the hospice homecare, Keochakim turned to what could be done for inpatients, founding and serving as first president and executive director of the Hospice of the Fisher Home in North Amherst, where the residents came in November 2006.
That same year, she was honored by the Massachusetts Commission on the Status of Women with a Massachusetts Unsung Heroines Award, and in 2007 she was a recipient of the Paul Harris Fellow Award presented by the Rotary Foundation of Rotary International.
Keochakian also understood the need for hospice care for people who were dying from AIDS and in 1986, at the height of the HIV and AIDS crisis, she developed what became known as AIDS CARE/Hampshire County.
It was another five years before this consortium was funded by a grant she wrote and received from the Ryan White Foundation, This federal aid paid for both health care and support services that could be offered to people living with those illnesses. In its first eight months, the organization worked with 32 clients, eight of whom died.
“Without Joan, we wouldn’t have had AIDS services in Hampshire County. Period,” said Reed Ide, first director of AIDS/CARE Hampshire County
Services in this consortium ranged from hospital beds that were provided at Linda Manor and the Veterans Administration Hospital, social and medical services, case management and a counseling center. Ide said the gay population needed socialization and support groups, and there also was a need to give rides to people and make sure they had access to food.
Keochakian’s commitment to issues that affected the gay population 30 years ago was remarkable, Ide said.
“It was the first time that gays and lesbians worked in hospice in an ‘out’ way,” Ide said. Today, that organization is known as A Positive Place and is run by Cooley Dickinson.
Woolrich said Keochakian was a natural leader who made those around her better.
“She found other people, and helped other people, to become the great nurses they are. She just had tremendous understanding.” Woolrich said.
Her legacy will be the continuing importance of hospice work.
“Joan made it so natural and a part of what’s being done for care for people at the end of their lives,” Woolrich said.
Scott Merzbach can be reached at smerzbach@gazettenet.com.
