Insight to Hospice Care Presenters: Wendy McCarty-Director CHI Health at Home-Dickinson Tami Christianson-MSW, Bereavement & Volunteer Coordinator CHI Health at Home-Dickinson NOTES

Common Misconceptions Regarding Hospice Hospice is where you go when there is nothing more a doctor can do. To be eligible for hospice, I have to be in the final stages of dying. Quality care at the end of life is very expensive. If I chose hospice care, I have to leave my home. Families are not able to care for people with life limiting illnesses. Hospice care is only for cancer patients. Hospice is just for the elderly. There is no hospice in my area After the patient’s death, hospice care ends.- Notes

It’s helping her live her life until she dies. -Julie Opdahl Kay’s Story It’s helping her live her life until she dies. -Julie Opdahl NOTES

When Do I Call Hospice? CHI Health at Home offers complimentary informational visits to help clients & their families learn more about hospice. *Unexplained significant weight loss *Worsening of disease, despite treatment *Difficult to control symptoms *Multiple health concerns *Recurrent hospitalizations or emergency room visits NOTES

Hospice Focuses on Life When you have a life-limiting illness, CHI Health at Home offers compassionate, expert care that helps you to live each day to the fullest. Once the decision has been made to stop curative treatment, the focus is on attainable comfort rather than unachievable cure. NOTES

While end-of-life is obviously an extremely difficult part of the life cycle, it also provides special opportunities—to strengthen relationships, to put one’s affairs in order, to find spiritual peace NOTES

Hospice Comes to You When surveyed, more than 90 percent of Americans said they would prefer to die in their own homes, yet more than two-thirds die in hospitals and nursing homes. NOTES

Hospice is not a place; it is a comprehensive program of services that come to the patient. We want the patient to be as comfortable and alert as possible, spending precious time with their loved ones in familiar surroundings whether a private home, Assisted Living Center or Nursing home. NOTES

Hospice Serves All   The Medicare hospice benefit covers all expenses related to the terminal illness, including medications and equipment. Hospice care also is covered under Medicaid, some private insurances and by the generosity of our donors. NOTES

CHI Health at Home provides care to everyone regardless of ability to pay. We are very grateful of the generosity and support of the communities we serve. NOTES

Hospice is Expert Medical Care, but with a Different Goal The shift is from cure to comfort. CHI Health at Home clients work with a special team of health professionals with expertise in palliative care—a medical specialty devoted to relieving pain and managing symptoms, not to curing a disease. NOTES

New Rules for end of life care Barbara Karnes-RN NOTES

New Rules for end of life cares-Discussion Withdrawal from the world and people Decreased food intake Increase in sleep Going inside self Less communication Mental changes Physical changes NOTES

Hospice Cares for the Client & Their Loved Ones   When a person is diagnosed with a life-limiting illness, everyone involved experiences periods of stress, uncertainty, doubt, fear and confusion. CHI Health at Home treats them and their loved ones— family members being whomever the person determine is “family”— as a single unit of care. NOTES

Hard Choices for Loving People Living Will Advanced Directive Do Not Resuscitate (DNR) Life Sustaining Measures NOTES

Hospice is on call 24 hours a day and 7 days a week   Aside from regularly scheduled home visits, the patient can always talk by phone to nurses who are trained to assess unexpected situations. Our staff can answer their questions, ease their mind. When the situation warrants, a nurse can come to the home at any time, day or night. NOTES

Hospice Regards Death as Part of the Continuum of Life CHI Health at Home neither prolongs life nor hastens death. We provide personalized caregivers, education and a caring community to enable the family to make end-of-life a time of peace and support. NOTES

Hospice Respects Patient Decisions The patient may not be in control of their illness, but they are in control of their care. CHI Health at Home professionals provide the information they need to make informed, thoughtful decisions. NOTES

Because the nature of dying is unique, it is always our goal to be sensitive and responsive to the special requirements of the situation. We want the patient and their loved ones to remain in charge of their lives as much as possible. NOTES

Hospice is a Team of Compassionate, Expert Health Professionals The hospice team includes primary care physician, hospice medical director, registered nurse, certified nursing assistant, social worker, spiritual coordinator and trained volunteers. NOTES

With our range of expertise, CHI Health at Home can address the entire range of end-of-life issues, taking a tremendous weight off the patients and their loved one’s shoulders. NOTES

Hospice Includes Your Doctor The primary care physician will continue in their role managing all treatment orders and plans recommended by the hospice team. Registered nurses will keep the physician up-to-date with the needs, even when the patient is unable to make visits to the clinic. NOTES

Hospice Means Having a Coach A good coach teaches, supports and demonstrates. Caring for a loved one at home involves learning many new skills. CHI Health at Home team members are excellent teachers. Whether it is learning to manage a pain pump, bathing your loved one or delivering medications, the staff will be there give you the confidence they need to provide excellent comfort care. NOTES

Hospice Helps with Talking About Difficult Issues End-of-life presents many concerns that need to be addressed. Whether it be medical management, living arrangements or family dynamics, these needs tend to intensify during a crisis. CHI Health at Home team members can help open the lines of communication and work towards a goal that our client has voiced as important to them. NOTES

Hospice is an Opportunity to Attend to End-of-Life Concerns End-of-life can be a very special time for the patient and their loved ones. With pain and symptoms under control, you can focus on various issues including: Life review: time to reflect and take inventory of your life Saying goodbye Completing your advance directives Completing unfinished emotional issues Spiritual search for meaning in one’s life Spending precious time with those you love NOTES

Hospice Means Flexibility The patient is never “locked in” to CHI Health at Home; they can opt out of hospice care at any time. Sometimes a patient’s condition improves enough that treatment again becomes an option. NOTES

Hospice patients are not necessarily bed-ridden either Hospice patients are not necessarily bed-ridden either. Thanks to expert pain and symptom management, we have patients who have been able to go deer hunting, take a special trip and attend a family event or even visit a cherished place; take a walk in the park. NOTES

Hospice is Help with Grief For the patient and their loved ones, the grief process begins with the terminal diagnosis, as everyone begins to contemplate the many losses ahead. The CHI Health at Home social worker and staff help to process this “anticipatory grief”. After death, we offer bereavement services-home visits, phone calls, support groups, mailings and education-for 13 months NOTES

Grief and Loss Death is normal and natural Everyone of us is going to die-none of us are promised another day Grief has physical sensations-We feel and we hurt Grief brings with it fear. We are reminded of how little control we seem to have over our lives NOTES

Stages of Grief -Denial -Anger -Bargaining -Depression -Acceptance NOTES

Journey of the Heart Finding Healing After Loss Provides group members to share their thoughts, hopes, feeling, and beliefs to that the group is pulled more closely together in an atmosphere of trust that enhances learning and promotes healing. CHI Health at Home offers grief & loss group 3-4 times a year Good Grief group is an ongoing grief group that meets monthly for social outing. NOTES

We at CHI Health at Home are here to help. Another benefit of hospice bereavement care: Caregivers often find the grieving process less complicated after having been intimately involved in the end-of-life progression. We at CHI Health at Home are here to help. NOTES

How to talk to a Grieving Person Understand that Grieving takes time Keep in touch no matter what Don’t use platitudes or comparisons Use these two simple phrases to keep communication channels open When to talk about the deceased person NOTES

Comments from families that received Hospice & Bereavement Services Mom’s 13 ½ months in your Hospice care was fantastic! *Your organization & your individual staff are nothing short of angels her on earth. You are a God sent nurse for our family! We have a special place in our hearts for Tami & Astro. Thank you for all of your love and support. Thank you for all of the love and care for Mom & Grandma. You were considered his angels & you were! You all are so patient and kind. What would we do with out caring, loving people like yourself that put their lives on call for others. NOTES

And then I realized that to be more alive I had to be less afraid, so I did it. I lost my fear and gained my whole life.- Author unknown NOTES

Additional Information Available to you at: http://chiathome.com/ NOTES