Care Giving

HOSPICE SERVICES SUPPORT THE LOVING CARE OF FAMILIES

As our population ages, medical professionals are finding that cultural factors influence the decisions of the patients and their families as their illnesses progress. End of life care involves a time of

Dr. Hanh Trinh

Dr. Hanh Trinh

medical, financial, and emotional changes for patients and their families. Patients can be referred to hospice when they are diagnosed with a terminal condition with a prognosis of 6 months or less. Hospice provides a team-oriented method of addressing not just physical pain, but also spiritual and emotional pain.

The cost of hospice care is covered entirely by Medicare and Medicaid for patients with these benefits. For those patients with private insurance, verifying benefits with the insurance company is important prior to signing on. The hospice team can provide services wherever the patient lives, whether that is in a home, an assisted living facility, or a nursing home. In the case that the patient has uncontrolled symptoms of pain, nausea, shortness of breath, or restlessness, hospice has inpatient facilities which may provide a higher level of care.

Having a hospice team to address their concerns and a 24-hour hospice nurse to call can provide families with the peace of mind that they are not alone, even in their most trying times. The hospice team can follow patients and families on their journey through illness; from the time their active treatments are no longer beneficial, to comforting moments enriched by hospice’s supportive care when patients can be among their loved ones. To learn more about hospice comfort care visit www.houstonhospice.org or call 713-467-7423 (713-HOSPICE).

Thuy Hanh Trinh, MD

Thuy Hanh Trinh, MD, MBA, FAAFP, FAAHPM, WCC, is an Associate Medical Director at Houston Hospice in Houston, Texas. She received her medical degree from Louisiana State University Health Science Center in New Orleans and trained in family medicine at Baylor College of Medicine. Following residency, she completed her geriatric fellowship at Baylor College of Medicine and her palliative medicine fellowship at M.D. Anderson Cancer Center. She joined Houston Hospice in 2007 and serves as the Education Liaison.

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A Bucket List Fishing Tale

FishOne day late last summer, the Houston Hospice Intake Team was answering calls as usual on a Wednesday morning when my colleague, Marcy Antiuk, received an unexpected call, and an unusual request. A doctor phoned to tell us that her patient wanted to be admitted to our inpatient hospice care center, but he had one last desire before discontinuing treatments and surrendering to his disease. You see, this man’s disease had progressed to the point that ceasing treatment would decrease his life expectancy to a matter of days. He needed to be transitioned to hospice services that day due to symptom management issues, but first, he wanted to go on one last fishing trip. In fact, . Working in the hospice field, we’re accustomed to satisfying end-of-life requests, and we often grant day passes out of our facility for this purpose. These are typically outings to visit other family members or to have a meal out. Journeying to the edge of our coverage area for several hours was not an issue. However, this man had a severe and painful wound at the base of his spine that made moving him difficult — transportation would be the key to successfully executing this bucket list wish. The family had already inquired about private-pay ambulance transport, but the quote they received was overwhelming — several hundred dollars, maybe even a thousand. Gathering a team of individuals (Larissa Williams, Dr. Elizabeth Strauch, Jayne O’Brien and me), we discussed the patient’s condition and possible complications. We determined that the request was reasonable as long as the patient was safe, and stable enough to make the trip. An evaluation by our Admitting Nurse, Debbie Breaux, confirmed that the patient’s symptoms were manageable, however it also revealed that pain management was a concern. Because of the expensive private ambulance quote, the man’s family had decided to transport him to the fishing pier in a family vehicle. He desperately wanted this last fishing trip, but we feared the car ride would cause excruciating pain. The only safe option was transportation via ambulance, so we started calling our contracted ambulance companies asking if they would consider a full or partial charity transport. Orion EMS came to the rescue. After gathering only a small amount of information, they immediately agreed to cover all transportation expenses in order to fulfill this last request! Arrangements were made to pick up the patient the very next day. Houston Hospice provided a wheelchair and oxygen for the patient to use during the trip. Hollie Sims and I assisted while Orion EMS transported the patient to his fishing pier. The water, the pier, the landscape—everything was perfect. The late summer sunlight shimmering from the water was matched only by the twinkle in our patient’s eyes. After he finished fishing, Orion EMS provided a safe and comfortable ride to the inpatient unit. This was a great collaborative effort by many people with a triumphant blessing as an end result—just another reason why we love this work so very much.

Thomas Moore, Houston Hospice Patient Care Manager

 

 

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Lessons from a Butterfly Family: Parenting a Dying Child


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National Hospice Month: Kathy Flinn and Tiffany Livanec

Kathy Flinn and Tiffany Livanec

Featured for National Hospice Month for the week of November 26 are Tiffany Livanec and Kathy Flinn. Tiffany is a Professional Relations Liaison and has been working at Houston Hospice El Campo office for five years. Kathy Flinn is the RN, PCM-IPU and has been working with Houston Hospice at the Texas Medical Center location for the past 14 years.

(Tiffany) What do you love most about working at Houston Hospice?
I love educating the community about hospice and knowing that many will have a much greater quality of life due to our efforts. 

 

(T) What draws you to your position?
My grandmother was on our services several years ago. The GIFT of hospice to our family is so dear to my heart that I feel incredibly blessed to have the opportunity to work for such an amazing organization.

(T) What have you gained from working at Houston Hospice?
I have gained a greater appreciation for life, even less fear of death, and an increased faith!

(T) If you hadn’t become a Professional Relations Liaison, what might you have become?
If I weren’t called to be a liaison, I would like to be a chaplain.

(Kathy) What has been a pleasant discovery for you in the hospice community? 
Meeting the dedicated people who do this work because they perceive it as a”calling”… not just a job.

(K) What impact has hospice had on your life?
It reminds me that this life is temporary. It’s the next life that is really important.

(K) If you hadn’t become a nurse, what might you have done?
A travel journalist.

(K) Who was the person who most influenced you, and how?
Jane Sidwell.  She was PCM of the Inpatient Unit in 1996 when I oriented to my role as on-call nurse. I spent a 3-week rotation in the PCC (Patient Care Center) as it was called back then. Jane is the epitome of what I perceive to be an effective manager.

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National Hospice Month: Robynette Hall & Elizabeth Erwin

Robynette Hall & Elizabeth Erwin

 

Elizabeth Erwin & Robynette Hall share their hospice experiences for National Hospice Month. Robynette Hall has worked with Houston Hospice for the past five years as an RN for the On-call Team and works throughout the city.  Elizabeth Erwin, Senior Accountant has worked at Houston Hospice in the Texas Medical Center for the past 15 years.

 

 

(Elizabeth) What has been a pleasant discovery for you in the hospice community?
There are some who don’t know what hospice is all about and then there are others who look at me with admiration when they hear I work at Hospice.

(E) What draws you to your position?
I love Accounting!

(E) What have you gained from working at Houston Hospice?
Respect for what the nurses and doctors do on a daily basis. And let’s not forget the Finance staff who book and report the results of their work!

(E) If you hadn’t become a Senior Accountant, what might you have done?
Forest Ranger – I love nature – the backyard outside my window helps with the forestry side of my accounting!

(Robynette) What do you love most about working at Houston Hospice? 
I love the Team work and how much everyone truly cares for the patients and their families.  I also like how many Disciplines are involved taking care of our patients and their families.  It takes an army to care for them.

(R) What has been a pleasant discovery for you in the hospice community? 
This is where I belong, working Hospice and how rewarding it is to be able to help the patients and their families.  I feel truly blessed.

(R) What impact has hospice had on your life?  
The company is terrific and growing, the Team work has been the best I have ever witnessed and I feel everyone really cares about each other.  Knowing how much impact you have on the patients and families is a great reward unto itself.  As well as being able to work for one of the only nonprofit hospices in the Houston area.

(R) If you hadn’t become an RN, what might you have done? 
This is my third career and my second career move as a nurse.  I think I am hooked as a hospice nurse however.

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National Hospice Month: Sharon Hempler and Sonja Payne

Sharon Hempler and Sonja Payne

 Houston Hospice employees Sharon Hempler and Sonja Payne talk about their experiences at Houston Hospice for National Hospice Month. Sharon has been an RN-PCM on the Blue Team in the West Office for the past five years. Sonja Payne, Receptionist, at the Texas Medical Center location has been working with Houston Hospice for 20 years.

(Sharon) What has been a pleasant discovery for you in the hospice community?
Inspite of the difficulty of our work, we support & uplift each other.

(Sh) What impact has hospice had on your life?
Not only was I able to assist patients and families, but Houston Hospice supported me through my husband’s death.

(Sh) If you hadn’t become an RN-PCM, what might you have done?
If I hadn’t become a PCM, I would still be out seeing patients and families.

(Sh) Who was the person who most influenced you, and how?
Cheryl Holbert was my PCM and set a high standard for me to follow. She is knowledgeable and was a good mentor and teacher. Ruth Landauer was a friend of a friend who recommended Houston Hospice to me. She is a calming influence and supportive of staff and our clients.

(Sonja) What has been a pleasant discovery for you in the hospice community?
What has been a pleasant discovery for me is the spiritual bindings that hold me to Houston Hospice.  No matter how I look at my position here, I can always find myself spiritually connected to the organization. 

(So) What impact has hospice had on your life?
The impact hospice has had on my life is tremendous.  I am grateful for all the years and experience that I have endured here.  I don’t take hospice or the people here for granted. I am aware of other people’s feelings and believe everyone here at Houston Hospice is on a journey. 

(So) What have you gained from working at Houston Hospice?
Compassion and patience are two things I did not necessarily exude before coming to work here.  I knew about compassion and I had heard about patience. However, had I not come to work here I would probably not have gained either.  It prepared me for the grief I suffered in losing my brother and helped me support my family during our losses. Many of my friends and family say that I have two lives; one before hospice and the one I have now, after hospice.

(So) Who was the person who most influenced you, and how?
The person who influenced me the most at Houston Hospice would be Ruth Landauer, Director of Volunteers.  I learned from Ruth’s warmth and dedication from the very beginning.  She embraced me very delicately and made me feel ‘right at home’ on my very first day at hospice.

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National Hospice Month Insight from Nora Heflin and Jodie Gonzalez

Nora Heflin and Jodie Gonzalez

 

For National Hospice Month, Houston Hospice employees shared insight into compassionate, end-of-life care. Featured for the week of November 5 are Jodie Gonzalez and Nora Heflin. Jodie is a social worker on the Blue Team, which is based out of the West Office and has been working with Houston Hospice for one year. Nora Heflin has been a Certified Patient Care Aide for the past four years and is working at the Texas Medical Center location.

 

(Jodie) What do you love most about working at Houston Hospice?
My co-workers! Everyone on my team gives 100% to every patient/family and truly believes in the work we do.

(J) What draws you to your position?
The ability to walk alongside families during the most difficult time in their lives.

(J) If you hadn’t become a social worker, what might you have done?
A champion flamenco dancer…of course!

(J) Who was the person who most influenced you, and how?
Elisabeth Kübler-Ross did amazing work with terminally ill patients and really opened the world’s eyes to the needs of dying patients and discussions of death/dying. As long as professionals understand that there are no “5 stages of grief,” her work is still inspirational to those of us trying to increase our culture’s comfort level with death.

(Nora) What has been a pleasant discovery for you in the hospice community?
I discovered that we all face pain in life; it’s what you do with it.

(N) What impact has hospice had on your life?
Hospice has had a great impact on my life, losing my sister to cancer in 2010. I trusted my loved one to the care of Houston Hospice.

(N) Who was the person who most influenced you, and how?
Dr. Trinh, She taught me even in the worst of times, there is always another way to look at the situation. Even under tremendous amount of stress she still can manage to find some good in every situation.

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Houston Hospice: National Hospice Month

National Hospice Month is upon us. Every Monday through the month of November Houston Hospice will be highlighting employee experiences and delving into the human aspect of hospice care. The 2012 National Hospice and Palliative Care theme is Comfort·Love·Respect – something we see daily at Houston Hospice. Hospice care happens because of skilled and compassionate hospice and palliative care professionals. These include physicians, nurses, social workers, hospice aides, chaplains and volunteers. Below is a glimpse of employee insight into compassion driven end-of-life hospice care.

What have you gained from working at Houston Hospice?

 “Knowing that we are truly helping patients, and their families at the most crucial part of their lives,” Robynette Hall, RN, On-call Team.

“What I have gained most at Houston Hospice is compassion and patience,” Sonja Payne, Receptionist.  

“Fulfillment in being a healing presence,” Kathy Flinn, RN, PCM-IPU.

 

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What Hospice Care Can Do for Seniors

To qualify for most hospice care programs, patients must have a terminal diagnosis and an expected prognosis of six months or less. Patients at any stage of their life span may enter, but because of the requirements, most hospice patients are seniors who are dealing with an advanced-stage cancer or chronic disease.

Seniors often begin to consider hospice once they have exhausted their potentially curative treatments. They may also turn to hospice if they are not candidates for traditional treatments because of their age or late-stage diagnosis. Once patients decide that a purely palliative regimen is right for them, hospice services can help them stay comfortable and maintain their quality of life.

Hospice programs also help seniors and their families cope with the terminal diagnosis. From counseling to support groups, these programs help seniors address end-of-life decisions, such as life support and wills. They also help seniors manage the emotional stress they may be feeling about the upcoming months. Patients’ family members – regardless of age – can also benefit from the emotional health services that make up a large component of hospice care.

Health Care Services

Hospice nurses provide a number of health care services that are specifically designed to help patients keep their symptoms under control. While these services are not intended to increase a patient’s life span, they are intended to improve the patient’s quality of life. These services primarily help seniors manage pain, nausea, diarrhea or constipation, fatigue, appetite loss and other common symptoms.

Hospice physicians regularly evaluate the patient’s condition and decide which palliative therapies would provide them with the most benefits. Through hospice, seniors can obtain pain medications (either non-steroidal or steroidal, depending on the severity of their discomfort), wound care, hygienic assistance and other general personal care. Seniors who need help portioning out or remembering to take their medications can also receive this assistance from their hospice nurse.

Seniors can also rely on their hospice staff in case of an emergency. While seniors who enroll in an inpatient hospice facility receive 24-hour monitoring, patients who receive hospice services at home also have hospice nurses on-call all day. This provides the patient and their family extra reassurance in case of a medical crisis.

Emotional Care Services

Seniors also gain access to emotional care services when they enter a hospice program. Hospice care incorporates several different supportive care options, including:

Throughout their time with hospice, seniors will be able to work with clergy members, professional counselors or psychologists, social workers and other volunteers who are trained to guide them through the process. While patients may not immediately realize the importance of these emotional care services, they help patients cope with stress, anxiety and fear. Additionally, family members often have access to emotional support and bereavement services through the organization.

Author bio: Faith Franz researches and writes about health-related issues for The Mesothelioma Center. One of her focuses is living with cancer.

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Celebrating Valentine’s Day as a Caretaker

Valentine’s Day is a holiday that people love to love or love to hate. Some people love the idea of having a whole day to celebrate their love for their friends, family, and that special someone. Other people believe Valentine’s Day is a made up holiday to generate card, chocolate and flower sales. Whatever your opinion is, as a caretaker acknowledging Valentine’s Day can benefit your loved one.

If you take away all of the commercialization of Valentine’s Day what is left? The answer is simple- love. Dedicating a whole day of love for the people in your life is a great way to realize how valuable they are. As a caretaker, you are already a laborer of love. Balancing work and family is stressful enough. You choose to become a primary caretaker because of your deep love for your family member or friend.

This Valentine’s Day, take some time to think about the love you have for the friend or family member you are taking care of. In the chaos of trying to create a successful balancing act, it’s easy to forget why you are a caretaker. Think about great memories shared between the two of you and talk about them with your sick loved one. You don’t have to buy flowers, chocolates, or cards to celebrate your love for each other.

Also, don’t forget to celebrate the love you have for yourself. Take a moment to think about your characteristics that make you unique and special. When you love yourself you can love others even more. Don’t let yourself forget your worth or that you are a strong, caring person. Give yourself a giant hug and compliment.

Even though Valentine’s Day can seem a little over the top and excessive, don’t forget the message of love. Let others in your life know that you love them even if it’s a simple phone call or letter. And celebrate the love you have for yourself.

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