Gail Asbury knew her close friend Jessie White was suffering, as well as extremely ill.

White, 97, had no family in town to care for her. Suffering from a serious bladder infection and advanced stages of dementia, she needed full-time care. Asbury knew her best friend of more than 20 years faced the prospect of dying alone in a nursing home, something she couldn't bear to think of happening, and was pushing for everything possible to turn her illness and deterioration around.

Due to help from the Transitions and Life Choices team at St. Peter's Hospital, Gail found the strength, reassurance and guidance to bring her loved one home with hospice care.

Asbury, 52, and her husband, Jim, did something for their friend that many people are unable to do for their own families. They cleared out their living room, put in a hospital bed and took care of her themselves for the final weeks of her life before her death Nov. 16.

Far from being a burden on her, Asbury said, caring for White was a gift and the most rewarding experience of her life.

"I loved Jessie like I love my own mother," said Asbury. "What a joy it was. I'm so glad she was able to spend the rest of her days with us."

Jan Jahner, St. Peter's Hospital coordinator of pain and palliative care, first suggested that Gail may want to consider bringing Jessie home as they were exploring Gail's hopes, fears, and goals for Jessie's care.

Jahner, who is a member of St. Peter's TLC program, wishes more people had Asbury's experience.

"People think they can't do it," Jahner said. "I think they're intimidated by all the care they see going on in a hospital or nurses home."

She said that with home health and hospice services, however, there is technical assistance, education, mentoring and support that make it possible for families to be the primary care giver.

"A care plan can be put together that enhances everyone's lives. A long time ago, (taking care of elders in the home through to the end of their lives) was the norm." She said people didn't live as long and the period of debility was usually far shorter than it is now.

"Gail was home-schooling her children and I recognized the possibility for her to try caring for Jessie. This isn't something she had ever contemplated being able to do."

Asbury had known White since White was a neighbor of Asbury's sister, Connie, in the 1980s.

"She was a born-again Christian and knew Jesus in a personal way, and my sister didn't," Asbury said of White.

Eventually, she said, Connie became a Christian too and a friendship bloomed between the two women that spanned the generation gap.

"From that point on, Jessie and Connie were like bosom buddies," Asbury said.

When Gail moved to Helena from Wyoming not long after that, White became like family to Connie and Gail.

Over the years, Jessie, Gail and Connie spent every holiday with the Asburys. When Gail's three boys -- Bryan, 10, Brad, 9, and Austin, 7 -- were born, she became like another grandmother to them.

As Jessie grew older and moved to assisted living at Eagles Manor, she continued to be a big part of Asbury's life.

Later as her health deteriorated and she lost more and more of her independence, she had to move to a nursing home.

"I never wanted her to go to a nursing home," Asbury said. "It kind of broke my heart. Eagles Manor felt more like home."

One day, when Gail stopped in to visit at the nursing home, she noticed a bruise above Jessie's eye. Jessie was listless, unresponsive and looked to be in bad shape. She called a nurse, and it was soon decided that Jessie needed to go to the hospital.

The bruise turned out to be nothing serious, but doctors found the bladder infection and told Gail her friend could only have a matter of days to live.

Gail felt every day during her hospitalization could be Jessie's last. She was wrestling with decisions about feeding tubes and artificial hydration.

Dr. Harrison, the hospitalist caring for Jessie, had recommended a consultation with Transitions and Life Choices progam, and she began developing a relationship with Jahner through TLC.

This program of physician advisers, certified nurses Sheila Nally and Jahner, social worker Wendy Cook and St. Peter's chaplain Jack Haas work together to help families figure out how to deal with end-of-life issues.

As Jahner got to know Gail by exploring her concerns and fears, and listening to her deeply felt spiritual beliefs, she realized how important it was to Gail that Jessie not go back to the nursing home. That's when she suggested Gail could take care of her.

At first, Gail was surprised; she had never thought of it as a possibility.

But she immediately liked the idea and went home to ask Jim if they could do it.

He agreed, and the couple figured out a plan with the hospital to make it happen.

Gail said that even though Jessie may not have always known whom she was with or what was going on, it made her happy to be in a home with the activity and the children.

Gail said the experience was rewarding for her boys, too. She called them her "pillow boys" because they would help rearrange the pillows to make Jessie more comfortable when she needed to be turned in her bed.

Gail reflected on how much she went through with Jessie -- from the time she was completely independent through the process of her losing the ability to walk, her hearing, her memory and finally the ability to take care of herself. She even held Jessie's hand as she took her last breath.

"We've seen the whole scope of her senior life," she said. "We've been with her for every joy and sorrow.

"I am sold on it. I would do it for our parents in a second. "What a privilege that I could do it. It was such a joy to take care of Jessie."

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