Judy Woodruff: Tonight, we look at the importance of palliative care in rural communities from three perspectives.

Our Brief But Spectacular team spoke with Dr. Jennifer Blechman of Bend, Oregon, hospice and social worker Liz Anderson of Asheville, North Carolina, and patient Joanie Devine, alongside her fiance, David Keenan, of Waynesville, North Carolina.

Dr. Jennifer Blechman: Many people say, how can you do the work that you do? It seems so depressing or so sad. But I find my job so rewarding.

Liz Anderson: Maybe I think about death a little bit more than other people, but it’s not on the top of my mind. I think what I really think about is how to live a meaningful life.

Joanie Devine: As long as I live a life that makes me happy, time doesn’t matter to me. I could go at any day, but take advantage of every day that I do have. And I’d rather live that way.

Liz Anderson: I have worked as a hospice and palliative care social worker, primarily in rural Virginia and rural North Carolina.

My first job was in a rural hospital in Vermont. We did everything. We did deliveries. We would work in the E.R. We worked in the intensive care unit. I learned about palliative care and realized it was really what I was missing in medicine.

Joanie Devine: I was born with a rare genetic disorder called cystinosis, and I was supposed to have been dead by the age of 13. We live in a very small town. Our local hospital doesn’t even have a dialysis unit.

Jennifer Blechman: We have some challenges as far as access. For example, I live in Central Oregon. The agency I work for, we serve a 10,000-square mile radius. We have patients that are as far as three or 3.5 hours away.

Liz Anderson: You have one social worker that covers seven different counties.

Jennifer Blechman: We have to be much more proactive than in a big city. So, we try to predict what somebody may be dealing with and make sure they have the tools available to them in their home.

David Keenan: We do her dialysis here at the house five days out of the week, and it takes upwards of 4.5, five hours a day.

Liz Anderson: I think health care professionals have a really hard time in rural communities, because they get pulled in so many different directions. And so a health care provider, like a social worker or nurse or doctor, might actually be asked to pray with a patient, because they’re having a hard time getting those adequate resources.

Joanie Devine: My palliative care nurse, her name is Carmen (ph). She’s probably, I would say, my best friend. She’s a nurse. She’s basically my therapist. She’s everything I need in one person.

David Keenan: She’s magnificent, you know, giving Joanie the tools to think things through and find a game plan of how to approach things.

Liz Anderson: The work that we ask patients and caregivers to do when they’re seriously ill is pretty tremendous.

And I have some stories of caregivers that have heard some really heavy things from the people that they love, and they haven’t had a place to talk about that. And I think particularly people in rural communities are carrying that around alone.

Joanie Devine: I’m pretty at peace with it. Dying is a release of pain, a release of everything that you feel negatively in life.

Jennifer Blechman: Many people get to a place of acceptance and a place of peace before they die.

And that can be so rewarding for us to see, which is just a small fraction of how it can help their families and loved ones that they leave behind.

Liz Anderson: When we allow people to share their emotional experience of suffering or watching a loved one suffer, that, in itself, is healing. That, in itself, alleviates suffering.

I am Liz Anderson.

David Keenan: My name is David Keenan.

Jennifer Blechman: My name is Dr. Jennifer Blechman.

Joanie Devine: My name is Joanie Devine.

Liz Anderson: And this is my Brief But Spectacular take…

Jennifer Blechman: … on the benefit of palliative care in a rural community.

Judy Woodruff: And we are so grateful that you shared these stories with us.

And you can find all of our Brief But Spectacular segments online at