A sip of cold cider. A crunch of apple. The sweetness of a cinnamon sugar doughnut.

For 30 years, Gloria Koch enjoyed those tastes of autumn, surrounded by her family, during their annual visit to an orchard.

To her surprise, she made the trip once again this year―despite being in hospice care. Despite congestive heart failure. Despite the fact she had not been outdoors in weeks.

Her family and caregivers at Spectrum Health Hospice cooked up the plan that made the treat possible.

“Isn’t that neat?” Koch said with a smile.

Sitting at a dining room table with her daughter, Lynda McGarvey, and granddaughter Jessica Schiebout, she talked about her health, illness and the tradition that has been a fall highlight for decades.

At 87, Koch is matriarch to a sprawling clan that includes three sons, one daughter, 13 grandchildren, 22 great grandchildren and two great-greats. She raised her family as a single parent, living in Wyoming, Michigan, and working as an administrative assistant for a church organization.

Because of her illness, she now lives in her daughter’s home in Coopersville.

Thirty years ago, she and her daughter made their first trip to Klackle Orchards in Greenville, bringing McGarvey’s daughter, Jessica, who was just 2.

A tradition was born. Koch visited the orchard year after year, with an assortment of children and grandchildren.

“We always go the last Saturday of September,” she said. “That’s when the galas and honey crisps are out.”

They picked apples, explored the maze, and watched the kids play on the playground and ride ponies.

McGarvey gave her a mom a look. “Really, it’s the cider and doughnuts we go for,” she said.

Koch agreed. Especially the cinnamon spice doughnuts, she said. And the caramel apple ones.

‘A different season’

This year, Koch experienced a series of health setbacks. She has congestive heart failure, a leaky heart valve, atrial fibrillation and emphysema. She had planned to get surgery for a hiatal hernia, but could not do so because of blood clots.

In early September, she decided to begin hospice care. It was a difficult decision, one that she didn’t want to talk about much at first.

“I just thought it was a death warrant,” she said.

She found it reassuring to know, however, that she still had the option of leaving hospice care if she decided to seek curative treatment.

“I shouldn’t worry about those things anyway because I know where I’m going,” she added. “Your days are all planned out and it shouldn’t matter what your doctor says. You will live as long as you are given life.”

To her surprise, she began to feel better. With help from her medical team, she lost 30 pounds of excess water weight. Breathing became easier. She stood stronger and could go farther with her walker.

McGarvey attributes her mom’s improvement to the consistency of care provided by her hospice medical team―“the same nurse, the same aide, the same doctor.”

Still, she didn’t think her mom could handle the orchard trip. Just getting down the porch steps to a car seemed to be an impossible challenge.

When hospice nurse Amanda Fredricks, RN, learned about the family tradition, she contacted social worker Troy Clink, MSW, to see if he could help.

He called McGarvey one day as she raked leaves in the yard to tell her he had lined up a Life EMS van to transport Koch, wheelchair and all, to the orchard.

“He said, ‘If you’ve done it 30 years, why should we miss this year?’” McGarvey said. “I just wanted to cry.”

They kept the plan a secret. The day before the trip, Schiebout put curlers in her grandmother’s snowy white hair, knowing she would enjoy a fresh hairdo.

On Saturday afternoon, McGarvey told her mom she was going with them to the orchard.

“My first thought was how is this going to happen?” Koch said. “I hadn’t been out of the house since the beginning of August.”

She had resigned herself to missing the trip.

“It’s a different season of my life,” she said. “That’s what I thought about the whole thing. A different season. A new normal. You can get used to it or you can buck it. I’d rather get used to it.”

When her daughter explained they had lined up an ambulance to transport her, Koch realized it was time to get ready. She traded her sweatsuit for a pair of slacks and a powder-blue sweater.

“Then, I was happy,” she said.

A group of orchard-goers assembled, including Koch’s close friend, Carol Parks, her granddaughter Jessica, with her sons, Aiden and Jackson, and her grandson Burton, with his girlfriend Racheal Gaffney and their children, Burton and Sophia.

At the orchard, they enjoyed cider and doughnuts under gloriously sunny skies, admired fall flowers in bloom and shopped for just the right sauce for dipping pretzels. Koch said she wasn’t up for apple picking, but the day clearly was a success.

At home, once she changed back into comfy clothes, Koch told her daughter, “That was the best day in a long time.”

That quality-of-life moment is what hospice is all about, Fredricks said.

“A lot of the time people think hospice is, ‘I’m going to die soon.’ But there is so much more behind it,” she said. “We can make things happen, those last hurrahs that people want.”

For Koch’s family, the joy extended far beyond the pleasures of cider, doughnuts and sunshine, as sweet as they are.

“It meant the world for us to be able to continue that tradition with Grandma and not miss a year,” Jessica said. “It made all these new changes in her life seem to disappear. And for a moment in time, we were all just back to normal.”