Music Therapy Benefits in Hospice Care

A Music Therapy Case Study | Joshua Gilbert, MT-BC

Throughout life, song can positively affect us both physically and emotionally. It influences bodily functions that we believe are beyond our control, such as heart rate, blood pressure and release of the body’s natural pain relief chemicals. Music therapy offers significant benefits for patients, caregivers and families. We offer it as part of our hospice services.

In a case study conducted (by Joshua Gilbert) on the impact of music therapy over a four-month period, with an older adult in hospice care, results exhibited significant signs of improvement in the following categories:

  • Quality of life
  • Self-esteem
  • Emotional expression
  • Breathing patterns

Through involvement in music-based interventions, these improvements allowed the patient to benefit from music therapy during hospice care. The patient often smiled, laughed and made positive comments about the music. After participating in deep breathing exercises and harmonica playing, the patient’s breathing became deeper and less labored. Additionally, the patient developed increased confidence in improvising harmonica music, and more open about expressing her emotions surrounding death.

Despite patient status or level of consciousness, music therapists can console and comfort them through music. Research has shown hearing is the last outside sensation that registers with a dying patient. Let us help your loved one make this experience more soothing.

To read the full case study, please click here.

Common Hospice Diagnoses

Hospice of North Alabama is here for you – 24/7/365.

Choosing Hospice is often a difficult decision. We help lead this conversation and can ease the anxiety of the transition from cure to comfort for patients who are appropriate for hospice care. If two or more of these potential indicators are present, hospice should be considered.

Common Hospice Diagnoses

End Stages of: Cancer, Heart Disease/CHF, Pulmonary Disease/COPD, Dementia/Alzheimer’s Disease, Neurological Disease/CVA, Renal Disease & Liver Disease.

If your loved one is requiring increased assistance with Activities of Daily Living (ADLs) such as bathing, dressing, grooming, oral care, toileting, transferring to their bed/chair, walking, eating, etc.; this may be an indicator that hospice should be considered.

Additional indicators include:

  • Muscle Loss/Weakening or Weakness
  • Multiple Falls
  • Multiple ER Visits/Hospitalizations
  • Recurrent/Multiple Infections
  • Altered Mental Status
  • Unintentional Mental Status
  • Unintentional Weight Loss
  • Difficulty at Mealtime
  • Increasing Shortness of Breath
  • Multiple Medication/Frequent Medication Changes
  • Sleeping Longer/Napping More
  • Skin Breakdown/Wounds
  • Other Diagnoses that Contribute to Decline

If you have questions about the hospice benefit or when to elect your benefit, please contact Hospice of North Alabama at 256-332-7011 (Florence) · 256-533-4300 (Huntsville).

One Word: Hospice

One word… One word that’s the most solidifying word you will ever hear. A word that can often be misinterpreted.

One word… Hospice.

This means you are dying. Maybe not dying today, tomorrow or the next day – but it is a word not many want to hear. As a hospice liaison, helping people understand to not be afraid is part of what makes my job so rewarding. Watching potential patients and their family member begin to ease as I explain the role of hospice is an incredible feeling.

As a hospice liaison, I help ease all your previous notions about what we do and assure you that we are here to help.

Hospice doesn’t mean you will die tomorrow. It does not mean you will be taken off all your medications or stay home while waiting for the end. What it does mean is that you have a terminal illness and instead of continuing to seek aggressive treatment, it is better for you to be comfortable and have a quality of life with loved ones, however that may be defined by you.

It is shown that a hospice patient lives more comfortably when: a nurse visits to manage pain and symptoms, a home health aide provides personal care, a social worker assists with community resources and counseling, a chaplain offers spiritual support, volunteers play cards with and a physician oversees it all to ensure you are as comfortable as possible for however long that may be.

That one word… Hospice. Let’s look at it in a more positive way, focusing on the benefits we can offer a patient and their family.

So, I ask both professionals and patients – Why would you not want to live more comfortably with support from hospice?

-Tracy Wagoner, Hospice Liaison

Our COVID-19 Response: A Letter from Our CEO Mike McMaude

To the Abode Healthcare Community,

I hope this note finds you and your loved ones safe and healthy. The COVID-19 pandemic is affecting each of us in different ways. As we navigate the current situation together, I want to provide an update on the steps we have taken to be there for our community, our employees, and our patients.

All of us at Abode Healthcare are focused on providing the highest quality of care to our patients. I provided an update at the end of March outlining the changes we implemented to prioritize safe patient care in this new environment. Every decision we have made, and continue to make, has been based on the priority of the health and wellbeing of our patients and employees.

I am deeply grateful for our employees who display incredible dedication by continuing to fulfill their commitment to our patients during this especially challenging time. These individuals, and everyone working on the frontlines of care, deserve to feel protected, confident, and taken care of.

In recent weeks we have made informed decisions and taken actions that ultimately support and benefit our entire community:

  • PPE: At the first sign of COVID-19, we prioritized spending where it’s needed most and to date, have purchased $1 million of Personal Protection Equipment (PPE) so no one reported to work without protection. I’m proud to say that we’ve not had to turn down any patients due to lack of PPE. We’ve even been able to assist other homecare and hospice organizations, and hospitals serving the Navajo nation as well as other underserved populations, in providing supplies for their employees by donating thousands of PPE items. In addition to our company’s commitment, several executives on our team have made personal PPE donations for local health organizations so they can work safely.
  • Paid Leave: To support employees who risk their own health and safety to care for patients, we instituted a special paid-time-off policy modeled after the Families First Coronavirus Response Act designated for companies with fewer than 500 employees. In Abode’s plan, employees receive unlimited leave for issues relating to COVID-19, including a newly instituted emergency paid time off (EPTO) benefit that is in addition to the PTO employees accrue with regular benefits. These additional benefits allow employees to potentially recover from COVID-19, care for a family member who is ill with the virus, or care for children whose schools and daycares have closed.
  • Business Investment: Rather than cut back, we’ve leaned into the business to make sure that we are even better prepared to care for patients. Some of these actions include:
    • Building out our telehealth and remote care solutions
    • Retaining a dedicated, talented workforce
    • Hiring new employees and growing our team locally and nationally
    • Expanding our team’s knowledge with the addition of an infectious disease physician, Dr. Shannon Thorn
  • Charitable Donations: As we have every year, we continue to support charitable organizations in our communities. That will not stop just because of COVID-19. Support for neighbors, near and far, is needed now more than ever.

I am extremely proud of how everyone at Abode has reacted and handled the unique situation that the COVID-19 pandemic has presented. It’s difficult to adequately express my appreciation for our community—patients, employees, and partners. I have been reminded, once again, what an incredible organization we have—one that is driven by a common purpose of caring for, and serving, vulnerable patients. Every member of our team has come together to do what’s right, and I thank you. We look forward to continuing to work together and supporting each other through this challenging time.

Stay safe and healthy,


Celebrating Nurses | Destin Ellison

Hospice of North Alabama is celebrating nurses during the month of May! Meet Destin and learn about her passion for nursing as she explains her “why.”

I believe I was called at a young age to become a hospice nurse. At 17, I lost my pawpaw to cancer. The hospice nurse was there through it all and provided so much comfort for my family and me. I craved to be that comfort for someone else.

At the age of 21, I became an RN, and a year later I entered my dream job of being a hospice nurse. I have been doing it for 7 years since. I have been with HNA since 2016, and I could not imagine a better company to work for.”

Destin adds at the end: “If you love what you do, you will never work a day in your life.” -Marc Anthony

Celebrating Nurses | Christy York

Hospice of North Alabama is celebrating nurses during the month of May! Meet Christy and learn about her passion for nursing as she explains her “why.”

“I chose to be a nurse because I wanted to make a difference in this world. I always knew I wanted to help people as a little girl, and I enjoyed marking people smile. I also wanted to leave people better than I found them by making a positive impact on their lives. My goal was to make my Dad and the rest of family proud, so I became a Nurse to give back to the world!”

Celebrating Nurses | Adam Heard

Hospice of North Alabama is celebrating nurses during the month of May! Meet Adam and learn about his passion for nursing as he explains his “why.”

“I became a nurse somewhat late in life, not going to nursing school until I was 34 years old. Prior to that, I grew up in a family of EMTs and firefighters, and some of my earliest memories were on medical and accident scenes, stuck in the car watching from the window of course. At the age of 17, I joined the military as an army combat medic and went to Iraq for 14 months running an ambulance. When I returned home, I was working as a medical assistant in an oncology practice. I decided to try something different and was out of the medical field for five years before deciding to go back to school.  This was the best decision I’ve ever made.

I love helping people, solving problems and educating my coworkers, patients, and their families. After working in the ER and as a travel nurse for a few years, I had a friend with Hospice of North Alabama who told me about some openings. I thought I might enjoy this and liked the idea of using my nursing knowledge to help people in a very tough time and make an impact on how they experienced the dying process. So, I decided to give it a try and have loved every minute of it since.

I truly enjoy caring for my patients and their families, along with the opportunity to educate people who are new to Hospice of North Alabama. I cannot see myself going anywhere other than hospice!”

Celebrating Nurses | Julie Doss

In her 8th year as an RN, Julie Doss of Hospice of North Alabama reflects on her journey towards becoming a nurse and all those who have influenced her along the way. In honor of National Nurses Week, we want to share Julie’s passion for hospice nursing and how her career choice has impacted her life.

Julie always knew she wanted to be a nurse but was cautious because she thought her stomach couldn’t handle it, so she became a teacher instead. Even as a child, her mother told stories of her pretending to stick her dolls with sewing needles, as if she was administering an IV, and taking care of them like real patients.

When her career of teaching pre-k abruptly came to an end, Julie saw the opportunity to pursue her dream of becoming a nurse. She arrived at this decision shortly after losing her grandfather. He suddenly became sick, and exploratory surgery revealed cancer that had metastasized throughout his whole body. The doctors announced he had seven days to live, and he was palliated in the hospital. During her grandfather’s seven days in hospice, Julie spent time keeping him calm and settled until he passed.

Several weeks after his passing, Julie’s other grandfather was admitted into hospice care as well. For nearly a year, Julie helped take care of him during his time with hospice. With those experiences in mind, Julie thought, “If I could do those things for the people I loved most – some of those most private caregiving duties – I could do it for anyone.” As a result, she enrolled in a CNA program and worked nights at a nursing home for almost a year, while her husband worked hard to help put her through school.

Her first job out of nursing school was working nights at a hospital in the neuro/ortho unit. While she loved this position, she couldn’t help but think of how highly her mother-in-law spoke of the hospice organization she worked for. With that in mind, along with her personal experiences, Julie knew that hospice nursing was her true calling.

When a fellow church member reached out to Julie about working for Hospice of North Alabama, she jumped at the chance.

“I thought I was going to be fired after my first day on the job. Two of my five patients passed away that day. Since then, I have grown and gotten to do many different things in my time with Hospice of North Alabama/Abode Healthcare. This is one-hundred percent because of the people who have supported me along the way, and my coworkers who have taught me so much and mentored me.”

How Hospice Nursing Has Impacted Julie

Not long after Julie became a hospice nurse, she had a patient with lung cancer who was declining rapidly. He was a minister with a very close-knit family. It was clear he was the rock of the family; the center of everything they did. Because of this, the family was taking the situation very hard.

After being with the patient for nearly a month, February rolled around, and with it came a prediction of ice and snow. As the weather became increasingly worse, Julie received an upsetting call from the patient’s daughter, saying he was declining rapidly. After finding a safe means of transportation, Julie made her way to the family.

When she arrived, she could sense the family was truly struggling. In the week before, Julie had talked with the family about how important it is for someone who is dying to have permission from their loved ones to let go. After getting the patient comfortable, the daughter came up to Julie and asked if it was time to do so. Julie then stood in the corner of the room and watched the family, one by one, sit on the man’s bedside and pour out their hearts by telling him how their lives were forever changed because of him.

When it came time for his wife to say her goodbyes, she could hardly do it. She looked at Julie and she responded, “If all you need to do is lay with him, that is okay.” Then, the wife laid next to her husband, wrapped her arms around him, and whispered her love to him and how thankful she was for the family they created together. As she told him it was okay to go, he took one breath and was gone.

“I will never forget experiencing this love of a family and what that means to people. I have cared for a lot of people and attended many deaths, but never have I heard regrets about money, work, etc.; all they talk about are people they love. This is such a great reminder of how you should live your life and what is truly important. There is not another job is this world that I would rather do than what I am doing right now – with the people I work with and the company I work for.”

Julie & Hospice of North Alabama – Personal Testimony

“We are incredibly blessed, here at Hospice of North Alabama, with a fantastic group of people whose mission in life is to make sure we take care of the patients who allow us into their homes, lives and hearts for whatever time they may have left. Hospice is not about dying, it is about living well for whatever time you have left. It is our job and privilege to help contribute to that.”

“Through hospice nursing, Hospice of North Alabama and my coworkers, I have had some of the best experiences of my life. I have learned more about life, how to live and what’s important through this job that any other thing I could possibly do.”

“When you work with people who are at the end of their life, and their families who are dealing with the loss of a loved one, you just learn so much about what is truly important. I have learned so much about forgiveness and the importance of the relationships in my life.”

“One of the things that sets this organization apart is the staff here. I am just beyond amazed at how they love their patients, their jobs, and how they take care of one another. We have been able to do and see many wonderful things for patients that would not have had that opportunity without the help of the staff here.”

Happy Nurses Day!

Today, we recognize our nurses for their hard work, support, and compassion. Because of you, we live in a happier, healthier world. Happy Nurses Day!

Your hard work and dedication does not go unnoticed. Now, more than ever, we appreciate you!

COVID-19 & Hospice

Pandemic Relief via legislation, CMS waivers, and enforcement discretion

  • Telehealth
  • Waived requirement to use volunteers
  • Waive non-core services (physical, occupational, and speech pathology) *hospice only
  • Waive on-site visits for hospice aide supervision

Telehealth and Telephonic Visits

  • CMS permits hospices to provide telehealth to a Medicare patient receiving routine home care during the emergency period, if it is feasible and appropriate to do so.
  • Face-to-face encounters for purposed of patient recertification for the Medicare hospice benefit can now be conducted via telehealth (must be 2-way audio-visual)
  • Must be physician-ordered and on the plan of care

In an effort to protect patients, some SNF, LTC, hospice, and other facilities are limiting the number of visits that Abode Healthcare staff may make to patients in their care. Some patients are even requesting fewer in-person visits to reduce their exposure to the outside world.

Abode Healthcare understands and joins in these protection measures by offering telehealth visits. In some cases where access has been limited or is desired, Abode staff are utilizing telehealth on a weekly or bi-weekly basis in order to maintain contact with high-risk patients.

In all cases, telehealth visits are meant to be supplementary to in-person patient visits. Telehealth visits should not replace in-person visits altogether.

Telehealth Tools

Our commitment, as always, is to serve our patients as best we can. Our clinical team has been trained in effective ways to utilize telehealth systems to streamline patient care through our own remote access system using the following tools:

  • Phone: Abode Healthcare staff may conduct remote visits with patients through phone calls.
  • Video: Abode Healthcare staff may conduct remote visits with patients through (All F2F between NPs or MDs, DOs must be done through a 2-way type of technology. This is for both HH and Hospice)
  • me can be utilized via tablets or phone and has been selected by Abode due to the ease of use for both the clinician and the patient/family/caregiver as well as its ability to capture/validate that the tele visit occurred, and its security features.

Though telehealth is never our first choice, it is the right choice during this time. Abode Healthcare continues to partner with providers to preserve the health and wellbeing of all of our patients.