National Hospice Month
A look at the comfort and support offered
STORY BY: LESLIE RESCHLY, BSN, RN
As a young nursing student with a heart full of invincibility, I recall a lecturing professor making a statement; that since the day we are born, we are dying…. Yikes, I thought, but yet how true! Death and dying is certainly not the topic people turn to for social conversation. In light of National Hospice Month, I briefly approach the expansive topic for consideration here in this column.
Hospice derives from the word hospitality, in medieval times where places of rest and shelter were offered to weary or ill travel- ers. A pioneer in caring for the terminally ill, Dame Cicely Saunders started the first hos- pice in 1967 in England. Already a leader in care of the dying, she was invited by Yale Uni- versity to discuss her concepts in 1963. First Connecticut Hospice was developed in 1974 bringing modern hospice care to the USA.
Hospice is a service entity that provides comfort measures to a patient and support to the patient and their family during the time of a life-limiting illness. Typically, the illness is no longer responding to treatments which are “cure” oriented or the pa- tient has chosen to stop such treatments. Life expectancy is frequently noted by the medical profession to be 6 months or less. Although often associated with cancer, hospice services are utilized in a variety of disease processes including end-stage lung, heart and kidney disease, Alzheimer’s and dementia, stroke, ALS, neurological diseases and HIV/AIDS to name just a few.
Hospice can be of benefit to those of all age spectrums including pediatric clients. Offered in a home, hospital or hospice center, care is focused on the whole patient/family assisting not only with medical care including pain management but also providing emotional/spiritual support to the patient and family. Resources, information and education are coordinated and provided throughout the duration and often continuing in the form of grief support. Positive benefits associated with implementation of hospice care include im- proved pain and symptom management and avoidance of unnecessary hospitalizations. The one thing hospice does not do is prolong life or hasten death.
Locally, we have several options available for hospice care including the SECU Hospice House of Brunswick connected with Lower Cape Fear Hospice located on Highway 17. Among several, one home-based hospice care agency is Amedisys Hospice Care which brings around the clock support to patient and families in the home or hospital setting. Rebecca Green, RN, CHPN is the Clinical Hospice Liaison in Brunswick County for Amedisys Hospice Care. A veteran champion of hospice care in our county, Rebecca represents this national company by linking all aspects of patient care and coordinating resources noting, “89% of people desire to stay in place (home) during this time”. Stressing the importance of patient specific desires in her company and staff, Rebecca emphatically stated, “We do everything to say yes to a request” in providing personalized home hospice services. Amedisys has contractual agreements with local facilities to provide for acute care as well as respite care if needed. Home agencies also offer a variety of other services to facilitate care such as social workers and staff to assist with insurance issues. Amedisys takes all insurances and non-insured individuals. Early decision to enlist the services of a hospice care provider allows for maximum benefits to be received.
Local physician, Lettie Doran, MD, offers her services in dealing with this transitional period through Hearts & Sol Wellness, Inc. on Oak Island. Following the desire to meet patient requests, she states, “What’s important is that the person, and those alongside them, feel supported and comfortable expressing what they need. There can be well meaning “compassion” from many different sources, but if the gifts don’t meet our needs, they are without use. Even pain medication given to someone who wishes to be lucid more than pain-free is without utility for that person. “Rebecca reiterates noting, “Recently I told one man that he is Captain of his ship…we will do everything to his desires just as he would have requested while in charge of his boat.”
Lettie states, “I empower people by giving them the confidence and the education they need to make decisions or ask difficult questions “ offering mediation with family and coordination of care with multiple providers if needed. However, she also notes, “Giving thought to what we wish under different circumstances is always easier before we get to that last six months when conversations about death are emotionally charged and sometimes painful. Thinking about death is as important as planning our retirement!” Personal experience allows me to be in agreement. As a nurse, I have been in multiple end of life events over my seasoned career…some expected and some completely unexpected due to trauma etc. I must note that those situa- tions where the patient had clearly communicated their wishes made for much less stressful decisions on the part of the family. In addition, my beloved mother sustained a life-ending disease which tragically gave us only 52 days to process. Her planning, conversation and written requests allowed us to make end of life decisions for her consistent with her wishes. Only a snowstorm prohibited us from getting her to her home!
Rebecca agrees that ongoing conversations are much easier than those made under crisis. However, whether or not you feel you can have that conversation with your loved ones for whatever reason, you can specify your desires through Advance Directives which specify how you would like to be treated if you cannot speak for yourself. These can be a part of your medical record at your local hospital or physician office. FIVE WISHES is a form of Advance Directive that meets legal requirements in the state of North Carolina. Amedisys believes so strongly in this form of patient-centered care that they provide a copy of Five Wishes to download on their website amedisys.com. This is also available online for a nominal fee at aging with dignity.org. Hearts & Sol Wellness, Inc. is offering a free Community Program in January of 2017 on the Transition of Death-Dying Consciously. Please contact them if you have further in- terest in programs around this topic.
Perhaps you are very well prepared and have carefully delineated your Advance Directive and had this crucial conversation with your loved ones. Maybe you have reaped the benefits of hospice services and would like to express gratitude by giving back during this month of Thanksgiving. Opportunities are always available for financial donation to local agencies and volunteers are always needed in a variety of situations.
Please support these Southport Magazine advertisers:
• Rebecca Green RN, CHPN, Clinical Hospice Liaison:
For Volunteer information: firstname.lastname@example.org
• Lettie Doran MD,
Hearts & Sol Wellness, Inc on Facebook