Support System

Deb and Tom Andera meet with Katie Huff (right) of the Avera Sacred Heart Hospital’s palliative care team.

Cancer may have ended Deb Andera’s teaching career, but it couldn’t take away so many other aspects of her life.

Those things included time with her family and friends, who provide important emotional support in her medical journey.

She also found support from the Avera Sacred Heart Hospital (ASHH) palliative care program. The program, started in March 2018, provides a wide range of services to help a patient dealing with a life-altering condition.

At first, Andera balked at the idea. She wasn’t even sure what was offered.

“I thought, ‘What is this? Hospice?” she said, referring to the end-of-life service. “I wasn’t ready for that!”

Instead, she has found the service offers her pain management and other forms of support as she battles breast cancer.

Andera has been diagnosed with Stage IV metastatic sarcoma, which means cancer has spread to other parts of the body. She was unable to attend Friday’s “Grand Give” benefit sponsored by the Avera Sacred Heart Foundation (ASHF), which had part of its proceeds designated for palliative care. However, Deb and her husband, Tom, shared their message in a video presentation during a short program at Friday’s benefit.

The Anderas met at the movies — not on a date, but as employees at Dakota Theatre in downtown Yankton.

“He was my boss when Dakota Theatre re-opened for movies in the mid-1980s, around 1985,” Deb said.

“I was the house manager, and she was the candy girl,” Tom continued.

“I sold tickets,” Deb said, offering a gentle correction to his recollection.

The Anderas, now married, have been together nearly 35 years. They have four children, three of them living in Yankton, and nine grandchildren. Her sister lives two houses away, and Deb spent a great deal of time with family and friends.

In addition, Deb felt passionate about her education career, spent mostly at Lincoln Elementary School in Yankton.

“I taught 34 years, the last 26 with third grade, and I substituted for three years after that,” she said. “I loved every minute of it.”

Then, she received the dreaded news that turned her life upside down.

“I was diagnosed March 1, 2017, with Stage 4 metastatic sarcoma, or inoperable tumors and terminal tumors,” she said. “I started treatment right away with chemotherapy, but there came a point where I had to face the fact that I wasn’t curable.”

Deb realized she needed help in dealing with her pain as well as the emotional and physical aspects of her illness.

She has also found support outside of her friends and family – through Avera Medical Group (AMG) Palliative Medicine. The team includes Katherine “Katie” Huff, a certified nurse practitioner (CNP).

“I gained a passion for this type of specialty care when I was a home hospice (registered nurse),” Huff said. “When I completed my master’s degree and became part of the Avera Sacred Heart hospitalist team, I hoped we could offer palliative care. It’s a true difference-maker for so many patients facing challenging conditions — patients like Deb.”

Many area patients aren’t familiar with palliative care, Huff said.

“I think, sometimes, palliative care can be scary for some patients,” she said. “In Deb’s case, she associated it with hospice, and she didn’t feel she was at that point in her journey. We educate people on palliative care — what it is and how it can perhaps help them.”

Palliative care has been used elsewhere for years, Huff said.

“Palliative care is new to Yankton, but it’s not new across the nation. It’s been around for decades,” she said. “It’s holistic care that focuses attention not only on the physical symptoms but also on the other aspects of their lives.”

Huff explained the distinction between hospice and palliative care.

“Hospice care is for patients who have a life-altering illness with a prognosis (for life expectancy) of six months or less if the disease follows its natural trajectory for the process,” she said. “Palliative care doesn’t need to be for a specific problem associated with the disease when the patient comes to us. We see patients that have a curable illness and help them manage their symptoms while they’re receiving aggressive treatment for a particular illness. They may recover and not need after care.”

The type of care can be tailored as individual as the patient, Huff said.

“We care for patients who have a serious medical condition that isn’t necessarily cancer. It could be for a chronic condition or for an acute condition. We see people with cancer but also people with heart failures and a wide variety of illnesses,” she said. “Palliative care can be offered alongside very aggressive medical treatments, but it can also be offered when there isn’t aggressive treatment.”

As part of the process, the team gets to know the patient and family members as individuals, Huff said.

“With all of our patients, we develop a relationship with them, which is at the heart of palliative care,” she said. “We get to know them before we have the difficult conversations that you sometimes need to have. We help the patients and their families as they face those challenges.”

The family plays a key role in palliative care, Huff said.

“It’s not as beneficial for the patient if the family isn’t as engaged,” she said. “We spend about 90 minutes to two hours with a new patient. Then we allow an hour during their follow-up sessions so we get to know them and who they are.”

Tom noted he receives a great deal of insight from accompanying his wife to each of her sessions.

“When they help her, they help me,” he said. “As I listen to her interacting (with the staff), I hear things that concern her that I might not know otherwise. It gives me a better understanding each time of where she is at.”

Deb has found palliative care important for dealing with all the feelings when facing a terminal illness. She finds it filling needs beyond her cancer treatment.

“This is more care for the soul, my body and pain. I sit and cry when things aren’t going as I think they should go,” she said.

Because of such moments, it’s important for patients to have a support system, Huff said. In Deb’s case, she remains connected to family and friends. She attends her grandchildren’s activities, and they in turn want to take care of her.

“I also go to lunch once a month with gals I met at Weight Watchers, so my support system includes my family and also my friends,” Deb said.

In addition, palliative care helps patients address spiritual issues, Huff said.

“We are blessed as we have great chaplain support from the hospital,” she said. “They’re really able to identify if there are spiritual issues that the patient is dealing with. Our chaplains at the hospital are intricately involved with that aspect as well.”

The staff has learned and received a great deal from Deb, Huff said.

“Deb has taught all of us on the team all about life,” she said. “She uses humor to brighten everybody’s day, and it’s really just being able to step back and to enjoy the things around you and what’s important to you. It’s something I have personally learned from Deb.”

Such an outlook remains crucial in facing whatever lies ahead, Huff said.

“The important thing is that Deb and Tom have the attitude that they are focusing on what is in front of us now, and we’ll deal with that. But we are also able to look at that and plan ahead,” Huff said.

“We’re not naïve on what we have to face and what may be coming down that part of our journey. It’s not an easy thing to talk about, but it’s important to talk about it and to embrace each day, which is what Deb does.”

In the video, Deb looks at Tom and speaks of the path they face.

“You’re going to lose me one of these days,” she said.

“Not today,” he said. “Not today.”


The palliative care program does have a waiting list, and patients must receive a referral from their attending medical provider. However, interested persons are encouraged to call the office at (605) 668-0808 to learn more and determine if the program may be right for them.

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