Helping through Hospice

The air is just beginning to crisp as Tomoko Yamshita Cerajeski sits in a wheelchair in the middle of her room. She stares out the bay window where birdfeeders swing lazily among the leaves as they slowly change from the color of summer greens to autumn sunsets. \n"This is our favorite time of year," said Marjorie Erwin, Cerajeski's home health aid and caregiver, motioning toward Cerajeski. "We can't go out in the heat."\nAlong with the cooler temperatures, fall also brings senior Yinan Lan, an IU student who spends part of her Sundays with homebound Cerajeski, as a hospice volunteer. Lan works with other members of the IU community and Cerajeski's family to make her as happy and comfortable as possible.\nCerajeski's daughter, Kathy Cerajeski, moves toward a wooden picnic table in the backyard, shutting off the humming lawn mower before she sits down. Kathy Cerajeski said IU students who are looking to volunteer often overlook Monroe County's elderly community.\n"I know they're there," she said. "I've been digging for years trying to find people."\nJust over a year ago, Kathy Cerajeski discovered Lan, who began volunteering at a hospice when she was in high school to build her activity sheet for college applications. She began traveling to nursing homes with an older friend and enjoyed interacting with the people she encountered.\n"I got really interested in their psychology and what they think," Lan said. "It's a very much ignored gap in the medical field. It made me feel needed."\nWhen she came to IU, Lan began working with Southern Care, a private hospice agency that told her about Tomoko Cerajeski.\n"Caregiving is a wonderful profession to learn honor, dignity and respect," Kathy Cerajeski said. "You see someone like Tomoko, who needs help, has survived World War II, breast cancer and two brain tumors, and she keeps on ticking."\nErwin sits next to Tomoko Cerajeski in the parlor as the early afternoon sun pours in and covers the room with a soft light. Hooked up to a tangled assortment of oxygen machines and IV tubes, Cerajeski retains a regal aura. Immaculately dressed in a sea green sweater set, she looks out from heavily lidded eyes and waits patiently for Lan.\n"Kathy always says, 'You should never take away somebody's hope,'" Erwin said. "Sticking someone in a bed, not simulating what's left -- that's taking away someone's hope."\nAfter knocking quietly on the French doors, Lan enters the room and greets Tomoko Cerajeski, slipping off her shoes. She is followed by IU masters student Naoko Ozaki, Lan's friend who speaks Japanese.\nCerajeski's eyes flicker when she sees the two, but she doesn't call a greeting of her own. Doctors could not remove her second brain tumor, so she went through a series of radiation treatments in an attempt to kill it. Unfortunately, the procedures destroyed the good tissue along with the bad and left Tomoko unable to speak.\n"For a couple of weeks when I first started, I wasn't sure how much she was getting," Lan said. "I really wasn't understanding the signs. I had no clue she was responding, but I slowly started to pick up the patterns."\nKathy Cerajeski said she thinks Tomoko still understands most conversations, although it takes her longer than most people to process information.\n"I'm a student of her's. She can teach me something if I pay attention," she said. "There is no verbal communication, but she still has something to say."\nLan and Ozaki take out an orange square of paper and place it against a white background so it's easier for Tomoko Cerajeski to see it. Lan and Cerajeski have a short conversation with their eyes, and Lan nods her head. As Ozaki holds the square steady, Lan takes Cerajeski's index finger in her hand and helps Cerajeski fold the paper, over and over, until a bird appears. \n"Let her hold it so she can look at it when she wants to," Lan says to Ozaki, who gives Cerajeski the orange bird. The delicate wings become partially crushed in Cerajeski's grasp.\nErwin moves into the room carrying two ceramic mugs of hot cider.\n"The keyboard's fixed this week," she mentions to Lan.\nLan moves over to the keyboard and begins to play "Let It Be," occasionally looking over her shoulder at Cerajeski.\n"We try and do whatever might stimulate what Tomoko has left," Lan said. "(Ozaki) sings in Japanese to her because she knows Japanese better than she knows English."\nOzaki moves over to the keyboard and begins to play a traditional Japanese song, singing along. Cerajeski's head and body begin to rock as Erwin hangs in the doorway, listening. The shadows of the leaves on the trees outside dance across Tomoko's face, seemingly in time to the music.\nErwin looks down at Tomoko Cerajeski.\n"I'm the cold washcloth and shots," Erwin said looking over at Tomoko Cerajeski. "Yinan's just for the fun things."\nKathy said she is lucky to be located close to IU because of all the opportunities the University brings to southern Indiana residents like herself. For her mom's birthday, Kathy called the East Asian Studies Center and spoke with outreach coordinator Ann Prescott.\n"I got a call asking if anyone knew how to play traditional Japanese instruments," Prescott said, "and I said, 'Yeah, I do.'"\nPrescott made a trip out to the Cerajeski house with her 13-stringed Koto and a Shamisen to play for Tomoko Cerajeski.\n"She seemed to be sleeping in her chair at first," Prescott said, "but she seemed to enjoy the music. I volunteered to go out again."\nOther organizations also are helping out at the hospice. A doctor from the School of Optometry went to the house with a translator to look after Tomoko Cerajeski's eyesight, and the Professional Golf Cart Corporation outfitted a golf cart with racing seatbelts and a place to put Cerajeski's oxygen tank so she could travel safely out of the house and around the neighborhood.\n"None of these people had to do these things," Kathy said, "but they did."\nTomoko Cerajeski has bad days along with good days. A few weeks ago, she mixed up her days and nights, so when the women came to visit, she could barely keep her eyes open. \n"She's probably about done (for the day)," Lan says. "If the big wrinkle between her eyes is gone, she's past listening."\nLan and Ozaki move back to the French doors, where they slip their shoes back on and promise to be back next week before quietly leaving.\nKathy Cerajeski and Erwin know Lan will move on after she graduates, but they are thankful for the time she's put in over the past year. \n"I don't know what it is, but something about (Tomoko's) personality definitely keeps you coming back," Erwin said. "It's just so peaceful here. It's just Tomoko."\n-- Contact senior writer Kathleen Quilligan at kquilig@indiana.edu