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Volunteers are an essential part of the hospice care team. The difference they make for our patients and their families is immeasurable. Whether it’s through direct care or administrative work behind the scenes, there are countless ways a hospice volunteer can help.
We are beyond grateful for the incredible people who volunteer their time and talents to make a positive difference in our patients’ lives. In honor of National Volunteer Month, we’d like to recognize just a few of them. We asked our volunteers to share what made them decide to be a hospice volunteer and what they find most rewarding about their experience.
“On September 10, 2018, Mr. Kelly Gafkjen, Chaplain, Hospice of the Midwest, was a guest speaker at our Urbandale-Johnston Veterans of Foreign Wars monthly meeting. Kelly was on a mission seeking veterans to talk to veterans in local hospice care in their homes or hospice facilities. Many veterans in hospice would like to share their life and military experiences, but feel only a fellow veteran can associate with their feelings. At the conclusion of his presentation, Kelly asked that we consider volunteering, receive some minimal training, and agree to talk to veterans who are seeking fellow veterans to talk to. After our meeting concluded, a number of us discussed the information presented by Kelly, and three of us thought this was right in line with our VFW mission of “Veterans helping Veterans”. Contact was made with Kelley and the three of us started our training at the Fall Training Session September 27, 2018 , conducted by Kelley and Taylor Schneider. By the end of October we had finished our training and were waiting for our first assigned veteran. Under the guidance of Taylor I was introduced to my first veteran during a pinning ceremony on November, 30, 2018. Since then I have had the privilege of meeting and sharing both civilian and military experiences with 9 veterans of WW II, Korea, Vietnam and the Cold War eras. Every veteran, whether Army, Air Force, Navy or Marine, were all comrades and had their own unique and fascinating stories to tell. Some sad, some humorous, but all seemed willing to share with enthusiasm. I so much enjoyed visiting with these men, and I only hope they felt the same comradery that I felt while in their presence. I will miss these veterans but look forward to meeting my next comrade.”
“We started volunteering for a local hospice during the pandemic (2020). We stumbled upon the opportunity from an email our mom received asking for donations of homemade casseroles and cards for hospice patients and their families. At first, it started by making occasional cards and casseroles, and then it turned into a routine every other week activity. This evolved into helping other hospices including including Grane Hospice. We have made homemade cards and even have given a virtual concert for the patients at Grane Hospice. We feel grateful to be able to give back to others in need even during a worldwide pandemic. It shows no matter what the circumstances, we can help others in our community. All this volunteer work has inspired us to create our own non-profit group called Rays of Sunshine, benefiting local hospices. We hope to expand and help even more local hospices in the future.”
“Coming from a family where both parents were in the medical field, I have had an interest in medicine ever since I can remember. In the pursuit of getting involved with medical volunteering opportunities, I wanted to commit to something that would provide meaningful experiences in vulnerable people’s lives, as well as my own. Although my patients’ physical bodies are failing them, they still have great wisdom to impart when given the chance to share and be heard. Many times, I leave the local assisted living facility with an enlightened perspective that I believe will serve me well in the career I am aspiring to have. From hearing first-person stories of World War II experiences to celebrating 96 years of living, there is always a window for valuable learning opportunities when I have the chance to spend time with these folks whom I now consider my friends.”
“I Prayed about being a Hospice Volunteer and this is how the Lord is using My ability as a Hairdresser, to bring Comfort and Joy to the Patients. The most rewarding aspect is seeing the Happiness in the Faces of the Patients and their Families. Working with Them is a Blessing to Me.”
“Being a hospice volunteer is about having a passion and love for helping others. No, I don’t physically help them but the most rewarding part about volunteering with my dog, Flynn, is seeing the joy it brings to residents. Residents look forward to our visits and remember us from week to week, allowing special connections to be made. I’m thankful for the opportunity Flynn and I have to give our time and make people smile.”
Kennedi and Ernest – graduate level social work students with Alabama A&M University and the University of Alabama – are student volunteers with Hospice of North Alabama in Huntsville. They sit with patients to provide caregiver respite. Hospice volunteer work allows students to garner a strong understanding of how social workers broker services within a healthcare agency as well as how to coordinate with various other healthcare and social service agencies.
Ernest states “I have learned that the process of dying and bereavement is as diverse as the families we serve. The first step of serving this population is engaging the patient and/or caregivers on what they want this time in their lives to be like—no two answers are the same.”
Along with the home environment, they also work with residential care communities to provide comfort and support. This gives them experience working with diverse community types and medical care needs.
Kennedi states “The things I’ve learned while interning at Hospice of North Alabama have prepared me to be a more caring and competent social worker. The compassion and kindness that HNA shows to the patients has been extended to me from the very beginning, and I’m so grateful. This has been the greatest experience of service I have committed myself to.” Ernest agrees, adding: “Knowing that you have provided support to a patient and/or their family in this transition period is rewarding. Establishing the trust that fosters comfort and emotional resiliency is an experience that will give volunteers a unique understanding of how health care best serves patients in all life stages.”
“My internship and volunteering experience with Premier Hospice was meaningful and fulfilled my longstanding desire of working with end-of-life services to clients and their families.
I enjoyed working with a well-resourced team that included a chaplain, bereavement coordinator, social workers, liaisons, nurses, a doctor, and a volunteer coordinator. Each of them brought to bear their own particular skillset, and we all collaborated to make our clients’ end of life as comfortable and dignified as possible.
Besides teamwork, I enjoyed, I enjoyed visiting with my client once a week. My primary role was to support and strengthen the care providers so that they might function better.
I also enjoyed supporting other team members by making caring calls to clients or their families. It was amazing how much comfort and reassurance I could bring to them through the calling service. My participation in the online bereavement group was my gain in the understanding and knowledge of the process in group work, particularly for grieving families.
Through my time with Premier Hospice, I have grown to better appreciate the important role of leadership in the hospice setting. The internship was profitable to my professional growth and development.”
“I volunteer with hospice to facilitate new transitions. In January 2020, I completed the training to become an End-of-Life Doula in New York City. In my move to Indianapolis, it was important for me to find a strong hospice program where I could be actively involved in the moments of life and death with others.
I volunteer because dying is an important cycle in every community. It is never easy to participate in the dying process, it pulls at every piece of your being. But there is nothing more rewarding than helping a patient or caregiver smile again while recalling a significant life moment. There is nothing more rewarding when the world feels burdensome, to help others find peace even for a single second.”
Thank you to these incredible individuals – and to all the volunteers on our team – for all you do for our patients and their families. You are amazing!
Interested in learning more about volunteer opportunities at Hospice of North Alabama? We’d love to have you on our team! Learn more and apply here.
By: Dr. Laura Mantine
Parkinson’s disease (PD) is caused by the loss of dopamine-producing nerve cells within the brain. The loss of dopamine causes symptoms like stiffness, slow movements, balance problems, and depression. There are certain specific motor symptoms that accompany Parkinson’s disease. A resting tremor happens when a body part, usually a hand or foot, shakes slightly when a person is not using it. Bradykinesia is whenmovements are extremely slow, and patients may have freezing episodes which are temporary, involuntary periods where a person is unable to move. A PD patient may also experience changes in speech, smaller handwriting due to difficulties performing repetitive motions, and a “masked” face due to a loss of facial expression. Patients are also at an increased risk of falls from a combination of poor balance and severe stiffness. A PD patient may develop difficulty swallowing which can lead to weight loss, malnutrition, dehydration, and pneumonia.
There are also non-motor symptoms that are present in Parkinson’s disease. Parkinson’s dementia is a significant, permanent decline in attention, memory, and problem-solving that impairs daily life. A patient may develop hallucinations or delusions throughout their disease course which can lead to increased caregiver stress. Patients may also suffer from severe constipation, urinary problems, and sleep disorders that affect their quality of life.
As a progressive disease, Parkinson’s disease symptoms will slowly worsen over time. While PD affects people in unique ways, there are typical patterns of progression, defined by five stages. In stage 1 and stage 2 of Parkinson’s, patients may experience mild shaking and stiffness. As the disease advances into stages 3 and 4, loss of balance and slowness of movement begin to impair daily functioning. Stage 5 is the final, most debilitating stage of PD. In this stage, patients are wheelchair- or bedbound and require 24-hour nursing care. Patients are said to have end-stage Parkinson’s disease at stages 4 and 5 of the disease. In end-stage Parkinson’s disease, symptoms are so severe that medication stops working well, and patients require full-time caregiver assistance. Eventually, end-stage PD patients become candidates for hospice care, a service that focuses on easing symptoms and improving comfort at the end of life.
There are no formal PD eligibility guidelines for determining when a hospice referral should be made, and there is no definite timeline when it comes to the final stages of Parkinson’s disease. However, hospice care is available to patients who are expected to live six months or less. Doctors and hospice agencies will consider factors relevant to PD like a patient’s history of falls, hospitalizations, withdrawal from activities, inability to perform self-care, and lack of benefit from medication. There are very general hospice guidelines intended to cover a broad-spectrum of neurological disorders. The guidelines for neurological illnesses state that patients must meet one of the following to be eligible for hospice: critically impaired breathing or rapid disease progression in the past year.
Critically impaired breathing is unlikely to be applicable in Parkinson’s disease. Primary respiratory problems are not typical in advanced PD. The second criterion, evidence of rapid disease progression in the prior year, tends to be more useful for patients with end-stage PD. A rapid disease progression means that patients are bedridden, have unintelligible speech, require a modified diet, and need major assistance with activities of daily living. Nutritional impairmentis common in end-stage PD. Patients are unable to maintain sufficient oral intake and experience weight loss and dehydration. Life-threatening complicationsthat may occur in end-stage PD include recurrent aspiration pneumonia and pressure ulcers of the skin.
Hospice care is an extra layer of support to help care for loved ones with end-stage Parkinson’s disease. The goal of hospice care is to optimize comfort and ease physical, emotional, and mental suffering during the dying process. Members of a hospice care team include a doctor, nurse, social worker, and home health aide. Most patients with PD die from the same diseases such as heart disease, stroke, and cancer, that others do. As such, hospice care may be considered even before a patient with PD reaches the end stages of their disease. Deciding when it is time to enter hospice care can be a difficult decision for a person and their loved ones. However, being admitted to hospice can ensure a person and their caregivers have access to a variety of services that are needed.
“Eligibility for End-Stage Parkinson’s Disease Hospice Care.” By Colleen Doherty, MD. Published on October 24, 2021. Medically reviewed by Isaac O. Opole, MD, PhD. https://www.verywellhealth.com.
“The Role of Hospice in Parkinson’s.” Parkinson’s Foundation. 2018. https://www.parkinson.org.
By Jacquelyn Buffo, MS, LPC, CAADC
Losing a loved one to a terminal illness is one of the most painful experiences you can go through. The loss of a spouse or partner is traumatic for many people, and the grief journey can feel overwhelming, confusing, and painful. However, each person grieves and works through the grieving process at their own pace and in their own way. If you are grieving the loss of a partner or spouse, you are not alone. The month of April is Bereaved Spouses Awareness Month, observed since 2008. Bereaved Spouses Awareness Month provides support and resources for bereaved spouses.
The difficulty of losing a spouse is followed by a grieving process that can be challenging for many people. Grief is a process and includes many different types of symptoms, some more severe than others. Feelings such as shock, sadness, numbness, and even guilt can occur after losing a spouse. Your experiences of grief may be different than others, and it is dependent upon factors specific to you. Grief can present as intense emotions and can also present in behaviors.
For example, bereaved spouses may experience:
There is no right or wrong way to grieve, and support and help are available to you. An available resource along your journey of bereavement is hospice care. Hospice can help spouses prepare for the impending loss of a loved one. The hospice’s bereavement team can also help spouses after a patient passes. The mission of hospice care is to deliver compassionate, quality care to individuals with terminal illnesses and support the families through the caregiving phase and bereavement process.
Many spouses spend a significant amount of time and energy caring for and tending to their ill partners. But unfortunately, they may overlook their own needs and feelings during this time. Utilizing the hospice team as a source of support can help spouses tend to their emotions and needs when it is difficult.
If you are struggling with the loss of a loved one, it is vital to get the help and support you need. First, talk to a trusted family member or friend about what you’re going through. Loved ones can be strong sources of validation, support, and compassion. You can also talk to your doctor if you notice a change in behavior and mood or if you are having difficulty performing the normal activities of daily living, such as showering regularly and eating. Your doctor may be able to provide you with medication and can also provide you with referrals to a grief counselor or support group near you.
By: Laura Mantine, MD
“Wear the white coat with dignity and pride, it is an honor and privilege to get to serve the public as a physician.”― Bill H. Warren
Physicians display heroism and courage every day in hospitals, nursing homes and clinics. National Doctors’ Day, celebrated on March 30th, is an annual observance aimed at appreciating physicians who help save lives everywhere. The holiday first started in 1933 in Winder, Georgia, and since then it has been honored every year. The idea came from Eudora Brown Almond, wife of Dr. Charles B. Almond, and the date was chosen as it marked the anniversary of the first use of general anesthesia in surgery. This month, National Doctors’ Day continues to highlight many questions, concerns and fears about what the future of medicine holds. The COVID-19 pandemic has already left its indelible mark on American’s health and well-being. Many doctors have courageously set aside their own fears to help those in need, lend a hand to an overburdened colleague, gather supplies and equipment for those who may soon go without, and accelerate the research to develop a vaccine or medication that may bring an end to this pandemic once and for all.
As the COVID-19 pandemic continues to unfold and upend American life, physicians, nurses, and the health care workforce are leading a remarkable response effort by putting their health and safety on the line every day. There have been many cases in the U.S and around the globe in which physicians have fallen seriously ill or died after treating patients for COVID-19. The physical toll alone is daunting with extremely long and taxing hours at a patient’s bedside. The emotional toll is just as significant, and enough to overwhelm even the most seasoned and experienced doctor. Ultimately, no one can say for sure how long this health threat will last or how much more our nation’s physicians will be asked to give.
The COVID-19 pandemic reminds physicians of the obligation to place a patient’s welfare above our own, the need to protect and promote public health, and the ethical considerations involved in providing care under the most urgent and trying circumstances. Physicians embrace all these responsibilities and more as a routine part of their professional lives. This fact does not diminish the burden a physician will undertake on a patient’s behalf. The selflessness displayed in the face of a deepening health crisis is truly extraordinary.
When physicians are asked why they chose their profession, answers will of course vary. One theme tends to underlie all the responses: a profound commitment to helping others. Physicians are called upon to help in moments like the COVID-19 pandemic. Dr. Patrice A. Harris, former president of the American Medical Association, said in her inaugural address “Physicians don’t run from challenges. We run toward them.” Physicians undertake these efforts because they are called to do so, not to earn public recognition or thanks. People should thank them and offer heartfelt gratitude and praise, not on National Doctors’ Day but every day.
Hospice is a special type of care for those living with a terminal illness and a life expectancy of six months or less, should the disease run its natural course. It uses a team approach in which the care team focuses on the patient’s physical, emotional, and spiritual needs.
Although over 1 million patients and families experienced the value of hospice firsthand in 2018 alone*, there are still a lot of misconceptions about hospice care.
A big part of hospice is education. We want to do all we can to educate our communities about the services hospice offers and how they can benefit you and your loved ones, starting with some common misconceptions.
Many people think that when they choose hospice, it means they are giving up hope. We have this instinct to fight and fight until the very end, and to stop fighting means to give up. However, hospice isn’t giving up. It is giving yourself and your loved ones permission to stop running back and forth to the hospital and stop the exhausting curative treatments. Hospice allows patients to be comfortable and at peace and to have the best quality of life possible.
Many people believe hospice is a place you must move to when you elect services. This is not the case. Hospice services can be provided wherever you call home – including your residence or a skilled nursing facility. The majority of patients on hospice services live at their home and continue to live at their home throughout their time on hospice.
Another common misconception about hospice is that it will cost you and your family a lot of money. The truth is actually quite the opposite. Hospice does not cost you anything out of pocket. It is covered by Medicare, Medicaid, Veterans’ benefits, and most private insurances.
This includes not only the cost of nursing visits, but also the cost of medications and medical supplies.
Learn more about how hospice is paid for.
The goal of hospice is to keep the patient’s pain under control and to keep them as comfortable as possible. While pain and symptom management can include giving the patient morphine and other comfort medications, not all patients will need it.
Hospice does not expedite death and does not help patients die. In fact, we sometimes find that patients live longer than expected when they choose to receive the support of hospice services. Hospice is about ensuring the patient is no longer suffering from the symptoms of their terminal illness. It keeps them comfortable by managing pain and symptoms, such as shortness of breath or restlessness.
This could not be further from the truth. When you elect hospice, you (or your power of attorney) are always in control. You are in the driver’s seat, and hospice is here to support you. If you decide you no longer want the support of hospice, you can make that decision. And if you are ready for hospice again at a later time, you decide that, too.
Hospice will not tell you what to do. You tell hospice what your care goals are and what you want. If you do not want certain medications, they will not be forced on you. The hospice care team will work with you to honor your wishes in every aspect of your care.
Many people think hospice is only for the very end of a patient’s life, but that’s not the case. Although hospice is for patients who have a life expectancy of six months or less (should the disease run its natural course), you can be on hospice for much longer than that – and many patients are.
Hospice patients are assessed regularly during each benefit period. As long as they continue to meet Medicare criteria, patients can continue to receive hospice support, indefinitely.
You do not have to give up your primary care physician (PCP) when you are admitted to hospice. In fact, your PCP is a very important part of the hospice care team. The hospice team will work with your physician to be sure they are updated on your condition and any changes in your care plan.
It is commonly thought that only cancer patients can receive hospice support. However, hospice is for any patient with any terminal diagnosis. Other common diagnoses of hospice patients are end-stage lung diseases (such as COPD or emphysema), heart disease, kidney disease, Parkinson’s, ALS, Alzheimer’s and other Dementias. Patients who have multiple chronic illnesses, that together result in their health being more fragile, also qualify for hospice services.
These are only some of the most common misconceptions about hospice care. If you are still feeling unsure of whether you or your loved one qualify for hospice or if it’s the right choice for you, please feel free to give us a call. We are happy to answer any questions you may have about the services we provide.
Just because you call, doesn’t mean you have to elect hospice. It never hurts to ask questions and learn more. If it’s not the right time now, maybe it will be later. And by calling now, you’ll have all the information you need to make an informed decision when the time is right.
By: Dr. Laura Mantine
Love is all around this month, especially on Valentine’s Day, when we take time to turn to those closest to us and say those three magical words. However, if you have a loved one who suffers from advanced cardiac disease, one of the best ways to show how much you care may not come in a sentimental card or a box filled with chocolates. Instead, it may come from calling hospice. Oftentimes, people don’t realize that hospice care is an option for people who suffer from advanced cardiac disease. Instead, these patients often spend their final days and months in and out of the hospital, receiving treatments that do little to improve the course of the disease. Hospice offers a supportive program of holistic care designed to help patients manage symptoms, forego emergency room visits and receive convenient, compassionate care right in their places of residence.
The estimated annual cost of heart disease is about $200 billion each year. Heart disease is the leading cause of death in the United States across all demographics. Heart disease accounts for 17.8% of hospice deaths, second only to cancer (30.1%). During hospice care, cardiac patients are monitored by a team of physicians and nurses, who administer medications and treatments to keep them as comfortable as possible. Social workers can access valuable community resources. Chaplains and counselors provide emotional and spiritual care for the patient and family. Volunteers can sit with patients, read to them or help them with light household chores, and allow caregivers to get some much-needed respite.
End-stage heart failure is often marked by an abrupt, dramatic decline, followed by recurring recovery and stability until sudden death. Patients are ideal candidates for goals-of-care conversations when they have severe refractory heart failure or extensive symptoms of cardiac insufficiency, have tried or cannot tolerate maximum medical management and are not candidates for curative therapies or surgical interventions. Hospice care addresses a wide range of symptoms, including shortness of breath, chest pain, weakness and functional decline. Eligibility for hospice may require documentation of progressive loss of functional capacity over years, progressive failure to respond to therapies and a desire to discontinue curative treatment. Patients should check with their physician to see whether they are eligible for hospice based on their history of congestive heart failure, arrhythmias or heart attacks. The physician may also consider any coexisting diseases like HIV, diabetes, respiratory illness or kidney disease when transitioning a patient to hospice care.
In addition to increasing a cardiac patient’s quality of life, hospice often increases the cardiac patient’s quantity of life as well. In a study reported in the March 2007 Journal of Pain and Symptom Management, congestive heart failure patients who chose hospice survived 81 days longer than those who did not. Even when modern-day technology or surgery can no longer offer hope, patients with late-stage cardiac disease need to know that help is always available. Hospice allows these patients to experience as much joy as possible in their remaining days while minimizing their discomfort and pain.
Centers for Disease Control and Prevention, National Center for Health Statistics. (2016). Multiple Cause of Death 1999-2015 on CDC WONDER Online Database. Data are from the Multiple Cause of Death Files, 1999-2015, as compiled from data provided by the 57 vital statistics jurisdictions through the Vital Statistics Cooperative Program.
Benjamin EJ, Blaha MJ, Chiuve SE, Cushman M, Das SR, Deo R, et al. Heart Disease and Stroke Statistics—2017 Update: A Report From the American Heart Association. Circulation. 2017;135:e1–e458. DOI: 10.1161/CIR.0000000000000485.
National Hospice and Palliative Care Organization. (2018). NHPCO Facts and Figures 2018 edition.
Ziaeian, B., & Fonarow, G. C. (2016). The Prevention of Hospital Readmissions in Heart Failure. Progress in cardiovascular diseases, 58(4), 379–385. doi:10.1016/j.pcad.2015.09.004
By: Angelique Riley
My name is Angelique Riley, and I have been at Grane Hospice Care, King of Prussia (an Abode Healthcare and BrightSpring Health Services company), for a little over two and a half years. I joined Grane after spending twenty years managing Life Enrichment in Continuing Care Retirement Centers. I found Life Enrichment rewarding, but it was time to hang up that hat and move on to another venture.
I chose to work in Hospice Care to share my natural gift of helping people during the most difficult time of their lives. I take pride in sharing compassion, support, and a great deal of care with our patients. It is a great honor to be spotlighted in our employee newsletter, and to share what Black History Month means to me.
Black History Month is an annual observance originating in the United States, where it is also known as African American History Month. It began as a way of remembering important people and events in the history of the African diaspora. Now that you have the Wikipedia definition of Black History Month; let me tell you what Black History Month really means…
Black History cannot be contained or limited to a single month. I grew up in a family where we honored and embraced our heritage year-round. My siblings and I were educated by our father on the rich history of African Americans. He taught us about inventors, writers, educators, musicians, and other notable Black figures.
It was important to my father that we had knowledge of our own history. We grew up as military children and were exposed to many different cultures and environments. My father prided himself in educating us on African American studies because he knew our schools and society, would more likely teach us an inaccurate version of our history, if they mentioned African Americans at all.
American schools teach students about Dr. Martin Luther King, Rosa Parks, and the enslavement of African American people in the US. Those are important topics to cover, but that barely scrapes the surface of African American contributions to our society. Sparse lesson plans fail to mention the large numbers of African American scientists, physicians, attorneys, and professors who have made huge contributions to American progress.
A quick funny story: When I was in World History Class my junior year in High School in Lawton, Oklahoma, the teacher presented a lecture about religion in the African American community. I remember cringing in my seat, my spirit stirred with frustration because the lesson was filled with errors about my history and my culture. I could not remain silent.
Each time that the teacher mispronounced a name, gave an inaccurate date, or worse, attributed an accomplishment to the wrong person, I spoke up and corrected him. After I contradicted him four or five times, the teacher grew so frustrated that he shouted,
“DO YOU WANT TO TEACH THE CLASS?”. I rose to my feet and said, “Yes, I do”.
It did not end well for me that day. I was sent to the office immediately and punished with an In-House Suspension. Despite the repercussions, I never regretted what I did.
My experience confirmed my father’s prediction that the school was not going to teach the proper information on African American History. Since my father took the time to teach me, I knew my history and had the conviction to share it with my peers.
I shared this story to illustrate the importance of teaching African American History and embracing it as an ongoing celebration in the African American Community. I am grateful to see schools, businesses and the community recognize Black History.
The month of February is a time to honor our ancestors and their hidden or overlooked contributions. It is also a time to reflect on the work still to be done.
Black History Month is a reminder that Black Is Love. I love being an African American woman and getting to reflect with others who are also proud to be African American. Black History Month is an invitation for others to join in the ongoing celebration of black excellence. It is unity in its highest form.
It can be stressful when an elderly loved one is admitted to a hospital or healthcare facility. You likely have a lot on your mind, and what to do when they are discharged may be one of the last things you are thinking about. However, it’s best to think about it early on so you are prepared to bring your loved one home.
You won’t know if you don’t ask. Don’t be afraid to ask your medical team any questions you may have. There are no silly questions when it comes to your loved one’s well-being.
While every person and situation is different, here are some questions you might want to ask (or might help you think of other questions you have):
Oftentimes, bringing someone home from a hospital or facility is more involved than simply getting in the car and driving them home. Whether they are going to their own home or to yours, there may be steps you need to take to make the home safe and accessible. A safe return home can be the difference between being readmitted to a hospital and a full recovery.
Let’s start with the first place your loved one will encounter when coming home: the entry. Make sure there are no cracks or other damage to sidewalks or steps that could cause them to trip. If there are steps (and they can use them), make sure there are sturdy railings for them to hold onto. If they cannot use steps, have a ramp installed.
Falls are a leading cause of injury for seniors, so it is important to reduce the risk for falls as much as possible.
The majority of seniors’ falls occur in the bathroom, so it’s an important room to focus on when preparing the home for your loved one. You can help make the bathroom safer by:
Remove fire hazards from the home, including:
Remember to check the batteries in and test all smoke detectors.
If your loved one lives in a home with multiple floors, make sure railings are sturdy and safe. Look into stairlifts if they are not able to use the steps. If possible, eliminate the need to use the steps at all and set up a one-level living environment.
If your loved one is able to live at home alone, medical alert systems can be great for their safety and your peace of mind. There are many options available that can be worn around their neck. If they fall, they can press a button and be connected to help right away.
Depending on your loved one’s needs, special equipment (known as durable medical equipment) may be needed when they return home. This can include:
Durable medical equipment (DME) that is prescribed by your doctor is covered by Medicare Part B. Medicare offers a great tool on their website that can help you find places near you to get the DME you need.
Have a plan for the day your loved one comes home. Who will be picking them up? What time? Do you need to get any medications or supplies on your way home? Having a plan will make the transition home go smoothly.
Talk to your loved one’s medical team about any other information you need to know. Ask them to go over things like medication and warning signs to look out for and when to call the doctor’s office.
If you can, include your loved one in conversations with the doctor about what to expect when they get home. Life at home will likely be different for them, and that can be difficult to cope with. Hearing it from the doctor and having the chance to ask questions can help make the transition easier for them.
There can be a lot to do before bringing a senior home from the hospital or a facility. Having conversations and starting preparations early can help make the transition smoother for everyone.
There are a lot of things to take into consideration when considering hospice for yourself or for someone you love. In our previous blog post, we discussed the important topic of who pays for hospice. Now, we want to talk about who makes up the hospice care team.
Hospice of North Alabama uses an interdisciplinary approach to care. This means all members of the team work together to determine the best plan of care for each individual patient.
It’s a common misconception that you cannot continue to use your primary care physician (PCP) when you choose hospice. This is not true. The patient’s PCP will continue to be as involved in their care as you want them to be, working closely with the hospice team to determine the best care plan options. The hospice team will keep them informed of all the patient’s wants and needs.
A Hospice Medical Director will also be part of the hospice care team. They oversee all clinical aspects of hospice care and provide medical education to community and facility staff. The Medical Director also actively participates in the admission, eligibility, and recertification decisions and provides overall direction to the rest of the hospice team.
Although they receive guidance from the Medical Director, the hospice nurse is the one who manages the patient’s care. The nurse will visit based on a schedule that meets the patient’s individual needs. Their main purpose is to provide pain and symptom management, keeping the patient as comfortable as possible. They will also administer medication as necessary and will tend to any wounds the patient may have.
There is always a hospice nurse on call – 24/7, 365 – to answer any questions that may arise.
A Certified Nursing Assistant (CNA), also referred to as an Aide, plays a pivotal role in the hospice care team. They are trained caregivers who work under the supervision of a registered nurse to assist with personal care and other duties around the home. CNAs will help the patient with things like bathing, dressing, grooming, and feeding. They will also help with light housekeeping.
CNAs also provide education to family/caregivers so they can feel confident in caring for their loved one when hospice is not there. This can include how to safely transfer your loved one from bed to a chair and back or the best way to help them get from room to room.
CNAs provide a special level of care for hospice patients and their family/caregivers.
Dealing with a terminal illness can be delicate and difficult for the patient and family. The hospice social worker is here to provide emotional support for you and your family, as well as to help with things like:
Our pastoral care team is comprised of ordained ministers with various religious affiliations who provide spiritual support to the patient and their family throughout the entire hospice journey. They provide an interfaith forum where the spiritual needs of the individual come first, not the denomination. Services they provide include praying with the patient/family, reading scripture, or even just sitting quietly with the patient. Chaplains can provide or arrange for religious sacraments or other religious rites. They may also help with funeral or memorial service arrangements.
The grieving process doesn’t wait until the patient has passed to begin. It is completely normal to feel grief when facing the impending loss of someone you love. Our bereavement coordinators are here for you and your family whenever you need them most. Their support begins at the time the patient is admitted to hospice and continues for up to 13 months after death. Everyone grieves differently, but no one should ever have to go through it alone. Please know, our team is here for you.
Volunteers are specially trained to support the patient and their family by providing services such as reading, art/music therapy, pet therapy, and so much more. There are also Veteran volunteers for Veteran patients who would like visits from a volunteer who served in the military.
Volunteers can have such a huge impact on a patient’s hospice journey. If you are interested in becoming a hospice volunteer, you can learn more about the program here.
The final and most important part of the hospice is care team is you, the patient’s family/caregiver. You will be involved in your loved one’s care every step of the way. Starting from the very first discussion about our services, our team will coordinate with you throughout your entire hospice journey to care for your spouse, parent, or other loved one as though they are our own.
If you’d like to learn more about the hospice care team, please contact us. We are here to answer any questions you may have.
‘Who pays for hospice?’ It’s a very common question. And it’s a very good question. If you are considering hospice care for someone you love (or maybe for yourself), you have a lotof things to think about. Worrying about how you are going to pay for hospice care should not be one of them.
At Hospice of North Alabama, we strive to provide exceptional care for our patients and their families. This begins with providing education and resources to ensure everyone involved understands what to expect when choosing our hospice services. That being said, we want to dive into how hospice is paid for.
Medicare Part A covers hospice through the Medicare Hospice Benefit, which states you pay nothing for hospice care. To qualify for hospice care, a hospice doctor and your own doctor (if you have one) must certify that you are terminally ill. This means you have a life expectancy of 6 months or less, should the disease run its natural course. When agreeing to hospice, you will sign a statement that confirms you are choosing hospice care rather than other benefits Medicare covers to treat your terminal illness and related conditions. Simply put, you are agreeing that you are choosing comfort care instead of curative treatment.
Medicaid provides health coverage to millions of Americans, including eligible low-income adults, children, pregnant women, elderly adults, and people with disabilities. It also pays for hospice care for terminally ill individuals in many states. Similar to Medicare, hospice services through Medicaid include:
To qualify, a hospice provider must obtain a physician certification that a patient is terminally ill, and hospice services must be reasonable and necessary for the management of the terminal illness and related conditions. A hospice plan of care must be established prior to services being provided.
The Department of Veteran Affairs (VA) covers hospice care for Veterans who are in the final phase of their lives. They work closely with community and home hospice agencies to provide care in the home. Since hospice is part of the VHA Standards Medical Benefits package, all enrolled Veterans are eligible for services as long as they meet the clinical need for service.
There are no copays for hospice care, whether it is provided by the VA or an organization with a VA contract.
Many private insurance companies provide some coverage for hospice care. Check with your insurer to determine whether hospice is covered. Qualifications and covered benefits vary based on the private insurer.
If you don’t have insurance coverage and cannot afford hospice care, it may be provided free of charge through financial assistance such as donations, gifts, grants, or other community sources.
Please feel free to contact us if you’d like more information about how hospice care is paid for. Our team is always here to answer any questions you may have.