New Van Delivers Information About End Of Life Care To South Monterey County

Dec 16, 2019

Since the 1950s, the Visiting Nurse Association has delivered hospice and home health care directly to patient’s homes across the Central Coast. Now, the nonprofit has a new Latino Mobile Resource Center. It’s a van on a mission to inform Latino families in South Monterey County about end of life care. 

The hospice office for the VNA is located in Salinas. VNA staff stop by here in the morning and then head out to provide hospice, palliative and home health care directly to patients' homes.
Credit Erika Mahoney

The hospice office for the Visiting Nurse Association, or VNA for short, is located in the heart of Salinas. A yucca tree hangs over its tile roof. Inside, it’s quiet. Staff stop by in the morning, check their schedules and head out to provide hospice, palliative or home health care.

“That's why the office is always empty, because everybody, all the staff is out and about making those visits,” said Elizabeth Birruete. 

Elizabeth Birruete is the Latino Outreach Coordinator. Her job is to deliver information about end of life decisions and care to the local Spanish speaking community.

Colorful Van Hits The Road

She has a new tool, a colorful van. It was recently transformed into a Latino Mobile Resource Center. The van is decorated with a colorful mural that illustrates a nurse standing in a field of calla lilies.

Birruete says getting this van has been a long process. Funding from the Hospice Giving Foundation helped make it possible.

Inside the van, a built-in shelf holds flyers and brochures about end of life services. Everything is in English and Spanish. 

The van is full of flyers and brochures about local end of life services. The Juntos con Esperanza partnership allows Birruete to carry materials from several nonprofits, such as the Alliance on Aging.
Credit Erika Mahoney

“We try to really give the community the tools that they need to be prepared for, you know, when we get to that time in life, which we all are going to be there sooner or later,” Birruete said. 

The VNA launched the van in November as part of the nonprofit’s Juntos con Esperanza, or Together with Hope, partnership. It’s a collaboration of nonprofits that serves the senior population. 

The VNA launched the van in November as part of its Juntos con Esperanza (Together with Hope) partnership. Juntos con Esperanza is a collaboration of nonprofits working to expand end of life care in South County.
Credit Erika Mahoney

Since early November, Birruete has been driving to apartment complexes, resource fairs, to an agricultural company in Moss Landing where 300 people listened in. 

This community, like many others, is one that Birruete says doesn’t tend to talk about death.

“We really just want to promote the dialogue of end of life and that it's okay to talk about it,” Birruete said. 

And promote planning ahead. The target area is South Monterey County, where most residents speak Spanish. Birruete says many in this area feel isolated; for some, doctors are an hour away. 

Ruiz Family Plans Ahead

The Ruiz family lives in the City of Gonzales and receives help from the VNA. Inside their apartment, framed pictures of weddings and family get-togethers take up the living room walls. 

Israel Ruiz uses his cane to point to a picture of his son wearing a graduation cap. Ruiz spent his life working in artichoke fields and then for a vineyard. He says it wasn’t the back-breaking work that eventually hurt him, it was bone cancer. He was diagnosed about two years ago. 

“I think when I was in the hospital, I, you know, I was... I had to say I was lost,” Ruiz said on an overcast Tuesday in December. 

Ruiz got a referral for palliative care through the VNA. Registered nurse Desiree Lacayo visits every Monday. She does his labs and helps with hard conversations. 

“We also have a social worker. So Joanna is involved as well. We have spiritual care. And between all three of us, sometimes we can do visits together to talk about it more,” Lacayo said while sitting cross-legged on the living room carpet. 

Israel Ruiz (center) was diagnosed with bone cancer about two years ago. He stands with his wife Lydia Ruiz (left) and nurse Desiree Lacayo (right). Lacayo visits the family every Monday.
Credit Erika Mahoney

The team helped the Ruiz family fill out medical and legal documents that assign someone to make decisions if the patient is unable to and clarify what types of interventions they would want. These documents are known as advance health care directives and POLST forms (Provider Orders for Life-Sustaining Treatment). 

Ruiz says finalizing these documents was difficult for his family. He drifts between English and Spanish.

“We're Mexicans, you know, and for somebody to come up to you and tell you, ‘Oye, have you, lo que te han dicho, que te vas a morir mañana, y necesitas que arreglar papeles, tienes que hacer esto,’ okay,” Ruiz said 

“Have you been told, in case you die tomorrow, you need to get your papers in order, you have to do this and that,” he said. 

“No, no, never heard of it. Pues ellos ayudan,” Ruiz continued.  

“They help you out,” he said.  

His wife Lydia sits on the couch next to him with tears in her eyes. She says now, she knows what his wishes are. She’s grateful for the help. 

“A lot of Hispanics or Mexicans are afraid to ask for help, when there is a lot of help out there,” Lydia said. 

Nurse Desiree Lacayo sees the VNA’’s Latino Mobile Resource Center as a way to get the word out in a creative way.

“I think not everybody is savvy on the Internet, or maybe they don't have it,” she said. 

It’s back in the van for Latino Outreach Coordinator Elizabeth Birruete. She visits South Monterey County about four times a week, helping the community navigate the difficult road ahead. 

VNA Latino Outreach Coordinator Elizabeth Birruete stands in front of the new Latino Mobile Resource Center. She visits South Monterey County about four times a week, delivering information about end of life care.
Credit Erika Mahoney

Juntos con Esperanza (Together with Hope) is holding an outreach event from 7 to 8:30pm on January 31, 2020 at Holy Trinity Church in Greenfield. It’s called Let’s Talk about Your Wishes/ Hablemos de sus Deseos. The event will be in Spanish. 

The Hospice Giving Foundation is one of KAZU’s many business supporters.