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May 18, 2023 | Read time 5 min

Allies: Elyse and Cheri

MSU nursing instructor helped family navigate grief, pregnancy loss and palliative care during the COVID-19 pandemic

Summary

  • After losing her husband to cancer while pregnant with twins during the COVID-19 pandemic, Haslett resident Elyse Hansen relied on perinatal palliative care nurse practitioner Cheri Salazar for guidance, advocacy and emotional support through the loss of one twin and the birth of the other.
  • Salazar coordinated care plans with neonatal and OB/GYN teams, supported Hansen and her surviving son during the crisis, and helped the family focus on quality of life and meaningful experiences through palliative care.
  • Now an instructor at the Michigan State University College of Nursing, Salazar teaches students about the importance of palliative care, emphasizing that the specialty focuses on easing burdens and improving quality of life for patients and families — not solely end-of-life care.
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Elyse Hansen’s family was about to grow: The Haslett woman’s family of three was about to balloon to five thanks to the twins she was carrying. Elliot, then six years old; and husband, Matt, would be joined by two more boys come the end of the year.

The news came as a shock to Elyse.

“It turns out that twins don’t run in your family, they’re just a random occurrence,” said Elyse. “I didn’t know that at first. I was alone in the ultrasound room when I found out because of COVID, so I completely broke down and freaked out because that was not part of the plan.”

Unfortunately for Elyse, she would soon experience several other life-changing moments that were also not part of the plan.

Joel and Marshall

It was the spring of 2020. The world had all but shut down due to the emergence of the COVID-19 pandemic. Elyse, early in her pregnancy, was finding herself often going to medical appointments herself due to restrictions on who was allowed in clinical settings.

An early appointment showed one of the twins — Joel — was smaller than Marshall, but that was common among twins. Some early bleeding also was typical, but still warranted visits to the doctor.

While the twins seemed relatively fine early on, shortly after one of those routine visits, Matt started showing signs of being ill. A visit to the emergency room found a large, cancerous mass inside Matt, who then traveled to Detroit with Elyse to see an oncologist.

That same day, Elyse’s water broke.

“I called my doctor and said, ‘hey, I need to come in, but I can’t until later because my husband has cancer,’” Elyse said. “We came back, I went to the doctor, and they found out for one of the twins, the water broke. We went to monitoring the situation from there on and out and, later on, realized Joel was not going to recover.”

Then came some more devastating news.

“Matt wasn’t able to get treatment. It was too quick — the cancer — and so he went into Hospice and three weeks later he died,” Elyse said, adding Matt passed away when she was about 22 weeks along.

Elyse, knowing she still had Elliot and unborn Marshall, collected her strength and relied on nurses, including Cheri Salazar. At the time, Salazar was a nurse practitioner specializing in perinatal palliative care and Hospice at Sparrow Hospital.

Salazar worked with Elyse and the regional neonatal intensive care and OB/GYN units to design and advocate for care plans for both Joel and Marshall once they were born. For example, Elyse spent time with Joel in her hospital room the day he was born, and Marshall spent time in the NICU. In addition, Salazar served as Elyse’s support person after the latter’s backup was in Canada and restricted from entering the country during the early part of the pandemic. She also ensured Elliot was receiving the attention he needed during this difficult time.

“She was so strong through the whole thing,” Salazar said. “They’re still a family. They may be three now, but they’re really five and, really, it’s watching how beautiful that is. It’s a sad thing, but a beautiful thing.”

Palliative Care

Palliative care is something Salazar, now an instructor at the Michigan State University College of Nursing, is passionate about and something she shares with her students.

“I am able to show my students how, in palliative care, we’re promoting their health. We’re giving them quality of life. We’re helping families coordinate between providers. So, when they become providers … they’ll know how important it is to collaborate with the palliative care team.”

Salazar is on the Palliative Care Coalition of Michigan, which is working to get this topic infused into nursing and medical college curriculums.

“Palliative care has been around a long time, but it is something many people do not understand,” Salazar said. “A lot of people hear ‘palliative care’ and they think, ‘end of life.’ In a majority of cases, it is about quality of life. It’s taking these young people … and working with the families on how to make the best experience for the child and family. Palliative care is, essentially, relieving their burden.”

Marshall has since left the palliative care program and is thriving as a two-and-a-half-year-old. Salazar has also become close friends with Elyse, with whom she recently co-authored a journal article on the experience.

“I would not have been able to do anything I did without her. She is still a part of our lives,” Elyse said. “Cheri was the rock, is the rock.”

Elyse Hansen and family, with Cheri Salazar
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