Hospice: Providing care on the patient’s terms

Published 11:55 am Wednesday, December 11, 2013

In a recent Huffington Post blog, Dr. Richard W. Besdine, medical officer for the American Federation for Aging Research, laid out some interesting statistics concerning aging in America.

According to statisticians, he said, most folks who make it to age 65 will live to be almost 85, and about 25 percent will live past 90. This increase in longevity can be attributed in part to the many medical breakthroughs realized in the past quarter-century. Now, diseases such as cancer, whose diagnosis was tantamount to a death sentence just decades ago, now become chronic illnesses. As a result, millions of older folks who have multiple chronic health problems, like diabetes, congestive heart failure and COPD, as well as cancer, will be able to live many years longer than they would have in the past.

But what is the cost of living longer?

Many people will find themselves living with chronic pain, complications from co-existing medical problems, disability and depression. And even with all the advances in medicine and rehabilitative procedures, eventually everyone will come to that place where they need more care than they can provide for themselves or that family members can provide. It’s at that point that home health or assisted living comes into play, and somewhere down the road, hospice, with its role of providing comfort, love and respect to individuals who have come to the end of their lives.

Providing more than medical care, hospice gives patients who are not expected to get better control of symptoms, pain management and just as important, emotional and spiritual comfort for themselves and their families and caregivers. Hospice provides trained teams of professionals and volunteers.

There are a number of hospice providers in Washington Parish, including Lakeshore Hospice, Camellia Home Health and Hospice, Community Care Hospice and AmeraCare Family Hospice and Home Health.

Lakeshore Hospice, which is a palliative care organization, is based in Mandeville, but its service area includes Bogalusa, Franklinton and Mt. Hermon in Washington Parish. The company, locally owned and operated, is currently looking for office space in Bogalusa, according to Director of Business Development Stacy Lawson, who spoke recently to the Bogalusa Rotary Club.

Lawson spoke frankly about the challenges faced by those who choose to work with patients who are not expected to recover.

“It’s been a challenge on many levels,” she said. “I still cry my eyes out after I walk out of a consult.”

But it’s that level of empathy and compassion that is necessary to do the work, Lawson said, quoting her mother, a nurse, as saying, “The day you stop crying is the day you need to quit.”

Lawson said many who work in hospice have suffered the loss of loved ones themselves and have been able to channel those experiences in such a way that they are able to help others faced with with their own death or with the death of a loved one.

The goal of hospice, Lawson said, is to make sure patients’ symptoms are under control, but also that they are supported philosophically, emotionally and spiritually. Lakeshore Hospice uses a very holistic approach, she said, addressing the physical using nurse practitioners, RNs, LPNs and CNAs to address patients’ needs. In addition, they provide and pay for all medications related to symptom management, all medical equipment necessary, whether it be a hospital bed, oxygen, etc.

“There’s a great deal of medical support that surrounds the patient,” Lawson said.

But one of the most important things hospice does is provide choices to patients and families.

“In a recent survey,” Lawson said, “88 percent of Americans indicated that would prefer to pass away in their own home instead of a hospital bed. And we make that possible.”

Hospice support is available 24 hours a day, seven days a week, to address the physical. “But not all pain is physical,” she said. To help with the emotional and spiritual pain there are social workers who are there to help the patient get through the end-of-life experience and to help families through their grief with bereavement counseling and spiritual counseling.

“We are blessed with a great team of professionals,” Lawson said, adding, “Working with hospice patients requires a level of compassion, a gift of empathy, that only God can give.”

“It’s not something that can be learned,” she said.

For more information about Lakeshore Hospice, call the office in Mandeville, 871-9272.

Camellia Home Health and Hospice is an organization that is based on family, said administrator Brandy Seals. Camellia has 10 offices in Mississippi and one in Marietta, Ga. In Louisiana, Camillia is located in Bogalusa and Vidalia.

“A family founded our organization,” Seals said, “and it has grown from there. We have a great team here and consider ourselves family, along with all of our patients,” she said. The company was founded by a lawyer, W.A. Payne. His son, Abb Payne, is the current CEO.

“It’s been handed down from father to son,” Seals said, noting that Abb Payne’s son, Ford, is only 3, but the business will eventually pass to him.

“What sets us apart is our great staff,” she said, “and we have a very close team.”

The medical director at Camellia is Dr. Hossein Tabari, whose offices are in the same building as Camellia’s hospice and home care offices.

Seals pointed out that Camellia also has a large volunteer program, with a new volunteer coordinator, Pam Stewart.

“(Stewart) has grown our volunteer program to double its original size since May,” Seals said proudly. “She’s got wonderful volunteers who have done great things for our patients and around the community.”

She listed a few activities the volunteer program has been involved in recently, including a food drive “so that our patients can have a food bank here,” and being available to help families whenever they need it.

She said volunteers do things like sitting with a patient if a family member has to run out to the grocery store or take care of some other errand.

“We even had a set of volunteers who went to a patient’s home and cleaned their porch because it had mildew and (the patient) was unable to get out there and clean it. So our volunteers went and did that,” she said.

In addition to its Louisiana location, Seals said Camellia has offices in Mississippi, Georgia and Tennessee.

Call the office in Bogalusa, 732-1762, for more information about services offered by Camellia, or visit the website, www.camilliahealth. com.

With offices in Metairie, Covington, Ponchatoula and Bogalusa, AmeraCare Family Hospice and Home Health is also a growing company. According to its website, www.ameracare.com, the company is working on expanding its territory to provide care to more patients.

Hospice Administrator Norman Davis, who is based in the Covington office, spoke highly of the other hospices located in the Bogalusa area, saying, “I think there are lots of good hospices in the community, and I feel like hospice is one of the bright spots in health care because the hospices take ownership in the overall well-being of the patient.”

Davis added while no one wants to be on hospice care, “If you do end up in a situation where you need it, it’s good to have a team of clinicians who are devoted to your overall well-being and not just focusing on one aspect of your particular situation.”

He said AmeraCare, because it has both home health and hospice, can help patients with the correct mode of care.

“We actually have nurses, social workers and chaplains who will do both,” he said, “so if you’re in home health and you’re considering hospice as an option you could be part of the AIM (Advanced Illness Management) program, where the nurses and social workers in home health will continue to work with you if you make the choice to go to hospice.”

Davis said that is an important aspect for those who might be receiving some kind of curative care, such as chemotherapy, but still require some type of palliative care.

“It’s good to have a key to help you in either a home health setting or a hospice setting,” he said. “What the AIM program does is give you the opportunity to have curative care and talk to the hospice-trained nurses and clerical staff who can advise you when it might be appropriate for you to make the decision to actually go to hospice. It gives you the opportunity to consider your options before you actually commit.”

Davis said about 80 percent of AmeraCare patients remain in their homes, but at some point, when they can no longer be taken care of in the home, the staff helps the family arrange for the patient to go to a nursing facility.

“There are times when the symptoms cannot be managed in the home, or they are having difficulty managing pain in the home. Sometimes we put them as inpatients to observe them more closely and give them closer attention.”

But in the end, Davis said, it’s the family’s decision, although some of it does depend on clinical interpretation.

For more information about AmeraCare’s services, call the Bogalusa office at 732-4848.

Located in Hammond, but operated by Washington Parish residents, Community Care Hospice is a smaller organization compared with those already mentioned, but that is something the owners and staff believe sets them apart.

Megan Thomas, RN, Community Care’s administrator, said, “All of our owners and the majority of the staff were born and raised and still live in Washington Parish.” The reason for locating the office in Hammond, she said, is strictly a function of rules that hospice providers must adhere to.

“With hospice, you have to service an area within 50 miles of your location. If we put our office in Washington Parish, we would have to service Mississippi, and Medicare and Medicaid are different in each state, so we chose Hammond,” Thomas said.

Technically, she said, all hospices have to provide the same services: a nurse comes out to visit, a CNA comes to give a bath and help with the daily activities of living like getting dressed, etc. Community Care CNAs come out a minimum of three days a week, she said, and do everything from changing bed linens, to fixing a small meal.

“In some of the more desolate areas of Washington Parish, with patients on hospice with no one else in the home and not much family, we try to provide anything we can that helps a family out,” Thomas said. In the past, she added, the company took up donations to help fund such things as an air conditioner to make life more comfortable for a patient — things that the company can’t provide but donations can make it possible.”

Thomas said that having most of the staff hail from Washington Parish is something that sets Community Care apart from the other hospices in the area.

“A lot of people here (Washington Parish) like to be taken care of by people that they either know or they know their families,” she said. “We seem to get close to our Washington Parish people because they’re home for us, it’s our community.”

Thomas also said Community Care gives the best high quality care.

“We provide comfort care,” she said. “That’s what hospice is — comfort care, palliative care. And we provide family support,” she added, listing such things as signing up a family for Meals on Wheels or finding a way to provide a certain medicine that’s needed but too expensive for the family to afford.

“Our social workers are there to help them find ways to get what they need. They help provide the resources they need,” she said.

And at the end, when a patient passes, Thomas said, hospice doesn’t stop there.

“We keep in contact with those patients’ families. Our social workers keep in contact with them during their bereavement visits, and our chaplains go out and have a word of prayer and read scripture with family members.

“It’s not just about patient care,” Thomas said emphatically. “We are there taking care of the whole family, making sure they have what they need to get through the hard times.”

Call Community Care Hospice in Hammond at 340-1880 for more information.