Category: Admission

Moments that Matter – Michelle Walden, RN, CHPN – Admissions Nurse

Michelle Walden

Describe your position with Cedar Valley Hospice:

As an admissions nurse, I meet with patients and families along with a social worker to discuss hospice criteria and admit patients to our program. It involves meeting with patients and families throughout our service area and offering education and support about terminal illnesses.

How does it support the mission of Cedar Valley Hospice?

Cedar Valley Hospice provides the leadership and sets the standard for excellence in delivering comprehensive palliative and end-of-life care to patients and services to those that grieve. I believe my position is important because I provide that initial information and set the foundation for the primary care staff that will be caring for those patients on a day-to-day basis.

What are the most enjoyable aspects of your job? Why?

I am always meeting new people. I think the best part of my job is knowing that I am helping others and seeing the relief from patients and family members when they realize they are not alone in this end-of-life journey.

Share a memorable story of a family or patient that has impacted you:

I had a patient when I was a home care nurse that really touched my heart. He was a physician before retiring and I had worked with him years ago. Honestly, I was always intimidated by him. When my visits first started with him as a patient he was trying to give me his own assessment. He would tell me his vital signs before I had a chance to do his assessment. One day, he called because he wanted to tell me he didn’t feel right. I told him I would stop over when I was done at a local nursing home. He told me, “You don’t have to do that.’ I remember telling him that I was going to be gone the next day through the weekend and I needed to know he was okay before I left town. Before I left his house that day, he took my hand and thanked me. I would have done the same thing for any of my patients, but the visit that day created a special rapport between us, which allowed him to fully trust me.

In your opinion, what makes Cedar Valley Hospice stand out above the other hospice providers in the area?

I believe that Cedar Valley Hospice patients are not just a number. Our staff truly cares for each and every one of our patients. I worked with another hospice in the Des Moines area as they cared for both of my parents. It was very difficult for me to stop being a hospice nurse and just be a daughter. I had to try to not question why they did things the way they did them, because it wasn’t the Cedar Valley Hospice way. I have helped patients that have had family members with other hospices and they have shared how much better the care is with Cedar Valley Hospice.

 

Paying For End-Of-Life Care

One of the many misconceptions of hospice is that it costs too much. Many families are not aware that hospice is paid for through the Medicare or Medicaid Hospice Benefit and most private insurers.

Cedar Valley Hospice is a not-for-profit organization and provides care to anyone who qualifies for admission, regardless of inability to pay. Community contributions assure care for those who cannot pay and for costs not covered by insurance.

The Medicare Hospice Benefit provides a model for financing end-of-life care that can bring great relief and support to families during one of life’s most difficult times. There is never a charge to Medicare or Medicaid recipients for hospice services. As a result, the financial burdens often associated with caring for a terminally-ill patient are lifted.

Hospice care at Cedar Valley Hospice also offers supports to the loved ones of the patient; this brings an added level of relief to the dying person, knowing their loved ones are being cared for as well.

Medicare covers these services from a hospice provider when related to the terminal prognosis:

  • Nursing care
  • Medical equipment (example – wheelchair or hospital bed)
  • Medical supplies (like bandages and catheters)
  • Drugs for symptom control and pain relief
  • Short-term care in the hospital or the Cedar Valley Hospice Home, including respite and inpatient for pain and symptom management
  • Home health aide and homemaker services
  • Physical and occupational therapy
  • Speech therapy
  • Social work services
  • Dietary counseling
  • Grief support (The grief services at Cedar Valley Hospice are always provided at no cost to anyone in the community grieving the death of a loved one)

Medicare will still pay for covered benefits for any health problems that aren’t related to a terminal illness.

The team members at Cedar Valley Hospice are experts in medical care, pain management and provide emotional and spiritual support expressly tailored to the patient’s needs and wishes. Families making end-of-life decisions for a loved one need compassion and support, not financial worries. Cedar Valley Hospice is here to Make Each Moment Matter and alleviates those concerns so that the main focus for the patient and family is spending time with their loved one.

Click here to read more about the Medicare hospice benefit, or visit www.caringinfo.org.

To learn more about the services at Cedar Valley Hospice and the resources available to patients, families and the community, call 319.272.2002 or visit www.cvhospice.org.

Tim Moses, Son

Don’t Wait to Call – Five Myths of Hospice

Far too many people wait until they are in the midst of a health care crisis before thinking about what options are available and what care they or their loved ones would have wanted. Hospice professionals deal with these challenging situations every day – that’s what they are trained to do.

When a family is coping with a terminal illness, hospice provides comfort and dignity, making sure every day is as good a day as possible. Hospice care includes expert medical care, pain management and emotional and spiritual support. Care is provided by an inter-disciplinary team of professionals, including trained volunteers, focused on making the wishes of the patient and family the center of care.

At Cedar Valley Hospice, we often hear, “we wish we would have called sooner.” This is because many people are scared of hospice and are faced with many misconceptions about it.

“We waited too late, we thought it was something that Dad would overcome. I wish we would have contacted Cedar Valley Hospice sooner because it would have taken the pressure off of us as kids. I’m glad we did make the call because it helped things go more smoothly at the end.” Tim Moses, Son

Here are five common myths of hospice:

MYTH: Hospice is a place.
FACT: Hospice services are provided in a patient’s own home, a nursing home, long-term care facility or hospital. Cedar Valley Hospice also offers a hospice home available for short-term stays to manage a pain crisis, provide respite or residential.

MYTH: Only a physician decides it is time for hospice.
FACT: Anyone can make a referral – family member, clergy, physician, hospital, nursing home.

MYTH: Hospice means not returning to medical treatment.
FACT: Hospice nurses and physicians are experts in the latest medications and devices for pain and symptom management. Once on a hospice program you are being cared for physically, socially and emotionally. Many times this quality care improves a patient’s health to a point that they no longer qualify for hospice, resulting in a graduation from the hospice program. At this time patients may choose to seek curative treatment again.

MYTH: Hospice is only for the last few days of life.
FACT: Hospice is for patients with a prognosis of six months or less. Research shows that those on a hospice program, live longer compared to someone with the same diagnosis and prognosis of someone who is not.

MYTH: All hospices are the same.
FACT: There are certain services hospices are required to provide for Medicare certification. Cedar Valley Hospice offers what is required and a variety of additional services to meet the needs of patients and families. These services include: grief services for families and children, a LINK palliative care program for people with a serious illness but do not yet qualify for hospice and CASS (Cedar AIDS Support System) case management for people with HIV and AIDS. There are also for-profit hospices and not-for-profit. Cedar Valley Hospice is a not-for-profit organization.

When hospice is involved at the end of life, there are many benefits to the patient, their family and friends. The sooner the call is made, the sooner our staff can begin building relationships come in and start a plan of care. This helps improve quality of life for the patient and helps ease many concerns from family members. Calling Cedar Valley Hospice allows family members to be the husband, the daughter, the sister or brother again, rather than only a caregiver. One of the best ways to make sure you and your loved ones benefit fully from hospice, is to talk about it and educate yourself before it becomes an issue before you would ever need this type of care.

Along with providing hospice services, Cedar Valley Hospice provides many different resources to the community. Our speakers bureau program provides presentations at no cost to any groups in the community and there are several topics including general hospice, grief, death and much more. Cedar Valley Hospice grief support services are offered to anyone in the community grieving the death of a loved one. There are also several different grief support groups taking place in our service area communities. We also offer workplace resources and tips for supporting employees going through a difficult time through the Caring Connections program. To learn more about Cedar Valley Hospice and the resources available to the community, call 319.272.2002 or visit www.cvhospice.org.

Research Shows Early Hospice Admission Is Important

By Dr. Michael Deters, Medical Director

The importance of early admission to hospice programs for patients with terminal illnesses is of utmost importance for both the patient and the family. The trend, however, across the country is for late admission to end-of-life care programs.

There has been a lot of research on admissions to hospice programs and the evidence shows that patients live much longer and have a much better quality of life than the similar patient not in a hospice program. Hospice is a specialty in relief of suffering that is not practiced in traditional medicine and this is why the quality of life is so much better.

Patients who have cancer and are still on palliative chemotherapy live longer with a much better quality of life than a patient with the same disease on the same chemotherapy not in a hospice program. We know that patients with non-cancer diagnoses live much longer and often graduate from the programs for a period of time due to the close monitoring of their health by the hospice team. Earlier admission to hospice allows the team to work with both the patient and the family, especially the caregiver. This also allows hospice to help the patient and family more readily accept the diagnosis, prognosis and help them prepare for the end of life.

The entire team including primary nurse, social worker, music therapist, aides, volunteers and spiritual counselors, all help to relieve the physical, spiritual and emotional pain. The team is also a wonderful support for the caregiver to help them with the difficult management of pain and use of medications that is not available if the patient is not in a hospice program. Cedar Valley Hospice is available at anytime by calling 319.272.2002 to evaluate a patient to determine if they are appropriate for hospice care.