Several generations of the Papale Family enjoying their time together.

Catherine Papale was an energetic Southern belle, one who wasn’t afraid to be vocal about what she liked and didn’t like.  She and her husband Rudolph had five children and lived in Dallas and San Francisco before moving to St. Helena in 1987. Rudolph passed away in 2010, but Catherine remained active until early 2018, when she was hospitalized three times within a matter of months.

During her last admission she was diagnosed with congestive heart failure. And that, she told her family, was her last time in the hospital. She wasn’t giving up on treatment, but she wasn’t going back to the hospital, either.

And thanks to Collabria Care’s Palliative Services, she didn’t have to.

“My wife recommended palliative care,” says Catherine’s son Lawrence. “Our dad had died at home, so I hoped my mom would be able to be home, too. She didn’t need hospice care at that point, but she did need care. And we needed help coordinating her care, figuring out her meds, and so many other things that her Palliative Care nurse navigator and social worker took care of. Her social worker also helped her set up a POLST (provider orders for life-sustaining treatment), which are specific medical orders to be honored by health care workers in a medical crisis.

Collabria Care coordinated not only care, but logistics .“You don’t know what you don’t know—it’s not like you go to Piner’s Medical Supply and just figure it out—but they coordinated and anticipated her needs and just made things happen seamlessly. It was so nice to know someone was watching over her.”

“Communication was also a critical service the palliative care team provided for the whole family,” Lawrence continues. “We are very tight knit, but have different styles of communication and had different opinions about what Mom needed. The team was invaluable in providing unbiased, professional information to make decisions that weren’t clouded by emotion or fear.

At her last Thanksgiving, Catherine had four generations of family at her house for the holiday. “If she hadn’t been on palliative care, that might not have been possible,” says Lawrence’s brother David Papale. “But because she was able to receive the  care she needed at home and not in the hospital, she felt better physically and emotionally—and because the family had a good understanding of her situation from her palliative care team, we knew how it important it was for us all to be there.”

Soon after, Catherine’s condition declined and hospice care became appropriate. “Fortunately, we had Collabria Care to let us know when it was the right time,” says Lawrence. The transition was smooth and easy, and while Catherine was expected to live six months, she lived another year in the comfort of her home with the help of Collabria’s Hospice Services.

“Hers was a slow decline, but it wasn’t as if every day she gradually got a little worse: it was up and down. Having an outside professional providing updates and guidance on what to expect was a huge benefit: it kept us from both despair and false hope.”

“Beyond the nurse and social worker, my mom spent quite a bit of time with the Collabria Care chaplain,” says David. “She didn’t attend church, but she always welcomed the chance to talk with him. One time, the two of them discussed what kind of service she wanted when she passed away. And I was surprised she told him she wanted a service in a church—none of us would have ever guessed that. But because the Collabria team had had that conversation—one we might not have known or wanted to ask—we didn’t have to guess what mom would have wanted.”

“In her final days, we were all there,” says David. “Throughout, the nurse kindly and patiently explained what was happening and why, and what to expect next. She really helped us understand the process.

“Afterwards, the grief support staff at Collabria Care called a few times to check in on me to see how I was coping. I thought that it was wonderful that they checked in on the kids of their patients. That struck me as thoughtful.”

“I know some people have fear about using palliative care,” says Lawrence, “but it helped make my mom’s life easier, better and allowed her to live on her own terms—what’s not to like about that?”

Thanks to the generosity of our donors, Collabria Care is able to offer these vital services to any who need it, regardless of their financial or insurance situation. Every year we serve Napa County residents and their families with the compassionate, expert care they need to navigate the challenges of treatment and care of life-limiting illness, and to improve their
quality of life.