Hospice Advocate Zelda Foster Has Died
MICHELE NORRIS, host:
This is ALL THINGS CONSIDERED from NPR News. I'm Michele Norris.
ROBERT SIEGEL, host:
I'm Robert Siegel and we're going to end this hour remembering two women who touched people's lives in very different ways.
Coming up we'll hear about the life of the mezzo-soprano Lorraine Hunt Lieberson. She took an unconventional path through the world of opera. First, a few minutes about a woman who helped to change the way we die.
NORRIS: Zelda Foster was an early pioneer of hospice and end of life care. She passed away yesterday. She was 71.
Here's Gregory Warner of North Country Public Radio.
GREGORY WARNER reporting:
Zelda Foster was 31 years old when she wrote the article that would seal her place in the American hospice movement. It was 1965. She was a social worker at the V.A. Hospital in Brooklyn. She described the conspiracy of silence around terminally ill patients, discouraged from learning the basic facts of their disease. Often not even told they were dying. Foster described the experience in an interview at the Story Core booth in New York City.
Ms. ZELDA FOSTER (Hospice pioneer): Patients started to tell me about terrible dreams and I found that most of them really did know what was going on but they hadn't been allowed to express it to anyone, even their loved ones.
WARNER: Foster's article caught the attention of Florence Wald, then Dean of Nursing at Yale.
Dr. FLORENCE WALD (Yale University): Truth was very important to her because she had a great respect for the individual and a feeling that health organizations were treating people as if they were children.
WARNER: This was actually a radically new idea in American hospitals. The going wisdom was to protect the patient from unpleasant truths. The new hospice movement sought to give patients more say over how they wanted to die. In 1966, Wald invited Foster and a handful of others to New Haven. The first hospice was just getting off the ground in England. At this meeting the American hospice movement was born.
Dr. WALD: What came out of that meeting was a sense of changing direction.
WARNER: Foster became the first president of the New York State Hospice Association. By 1984 she'd successfully lobbied state legislators to formalize hospice standards. That made insurance reimbursements possible. Hospice was becoming mainstream.
As a teacher at Columbia and NYU, Foster inspired young social workers to speak up for patients. One of them was Susan Gerbino. She directs the post- Master's program in Palliative Care in the NYU School of Social Work.
Dr. SUSAN GERBINO (New York University): Zelda was a social worker and we didn't have a lot of power back then. We still don't have a lot of power and somehow she found that social work voice and that's way she's so important to our profession, to the social work profession. It's hard to make a change in the medical system when you're not a physician or a nurse.
WARNER: But Zelda was a tough person to say no to. As social work director at the VA Hospital in Brooklyn in the '80s she lobbied ceaselessly for better end of life care. So much so that Jim Farsetta(ph), the hospital director would take extreme measures to avoid passing by her door.
Dr. JIM FARSETTA (Hospital Director): And I would try to walk through the basement to get to my office. But we just had a wonderful relationship and I considered Zelda to be the institutional conscience. In many respects, she was my conscience.
WARNER: He credits Foster with introducing palliative care to the Veterans Administration, now a national leader in the field. Foster's work made her own ovarian cancer no less hard but she did get prepared. That included doing an interview at Story Core in late May, one of the last real outings she took.
Ms. FOSTER: Our doctors are continuing treatment but I will at some point make a decision about whether I think the treatment is effective or not and whether I want to continue.
WARNER: Zelda Foster died on July 4th at her home in Brooklyn under care of her husband and hospice aid. Her daughter Rachel says it's fitting that her mom would die as the nation was celebrating independence.
For NPR News, I'm Gregory Warner.
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