Physicians Believe Educating Patients on Hospice Services is Key to Quality of Life During End Stages

Physicians are taught to save lives. But when a patient has a terminal diagnosis, that is not always possible.

“Doctors do not like to come to terms with what can be viewed as their own failures,” said Sandpoint physician Tim Bonine. “But when a cure isn’t possible, we need to redefine success. We need to do what we can to keep our patients comfortable and help them reach their goals - whether it is a trip to the Grand Canyon or spending one last summer with their grandkids.”

And when that time comes, Bonine and other Sandpoint physicians turn to Bonner Community Hospice, a department of Bonner General Hospital.

“I am a big proponent of Hospice,” said Bonine.

Debra Kellerman, Executive Director of Bonner Community Hospice, says that people don’t make the decision to come to Hospice in a vacuum.

“Physicians play a significant role in encouraging eligible patients to consider hospice care,” said Kellerman. “Coming to the realization that curative care can no longer benefit a patient, brings the physician and the patient face-to-face with death. Helping patients understand the benefits of hospice care can help shift a patient’s focus to a more realistic situation and allow a patient to fully participate in their end of life care and decision-making.”

But according to Dr. Steven Puffer, medical director for Bonner Community Hospice, it has only been in the last 20 years that the American medical system has begun to educate doctors on palliative care.

“We still have the mindset of always looking at treatment options,” said Puffer. “But at least now (medical students) are doing rotations with hospice care.”

Sandpoint physician Dan Meulenberg says patients are not always receptive to hearing about Hospice; and he attributes that in large part due to the misconception people have about the organization.

“Sometimes it takes two or three times to bring it up before a family is receptive to it,” said Meulenberg. “The misconception that it’s (hospice care) for the last few weeks of life is totally erroneous.”

Puffer agrees saying that terminally ill patients are often unwilling to address the issue of their death.

“But it isn’t about a choice. It’s about the trajectory of your disease,” said Puffer.

Kellerman adds that while Hospice is considered the ‘gold standard’ for end of life care, many patients enroll in hospice only in the last weeks or days of life.

“Hospice is still thought of as a place of last resort; a last-ditch, brink of death kind of care,” said Kellerman. Although families perceive the value of hospice care in the last few days of a patient’s life, earlier referrals and longer hospice stays have greater benefits to improving the patient’s remaining quality of life.

“Ideally we would serve patients for months,” said Puffer. “But patients are coming too late.”

So when is it time for a physician to talk to the patient about Hospice?

“I am guided a lot by what a patient is voicing to me,” said Bonine.

He has seen patients who are 80 years old and do not want to go through chemotherapy or radiation but instead want to make the most of what time they do have left; and there are other patients who want to fight an illness up to the very end.

“When a patient tells me they want to get the best quality of life of what time they have left that is by definition Hospice,” said Bonine.

Puffer says part of the difficulty that doctors face is that they cannot predict exactly how long a patient has to live. “From a physician’s standpoint, we don’t have the tools to predict longevity,” he said. “We have to use the art of medicine instead of the science of medicine.”

Dr. Meulenberg says that once a patient ceases treatment by a specialist, the primary care physician once again steps in to take over the patient’s care and helps manage any pain the patient has. The history the primary care doctor shares with a patient can be a big advantage.

“As a primary care doctor we are there before (the diagnosis), during treatment and at the end and we’ll be there with the family when it’s over too,” said Meulenberg. He said having that type of relationship with a patient makes it easier for him to know when the time is right to approach a patient about Hospice care. “If I have someone who I’ve taken care of for ten years, then I have a good sense of what their goals and expectations are.”

But the real key is for the physicians to educate patients on the services and benefits of Hospice. Once they understand it, patients and their caregivers find great comfort in the services provided.

“We are not looking to pull out all the stops (when a patient is referred to Hospice),” said Bonine. “We are instead trying to give the patient as much dignity and as much freedom of choice as possible.”

Puffer and the team of Hospice employees meet at least every two weeks to review each patient’s file.

“Hospice is a team approach to patient care,” said Puffer.

Dr. Bonine emphasizes the supportive role that hospice provides to the caregiver is often overlooked. Initially, said Bonine, some caregivers feel overwhelmed thinking their loved one will die at home. “But after they learn about the support that is available through hospice it often becomes the family’s preference,” he said.
Meulenberg encourages patients to utilize Hospice to the fullest extent and not wait until the final days of life. “It’s an amazing way to craft your last few months on earth. The people at Hospice are experts at helping people have a noble finish to life.”

To learn more about the services Bonner Community Hospice provides, please contact them at 208-265-1179. Bonner Community Hospice serves both Bonner and Boundary counties

Buy Bonner Campaign Set to Kick Off By Summer's End

Last March when the Sandpoint Chamber of Commerce announced the formation of a buy-local task force, the community response was impressive.

Since then, an increasing number of individuals and businesses have come together to help implement the plan to encourage residents to purchase goods and services from local businesses.

The as-yet unofficial name of the campaign is Buy Bonner. The program is set to launch at the end of the summer.

A response to a struggling economy, the Buy Bonner campaign has partnered with Spokane’s recently launched Buy Local program to promote a regional effort to support local communities.

“We have been discussing and promoting the notion of keeping money locally for quite some time,” said Amy Little, the executive director for the Sandpoint Chamber of Commerce. “Rather than re-create the wheel, we started looking at what other communities were doing and invited the Spokane Chamber to find out how they put theirs together. It was then that we found out that they have been planning on using their program to drive a regional buy-local program. We were thrilled to learn that we could partner with them.”

Kim Diercks, community development officer at Panhandle State Bank in Sandpoint, serves on the Buy Bonner task force. Diercks and her husband owned a local restaurant which recently fell victim to the struggling economy. Her personal experience, coupled with what she sees in her work in the financial industry, are reasons why Diercks feels it is critical to promote shopping locally whenever possible.

“One of the slogans of Spokane’s campaign is ‘Keep Our Neighbors Working,’ and with closing the restaurant, that strikes home,” said Diercks.

Committee members say that educating people about the ramifications of taking business away from the community is vital in its campaign.

“We know we can’t do much about the national economy, but what we can do is support each other by becoming aware of how much it costs all of us when we take our money out of our community,” said Diercks.

Little said that simply putting up signs to encourage people to purchase locally is not the answer.

“People need to understand why staying local is important,” said Little. “It doesn’t matter if it’s shopping, dining or linen service. Whatever it is, people need to see the big picture. People don’t think about where that dollar travels in the community and how much of an impact it makes. That is really the task ahead of us.”

One idea the committee has come up with to help promote Buy Bonner is to provide workshops to train businesses on how to make the transition from being competitors to working in a cooperative environment.

“We have a group called Sandpoint Transition Initiative and I think they will be working on the competitive-to- cooperative model with our community,” said Little.

Other ideas include providing a logo for businesses to display if they are participating in the campaign as well as providing a training program for participating businesses.

“We want to include any employer in our area because they create jobs, pay payroll and taxes,” said Diercks, who said any community member is welcome to join their efforts whether they own a business or not. “On our buy local committee, we have representatives from the Chamber of Commerce, Ponderay Community Development Corporation, Bonner County Economic Development Corporation and Downtown Sandpoint Business Association.”

Little agrees that it is important to seek input from as many people and businesses as possible.

“Nothing this great can be done alone. We want to gather community leaders and members who are concerned and create a program to truly benefit the entire community,” Little said. On the committee is Meadow Summers, one of the founders of the new Six Rivers Market in Sandpoint. Six Rivers is a local cooperative that brings together producers and consumers of food and products within 250 miles of Sandpoint. Summers joined the task force because she believes it is important to do what she can to support the local economy.

“Six Rivers Market is about products that are crafted and produced locally,” said Summers. “A major goal for Six Rivers Market is to encourage more local production. Although we focus on food and agricultural items, by supporting all local businesses we can help achieve our goal.”

Summers adds that while there are people in Sandpoint who will drive farther to save a few dollars, there are also many people who clearly see the benefits of shopping locally.

“(They) see through the ‘cheaper prices’ and realize shopping locally is a much more economical choice in the long run by keeping dollars local and supporting local jobs,” said Summers. As part of its campaign, the Buy Bonner committee will encourage participating businesses to offer residents a percentage or dollar amount reduction in prices for goods and services.

Diercks said education and communication will be a large part of the campaign since many people are not aware of all the items that can be purchased locally.

“We just want people to spend money consciously, rather than just assuming that a great deal online is always better, or that everything is cheaper at Costco,” said Diercks, who agrees with Summers that when you factor in gas for out-of-town shopping trips, items are not necessarily cheaper.

Little says that shopping locally will have a different meaning to different people.

“Those big-box stores are just as important to our local economy,” said Little. “Many of them are members of local business organizations, but even more important, they employ many members of our community who otherwise may be unemployed. It really is about education. People don’t always realize the impact of a dollar in our community, whether it’s from a tourist or a local or a big-box store. All of it is important.”

Pend d'Oreille Winery Celebrating 14 Years in Sandpoint

For the last 14 years Steve and Julie Meyer, owners of Sandpoint’s Pend d’Oreille Winery, have built a reputation among premier winemakers in the Northwest. But the road to success really began when a passion for adventure brought them to Europe 24 years ago.

Steve, a native of California, was attending college in Santa Cruz during the early 1980s when he met Julie Fenton in the ski club. Studying physical therapy, Steve took a break from school in 1985 to travel to Europe with two other friends. His plan was to ski the Alps while his friends hoped to work the grape harvest in France. Steve invited his friend Julie to travel with him.

“I had a one-way ticket and my skis,” said Steve. But Steve and Julie’s side adventure of picking grapes with his friends turned into a life-changing experience. The group stayed with a family in France who took them under their wing. It was then that Steve’s love of winemaking and his love story with Julie began.

In 1986 the two returned to California, where Steve attended UC Davis and San Jose State University and enrolled in classes to enhance the knowledge of winemaking he acquired in France. For six years Steve also worked at various California wineries. He and Julie married in 1988.

Realizing it would take more than being an exceptional winemaker to be successful, Steve returned to school and received an accounting degree.

“It gave me the next tool I needed to run our business,” said Steve.

He and Julie moved to her native Sandpoint in 1993 where Steve was employed with a local CPA firm. Then in 1995 the couple realized their dream when they opened Pend d’Oreille Winery. Since then the local winery has become popular for not only its wine but also its commitment to community.

This year, Fridaythrough next Sunday, the Pend d’Oreille Winery will host its 14th anniversary celebration. Marking the celebration will be the release of Pend d’Oreille Winery’s first Reserve Cabernet Sauvignon.

“It will be a winemaker signature series and well worth the wait,” said Steve.

During the weekend there also will be 20 percent off all current release wine and merchandise, live music and complimentary appetizers.

While the community will celebrate the success and the fine wine that is produced at Pend d’Oreille Winery, it will also be a celebration of Pend d’Oreille Winery’s impact on and love for the Sandpoint community.

Since it first opened, Pend d’Oreille Winery has done much to contribute to the well being of this small North Idaho community, and is known for the support it lends to the many nonprofit groups.

Last year Ponderay Rotary wanted to put on a wine-tasting event with proceeds going to a local cancer organization. Barb Perusse, a member of the Rotary, approached Steve Meyer and asked for some assistance.

“Steve jumped right in with both feet,” said Perusse. “His passion to help local organizations and contribute to the betterment of the community made the whole difference for our fundraiser. We were more successful than we ever dreamed of thanks to all of the help Steve provided. He and Julie truly care about this community.”

During the Christmas holiday season, Pend d’Oreille Winery hosts several Sip ’n’ Shop events over the course of the weeks leading up to the holidays.

“For three weeks we invite nonprofits to come into the Winery to host an evening of social fun and shopping,” said Steve. “We donate 10 percent of the proceeds back to the charity of the night. It is always so much fun to give back.”

Another way that Pend d’Oreille Winery reaches out to benefit the community is through its new Think Green Drink Red Campaign which was introduced in February. Julie Meyer became increasingly disturbed when she witnessed the glass bottles that were being set out for curbside recycling. For anyone seeking to do what it can for the environment, this would normally be the perfect answer – recycle. However, because Sandpoint does not have a market for recycled glass, all of the glass was being reintegrated into solid waste. It is then sent to a landfill in Eastern Oregon.

Eager to see what they could do to help curb the amount of glass being disposed, Steve and Julie sat down with their staff to see what ideas they could generate. The result was a 1.5 liter bottle that patrons can purchase and have refilled.

The wine being offered in the refillable bottles is the popular Bistro Rouge. But by using a generic label, Steve says they have the freedom to change the type of wine that they sell in the refillable containers.

“The program has been enthusiastically accepted by our clients who love the idea of coming into the winery to get their bottle refilled,” said Steve Meyer. “It gives us a chance to touch base with them and to return the favor by putting a delicious wine into a reusable and sustainable container. It’s a win-win idea.”

Steve attributes much of their success to not only his longtime mentors in the wine business, but also to the Sandpoint community.

“We put wine quality and commitment to the community first,” said Steve. “Without community support it would be difficult to make this business go day to day. It’s a partnership.”

Steve said his and Julie’s common vision has helped them become the success they have.

“Julie and I are partners in business and in life,” said Steve. “And we strongly believe that when you can you should give back to your community. When we give back to the community we are helping those who have supported us, allowing us to flourish and become an integral part of the community. In the end it is all about the integrity of life.”

If you go
Pend d’Oreille Winery Anniversary Party
220 Cedar Street, Sandpoint

Free tours of the winery all weekend.


Friday: 10 a.m. to 8 p.m.

Artwalk reception featuring the art of Daris Judd

Live music with Daniel Mark Faller, 5:30 to 7:30 p.m.


Saturday: 10 a.m. to 8 p.m.

Live music with Mike and Shanna Thompson, 5:30 to 7:30 p.m.


Sunday: 11 a.m. to 5 p.m.

For more information log onto www.powine.com or call (208) 265-8545

Kinderhaven to Host Open House on June 23rd

Hundreds of children have called it home over the past 13 years. More than a house, it exemplifies the true meaning of a home - a place where children can feel safe and secure. Kinderhaven has provided shelter and comfort for many abused and neglected children over the last several years and now its staff and Board of Directors are opening its doors to the public to show just what the generosity of the community has done for these kids.

“Kinderhaven offers everything a traditional home has,” said Board President Kim Diercks. “The children all gather together for meals and we have a family room where they get together to watch television or play games. But equally important, they also each have a room where they can go when they desire privacy.”

Through the years numerous individuals, businesses and organizations have donated their time, materials and talent to transform Kinderhaven into a beautiful place where children can not only survive, but also thrive and feel safe and secure doing so.

On June 23rd from 10 a.m. to 2 p.m. the public is invited to tour the home, located at 900 Spruce Street, and to visit with the staff and members of the Board of Directors.

“It’s a great opportunity for the community to learn more about our mission and our volunteer needs,” said Board member Jacinda Bokowy.

Sandpoint has come together over the last several years to wrap their arms around the children of Kinderhaven and have adopted them as their own. But because it is just like a home, with often many more children living there than in a traditional family, the expense of keeping the doors open is costly.

“Unlike so many of the other non-profit organizations, our doors are open 24 hours a day 7 days a week 365 days a year,” said Diercks. “And with the cost of living going up all around us, so does the cost of keeping our doors open. It makes it increasingly difficult to continue to make a difference in the lives of these children.”

But Diercks said the community has always pulled together for the good of the children and she and her board continue to be amazed at the generosity of the people living here.

“We are truly blessed here at Kinderhaven,” said Diercks.

Come to Kinderhaven on June 23rd, tour the home and meet those who are involved with this incredible organization.

For more information, call Kinderhaven at 208-265-2236. If you would like to make a tax deductible donation please mail it to Kinderhaven, P.O. Box 2097, Sandpoint, ID 83864.

Community Cancer Services Offers Extensive Services for Cancer Patients and Their Families

When Debra Rawuka was diagnosed with breast cancer in February last year, she worried about many things, but most of all she was concerned about her kids.

“I was really worried about how they were going to take it,” said Rawuka of her two daughters, 11 and 12 years old.

But thanks to Community Cancer Services, Rawuka found help for not only herself but also her children.

“I had read about Community Cancer Services before,” said Rawuka. “Then I read it and thought ‘that’s me now!’”

After being diagnosed, Rawuka visited Community Cancer Services and found that there were many services available including a women’s support group for her, a children’s support group for her children and local prosthetic fittings for post mastectomy women so they don’t have to travel to Coeur d’Alene or beyond.

“Because this is such a little town, it was really surprising how many services there were available,” said Rawuka.

She said one of her daughters was initially reluctant to attend the children’s support group, but after she went she really enjoyed it.

“I think it helped them to realize it happens to other people too,” said Rawuka.

Community Cancer Services relies upon donations from the community to keep its doors open and to be able to continue to serve cancer patients in the community. But with the declining economy have also come fewer donations.

“It is difficult because everyone is struggling to make ends meet,” said CCS Board President Stefanie Nostdahl. “But imagine also being diagnosed with cancer. It is these people who desperately need help and we need to do what we can to assist them.”

Some of the many services provided by Community Cancer Services include gas vouchers to help with transportation to and from treatments and medical appointments, prescription assistance, support groups for men, women, caregivers and children, a lending library and yoga classes.

Now on the road to recovery, Rawuka said she is so thankful for the support she received from Community Cancer Services. She continues to attend support groups and has found she has already been able to help other women who are on the same path she was just over a year ago.

“It is nice to get together with other people that were in the same boat I am,” said Rawuka. “And it’s also nice to be able to help other people too.”

Community Cancer Services is located at 1215 Michigan Street, Suite B in the Westside Center. Please call 255-2301 to learn more about their services or how you can volunteer. If you would like to make a tax deductible donation, please mail it to the address above and a receipt will be mailed to you.