Karen Martin and Jimmy McPeak have been together for better and for worse for more than 20 years.

The Smiths Grove couple were married in 1998 and divorced in 2004, but they were back together within a month. They realized they still loved each other and wanted to remarry.

“We were in the process of redoing the house,” Martin said. “We were going to sell it and move.”

One day in 2009, McPeak was carrying something to the garage and said he didn’t feel well. Because he didn’t have any insurance, he wouldn’t let Martin call an ambulance. Although McPeak had insurance for his business, he couldn’t afford health insurance for himself. “We didn’t need no ambulance,” McPeak said.

Martin smiled at McPeak. “Jimmy has never been sick. He never had a cold,” she said. “He’s never been in the hospital.”

He ended up having to go from a hospital in Bowling Green to one in Louisville. Tests showed he had cirrhosis and cancer of the liver.

To be considered for the transplant program, McPeak needed insurance because the medicine that transplant recipients need is expensive.

“He needed a liver,” Martin said. “The social worker there signed him up for disability and sent him home.”

McPeak briefly received Medicaid, but lost it because he owned a home and various other reasons, Martin said. He finally received his first Social Security check. He knew that he had to wait two years before he was eligible for Medicare. When the Medicare card didn’t come, Martin called to find out what had happened.

“They told me it had to be two years from the time he got his first check,” she said. “It was two years and five months.”

While they were going through this battle, a friend suggested they call Hosparus for services. Martin had thought hospice was for people who were predicted to die within days.

“They’re there for much more than that,” she said. “God blessed us both that day.”

McPeak is the sort of patient Hosparus medical director Dr. Jim Gaffney said could get the most benefit.

“We do our best work if we can have months to work with the patient and the family – months or more ahead of time, if possible,” he said. “Instead of a process, it’s a calm and peaceful death. I think it’s better if it’s out in the open.”

“If we don’t have a lot of time, it’s a loss to the patient and family,” Hosparus case manager and registered nurse Cindy Manteris said.

It’s something that Julie Griffin, a social worker at Hospice of Southern Kentucky, believes, too. She said the best time to start planning hospice services is before the crisis happens.

“Our mind is on taking care of loved ones or trying to cope with illness. You want to broach the topic very carefully because their world is spinning at that point,” Griffin said.

People should talk to their loved ones about their wishes in case something happens and let them know where they can find the important papers – such as the bank accounts, insurance policies, powers of attorney and living wills.

“You have to delicately broach those subjects,” Griffin said. “If they can be broached before these issues come up, it makes it a little easier because they’re already on task. Keep your papers in one place. Have one central location for all those things. It would make the process easier for them.”

It was a sentiment Griffin had heard from widows with whom she had spoken.

“It’s something they kept saying again and again. ‘I was so much in the moment that I couldn’t get my head around the financial things,’ ” she said.

When Griffin was choosing a Western Kentucky University undergraduate project while interning at Hospice, a widow suggested she put the information together to help others. She went to a funeral home and got a sheet of necessary items to take to a funeral home after a loved one dies. She received information on state settlement steps, estate planning and Kentucky probate procedures from other sources.

“Her husband had passed away and she was wondering, ‘What should I do now?’ When you’re going through grief, you’re not always able to concentrate and you’re overwhelmed,” she said. “We want to make the journey a little less traumatic.”

Part of that process is helping the patient and the family accept the fact that the patient is dying.

“You can’t prepare for something you haven’t accepted,” Gaffney said. “You can’t have those comforts unless you have acceptance in the room.”

The emotional and spiritual aspects of preparing are also important, Gaffney said. Sometimes dying patients just want to make peace with family members from them knowing that they are loved or forgiven or that that they’re going to be OK once the patient dies.

“Tell a number of your family members what you want. You never know when it will happen,” Gaffney said. “It’s a kindness because you’re taking a load off them when it happens.”

Manteris said the group works together as a team.

“We assist from a medical standpoint. We help relieve pain and symptoms so that they have true quality of life,” she said. “Death is one of the most important things in life.”

Hosparus was able to help McPeak before he finally received insurance.

“We rely on resources and donations to take care of patients who don’t have insurance,” she said.

Hosparus social worker Octavia Pendleton works more with the families, helping them prepare for the road ahead.

“I help get them ready for life without” the patient, she said.

That doesn’t mean the patient isn’t involved. There are family meetings to figure out what their wishes and dreams are, Pendleton said.

“Is there anybody who has not come to their house and said their goodbyes?” she said.

There is also bereavement follow-up, Pendleton said.

“We hear people say, ‘Thank you for saying that. Now I see how important that was,’ ” she said. “We can’t cure them, but we can give them a good death.”

Martin said Pendleton has helped her with paperwork that would have overwhelmed her otherwise.

“Octavia has taken off so much weight in handling the paperwork,” she said. “If I have any kind of question, I don’t have to get on the phone and call 100 people.”

McPeak was grateful for pain relief. His doctor wouldn’t give him any because he thought it might be dangerous. He had been in pain for more than one year when Hosparus began helping him.

“They made all the difference in the world,” he said. “I’d been hurting everywhere all the time.”

Doctors had determined he wouldn’t be an ideal candidate for a transplant. Instead of dying in a hospital, McPeak decided to “go out his way,” Martin said.

“I’d rather spend time being here than being in a hospital,” he said.

Hosparus has helped the couple in a variety of ways, including helping find other hospice services for McPeak while they visited Florida for three months. Hosparus faxed McPeak’s medical records to the service.

“I didn’t think we could ever go back there,” McPeak said. “We just went to the beach.”

Martin showed pictures of the couple in Santa hats, red noses and antlers while they were in Florida. They laughed as they remembered the fun times they had. They find fun in Smiths Grove, too.

“We have a golf cart downstairs, and we cruise the big town of Smiths Grove,” Martin said, laughing.

McPeak laughed.

“It don’t take a lot to excite us,” he said.

McPeak has also planned his funeral.

“We’re planning to say in lieu of flowers, we want people to donate to Hosparus,” Martin said.

Unfortunately, the couple can’t fulfill one of their deepest desires – to get remarried. They’d lose benefits if they did, Martin said. It doesn’t make them love each other any less.

“We wake up every morning, hug and say, ‘We’ve got another day,’ ” she said, smiling. “He’s the love of my life.”

McPeak grinned.

“You know I love you very much,” he said.

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