Hospice care offers comforts of home at home
The comforts of home can ease the grief of death.
“Many people, they want to be able to die in their own home. They don't want to have to leave their home, they don't want to have to go to a facility or the hospital,” said Suzanne Grove, director of hospice and palliative care of VNA, Western Pennsylvania Lutheran Senior Life. “They want to be able to be surrounded by their family, things that they're used to.”
Since 1981, the VNA, Western Pennsylvania Lutheran Senior Life — which serves Allegheny, Armstrong, Butler, Lawrence, Mercer and northwest Westmoreland counties — has provided services for the area, said Grove, whose career with the VNA spans 20 years.
The goal of VNA hospice care is to support the patient and family to stay at home at the end of life. At home, a patient's family is present and offering support.
“Especially in the last maybe days to weeks of life, the family is in visiting more frequently, they're pretty much right there all the time,” she said.
Grove's own father died in hospice care at his home, which was his wish.
“We set his hospital bed up where his recliner always was in the living room. In my mom and dad's house, there's pictures all over the walls of all the grandkids,” she said. “He was surrounded by all of that, what he loved in the environment he wanted to go in. I think many people feel the same way about that.”
Collectively, the VNA serves about 200 hospice patients and palliative care patients ranging from infants to 100-year-olds, Grove said. The average length of stay for patients is typically days to months.On a visit, the nurse assesses the patient, which includes reviewing medications and symptoms and providing education and support to the family, she said. The staff includes home health aids, spiritual counselors and social workers.The nursing staff of registered nurses and licensed vocational nurses receives an intense six- to eight-week orientation process about end-of-life care, hospice care and palliative care.People who go into the hospice care field feel a call to the career, Grove said.“They feel like this is something they were meant to do,” she said. “They really feel this is something that's meaningful to them. The job can be difficult at times. Hospice care is not easy.“It's not easy to take care of the patients all the time because we're going from one house to another, and sometimes you're dealing with symptoms in this house, and sometimes you're dealing with emotions and family issues in another house.”
First, the staff talks to the patient about their goals, which differ from patient to patient, Grove said. Examples of goals may be to attend a wedding, sit on a porch swing or be pain free.The conversation has to be open and honest.“The patient is experiencing what they are experiencing at the time. To not be honest about that or to skirt around the issues is not very helpful,” she said. “Often times, when patients are dying or know they're declining, they know that. They know what they've been feeling and know something hasn't been right.”The same team of nurses and staff follows the patients as they make their decisions between palliative care and hospice, Grove said.A common misconception is that hospice care is limited to days or weeks of life, she said. However, there are patients who stay in the program for longer periods of time while their condition remains stable.The sooner patients choose hospice care as their end-of-life option, the sooner the VNA can manage symptoms and provide support, Grove said.“When we get someone in the last few days or hours of their life, it's more difficult,” she said about when the situation turns toward crisis management.The Caring Decisions program helps people who are unsure whether they need palliative care or hospice, she said. A social worker will talk to the potential patient about their goals, options and what can be accomplished.Educating people about hospice is important to the VNA, Grove said.“We want to make sure that they understand what they're seeing and what they are dealing with in that moment, and what they're going to be dealing with,” she said. “Sometimes, it's just listening to patients' families. Sometimes, family needs to talk and go through what they've been experiencing.”
Hospice careA program of care and support for people who are terminally ill — with a life expectancy of six months or less, if the illness runs its normal course — and their families.The focus is on comfort, not on curing an illness.Services typically include physical care, counseling, drugs, equipment and supplies for the terminal illness and related conditions.Care is generally given in the home or at in-patient hospice facilities.Palliative careThe part of hospice care that focuses on helping people who are terminally ill and their families maintain their quality of life.If you're terminally ill, palliative care can address your physical, intellectual, emotional, social and spiritual needs.Palliative care supports your independence, access to information and ability to make choices about your health care.SOURCE: U.S. Centers for Medicare and Medicaid Services
