Hospice Care

Houston Hospice Nurses Receive Prestigious Award

Good Samaritan Excellence in Nursing Award

Houston Hospice nurses Hope Cook, Svanhaniel Crim and Darelle Robbins received the Bronze Excellence in Nursing Award from the Good Samaritan Foundation at a luncheon ceremony on September 8, 2016 at Houston’s Royal Sonesta Hotel. The event was chaired by Kathryn M. Tart EdD, MSN, RN, founding Dean and Professor of the University of Houston School of Nursing. This year 249 nurses were nominated by their peers from hospitals, clinics, colleges and universities throughout Houston.

Hope_Cook_Recieved_Excellence_In_Nursing_AwardHope Cook

Hope Cook BSN, RN, CHPN has been a practicing Registered Nurse since graduating from Texas Woman’s University, Houston 41 years ago. This year she tackled a new role as Educator for Houston Hospice. Hope has created several educational programs and works diligently toward positive outcomes in patient care through education. Hope’s colleagues note that she tenaciously seeks the latest information to stay abreast of changes in the hospice specialty. Her educational programs have enriched and supported the Houston Hospice nursing team.

Svanhaniel_Crim_Received_The_Excellence_In_Nursing_Award

Svanhaniel Crim

Svanhaniel (pronounced Swan-Nell) Crim BSN, RN embarked on her nursing career 40 years ago, after graduating from the University of Texas System School of Nursing. She has served as a leading member of her Houston Hospice care team for over six years. Because of Svanhaniel’s diverse experience and penchant for learning, she is a go-to person for nurses and physicians. Svanhaniel is eager to help her colleagues succeed and she is often called upon to act as a mentor and educator for new employees, nursing students and medical residents from nearby programs. Svanhaniel is also well-known for her exceptional bedside manner. Patients and families frequently express gratitude for the care she provides.

darelle_robbins_received_the_excellence_in_nursing_awardDarelle Robbins

Darelle Robbins MN, RN has been an RN since graduating from Odessa Junior College. She earned a BSN in 1979 from the University of Texas in Austin and completed her Masters in Nursing in Staff Development, Clinical Nurse Specialist degree in 1990 from LSU in New Orleans. Darelle’s Houston Hospice care team says she has been an inspiration to them with her positive attitude and can-do spirit. Darelle steps in when nursing needs arise, even traveling from Houston to El Campo to Humble in one day to see patients. At their weekly care team meetings, Darelle shares her wealth of knowledge making valuable contributions toward patient care planning. Beyond her medical expertise, families express appreciation for the calming and reassuring presence Darelle provides.

Thank you Hope, Svanhaniel and Darelle for your expert medical care and for providing comfort, dignity and reassurance for patients and families. You truly care and it shows.

Work with the best of the best. Houston Hospice employment opportunities.

 

—Karla Goolsby, Houston Hospice Communication Specialist

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Personal Experience Brought Volunteer to Houston Hospice

IMG_0007_peCake, Balloons and a Big Announcement

During a recent volunteer shift, Sylvia Valverde was summoned to the dining room of Houston Hospice. Her initial confusion at seeing a cake, flowers and balloons turned to stunned surprise. The celebration was in her honor because she had been named Houston Hospice Volunteer of the Year. When she retired from a 33-year career as an educator, Sylvia knew volunteering with hospice was what she wanted to do. A very personal experience prompted her to seek opportunities to help others through Houston Hospice.

Unexpected Blessings of Volunteering

Sylvia says her biggest surprise about volunteering at Houston Hospice is how much she loves it. “The patients have given me tremendous insight about living life to the fullest and that the dying process is not to be feared. I’ve especially been blessed to give babies and toddlers love and care in their final days when their parents haven’t been able to be present. That has been my most rewarding experience.”

Because she is bilingual, speaking English and Spanish, Sylvia often translates for patients and families. She enjoys her conversations and says seeing patients and loved ones smile is priceless. “I enjoy visiting with the patients and family members and they like knowing that Houston Hospice is very special to me because my mother was a patient there. That experience connects us and lets them know that I have personally experienced hospice care. While every death is different, I can somehow relate and understand what they’re going through.”

SylviaValverde_Volunteer_of_the_YearInspired to Give Back

Her mother’s experience is what inspired Sylvia to volunteer. She says the care her mother received in 2003 made a big impression on her. “I always said I wanted to give back when I had the opportunity. I retired from education in August 2011, and I immediately contacted Houston Hospice and began the training that September. God has blessed my life tremendously and He calls us to be servants—this is why I’m here—to serve.”

Volunteer Manager, Patsy Piner said it wouldn’t be Friday mornings without Sylvia Valverde’s lovely smile and sweet spirit. “Whether she is passing out pillowcases to patients, training new volunteers or sharing her delicious homemade goodies, she is a blessing to everyone she visits. We are so fortunate that she chose to volunteer with us.”Volunteer of the Year 012_pe

It Takes a Village of Volunteers and Staff

Volunteers are an integral part of nonprofit Houston Hospice’s team. To learn more about volunteering at Houston Hospice, call 713-467-7423 or visit www.houstonhospice.org.

—Karla Goolsby, Houston Hospice Communication Specialist

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Veterans Day: Honoring America’s Veterans Includes Meeting Their Unique Needs

soldier-708711_1280Houston Hospice delivering Veteran-centric care to those who served our country

1 in 4 of All deaths in the U.S. are Veterans

Many Americans do not realize that 1 in 4 of all deaths in the U.S. are Veterans. As the nation honors these American heroes for their military service on Veterans Day, November 11, it’s important to remember that they also deserve recognition and compassionate care when dealing with a serious illness.

As a We Honor Veterans participant, Houston Hospice is providing specialized care to Veterans who are facing a life-limiting illness. The National Hospice and Palliative Care Organization (NHPCO) in collaboration with the Department of Veterans Affairs created We Honor Veterans to empower hospice and other healthcare providers across America to meet the unique needs of seriously ill Veterans and their families.

We’re Intentional About Caring for the Unique Needs of Our Veterans

“Through We Honor Veterans we are taking a giant step forward in helping healthcare professionals and volunteers understand and serve Veterans at the end of life,” said J. Donald Schumacher, NHPCO president and CEO. “It is time that we step up and acquire the necessary skills and fulfill our mission to serve these men and women with the dignity they deserve.” Houston Hospice CEO, Jim Faucett, noted the benefits of the program to patients and families and the organization, “As we’ve trained to meet the unique needs veterans face at the end of life, our staff has become more aware of all veterans. We’ve been enriched by seeking out our veteran volunteers and learning their stories, and we’re less hesitant to introduce ourselves to other veterans and thank them for their service.”

military-864397_1920Within the We Honor Veterans program, there are four levels of distinction that hospices can earn based on their involvement with Veteran education and their interaction with the Veterans and their family members that they are caring for. The goal of these levels is to ensure the very best care is being provided to those who have served our country. Houston Hospice is working toward the highest level of participation. It is meeting the specific needs of Veterans by being knowledgeable about the wars in which they served and the associated traumas; such as radiation exposure from atmospheric nuclear weapons tests after World War II, and pulmonary maladies resulting from the oil rig fires of the Gulf War. Houston Hospice is also strengthening its relationship with the Michael E. DeBakey VA Medical Center and offering community outreach educational programs for Veterans’ groups about advance care planning, available resources, and care options.

They Know I UnderstandMikeMcCardle_BronzeStar_ForValor_FtBragg_1968

Houston Hospice volunteer, Mike McCardle, began visiting veteran patients 15 years ago. Because he’s a veteran, he said patients open up to him about their lives and the emotional burdens they’ve carried since battle. “I walk in, give my military pedigree, then they give me theirs and we’re off and running. They know they don’t have to explain. They know I understand.” Mike served in Vietnam from 1964-69. He went to war as a young private and left Southeast Asia just five years later as a battle-seasoned Captain in the United States Army. Often, the wives of the veterans he visits have not even heard the stories their husband’s share with him. “The biggest surprise is how much I get out of it. I form a bond with these guys. I’ve met some real characters. I’ve heard about the Battle of the Bulge, and lots of stories about the South Pacific. I was just mastering my own PTSD and these guys really helped me to know that what I was going through is normal.”

As we celebrate our nation’s heroes this Veterans Day – and every day of the year – we must not forget that it is never too late to give them a hero’s welcome home. Learn more at www.WeHonorVeterans.org.

—Karla Goolsby, Houston Hospice Communication Specialist

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Watch – Hospice Conversations and Policies are Changing

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Houston Hospice Volunteer of the Year

WP_20150514_11_58_32_Pro_peIt Wouldn’t Be Monday Without Debbie

Eleven-year volunteer, Debbie Hoelscher, has been named volunteer of the year by Houston Hospice. As a nonprofit organization, Houston Hospice relies upon over 300 volunteers to help set the tone for the compassionate care patients and families receive. Since 2003, Debbie Hoelscher has volunteered in both the inpatient care center and in patients’ homes. Volunteer Coordinator, Patsy Piner said, “It wouldn’t be Monday at hospice without Debbie here tending the flowers, tending the patients, and bringing serenity and calmness into our lives.”

Volunteering With Hospice Isn’t For Everyone

About her work in hospice Debbie states, “The families truly appreciate the smallest gift of your time and doing this type of work gives me a great sense of gratefulness.” Debbie also trains incoming volunteers and many have noted her ability to engage and be at ease with patients and their families. Ms. Piner added, “We often say that volunteering with hospice is not for everyone, but Debbie has a gift for this type of work and we are glad she spends her Mondays with us.”

Volunteers are an integral part of nonprofit Houston Hospice’s team; serving patients and families with caring expertise in the Houston Hospice care center, in patients’ homes and in assisted living facilities. To learn more about volunteering at Houston Hospice, call 713-467 7423 or visit www.houstonhospice.org.

-Karla Goolsby, Houston Hospice Communication Specialist

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Service of Remembrance Brings Closure for Hospice Worker

Every six months Gloria Garza coordinates a service of remembrance. Gloria’s been putting together these biannual observances for 15 years; since she came to work for Houston Hospice in 2000. CandlesShe invites families, makes sure the ceremony runs smoothly, and organizes a reception with food and punch. At the service on April 30, 2015 at St. Thomas’ Episcopal Church in Wharton, 135 people were remembered. “This event means a lot to our families. They get the opportunity to see the staff that helped them with their loved ones again,” said Gloria. “And, we get to see how the families are doing. After the service, we walk over to the fellowship hall and have refreshments and the families talk to the staff and exchange stories, hugs, tears, and appreciation for the care and for the service they just attended.”

The services of remembrance began when hospice employees realized that both they and the community needed a way to honor their patients and to have closure. After fifteen years of planning some thirty services, the April 30 observance was different for Gloria. As usual prayers were recited, music was played, and, as their loved ones’ names were called, families were invited to the altar to light a candle. However this time, the name of Gloria’s mother, Lena Quintanilla, was among those called.

Lena, the family matriarch, suffered a massive stroke on January 8, 2015. Four days later her doctor told the family there was nothing more they could do. Gloria responded saying, “Call Houston Hospice now.” As a hospice employee, she knew she had a right to select the hospice of her choice, and because she was designated as her mother’s medical power of attorney agent, she knew it was what Lena wanted. “We already talked about what she wanted and what I should do,” said Gloria. “It made it so much easier. I had a hard decision to make. Even if it was not what I wanted, I had to honor what she wanted. She didn’t want to linger. She didn’t want to be a burden.” Gloria feels strongly about Medical Powers of Attorney and Living Wills. After she helps her siblings complete theirs, she plans to speak to community groups and help others, so that their wishes can be carried out should they become incapacitated.

Lena Quintanilla was a doting and energetic mother of five, and she had touched countless lives working as a hospice volunteer since June 2004. “She was a loving and caring mommy to me and to

Gloria Garza and Lena Quintanilla

Gloria Garza and Lena Quintanilla

everyone that knew her. She could cook Spanish rice and hot sauce like no one else. Just ask our El Campo office,” said Gloria. “My father is grappling with how to go on. She did everything for him. They were married for 72 years. She was only 14 and he was 17 when they got married. She did everything around the house. She even paid the bills. All he did was work and he was a good provider with only a second grade education.”

“About 40 people attended and the service was beautiful and peaceful,” said Gloria. “I’m normally busy helping. I sat back by the pianist like I always do, but this time my family was there. It [the service] helped us to take it in and gave us some closure that this really did happen. It means our loved ones are not forgotten and we have to go on.” Gloria stilled a slight quaver that threatened to expose her sorrow and continued, “My oldest sister, who lives in Clear Lake came and she was so touched that we do this every six months. She told me she wants to come to the next one. I asked why since she wouldn’t know anyone and she said she would light another candle for mama.”

Houston Hospice is Houston’s only nonprofit hospice, providing care for patients and families throughout ten counties. To learn more about the local bereavement services offered by Houston Hospice, visit www.houstonhospice.org, or call 979-578-0314 or 800-420-6193.

-Karla Goolsby, Houston Hospice Communication Specialist

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Pat Matthes: A Heart for Hospice

After a long career dedicated to helping others, Bay City native, Pat Matthes, is retiring at the end of May. Pat has served as a Social Worker for Houston Hospice for thirteen years.

Pat Matthes

Pat Matthes

During that time, he regularly traveled throughout a 50-mile radius of his El Campo office; helping patients and families during their times of greatest need.

Pat’s career as a Social Worker began in 1976. During an almost 40-year career he worked in private practice, helped special needs patients in Bay City, and tried his hand at Hospital Administration before filling a rewarding niche as a Social Worker for Houston Hospice. “I love my job very much,” said Pat. “I love the team. I love the people at Houston Hospice. They’re a class act.” When asked what he’ll miss most Pat answered, “I’m going to miss hearing people’s stories. There are always beautiful stories in hospice.”

Pat’s colleagues anticipate that his absence will be strongly felt. Houston Hospice Professional Relations Liaison, Tiffany Livanec said, “If there was a national ‘Heart of Hospice’ award, Pat would certainly be the recipient. I’ve rarely met anyone who didn’t know him, and I’ve never met anyone who didn’t sing his praises. He will definitely be greatly missed.”

Volunteer Coordinator, Gloria Garza said of Pat, “We have been together for so many years with Houston Hospice – El Campo. He is an amazing, compassionate and kind soul. I am greatly going to miss my friend!”

Pat’s not exactly sure what he’ll do in retirement, but he knows it will involve helping people. He plans to volunteer for First Baptist Church of Bay City where he’s a member. Pat said he likes building things and looks forward to helping the Baptist Men’s Association, a group that provides assistance in the aftermath of disaster. He said he might consider volunteering with hospitals and hospice too.

Houston Hospice is Houston’s only nonprofit hospice, providing care for patients and families throughout ten counties. To learn more about Pat’s retirement celebration or the local services offered by Houston Hospice, visit www.houstonhospice.org, or call 979-578-0314 or 800-420-6193.

-Karla Goolsby, Houston Hospice Communication Specialist

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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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Is Profit Seeking Trumping Care? Nonprofit vs. For Profit Hospice

The truth is, most people don’t think about hospice at all until it becomes a necessity. The concept of hospice is relatively new in the United States. However, as the number of hospice providers grows, with varying degrees of quality, it’s important to be informed. Hospice places its emphasis on quality of life with care that’s tailored to the unique needs of each individual and their support network. When curative treatments cease to help, the relief of palliative care can bring a new form of hope for terminally ill patients and their families, as hospice services help them make the most of their time together. In 2007, research published in the Journal of Pain and Symptom Management reported that hospice patients lived an average 29 days longer than similar patients who did not have hospice care.

When it came to the United States from England in the 1970s, the hospice movement began as a grass-roots campaign to address the unmet needs of patients with terminal illnesses. The benefits of this care were quickly recognized by the medical establishment. In a 1978 report, a U.S. Department of Health, Education, and Welfare task force noted both the altruistic and practical advantages of government support for hospice care: “The hospice movement as a concept for the care of the terminally ill and their families is a viable concept and one which holds out a means of providing more humane care for Americans dying of terminal illness while possibly reducing costs. As such, it is the proper subject of federal support.” In 1982, Congress included a provision to create a Medicare hospice benefit in the Tax Equity and Fiscal Responsibility Act.

With hospice services covered by Medicare, what started as a purely charitable movement became a probable source of revenue. As a result, the number of for-profit agencies entering into the business of hospice has grown exponentially, with

alarming results. An article published by the Washington Post on May 3, 2014 entitled “Terminal neglect: How some hospices treat dying patients” reported that the quality of care provided by 920x1240hospices varies widely. A Washington Post investigation analyzed Medicare billing records for over 2,500 hospices, obtained an internal Medicare tally of nursing care in patients near death and reviewed complaint records at hundreds of hospices. At many hospices, they discovered that little care was provided for patients most in need. The investigation ascribed this absence of care to skimping on nurses, and to the failure of these hospices to have access to a facility where continuous crisis care could be provided. The investigation found that about 18 percent of U.S. hospices did not provide a single day of crisis care.

The investigation noted that the absence of crisis care at those hospices stands in stark contrast to most others, where such care is common. Medicare payment rates and their unintended financial incentives may be responsible. Providing routine care such as semiweekly nursing visits can be very lucrative. However, symptom management that requires continuous nursing care or inpatient care can be financially draining and logistically problematic, especially for smaller agencies.

An area of great concern is the burgeoning growth of home health care businesses that offer hospice. “For-profit home care agencies are bleeding Medicare; they raise costs by $3.3 billion each year and lower the quality of care for frail seniors,” said Dr. Steffie Woolhandler, professor of public health at CUNY’s Hunter College, lecturer at Harvard Medical School. “Letting for-profit companies into Medicare was a huge mistake that Congress needs to correct.”

William Cabin, assistant professor of social work at Temple University and lead author of a nationwide study published in the August 2014 issue of the journal Health Affairs said, “While our study is the first to show that profit-making has trumped patient care in Medicare’s home health program, that’s no surprise. A large body of research on hospitals, nursing homes, dialysis facilities, and HMOs has shown that for-profits deliver inferior care at inflated prices.”

Researchers believe that most hospices are providing quality care and many nurses in the field consider palliative medicine as much a calling as a job. When the hospice movement took root in the United States, hospice practitioners were typically part of religious groups, or were community-supported like the Texas Medical Center’s Houston Hospice. However, since for-profit businesses have come to dominate the industry, early planning and investigation of hospice care options is a necessity.

Karla Goolsby

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I Remember Tommy: Coffee, Cigarettes, Harley Davidson and Hospice

Patsy Piner

Patsy Piner

I remember the first time I saw Tommy. He came for a tour of the Hospice with his aunts. He sat on the couch in the first floor family room where he nodded off several times while I answered the many questions his aunts asked. When we walked down the hall of the first floor, Tommy made comments and had questions too, “Don’t put me in no pink girly room. Do you have an orange and black room? Those are Harley Davidson colors. Manly colors – loved and revered by bikers.” Tommy was a biker, had a Harley and loved to talk about it. He had plans to ride again – just as soon as he felt better. He was here to get his medicines regulated so he could get on with his life. This hospice stuff was an inconvenience he was dealing with begrudgingly.

Tommy was young, in his early forties, and had pretty much lived life on his own terms until brain cancer stopped him in his tracks. He had dealt with the treatments and surgeries the best he knew how, with blend of humor, reality, anger and denial. A kind of cocktail that he partook of each day just to keep going. Little doses of each when needed so he could hear what he had to hear, see what he needed to see and do what must be done.  After his initial visit, Tommy was in the inpatient care center several times and we always knew when he was here. He had been a large man with an outgoing personality before cancer and treatments had taken their toll; his body had changed but his personality remained intact. He made his presence known.

Tommy was blessed by his loving family who took turns caring for him at home and being with him while he was here. The few times he was alone here, he had the volunteers and/or the staff jumping. We all knew Tommy. Ask anyone who met him while he was here what his two favorite things were and I am sure the response will be, “Coffee and cigarettes.” Tommy loved good coffee, particularly Blue Mountain from Central Market and his smokes. I could see Tommy from my desk, sitting outside drinking coffee, smoking, and visiting with his friends, old and new. A few times he managed to sneak out alone. He would sit on the bench, smoke a little and doze a little. On those occasions, I would walk over, gently wake him up, sit and chat for a moment so he could finish his cigarette safely. We would amble back to his room and he usually had me making fresh coffee before I went back to work. Old coffee was a no-no according to Tommy, so the Volunteer department bought a little coffee machine that made just enough to fill a travel cup. That was Tommy’s pot, Tommy’s cup and Tommy’s coffee.

When the last days of Tommy’s life were approaching, his family brought him back here for the end. I saw very little of Tommy that last time; he wasn’t going outside for a smoke and his coffee dispenser was idle. He was in his room on the 2nd floor quietly preparing to die. His mother held his hand and sang “Hush little baby, don’t you cry.” She wanted to be as close to him as she could get, so a nurse found a small plain wooden stool for her. She pulled it close to his bed and stayed there holding his hand and singing for hours. When the time came for Tommy to take his final breath, he did so while being cradled in his mother’s arms – one last time. After Tommy was gone, his mother wanted to do something meaningful in his memory. A simple wooden stool had made such a difference in her last hours with her son that she and her family and friends acted on a suggestion made by the nurse who was with Tommy when he died — every room should have a stool. Now, we have stools in every room and they are there because of Tommy, and his mom, and his family and his friends. Even though they are small plain wooden stools, there is nothing little or ordinary about what they will be used for. We will think of Tommy and his mom each time we see someone sitting on a plain wooden stool close to a bed, saying goodbye. —Patsy Piner is the Houston Hospice Volunteer Coordinator 

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