by Roxanne Riley, Executive Director, LifePath Hospice
For years, state and federal lawmakers have tried to find an answer to escalating health care costs. At the same time, patients and families want access to quality health care that is both compassionate and cost-effective.
A new study once again reveals that one type of health care consistently provides significant savings while offering high-quality, individualized care that traditionally tops patient and family satisfaction surveys. That care is hospice care.
The journal Health Affairs published a study in its March issue that reinforces the cost-effectiveness of hospice care. The authors compared hospice patients with non-hospice patients and found $2,561 in savings to Medicare for each patient enrolled in hospice from 53 to 105 days before death. In addition, the study found that patients enrolled in hospice had significantly lower rates of hospital services and fewer in-hospital deaths.
Beyond the cost savings, hospice offers patients and their loved ones the specialized care to face the unique challenges associated with serious medical conditions. The hospice care teams professionally address pain and symptoms, so patients can avoid unwanted hospitalizations and remain in their homes, comfortable and calm, surrounded by family and loved ones. Additional support from hospice chaplains and counselors can help patients and families confront spiritual and emotional issues that can come with the end of life. Finally, hospice provides patients and families the dignity to make the most of the time they have remaining together.
Lifepath Hospice is a part of the Chapters Health System. Chapters Health System, formerly HPC Healthcare, is committed to improving the lives of those affected by advancing age and advancing illness, giving them independence when possible, comfort when necessary and dignity at all times.
To learn more visit chaptershealth.org.
Traveling to a destination rarely happens without adventure, mishaps, or detours, and the same goes with one’s life destination. FHPCA’s 28th Annual Forum Conference “Journey: Mapping Our Past, Paving New Roads” is about looking at the past, present, and future of hospice, but what’s more important than an industry is the people that make it work.
That’s why we want to know your personal
or professional hospice journey.
Tell us about a specific moment in your hospice journey that really made an impact in your life (please include year of event) by leaving a comment below or emailing us at info@nullfloridahospices.org*, then look for your story by visiting us online at:
*By submitting your story you agree to allow FHPCA to post your story on it’s online channels or at the 2013 Forum conference.
By Joyce Baldrica, President and CEO of the VNA of the Treasure Coast
and Nightingale Private Duty Nursing
Hospice care offers the services you want. What stands in the way of more people choosing hospice care, is limited awareness of what services it offers and how to find it. When making a decision about hospice care, it helps to have a good understanding of what hospice is, and what it isn’t. Here are some of the most common misconceptions about hospice, along with the true facts about this special kind of care.
Myth: Hospice is a place.
Fact: Hospice care usually takes place in the comfort of your home, but can be provided in any environment in which you live, including nursing homes, assisted living facilities, and hospitals.
Myth: Hospice means that the patient will soon die.
Fact: Receiving hospice care does not mean giving up hope or that death is imminent. The earlier an individual receives hospice care, the more opportunity there is to stabilize your medical condition and address other needs. Some patients actually improve and may be discharged from hospice care.
Myth: Hospice care starts a few days before death.
Fact: Hospice is not just for the last few days or weeks of life. The benefit is designed to provide care for six months, or longer. For most people, it is a relief to find that there is another source of help and support. Hospice care, at any stage of illness, bur particularly early on, can significantly lighten the burden for both the patient and family.
Myth: Families have to pay for hospice care.
Fact: Hospice care is a Medicare benefit. Most private insurers also cover hospice care as well. Some Hospices have a charity program, which helps to care for all patients, regardless of an individual’s ability to pay.
Myth: Hospice is only for cancer patients.
Fact: A large number of hospice patients have congestive heart failure, dementia, chronic lung disease, or other conditions.
Myth: Patients can only receive hospice care for a limited amount of time.
Fact: The Medicare benefit, and most private insurance, pays for hospice care as long as the patient continues to meets the criteria necessary. Patients may come on and off hospice care, and re-enroll in hospice care, as needed.
Myth: Hospice is just for the patient.
Fact: Hospice focuses on comfort, dignity, and emotional support. The quality of life for the patient, but also family members and others who are caregivers, is the highest priority.
VNA provides compassionate, innovative care of the highest quality, setting the standard for patients and caregivers needing home health, hospice, and community health services.
www.vnatc.com
Florida Hospice & Palliative Care Association (FHPCA) announces the new additions to its Board Leadership and Executive Committee.
Linda Ward, President/CEO, Gulfside Regional Hospice, was elected a two two-year terms as President of FHPCA Board of Directors this past November. Formerly the Secretary of FHPCA Board of Directors, Linda will continue to bring her 26 years of healthcare experience in acute care, long-term care and hospice care along with administrative experience in operations, management and marketing to FHPCA’s Executive Committee. Linda holds a Master’s Degree in Social Work and Healthcare Administration, and is a national speaker on the topics of Alzheimer’s, Hospice and customer loyalty, and is a member of many healthcare organizations.
Rana McClelland, Executive Director, Compassionate Care Hospice, was elected Secretary. Rana joined Compassionate Care Hospice in 2010 and brings to the FHPCA Board her skills and experience in healthcare management. She received her MBA in Business Administration from Southeastern University in 2009 and her BS in Business Administration from Auburn University. Rana has been a Certified Hospice Administrator since 2007.
Tom Barb, President/CEO, HPH Hospice, was elected Treasurer. Tom has been president and CEO of HPH Hospice since July of 2008, and brings his 35 years of varied healthcare experience with for-profit, non-profit and governmental hospital organizations to FHPCA’s Board of Directors. Tom has a Bachelor’s of Science from the University of Florida and a Masters of Health Administration from Georgia State University.
Mary Ellen Poe, President/CEO, Hospice of Marion County became FHPCA’s Immediate Past President and will remain on the Executive Committee for two more years. Mary Ellen Poe joined Hospice of Marion County and its Affiliated Companies as Chief Executive Officer in May 2009. In addition to being FHPCA’s Immediate Past President, she is also an officer for the Access to Healthcare Inc. Board, and serves on the Governance Committee of the National Hospice and Palliative Care Organization.
Mary Ellen’s style as president was excellent for convening ideas. She worked well at 
managing sometimes competing interest in such as way that the association was able to make forward progress with its goals and objectives, and empowered the FHPCA staff to excel at their work. “Serving hospice at the state level these past two years has been an honor, and one I have thoroughly enjoyed as well. Being in FHPCA’s leadership role provided me with the unique position of bringing us all together for the right reason—to ensure that all our patients across Florida are benefiting from the highest quality of care available at the end of life. This is the rare privilege we jointly share, and a commitment to mission we all hold dear.”
Although Mary Ellen moves into a less demanding role on the Executive Committee, she still remains involved with issues regarding quality measures, and building relationships with agencies and legislators in support of FHPCA. “Mary Ellen always offered a voice of measured reason. Her style of leadership was exactly what FHPCA needed during her tenure and we appreciate the dedication and hard work she put into her role as president”, says Paul Ledford, Executive Director, FHPCA.
Staying on in her current role, Kathy Fernandez, President and CEO of Chapters Health Systems remains FHPCA’s Internal Vice President. In 1993, she joined Hospice of Hillsborough (as Chapters Health was then known) and was named president and chief executive officer in 1998. Under Kathy’s visionary leadership, the company has experienced a significant increase in the number of patients served and expanded programs to address the needs related to aging, complex medical conditions and end-of-life concerns.
Kathy earned a Bachelor of Science in Nursing from the University of Tampa and a Master of Science in Health Administration from the University of St. Francis in Joliet, Illinois.
Samira K. Beckwith, President and CEO of Hope Healthcare Services remains FHPCA’s External Vice President. Samira has served as president and CEO of Hope Healthcare Services for more than two decades. She also serves as chair of the National Hospice Foundation Board of Directors and is a National Hospice Work Group founding director. She also serves on the American Society of Pain Educators Board of Directors, National Hospice and Palliative Care Organization Board of Directors and is the founder and president of Florida PACE Association.
Beckwith earned undergraduate and graduate degrees from The Ohio State University and has been recognized for her leadership, career accomplishments and commitments to diversity.
Also joining the Executive Committee under new committee roles as created by the FHPCA’s 2012 strategic plan:
Ron Fried, Senior Vice President of Development, VITAS Innovative Healthcare, was confirmed to the role of Public Policy Committee Chair. Though this is not a new committee, it is one of the most active. Ron brings more than fifteen years of hospice management and administrative responsibilities and more than thirty years of experience in legislative and regulatory affairs to his role Public Policy Committee Chair. Along with his extensive work and public policy experience, Ron also is active with NHPCO and was recently elected Chair of their Board of Directors.
Cathy Adkison, President/CEO, Big Bend Hospice, was confirmed as Chair of the newly developed Funding Committee. Cathy joined Big Bend Hospice in 2011 from Alabama where she was a Senior Vice President of Operations for a large home health and hospice provider serving over 54 counties. She is a Registered Nurse and holds a bachelor’s of science in nursing as well as certification in Hospice and Home Care Administration. Adkison has 30 years of nursing experience, with 26 of those years in administrative and management positions.
Susan deCuba, Executive Vice President/President Elect, Treasure Coast Hospice, was confirmed Chair of the newly created Quality Committee. She brings to the board her experience in Marketing, Foundation, Finance, IT, Compliance, Bereavement and Volunteer Services. Susan was recognized by the American Marketing Association as one of the top non-profit marketers in the country and was responsible for Treasure Coast Hospice’s award winning media education campaign.
She holds a Bachelor’s degree from Florida Atlantic University with a double major in Humanities and Spanish, and a Master’s degree in Counseling from University of South Florida.
“We are excited about the new officers, and as we celebrate 30 years as an association we look forward to the talent and experience these new members bring to the leadership”, says Paul Ledford, Executive Director of FHPCA.
Written by: Ebony Faber, Publications Coordinator, Suncoast Hospice
Sometimes, in the midst of the darkness of dementia, moments of light shine through – an awakening. While under Suncoast Hospice care before his death, Christopher “Chris” Witt experienced his awakening through music.
Chris was a former NASA engineer who had severe dementia and lived in an assisted living facility (ALF). Clara, his loving and devoted wife of 50 years, requested that music therapy, a form of palliative care, be integrated into his care plan. A college senior studying music therapy joined Chris’ care team. She visited Chris at the ALF and played a guitar-like instrument and sang to him. The music struck a chord with Chris, who responded strongly to the music.
“When she played, if she stroked the frets, he would reach out and touch the instrument. He just loved it. She would sing to him. She took care of Chris and we noticed a change in him,” Clara said.
Clara, too, would sing to her husband. And soon a crowd would form outside Chris’ room for all to enjoy. “People would stand in the doorway. We sang religious hymns and others that soothed him. I even sang some old fraternity songs, which were very raucous, but they made everybody laugh. It was a happy hour when his music therapist was there. The music helped me too because if you’ve ever taken care of someone you love, it’s very stressful emotionally. It certainly helps the patient and the caregiver,” Clara said.
Clara believes the music played a role in Chris’ sudden speech. They were dancing one day and he began to speak after three months of not talking. He said, “I’m not so good anymore…and you are…Thank you for taking such good care of me. I love you so much.”
Rocket Scientist and Rockette in Love
Chris and Clara first met in Sunday school when they were teenagers. He joined the Army Reserves and served two years after college. Chris landed a job at NASA and designed the re-entry apparatus for the first men who went to the moon for their return trip to Earth. Clara was in show business. She modeled, acted, danced, performing as a Rockette at the famous shows at Radio City Music Hall in New York City.
The couple lived for years on Long Island, NY. They loved sailing and taking weekend trips out on the water. They had a wonderful life together and celebrated their 50th anniversary at the ALF where Chris lived.
Involve Hospice Sooner
Deciding to bring in Suncoast Hospice for her husband was not easy. Clara had heard about hospice care before but was uneasy about it. “You hear the word hospice and think, oh your loved one is dying. It’s frightening and you hope you never need hospice for your family or friends. But then I tried it and slowly I saw what they were doing for us. Chris received the extra attention he needed.”
Clara is extremely thankful for Suncoast Hospice’s care and support. “Suncoast Hospice was wonderful to us. They called me to see how I was doing. That was a help to me. It’s a very uplifting organization. You can tell that the people who work for Suncoast Hospice have this special gift of having heart.”
In photo: Clara Witt
Learn more about Music Therapy:
The American Music Therapy Association – www.musictherapy.org
Article – http://www.clinicaladvisor.com/music-therapy-in-palliative-care/article/177883/
Suncoast Hospice is a not-for-profit organization committed to serving those living with chronic and or terminal illnesses, nearing the end of life, or experiencing grief. For more information, visit www.suncoasthospice.org.
Article courtesy of Avow Hospice, Naples, Florida
The sobbing didn’t start until it was time to put the lights on the tree.
For years Nancy had chided Don that it was time to ditch the old artificial spruce: it was spindly, with bits of tinsel from earlier Christmases stuck to some of its prickly plastic branches. It also wasn’t “pre-lit”, the way newer trees were. So every holiday season Don patiently untangled string after string of multicolored bulbs and green wires. Without fail, a loose bulb darkened an entire strand. Nancy would have ditched the whole set and bought a new one, but Don enjoyed the challenge of finding – and fixing – the problem. He twisted and tugged on the little bulbs until the entire string twinkled with light in his hands.
Ten months had passed since Don’s death – ten months that were filled with depression, loneliness and poor sleep – but also with the first signs of healing. Nancy had coped when Don’s birthday and their anniversary came and went; she’d even attended their daughter’s wedding alone and had joined a new book club.
So she was surprised when the floodgate of tears came in early December, when she’d hauled out the decorations for her first holiday alone. It was the sight of the tangled lights, waiting for Don’s patient touch – waiting, as she was, for things to be the way they’d always been.
For those facing their first holiday season grieving the loss of a loved one, may feel lost, like Nancy. Family traditions may feel hollow or pointless, given the reality of life without the person who has died.
There are some things you can do to live more peacefully through a season that focuses on families, togetherness and celebrations – even if all you want to do is curl up on the sofa and stay home until the New Year arrives. Here are some suggestions.
About Avow Hospice
Avow Hospice is an independent, non-profit, community hospice serving Collier County, Florida since 1983. To learn more about the programs offered by Avow Hospice, visit www.avowhospice.org.
Hospice is a special kind of care provided for those at the end of life, and Governor Rick Scott has declared this November as Florida Hospice Month. November is an opportunity for hospice providers statewide to raise awareness about hospice to patients and families who could benefit from the many services available. Some of these services include pain management, physical therapy, respite care, grief and bereavement therapy for loved ones, among many others. Hospice provides their services wherever the patient calls home, and works to empower the patient’s family by providing the needed support services. Hospice regards everyday as a gift, and strives to help patient’s achieve the best possible quality life.
“An important message we try to get out is that hospice cares about life. If a patient has a life-limiting illness, hospice wants to help make every day of that patient’s life one of quality and substance. This care philosophy not only benefits the patient, but the family and loved ones as well.” says Paul Ledford, Executive Director of Florida Hospice & Palliative Care Association (FHPCA). “In 2011, over 112,000 patients experienced the care and comfort provided by hospice providers throughout Florida. That is a lot of lives being touched already, but there are so many out there who need to know the benefits hospice can provide them. Too often patients enroll in hospice within a week of their passing. That’s not enough time for them to truly benefit from the available services, particularly since patients are eligible for the hospice benefit within their last 6 months of life.”
Read Gov. Scott’s Declaration
By: Abby Vandegrift, Communications & Policy Coordinator for
Florida Hospice & Palliative Care Association
This October, Florida Hospice & Palliative Care Association (FHPCA) celebrates its 30 year anniversary of dedicated service to hospice care in Florida. Established as Florida Hospices, Inc. in 1982, FHPCA’s grassroots effort first began in 1979 with the formation of the Florida State Hospice Organization (FHSO). The hospice pioneers that formed FSHO, including incoming Florida Senate President, Don Gaetz, were instrumental in establishing hospice in Florida by coauthoring the Florida Hospice Act of 1979 – the first state law in the country to establish hospice and allow patients to be admitted into hospice care, and nationally in supporting passage of the Medicare Hospice Benefit in 1982.
FSHO was only in operation from 1979 to 1982, and during that time completed its primary mission and purpose of passing the hospice licensure law, getting rules implemented, and in securing passage of the Medicare Hospice Benefit. With those tasks completed, the organization handed over the duties and responsibilities to a successor association, FHPCA, to continue the work. “The association started off with no staff and financials in a shoebox. Now we have a full staff with multiple projects, committees, and initiatives happening everyday. We have accomplished a lot these past 30 years.” says Mary Ellen Poe, President of FHPCA and President and CEO of Hospice of Marion County. Poe continues, “Besides turning 30, this year has brought a lot of changes for the association. We’ve built a new website to better inform the community of hospice and palliative care and adopted a new strategic plan that will help the association navigate today’s challenges and opportunities. We are confident FHPCA is prepared and ready for the years ahead.”
Paul Ledford, Executive Director of FHPCA states, “I’ve been here for eight years now, and have seen a lot of growth and changes during that time. I am very proud to work for an association with a mission to assure quality and access to hospice care for all Floridians. It is something that drives you to work hard everyday. However, this work could not be done without the generous support and involvement of our members. It’s because of their energy, dedication, and expertise that we’ve been going strong for these 30 years.”
FHPCA’s 30 year anniversary comes before the National Hospice and Palliative Care Month which is celebrated throughout the month of November. This month of recognition is a great time to show appreciation for the hard work of the many dedicated staff in hospice and palliative care. For more information regarding hospice and palliative care or FHPCA, visit www.floridahospices.org.
By: Paul A. Ledford, CAE, CHA, Executive Director of
Florida Hospice & Palliative Care Association
When you think of hospice, do you think of life? Chances are probably not. Often people think of hospice as a place you go to die, but that is an unfitting way to define what hospice actually is. Hospice is a special kind of care for people who no longer pursue a cure for their illness at the end of life. To be eligible for hospice, a patient must have a terminal illness with a prognosis that puts their life expectancy within six months or less (in Florida, some private pay insurers allow for a year or less). With hospice, care priorities shift to the support of patients and the care givers with end-of-life decision-making to reach the best quality possible for each day.
Imagine you have stage IV cancer. You have been through multiple radiation treatments that have left your body wrecked. You don’t eat, everything hurts all the time, and you don’t enjoy spending time with your family anymore because you are battling depression. Technically you are alive, but with a quality of life so poor, could you really say you are living? The simple fact of the matter is we all die. Everyone knows it, yet there is still this innate belief that we can evade the inevitable. How and when we die is something we have no control over, yet if we get the opportunity, how we live those last precious months is something we might have a say in. If you were dying with little hope for recovery, would you choose to live out your life in the acute care setting, continuing curative treatments, or would you choose to be comfortable at home with your pain managed and surrounded by loved ones? According to a 1999 Harvard Public Opinion Poll, 71 percent of Americans would prefer the latter and to die at home.
So how does hospice help one to live well? First, hospice uses a team approach. Each patient admitted, receives care from a physician (who works with patient’s current physician), nurse, medical social worker, spiritual counselor, therapist, home health aid, and volunteer. Hospice uses this approach to manage the complexities of end-of-life care by covering all aspects of a patient’s needs, including pain and symptom management, fulfilling end-of-life wishes, providing education, working towards reconciliation with family and friends, grief and bereavement support, housekeeping, respite for caregivers, and much more. Each member of the hospice team is crucial for the care of the patient, extending both the quality and quantity of life. Studies show that patients with hospice/palliative care interventions will have a better quality of life, and will on average live up to 29 days longer.
Pain is not the only symptom that needs to be regulated, a patient’s emotional and spiritual issues need to be addressed as well. People with heart disease, diabetes, cancer, stroke, Parkinson’s disease, and HIV/AIDS are at much greater risk for depression than the overall population, up to 75%. Effects of untreated depression can have dangerous consequences including a lack of hope and peace, withdrawal of interaction with loved ones, limited ability to organize end-of-life affairs, increased interest in terminating life early, and can also make managing pain and other symptoms more difficult. Because depression is both emotional and physical, palliative medicine can only go so far. Along with medication, hospice provides spiritual counselors and grief support counselors to help patients overcome their depression so that they can live out the rest of their days in peace.
Hospice patients often worry about the stress of family caring for them and what will happen to their family when they are gone. Caregiving for a hospice patient can be an enormous and difficult task, and often caregivers are at a high risk for psychological and physical disorders of their own. However when caregivers are given support, end-of-life care of a loved one can actually be a positive experience. Hospice helps provide support by nurse intervention, educating caregivers on end-of-life, providing respite care, grief and bereavement support counseling. Hospice also provides family and loved ones the option of bereavement counselors and/or support groups for after their loved one has passed away.
Hospice is a great resource and service for those who are dying, yet out of the 71% who say that they want to die at home, only a small fraction of that number actually do. Why is that? Besides having to overcome a society’s general fear of death, there is the stigma that a patient will soon die after electing hospice. As mentioned above, hospice may actually add days to your life by managing the pain and symptoms associated with a terminal illness. Patients can elect hospice up to 6 months before they are expected to die, even though the average length of service was 67.4 days in 2010, the median length of service was only 19.7 days, which means that half of hospice patients received care for less than three weeks. This short time frame does not allow for a patient or their family to really benefit from the many services hospice provides, and makes it difficult for family members and patients to prepare themselves emotionally and physically for the end. Being unprepared for death is hard on the patient and results in a longer grieving period for the family.
Research shows that when physicians are planning for their own personal care they tend to plan ahead, reject CPR, and die in peace more than the general public. Physicians know what quality end-of-life is. Yet, it is often difficult for these physicians to have a candid discussion with a patient and their family about the patient’s trajectory toward death. This difficulty is understandable when a doctor’s main goal and desire is to make their patients well. However, there are ways in which having the end-of-life discussion can be made easier and more meaningful. Quality-of-life discussions are helpful for ICU patients and for their families when end-of-life discussions need to be made. Communication about end-of-life is best handled early, before aggressive treatments begin and the patient is more stressed and less likely to really reflect on their end-of-life options. Hospice is prepared for all types of end-of-life discussions, especially the difficult ones. Physicians can call their local hospice to come and speak with patients and their families, so that they can know all of the options available to them and make well informed decisions for if and when the time comes.
With the country focusing on quality healthcare more than ever, there is much to be gained when all parts of the healthcare spectrum collaborate to serve patients. The purpose of hospice is to allow death to come naturally, with the goal that each remaining day be one of quality. People can only live for so long, healthcare has cared for them through their entire lives, but when the end is near, hospice can be there to help make the final journeys of dying patients a pleasant experience. A life well lived to a peaceful and graceful end is what hospice is about.
By Joyce Baldrica, President and CEO of the VNA of the Treasure Coast
and Nightingale Private Duty Nursing
In life we prepare for everything… college, marriage, children, and retirement. Despite the conversations we have for these important milestones, rarely do we have conversations about how we want to be cared for at the end of our lives.
Research shows that Americans are clear about what they want when it comes to end-of-life care. They want to remain at home with control of their treatment options, effective pain and symptom management; along with supportive services that aide with personal, spiritual, and emotional care.
Deciding when is the right time for hospice is a question that all of us will one day face. Hospice is traditionally thought to be for patients who are in the last six months of life, but some patients stay on hospice services for years if their disease process is slow. Because hospice is focused on living, people who utilize hospice services early in the course of an illness have more time to discuss goals and create an optimal plan of care designed around patient and family wishes.
Families often avoid the conversation or delay approaching the subject out of fear or uncertainty. Furthermore, it is never easy to begin a conversation with a family member who has been diagnosed with a life-limiting illness about hospice. However, the earlier you can have this conversation, the better the chances are for your loved one to be able to stay where they are, whether it’s at home, in an assisted living, or skilled nursing facility. Talking is the single most important thing that you can do to prepare for this journey.
Talk with your doctor about the treatment plans ahead and how these match goals and wishes for you – or your loved one. Your doctor can help you decide if it is time for hospice. You can also contact your local hospice provider and request an evaluation. Hospice teams do this work every day. Hospice nurses and social workers can answer your questions, dispel the myths, and support you and your family in meeting your end-of-life goals.
Every moment is precious – especially at the end-of-life. Starting the conversation early can ensure that your choices are heard. It also means that when time becomes short, it can be spent doing what you most enjoy and not making last minute decisions. Talk about your wishes while you are in good health so you will be prepared.
A health crisis can happen to anyone at any time. Don’t wait. Start the conversation today.
VNA provides compassionate, innovative care of the highest quality, setting the standard for patients and caregivers needing home health, hospice, and community health services.
By: Vicki Arant, RN, BSN, Vice President of Clinical Services, Hospice of the Comforter
When someone is diagnosed with a terminal illness, where do they and their loved ones turn for support? A hospice cares for patients and families on their end-of-life journey by providing medical, emotional, spiritual and physical support wherever the patient calls home. Care is provided by a team that includes a physician, nurse, social worker, non-denominational chaplain, certified nursing assistant and trained volunteers.
Hospice care focuses on improving quality of life with pain control and symptom management so that patients can maximize the quality of the time that remains. Each patient and his or her caregivers receive individualized care that meets their unique physical, emotional and spiritual needs.
Hospice is not a single place or organization. Some hospices are independent and others are part of a large company. Hospices are not all connected together. Both for-profit and non-profit hospices provide care. Hospices care for patients with many different diseases such as Alzheimer’s/dementia, ALS (Lou Gehrig’s Disease), cancer, congestive heart failure, COPD, emphysema, liver disease, Multiple Sclerosis, renal disease, stroke or failure to thrive.
A patient is immediately entitled to hospice care once he or she is diagnosed with an end-stage illness that has a prognosis of six months or less. It is most ideal for patients in the last six months of life, not just for people in the last 24-48 hours of life. Selecting hospice care early lets patients achieve control of their environment and symptoms. A 2004 Journal of Pain and Symptom Management article, “Medicare Cost in Matched Hospice and Non-Hospice Cohorts,” showed that patients enrolled in hospice cost Medicare less. The research also showed that hospice patients lived longer on the average than similar patients who did not choose hospice care.
Hospice care eases caregiver burdens and provides cost savings for weeks, months and sometimes years. Hospice care also decreases costly hospitalizations. According to the Journal of the American Medical Association, patients not enrolled in hospice care spend 23 or their last days in the hospital, while patients enrolled in hospice spend only eight days in acute care settings.
Choosing hospice care shifts the focus of treatment from aggressive medical curative measures to medical comfort measures. Hospice does nothing to speed up or slow down the dying process, but accepts death as a natural and inevitable event. Although some mistakenly see hospice care as giving up all hope, studies have demonstrated that hospice patients improve physically and emotionally, because their home and family situations have stabilized, their economic worries are reduced and lastly, but most significantly, their pain is better controlled.
Hospice care is most beneficial for patients who enroll early rather than in the last days and weeks of life. “With earlier referral to a hospice program, patients may receive care that results in better management of symptoms, leading to stabilization of their condition and prolonged survival,” wrote the authors of a 2010 New England Journal of Medicine study. The study reported patients were happier, more mobile, in less pain and lived nearly three months longer.
The National Hospice and Palliative Care Organization (NHPCO) reports that eight out of 10 Americans want to be cared for in their homes when facing a life-limiting illness. And, almost 70 percent of patients receive care in their place of residence. More than 1.5 million people with a life-limiting illness get help from the nation’s hospice and palliative care providers every single year.
People choose hospice so that their final months and days are spent comfortably with loved ones. Family members, friends, physicians and even patients themselves can refer to hospice, but a physician’s order is still required. Finding a hospice in your area is as simple as using NHPCO’s website, www.NHPCO.org, or Florida Hospice and Palliative Care’s site, www.FloridaHospices.org. It’s never too early to call a hospice for help, to ask a simple question or to refer a patient.
Since 1990, Hospice of the Comforter has provided compassionate care to tens of thousands of patients and families who are our friends and neighbors. As a local, nonprofit hospice, our support and resources come from our supportive community. We stand behind our mission of being compassionate people providing compassionate care. For more information on Hospice of the Comforter, please visit www.HospiceoftheComforter.org.
By: Tiffany Campion, Director of Communications, Covenant Hospice
It has been said that human beings are the only living beings that have knowledge of and can anticipate their own death. Even if that is true, most of us just don’t like to think about our own mortality. We are too busy living a full life, raising our families, earning a living and doing so many other things that contribute to our quality of life.
For some, death comes unexpectedly and swiftly by auto accidents, trauma, and sudden medical conditions such as strokes or heart attacks. However, for the remainder, a slowly progressive medical condition or disease process can give us the unique perspective to anticipate and plan for our death.
Most people do plan for death in one way or another. We purchase life insurance, prepare wills, and often invest in funeral plots and pre-planning. Hospice care could be, and for many people should be, one of the elements of that plan. However, there are many uncomfortable questions and preconceived ideas about hospice and pain management that hinder the ability to move forward with hospice planning. Education about the individual roles of hospice team members and the wide variety of pain management techniques available is one of the best ways to dispel fear when discussing care. Our chaplains are compassionate listeners who get to know the patient for their human value and help them on their individual spiritual journey, regardless of the denomination they identify with. Hospice doctors and nurses assess and evaluate symptoms and improve comfort for the patient so that suffering is diminished and quality of life is enhanced. Social workers, hospice aides, and volunteers all look for ways to elevate the patient and share a common goal of helping patient wishes to become reality.
We know expectations of a sad, gloomy, depressing experience are mistaken and hospice really provides a compassionate, positive, uplifting care experience that adds quality to days when days can’t be added to life. Many hospice organizations, including Covenant Hospice, use a journaling tool to help patients complete a life review. It is important for both the family and the patient to share who they are, what they have done, what they believe in, the strength they have brought to their family, to their church, and to their community. Unfortunately, financial concerns also frequently deter family members from making informed decisions about hospice care. It is important to understand that many non-profit hospice organizations like ours provide care based on need and not financial ability. This offers us the opportunity to bring quality of life and kindhearted care to the patient regardless of their ability to pay.
We have found that families who are not well-informed about hospice often reject it thinking that it would become a great, sad burden on them emotionally and financially. On the contrary, families who have been through the hospice experience seek it out continuously and benefit significantly from bereavement programs that are offered after the patient is gone. The educated and knowledgeable family knows that the focus of care is not the patient’s death, but rather their life.
Covenant Hospice is a not-for-profit organization dedicated to providing comprehensive, compassionate services to patients and their loved ones during times of life-limiting illnesses.