Bette Kundert calls the 14 months of her husband's final illness the most heartbreaking -- yet wonderful -- time of their lives.
The quality of their time together was a gift, she says.
The giver was Mary Frances Stulginsky, a fellow member of the close-knit choir at St. Francis of Assisi Catholic Community in Fulton and a volunteer parish nurse.
More and more congregations across the nation are embracing the concept of parish nursing, an idea originated in 1984 by Dr. Granger Westberg, a clergyman at Lutheran General Health Care System in Park Ridge, Ill.
Parish nurses do not treat. They assess, educate, facilitate and counsel. Based in a faith community, they are not afraid to confront personal or spiritual issues -- subjects that traditional medicine often shies away from.
"She empowered us to take care of Bill and make his days really meaningful," says Kundert of Columbia's Kings Contrivance village. "Her involvement gave us freedom to realize how very much we loved each other, how very fortunate we were to have had this time.
"It gave Bill the time to spend with his kids and made it so much easier to be on this end now, because we got to bring closure to our lives."
When Bill Kundert was diagnosed with cancer last year, Stulginsky, a nurse with a master's degree in nursing from the University of Maryland, was just exploring the concept of parish nursing.
The idea deeply touched Stulginsky, who had watched her father die of cancer in 1987. Home hospice care made it possible for him to die at home with dignity, she says, surrounded by a loving family.
"They helped us feel that we had some control in an uncontrollable situation. He was affirmed, accepted. We all were," Stulginsky said. It was "one of those experiences that changes the way you see health care."
Nationwide, 600 parish nurses work in 48 states, said Ann Solari-Twadell, director of the International Parish Nurse Resource Center in Park Ridge.
Indeed, parish health programs exist in Howard County at Glen-Gary United Methodist Parish and Our Lady of Perpetual Help, both in Ellicott City.
"It's a very strong grass-roots movement," Solari-Twadell said. "You don't have to have a particular kind of health care coverage to access a parish nurse."
The Kunderts didn't even have to ask. When Bill Kundert suffered a recurrence of his cancer in August and the only remaining treatment option offered little hope, Stulginsky approached him with a proposal.
"I know this sounds crazy," she said, "but I need to try something out. Would you be willing to let me try these concepts with you and Bette?"
Stulginsky says Kundert joked, "So, Maryfran, you want me to be a guinea pig? OK."
She thought she would help them navigate the health care system.
If they wanted to focus on quality of life for the time Kundert had left, good pain control would be necessary, and by October he was in terrible pain.
But although his doctors asked him repeatedly to rank his pain on a scale of zero to 10, with 10 the most extreme, the numbers made no sense to Kundert.
So Stulginsky helped him describe the pain, using a standardized series of happy and sad faces and a scale of adjectives.
When she translated the result into a number, it was nine.
"Well, that's not acceptable for someone who's dying," she says.
When Bette Kundert relayed that information to doctors, her husband's pain medication was adjusted. In addition, they found he qualified for services from the Hospice of Howard County.
"So we connected him to all the systems that he needed," Stulginsky said.
The pain made him sensitive to touch, so Stulginsky taught his wife how to massage his feet. It became a way for the Kunderts to be intimate and giggle together.
"It's not always what's wrong, but more what's needed," Stulginsky says. "Healing does not necessarily mean curing. Healing can occur if people are cared for, they're listened to and they're touched."
During a visit in October, Bill Kundert had tears in his eyes when he told Stulginsky, "I used to be a singer." So she asked if he would mind a visit from the choir.
The next Friday, more than 20 choir members crowded around his bed and sang hymns, "The Star-Spangled Banner" and "some things that made us all cry," Stulginsky says.
Bill Kundert conducted.
"It was standing-room only. He was thrilled. It was such a joyous night -- a celebration. We had so much fun," his wife recalls. "We wanted to keep going and going."
A week later, Oct. 31, Bill Kundert died.
"There was no fear," Bette Kundert says. "What came out of Mary-fran's nurturing was a celebration of Bill's life. It was a treasure in my eyes. It brought tremendous peace."
The St. Francis of Assisi Community counts 553 families in its parish. The 8-year-old congregation meets for services in the Atholton High School cafeteria but plans to build a church on land near Route 216.
With the new building, the numbers may double. One pastor could not touch so many people, Stulginsky says.
With the support of the pastor, she is organizing a health ministry using a $2,500 grant from the Cardinal's Lenten Appeal.
She invited 100 health care professionals in the parish to participate, and of the 14 women who attended an organizational meeting last month, 13 volunteered to join.
Educational programs, a telephone referral service and a library are envisioned by the group.
"It wasn't right for Bill Kundert, at age 50, to get this kind of cancer," Stulginsky said. "There's no answer to that. But we can have a response."
Pub Date: 12/15/96