Category: Hospice Services

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.

 

Independence hospice pioneer’s vision becomes a reality

Dorothy Burkhart, second from left, joined longtime friends Kitty Myers and Lorraine Mochal at Cedar Valley Hospice’s Diamond and Pearl Gala celebrating the organization’s 30th anniversary in 2009. While there, Kitty won an auction bid for a skydiving adventure – one she took to the sky on Sept. 26, 2010. She wore her husband, Dick’s orange jumpsuit in honor of him. All three ladies were pioneers in starting Independence’s first hospice. Also pictured are Cedar Valley Hospice supporters Cary Nielsen, Pat and Burnell Haven and Wilbur Nielsen.

Dorothy Burkhart, second from left, joined longtime friends Kitty Myers and Lorraine Mochal at Cedar Valley Hospice’s Diamond and Pearl Gala celebrating the organization’s 30th anniversary in 2009. While there, Kitty won an auction bid for a skydiving adventure – one she took to the sky on Sept. 26, 2010. She wore her husband, Dick’s orange jumpsuit in honor of him. All three ladies were pioneers in starting Independence’s first hospice. Also pictured are Cedar Valley Hospice supporters Cary Nielsen, Pat and Burnell Haven and Wilbur Nielsen.

Note: In December, a plaque was posted in the Cedar Valley Hospice Independence office to pay special tribute to longtime advocate and the founder of the first hospice in Independence, Dorothy Burkhart. Her story is below. 
By Stephanie Abel Hohenzy

Hospice began in Independence with the dream of a mother.

When Dorothy Burkhart held the hand of her only daughter, Lynn, for the final time in July 1978, it changed her life. It bothered her that at the age of 35, Lynn would not see her two children grow or live life by her husband’s side. As Lynn’s main caregiver, it was difficult to watch her body go through the final stages of breast cancer. It wasn’t until she traveled to her Florida home and volunteered for a hospice there, that she learned the value and comfort such a program could offer terminally ill patients and their families.

Upon her return to Independence, she set out on a mission – to start a local hospice. She didn’t want another family to ever have to go through life’s most difficult stage alone. Her son, Brooks, remembers how “fired up” she was, which, he adds, wasn’t uncommon for his mother when she set her mind to something. She started talking to friends and enlisted their help to gather support in the community.

“She went right to the town’s prominent family physicians, Dr. Myers and Dr. Mochal, and their wives and said flat out, ‘We are going to start a hospice.’ When my mother asked for something, you didn’t turn her down,” says Brooks.

Dorothy often went door to door asking for donations but raising money was difficult at first since the concept of hospice was generally foreign to most. Although there had been only a few contributions, in 1982, a Board of Directors was formed. So, in a number of meetings headquartered in Dick and Kitty Myers’ backyard, the Myers, Mochals, Dorothy and others started Buchanan County Hospice. These community pioneers often contributed their own funds at meetings to carry out the work of the new organization.

Thanks to Bob Richards, the administrator at People’s Memorial Hospital at the time, office space was opened for the endeavor. The hospital also provided a hospice in-patient room, which was furnished with a home-like setting thanks to a generous memorial gift from the Orval Shatzer family of Jesup, following his death.

A coordinator was hired in 1983 and the first training program took place in 1984. One year later, the organization cared for its first patient. In the following years, the organization grew, gaining more support. Dorothy then went out and found more resources to begin to train volunteers to help patients’ families. By 1989, they had trained volunteers numbering far more than their patient load. They then started a program called Project Love to provide respite care for the chronically ill – providing caregivers with much-needed support when their loved ones aren’t hospice eligible or ready for hospice.

In 1991, Hospice of Buchanan County was able to look at expanding its offices and services thanks to a bequest from Cecilia (Slater) Pochedly. However, as hospice grew, they realized that more services could be provided to patients if they were Medicare certified. With that in mind, negotiations began with Cedar Valley Hospice, and an agreement was signed in 1992. Drs. Myer and Mochal stepped up again, donating their office building on First Street East, where Cedar Valley Hospice currently resides.

Dorothy remained involved as a volunteer over the years and was a valued donor. She enjoyed watching the hospice she helped start, prosper to include not only Buchanan county but Fayette, Delaware, Linn and Benton.

Since then, over 1,000 families have been served, including Dorothy’s husband, Dwight, in 1996, and Dorothy, who passed away on Sept. 2 at the age of 99.

Brooks and his wife, Hildegard, are so grateful to Cedar Valley Hospice and the support they provided for his mother. Team physician Dr. Duane Jasper was also an instrumental part of the care team.

“Jasper didn’t waste any time, he knew it was the right moment for my mother to be placed in hospice care,” says Brooks. “Cedar Valley Hospice showed up within a few hours. I will never forget our nurse, Jean. She was excellent. The knowledge and caring she had made all the difference for my mother and for us. We knew we could leave because hospice was there.”

Dorothy had struggled with a constant restlessness for weeks. This all changed when Cedar Valley Hospice became involved, says Hildegard.

“The Cedar Valley Hospice Nurse was the only one that could calm her down. It was wonderful,” Hildegard adds. “She advised us how to talk to Dorothy to help bring her peace…telling her that she was going to see her Lynnie, which, when other conversation failed, she would nod and relax.”

“Cedar Valley Hospice takes all the guesswork out of caring for your loved one,” adds Brooks. “We know how it started and have seen them in action…they are the experts…How could it be done any better?”

Dorothy’s dream came true. No family has to be alone at the end of a loved one’s journey and throughout their bereavement. 

Hildegard looks at a photo of Dorothy and a tear rolls down her face, “Lynn would be proud.”

Pain Awareness Month – Benefits of Palliative Care, LINK

September is Pain Awareness Month and a perfect opportunity to focus on awareness of issues in the area of pain and pain management. It’s also a great time to talk about palliative care. For those that don’t know what palliative care is, it is a type of care that focuses on pain and symptom management and places attention on the patient rather than the disease or illness. Palliative care can be provided anywhere – home, hospital, assisted living facility or nursing facility.

Cedar Valley Hospice staff are trained experts in this area and we also offer a program, LINK, specifically for palliative care. LINK stands for Listen, Inform, Navigate and Knowledge and was developed to provide supportive care to those individuals and families facing a life-limiting illness and don’t yet qualify for hospice, or simply aren’t ready for hospice. The goals of LINK are: listen to patients and families, inform patients and families of resources in their communities, navigate the current health care system and educate patients and family members on health care choices and treatments.

Patients on the LINK program receive visits from a nurse and social worker that offer support, companionship and assistance. Someone might consider LINK if they have recurrent hospital admission for an advanced illness, difficulty managing symptoms, family conflicts regarding course of treatment or distress, anxiety or loss of hope. To be eligible for LINK, patients must be diagnosed with an advanced stage of a life limiting illness with a physical and/or psychosocial need.

The difference between LINK and hospice is LINK patients can still be seeking a cure for their illness. All hospice care is palliative but not all palliative care is hospice. Many patients on LINK might qualify for hospice but may not be ready to take that step yet.

LINK social worker, Erin Hubbard, says this program is beneficial to help those who may qualify for hospice in the future be prepared and know not to be afraid of making that transition to hospice.

Erin’s favorite part of her job is building relationships with patients and coming into their lives at a time when they need support, guidance and direction.

“We help ease the stress of their diagnosis and help patients make necessary decisions,” Erin said.

Having a palliative care program is another quality that makes Cedar Valley Hospice unique. Palliative care provides a way for those with a life-limiting illness or chronic pain to take control of their lives which helps improve quality of life. For questions on palliative care or the LINK program or to find out how LINK can help you or your loved ones, click here or call Cedar Valley Hospice at 319.272.2002.

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.

Cedar Valley Hospice Music Therapist Rachel Johnson works with children at the 2014 summer grief camp.

Music Therapy at Cedar Valley Hospice

Cedar Valley Hospice offers a variety of unique services to patients and families. Music therapy is one of these services. The use of music is beneficial and meaningful to all patients regardless of age, sex, background, musical preference or diagnosis. Music therapy has also been shown to be very effective for hospice patients by reducing anxiety, providing relaxation and helping with pain control.

Because music therapy is a service that is not reimbursed by government funding, Cedar Valley Hospice relies on donations to offer this service to patients and their families. Every patient is offered the ability to receive music therapy with the opportunities to choose specific goals to improve their overall quality of life and hospice experience.

There are currently 58 patients at Cedar Valley Hospice receiving music therapy visits. Each week, there are 35-40 music therapy visits offered in all of our site areas and locations. Visits are offered wherever the patient calls home (nursing homes, patient homes, hospitals and the Cedar Valley Hospice Home). All patients at the Hospice Home are offered a music therapy visit 1-2 times per week. In 2014, 429 patients at Cedar Valley Hospice received music therapy visits.

Music therapy plays an important role at Cedar Valley Hospice because music is something nearly everyone can relate to in some way. For those who are grieving, music can help bring back positive memories of their loved ones. This past summer, Cedar Valley Hospice held its first children’s grief camp and the campers were able to write their own verses to a song that included memories they shared with their loved ones.

Choosing to participate in music therapy allows patients the opportunity to make choices like what style of music is played, how many songs are played, how long a session is and so much more.

“In a situation where patients have very little control over so many decisions – it is a blessing to be able to provide one thing they still have a chance to control,” Cedar Valley Hospice Music Therapist Rachel Johnson, said. “I feel so honored to be able to provide music in a way that truly meets the Cedar Valley Hospice mission of Making Each Moment Matter.” For more information on music therapy at Cedar Valley Hospice, call 319.272.2002 or visit www.cvhospice.org.