Death is personal and mysterious. It's a part of life, the final stage of life.

As a registered nurse case manager at Hospice & Community Care of Lancaster, Gordon Smoker has watched many patients experience the end of life.

"I feel like we all have our ideas of what death is. Religion and spirituality can provide a framework, but until we're at the door, we're not exactly sure what it's like," Smoker said. "We truly don't know what's going on. It's a very spiritual time."

In his position, Smoker cares for patients diagnosed as terminal, with six months or less to live, and their caregivers, very often in their homes. There's a technical side, a medical side, to his profession, but also a mental and emotional side.

"There's a balance you have to find," said Smoker, a resident of Manheim Township. "You don't want to be too cold and detached, but you have to be empathetic to what the patient and the families are going through. You have to limit how attached you get. There have been times when I've become emotional. Sometimes there's nothing to say. You have to be able to recognize when people are making those end-of-life changes. You have to be able to talk through things."

Hospice & Community Care employs nearly 400 individuals, more than 200 of whom practice some level of nursing. At any given time, Smoker works with 12 to 25 patients and their families in the Lititz area, the Denver area, north of Ephrata, into Myerstown and Berks County.

"Hospice is a great service, and it's important to the community," said Smoker. "Hospice care is something many people may be able to benefit from. It doesn't have to be a scary thing. It's like the rest of life. We approach death the way we approach life. It's the next challenge."

One of 25 hospice providers in Lancaster County, Hospice & Community Care supplied care for 4,800 patients and their families in 2023.

"We're here to make our patients' remaining time the best we can," said Smoker. "That's what I enjoy about the job. A lot of people are going to have different stories. You deal with acceptance, and you deal with denial. Sometimes, it can almost be a positive experience."

Smoker has been a registered nurse for 10 years, the last four of which have been spent in the world of hospice. Included in his duties as a registered nurse case manager, Smoker collaborates with other nurses to coordinate patient care, devises plans for ongoing care, responds to patients' pain and emotional and spiritual needs and oversees the efforts of licensed practical nurses, hospice aides and family caregivers.

"There are definitely cases when you have to take some time," said Smoker. "I'm usually pretty good at leaving work at work. I started out working in an intensive care unit, and that took a greater toll on me. I think it's more difficult to try to prevent death than finding ways to manage it."

For additional information about Hospice & Community Care, go to http://www.hospiceandcommunitycare.org.