Archive for Hospice Team

Entering a Home in the Wee Small Hours

Had it been that long since they were able to take a walk?

The phone rang at one in the morning.

I sleep deeply and wake fast. Moments after the call, I was dressed. In less than fifteen minutes, I arrived at their home and stood beside their bed.

The husband wept. I’d never seen him cry before.

She lay beneath the sheets. In repose, eyes closed, and you could (almost) pretend she was blissfully slumbering through the night. But she was dead.

Later I’d recall Charles Dickens’ familiar opening in his Tale of Two Cities: “It was the best of times, it was the worst of times . . .” Aren’t those extremes how you react to the after-midnight calls? Why else would the phone ring in the wee small hours, except to convey the best news about a child’s birth or a beloved’s safe arrival from a far-flung war zone?

Or to share the worst news.

The odds of a jangling phone conveying the “worst” message was high. Back then, I was the on-call chaplain for a hospice. Most nights remained calm, but all could be disrupted.

And death always seems a disruption. Read More →

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Please Say “Yes!” to a Home Health Aide!

Why would hospice patients say no to a home health aide?

At our weekly hospice team meetings, we review every patient’s current situation. This includes the various staff assigned to a patient’s care. It goes something like this:

What about Juan Lopez?

  • Nurse . . . two to three times a week
  • Social Worker . . . one to two times a month
  • Chaplain . . . phone contact only
  • Home Health Aide . . . declined
  • Volunteer . . . one to two times a month

What about Mary Jones?

  • Nurse . . . one time a week
  • Social Worker . . . two to three times a month
  • Chaplain . . . two to three times a month
  • Home Health Aide . . . declined
  • Volunteer . . . declined

Of course, the above names are fictional. In a typical meeting, the hospice where I work will talk in detail about scores of patients. We discuss the recent deaths and new admissions, along with all of the ongoing patients served in their homes or facilities. Every patient has a choice about which of their “team” provides direct support to them. However, every patient must be seen by a nurse, from as little as several times a month to (though rare) every day. It depends on the needs. Read More →

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Hospice: Mistakes and Disappointments

I’d prefer not to write these next words, but they are occasionally true: a hospice will disappoint patients and families.

  • A hospice social worker brings the wrong forms, wrong answers, or wrong attitude.
  • Patients rightly get angry if the chaplain or home health aid says one thing, but does another.
  • Families feel neglected because they phoned on a Saturday morning for an on-call nurse and are still waiting for the visit as evening approaches.

My goals for this website include being upbeat and informative about hospice care. As a pastor in various congregations over many years, I’ve witnessed hospice compassionately serving church members. The hospice “team” helped make the worst time of life become bearable. I was a hospice chaplain and now work with bereavement at a hospice. My current (and past) colleagues are responsible, caring, and thoughtful hospice professionals.

Then why say anything negative? Because . . .

  • Unintentional mistakes are made.
  • Sometimes there was nothing “wrong” done by any staff, but families can still be angry and will blame hospice.
  • Though I’ve only known good and kind hospice staff (and volunteers) . . . there will always be some “bad apples.”
  • When anyone searches for lousy news about hospice (like “killing a patient” by misusing medications or Medicare fraud), it will be found on the Internet.

Bad exists. Bad happens. Inevitably, the rare bad occurrences are usually more tempting to headline and highlight than the frequent, commonplace good.

What are some of the disappointments that patients or families will experience? (And what I mention next is not based on researching formal complaints or sharing confidential data about specific patients at hospices where I’ve worked. Instead, these are generic—but possible—scenarios that can happen at any hospice with any family while caring for a dying loved one.) Read More →

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