Monthly Archives: April 2012

Hospice Staff Members Bring Smiles

Hope Hospice employees are sometimes asked: “You deal with death and dying on a daily basis. How can you not be sad and downbeat?” As Hope Hospice chaplain John Wilson explains, “Yes, we deal with death. But we also deal with life.”

Hope Hospice and its staff members recognize the serious conditions of patients and the concerns of caregivers. But the Hope Hospice team knows that patients want a smile and an upbeat disposition with each visit. One patient may want a joke. Another may want a Budweiser. They don’t want doom and gloom from the Hope staff people who drop by several times a week.

Persons not familiar with hospice may think that hospice care is only for those who are literally on their deathbeds. While Hope Hospice does sometimes add patients just days or hours before their passing, most of our patients are with us for several weeks to several months.

The main requirement for admission to hospice is a diagnosis that indicates a life expectancy of six months or less. Patients frequently live well beyond that six-month period. (This life extension may be one of the more positive effects of hospice care.) Patients in the early period of the end-of-life process do not need to be reminded of what lies ahead. Instead, Hope Hospice tries to bring a bit of joy to each patient visit. It doesn’t always work out that way, but it is a goal.

When you walk into the offices of Hope Hospice in West St. Louis County, you’re likely to see a couple of people hanging out by the receptionist’s desk, talking and sharing a laugh. You might see a group of employees sitting around the kitchen table having coffee and a pleasant chat. You will notice employees in offices, doing paper work and listening to music. The Hope Hospice office is not a grim environment.

When we lose a patient, however, we grieve alongside the family and caregivers. The entire Hope Hospice organization feels a large share of sadness when a patient leaves this world. But to be productive and provide the best possible patient care, Hope Hospice team members strive to stay upbeat. Our patients want our services delivered with a smile. We do our best to make it happen.

 

 

 

 

 

 

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The Death of a Spouse

A few years back, a man in his late 70’s lost his wife to cancer. With the help of hospice, he was with her to the very end of her life. Her passing was a gradual thing, not a sudden surprise. They had had time to talk together and cry together during her treatment and later when her death was inevitable.

Her life had been a good one. She and her husband were married for 57 years. They were able to travel together following their retirements. She was blessed with many friends. She had received excellent medical care following her initial diagnosis, care that extended her life by several months.

Still, her passing was a devastating event. The visitation and funeral were more meaningful and emotional than her husband had imagined they would be. The support of friends and family gave him comfort. The things they said about his wife reinforced everything he had known and felt about her.

The weeks immediately after her death were the most difficult. Tying up loose ends brought back memories of her life and death. While watching TV, he repeatedly turned to her empty chair to share a laugh or ask what she thought about something on a show. It took several months before he invited neighbor ladies to help him clean out his wife’s side of their closet.

Gradually, the old routines gave way to new ones. With help from church members and former co-workers, he established new social patterns. Having spent nearly two-and-a-half years as his wife’s caregiver during her up-and-down battle with cancer, he had shared much of her emotional pain. Although he survived, he still bore the sadness and sorrow that accompanies the illness and death of a partner.

Later, he was able to share grief with a lifelong friend whose wife faced a similar slow, steady decline and death. Just three years earlier that woman and her husband had provided love and support when his own wife died. He attended funeral home visitations of his contemporaries with a different perspective. Yes, he had buried both his parents decades earlier, but the loss of a spouse is a life event that has no match.

Now that he is in his 80’s, he appreciates every day of his life. He still keeps photos of his wife throughout his home. He enjoys a lifetime of memories, focusing on the good. He realizes that his life continues to bring joy and happiness and that family and friends are more important than ever.

When he is asked about hospice he says, “Those people are angels!” The hospice care provided to his wife was beyond his capabilities. The attention to his wife’s pain kept her comfortable during her final days. Hospice care made it possible for her to spend her end-of-life period at home, with minimal discomfort. The positive experience hospice provided to this couple affected the surviving husband’s attitude and made it easier to transition to the next chapter of his life.

If you have a friend or family member who could benefit from hospice care, please call Hope Hospice, based in St. Louis County, for information about how hospice care can help. 314-984-9800.

 

More On The Cost/Value Of Hospice

An amazing statistic appeared in a recent New York Times op-ed column. According to writer Susan Jacoby, “A third of the Medicare budget is now spent in the last year of life, and a third of that goes for care in the last month.” The column also states “the average hospital stay costs Medicare over $6,000 a day.”

Those are startling numbers. If you have recently filed taxes, you may have noted on your W-2 form the significant amount of your 2011 income that went directly to Medicare. (And that amount is not deductible.) Whatever the amount, you would probably have preferred to have that money in your own pocket.

Consider the amount of money that could be saved by Medicare (and we whose contributions fund it) if those who are dying in hospitals chose to die at home, under hospice care.

Another note regarding the massive hospital bills that are accumulated by those who prefer to die connected to tubes and monitors in a hospital: families are often obliged to pay some of the costs that are not covered by Medicare, including the tab for certain drugs. Whereas patients on hospice care are not obliged to make additional payments to the hospice agency.

How do you know if your loved one would prefer to spend his or her last weeks and months in the comfort of home? (As opposed to being in a hospital.) You ask. And you ask early in the dying process, when the patient still has a grip on reality.

These conversations can be difficult to get started. But once the topic is addressed, you may discover that your loved one has thoughts and desires that have never been voiced. And, like with many such dialogues we conduct in our lives, they often turn out to be much less uncomfortable than anticipated.

Hospice care is a money-saver for Medicare when compared to the cost of hospital in-patient care. Hospice care can also be a money-saver for families of patients whose hospitalization coverage is less than complete. But the main concern of families and health care providers should be patient comfort. That is always the top priority of Hope Hospice staff and administrators.

To learn more about hospice and all the elements of care provided, call Hope Hospice at 314-984-9800. Or click on HopeHospiceStL.com.

Hospice Care From The Family Point of View

Hospice patients are generally aware of their ultimate fate. Those with dementia may have limited awareness, but even they can have periods of lucidity and understanding. Patients tend to come to terms with their approaching end of life. If hospice care is administered properly, the patient is comfortable and at peace.

Family members, however, may be another story. They are the ones who will be the survivors. While the patient will be leaving this world, the family members will be left behind to deal with a whole new set of circumstances. Those of us who have lost a key family member know what a big hole in our lives their departure can leave.

In addition to the sadness that accompanies a loved one’s passing, there may be family disagreements about the funeral, burial/cremation and distribution of belongings. Lingering resentments that date back for decades may suddenly reemerge.

A family member may hold out unreasonable hope of a miracle recovery after medical personnel have agreed that the patient’s demise is near. Another may be all but invisible during this period because he/she can’t handle death. Another may swoop in from out of town and decide that he or she should handle all the family matters. There may be concerns about legal issues, such as who is to be granted power of attorney, if necessary.

In families, large and small, these issues arise. Hope Hospice personnel cannot control nor resolve disagreements. We can offer our input, as we have walked this road many times. We do recommend that certain family discussions be held away from the patient. The stress of family arguments can be harmful and upsetting for the patient.

Hope Hospice offers counseling to families as well as to patients. Stress, depression, anxiety and pre-death grief are common among family members. In many cases, we attend to families and their grief well beyond the patient’s death.

Hope Hospice personnel value all family members and consider family members and other caregivers to be important partners in the work we do. Family members provide significant input that helps us do our job. While we work to make end of life comfortable for patients, we also work to make continuation of life better for family members.