People
Houston Hospice WOWs with New Technology
Digital Health Transformation Rolls into Hospice Care
By Suzy Martin, Volunteer Blogger
According to the recent article More Than Just Tech: How Houston’s Smart Hospitals Are Embracing Tech Innovations by Emily Reiser, “Texas Medical Center (TMC) member institutions are leading the nation in innovation and setting the standard for what smart hospitals can look like and how they will transform the healthcare landscape in the coming years.” As a TMC member institution, Houston Hospice is leading the way in Digital Health Transformation in the hospice care industry.
The 42-year-old nonprofit hospice organization implemented several new technology solutions that help doctors and nurses communicate more effectively with patients and families during fourth quarter 2021. In addition, admitting patients into hospice care is now streamlined and hospice field teams have greater access to online, on-demand, multi-lingual interpreters, as well as accurate procedural instruction available 24/7. Funding for this digital transformation effort was made possible by grants, donations, and the COVID-19 Economic Relief Fund.
Workstations on Wheels (WOWs)rolled into Houston Hospice to the excitement of nurses across the organization.
“I can’t wait to chart immediately so that I can continue to help others,” said Thomas Moore, RN, Director of Specialty Teams, and nine-year veteran of Houston Hospice.
Thomas Moore Director of Specialty Teams Houston Hospice
These eight mobile workstations help nurses document care and update electronic medical records EMRs in real time. Houston Hospice is the only hospice using WOWs in its Inpatient Unit and within its 13-county service area in Southeast Texas.
Prior to this update, nurses recorded notes on desktop computers at each of three nurses’ stations. Now that WOWs are being introduced, patient information will stay up to date which streamlines workflows. In addition to new technology, Houston Hospice uses hardware that is well known throughout the world.
The nurses at Houston Hospice also use iPads to chart notes and share confidential information securely within the seven-member hospice team called the Interdisciplinary Team (IDT). Faster charting means a better work/life balance for these IDT members. In addition, 60+ iPads (with more arriving in the future) and keyboards have been deployed for these health professionals.
Amy Morales, LVN, Houston Hospice with WOW.
Houston Hospice physicians also use secure electronic devices to assess the needs of patients and communicate updates instantly. “The [Houston Hospice] physicians use mobile laptops and iPhones, which work in much the same way as the WOWs to provide up-to-date information for the physicians during visits, to document the visit, email clinicians’ concerns about the patient, and to provide patients and families with information that they may be looking for from clinical information. I can email the nurses questions about the family’s concerns during rounds, and I often get a response before I leave the patient’s room,” said Thuy Hanh Trinh, MD, MBA, Fellow of the American Academy of Family Physicians, Fellow of the American Academy of Hospice and Palliative Medicine, Wound Care Certified, Hospice Medical Director Certified and Team Physician, Houston Hospice.
When collaborating among team members, Houston Hospice relies on a healthcare platform that is secure and performs in real time, making high-quality care more accessible and efficient. The software increases accessibility to documentation and records and streamlines the admission process. Telehealth (seeing patients via video or audio) is also available to keep patients safe from others who may have viruses or other illnesses while caring for their unique needs.
WOWs, iPhones, iPads, and laptops are important components of improved patient management at Houston Hospice. To make these technologies work well with one another, the best software solutions must be utilized so that hospice patients and families will have the greatest care possible. To achieve this, the organization uses state-of-the-art cloud technology to obtain and share hospice information instantaneously, including everything from patient intake to documentation to scheduling, all on a secure network.
Houston Hospice nurses may find the need to research procedures specific to the needs of their patients. To accomplish these kinds of immediate goals, nurses have access to a software program that contains 1,800 procedures in various specialty settings. In addition, the program maintains compliance with current national guidelines and empowers nurses with the knowledge and confidence to make informed clinical decisions.
As Houston Hospice is a member institution of the world-renowned Texas Medical Center that hosts 10 million patient encounters annually, translation services are in great demand. The nonprofit has hired one of the best translation companies in the world to help communicate with patients from all over the world. The interpreter service provides 14,000 professionals, who are on demand interpreters and available via audio and video in 30 seconds or less.
Thuy Hanh Trinh, MD, MBA, Fellow of the American Academy of Family Physicians, Fellow of the American Academy of Hospice and Palliative Medicine, Wound Care Certified, Hospice Medical Director Certified and Team Physician, Houston Hospice.
“The visually-enhanced translation services have been an excellent resource to help connect our patients, their families and our hospice team members,” Trinh said. “Having the mobile translation system with visual contact makes communicating with patients and families easier and more personable. The translator may be better able to address the patients who have difficulty expressing their needs, such as those with slurred speech, when the translator can see the movements of the patient’s mouth and body language.
“For example, one of my patients spoke Cantonese, but I was unaware of which Chinese dialect when I made the request. I had requested the Mandarin translator, who recognized the patient’s dialect even though the patient was speaking with a muffled voice, and she was able to refer me directly to the Cantonese translator for the patient’s support. I think the translator’s ability to see the patient made a difference in realizing what was needed during the visit. The visually enhanced translation system has been a great asset to ensure our hospice team can address the patients’ and families’ needs at any time of day or night,” Trinh said.
As Houston Hospice continues to find new ways to help patients and their families, the use of advanced technology continues to play a key role. “Technology used by Houston Hospice is designed to improve communication between doctors, nurses and patients,” said Scott Watson, IT Manager, Houston Hospice. “This improved care coordination allows for the care of patients remotely and saves time for both the doctor and patient.”
When working to advance technology in the healthcare industry, speaking with colleagues about best practices adds value to the organization’s progress. “We are collaborating with a hospice in Tyler [Texas] to share best practices for healthcare technology implementation,” Watson said. “As we continue to share valuable insights with one another, we will improve hospice care for patients across Texas, the U.S. and even the world.”
As a subject matter expert in IT, Watson has made a prediction that technology in the hospice environment will only get faster and easier to use.
Houston Hospice WOWs with New Technology and its compassionate care is unmatched, reaching hundreds of patients daily. It continues to offer vital services for patients and families, using state-of-the-art practices and procedures. As the organization continues to reach new patients and families who could benefit from hospice care, it will continue to look for new ways to advance hospice care for patients of all socio-economic backgrounds, ethnicities, and beliefs, regardless of their ability to pay.
For more information about Houston Hospice, visit https://www.houstonhospice.org/what-we-do/services/
Houston Hospice Volunteer of the Year 2021 – Jerri Trigg
Jerri Trigg, Volunteer of the Year
Each year, our Volunteer Team thoughtfully selects the Houston Hospice Volunteer of the Year from over 120 wonderful and generous people. This year’s special altruist was selected for going above and beyond general duties to help hospice patients, families, and staff during one of the most challenging year’s the world has seen. We are pleased to share that Jerri Trigg has been named 2021 Houston Hospice Volunteer of the Year!
“Over her seven years of volunteer work at Houston Hospice, Jerri has donated her time and talent in so many valuable ways,” said Patty Valle, Volunteer Manager, Houston Hospice. “She has worked directly with patients and families, assisted in our Texas Medical Center business office and Northwest office, delivered Thanksgiving dinner to a family in need, decorated holiday wreaths that adorned our in-patient unit, delivered elusive cans of Lysol and N95 masks to help keep us safe during the pandemic, and so much more! We are grateful to Jerri for her generosity, kindness, and dedication to Houston Hospice,” continued Patty.
Jerri’s path to Houston Hospice began when her parents were in hospice care one year apart from each other. In both cases, the family experienced compassion, caring, patient and informative guidance during their journey through the end-of-life process. These quality-of-life experiences had a positive impact on Jerri and encouraged her volunteer efforts.
“I have always volunteered and participated in fundraising events throughout the community,” recalled Jerri. “After my own experiences with hospice, I always said I would like to give back in some way. Then, a friend of mine shared information about an upcoming Butterfly Luncheon. I was surprised to find out that it was hospice for children and that really touched me! I attended the luncheon, and as they say, the rest is history,” she proudly stated.
Houston Hospice Volunteers are an integral part of our multi-disciplinary team, are carefully vetted and thoroughly trained to focus on improving the quality of life of patients with a serious illness. Each team consists of seven members – a physician, nurse, social worker, chaplain, bereavement counselor, hospice aide and volunteer. This specialized group of people provide a unique care plan for each individual patient, and their family, throughout the hospice care experience and the bereavement process. It takes a great deal of courage and compassion to be a hospice volunteer.
“Volunteering at Houston Hospice has been a positive and rewarding experience,” said Jerri. “I have met so many wonderful people here. Our many volunteers are like a big, caring family and I am so honored to be a part of this organization,” she beamed.
Houston Hospice is grateful to Volunteer of the Year 2021 Jerri Trigg, and to all her fellow volunteers, for the time, talent, and compassion they have invested to ensure patients and families receive the best possible end-of-life care they truly deserve.
For more information about volunteering at Houston Hospice, visit www.houstonhospice.org/volunteers.
Nurses Week 2020
Houston Hospice 
‘s Our Nurses
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National Nurses Week starts with National Nurses Day on May 6, 2020 and concludes on May 12, 2020 with International Nurses Day, the birthday of Florence Nightingale, who is credited with founding modern nursing. The week-long celebration has been established as a recognized, annual event for appreciating health care workers, but you already knew this long-established, nursing-history fact. I bet you didn’t know that nurses make up over 50% of the global healthcare workforce, and on January 31, 2019, the Executive Board of the World Health Organization (WHO) endorsed a call for 2020 to be officially recognized as the ‘Year of the Nurse and Midwife’. Finally, a whole year dedicated to nurses, and it’s about time. Wouldn’t you say?
Presenting! 
Today’s modern nurses are Frontline Heroes, from all walks of life, and with more strength and courage than you can shake a stethoscope at. “Houston Hospice places tremendous value in our nursing team,” says Jim Faucett, President and CEO, Houston Hospice. “Our highly skilled RN’s, LVN’s, and Nurse’s Aides epitomize hospice care excellence and are the cornerstone of Houston Hospice. Without them, we would not be able to provide the team-oriented, medical care that our patients deserve. For their faithful compassion and commitment to the needs of our patients and their families, I want to extend my deep appreciation and a Thank You to our entire Nursing Team,” continued Jim.
People of TMC
The Texas Medical Center interviewed our very own, Gabrielle Staten, RN, BSN, associate patient care manager, IPU. “We’ve been able to allow family members to visit their dying loved one when hospitals couldn’t,” stated Gabrielle. Click here to read the entire piece, highlighted on the TMC website.
Employee Committee Lights the Way
“Let me know if there is anything I can do”
Published by unknown hospice physician
“Let me know if I can do anything.” How many times have we uttered that sentence when a friend, distant relative or a colleague has informed us they have suffered a loss of a loved one? Don’t get me wrong, I’m sure most of us mean it and it seems like the right thing to say along with “I’m so sorry.” When I look back through my life, I can easily count how many times people have taken me up on my offer. As you’ve guessed, and I’m sure you can relate, it’s 0 number of times. In a time of loss and pain, people don’t want to ask others to go out of their way to help. They aren’t going to tell you they have no energy to cook, need help watching children, money to pay the bills or buy groceries. They won’t tell you they just need a hug and your gentle presence. We are afraid of impinging on people’s privacy and space. We don’t know what words to share or how to behave and in that uncertainty of what to do or say is where the subsequent isolation occurs for the one grieving. The isolation then leads to a sense of loneliness despite the rich number of friends and family willing to help but not knowing how.
Read the rest of this entry »
Suggestions for adult children caring for aging parents
Published in OA Online By Raylene Weaver, LPC of Centers for Children and Families
The Beatles will always be one of my favorite groups. One of their songs that has hit home with me while thinking about this particular article is, “When I’m Sixty-four”.
People want to be needed and appreciated especially when approaching a time in life when it’s easy to be disregarded or forgotten. The aging process can be stressful, causing some to suffer anxiousness and sadness. Several of my clients and friends have faced or are facing tough decisions that are affecting their parents and themselves. I would like to pass on a few suggestions regarding the physical, emotional, mental and financial aspects of AGING that might alleviate some of the stress that can definitely arise for all concerned.
A…ASK parents specific questions concerning their health. Do family members know their medical history, names of their doctors, any medications they might be taking or appointments they are scheduled on a regular basis? If on Medicaid or Medicare, do they also carry supplemental insurance? Are all financial papers, investments, bank account information, bill payment procedures, updated will, computer passwords and any other important documents or information easily accessible? Do they have a bereavement plan?
G…GUILTY feelings about wanting to be prepared by creating a plan for a parent’s future? Questions concerning the private aspects of their lives might seem like prying but this can hopefully be of some consolation for parents, knowing that they will be taken care of “when the time comes”. The objective for the children is to be “in the know” not to be “nosey”.
I…INDEPENDENT lifestyle is what one wants for aging parents. Parents hope to be independent for as long as possible. They want to continue to travel, take care of their own bills, shop, visit friends and attend worship services. Children sometimes become too “helpful” when parents are capable of handling chores and projects and making decisions for their future. Parents do need family members visiting and checking in on them, showing care and concern, just not insisting on control.
N…NECESSARY intervention will be inevitable for many parents. Knowing when to step in and offer the appropriate type of care and assistance can be stressful. Emotions will surface that might not have been seen or experienced before. When going thru matters for instance, pertaining to insisting a parent not drive any longer, taking over their physical and financial aspects of daily life or ultimately moving them into a facility for mental or physical issues or children becoming caretakers of parents in their own homes, professional agencies might be considered. Seeking assistance from those in the medical field, state/local agencies and counseling professionals might become necessary. But until this time arises…
G…GIVE the gift of respect, love and kindness to parents. They are experiencing and living life to the best of their abilities like their children. One article I came across by Evan H Farr, “What Aging Parents Really Want from Their Adult Children”, stated that adult children should: 1) make suggestions instead of giving orders, 2) pick your battles about what parents can and cannot do, 3) reframe, don’t blame and 4) stop and think how you would want to be treated.
So I guess that brings me back to the Beatles. A couple of the lines from Paul and John’s song says, “Will you still need me, will you still feed, me when I’m sixty-four?” Can I just ask…when I’m 74, 84, 94?
Mesothelioma Patients to Learn about Hospice
Published in mesothelioma.net
Palliative care experts are using the occasion of Aretha Franklin’s death to urge mesothelioma patients and others diagnosed with terminal illnesses to learn about hospice care and understand that it provides far more than just a “days before” benefit. Franklin’s family announced that she would be entering hospice care just three days before she died, less than the national median length of stay in hospice which is just slightly over three weeks and far less than the amount of time that the service is available. According to palliative care experts, when announcements are made that celebrities are entering hospice just days before their deaths, it confirms the public’s impression that hospice is a place to go before you die, rather than its actual goal of anticipating, preventing and managing patient suffering. The earlier mesothelioma patients enter hospice care, the more benefit they are able to get and the greater the improvement in their quality of life.
People diagnosed with mesothelioma who are considering hospice care would do well to learn about those celebrities who have used it to its fullest: columnist and author Art Buchwald called the five months he was in hospice “the best time of [his] life”, where he was able to continue working, seeing friends and dying with a minimum of discomfort, in a warm and comforting environment. Palliative care professionals are working to spread this news and reframe the narrative about what hospice care from “nothing more we can do” to “living as well as you can for as long as you can” writes Jennifer Moore Ballentine, executive director of the CSU Institute for Palliative Care, based at Cal State San Marcos.
In an article she wrote for the San Diego Union Tribune, Ballentine urges family members and physicians alike to remember that palliative care is available for mesothelioma patients and others with a life expectancy of six months or less who are no longer seeking treatment. Unfortunately, a study in the AMA Journal of Ethics found that specialty physicians are less likely to suggest palliative care than are family and internal medicine clinicians. Much of this is due to the challenge of having difficult conversations.
If you or someone you love has been diagnosed with mesothelioma, you are already aware that the rare form of cancer has no cure. If you would like information on the benefits of palliative care or any other resources to support you as you face this challenging disease, contact the Patient Advocates at Mesothelioma.net today at 1-800-692-8608.
Five Reasons Home Health Care Is on The Rise
Published in Third Age by Tina Marrelli, MSN, MA, RN, FAAN
If you have tried to get care at home for a loved one, it may have been a difficult and time-consuming process. You are not alone. I also had the experience of trying to find care for an older adult family member, and though I have worked in home care for many years, it is not an easy experience. According to the National Association for Home Care and Hospice, around 12 million people in the United States (U.S.) receive home health care from more than 33,000 provider organizations. As the population continues to grow, that number will likely more than double by 2050, increasing to 27 million.
Here are five factors contributing to the complexity.
*Aging of the population. This has been referred to as the graying tsunami, and for good reason. The projection that roughly 10,000 baby boomers will turn 65 each day, and that this trend will continue for the next 19 years, is staggering, no matter how many times it is repeated. In the U.S., one of the fastest growing segments are those people who are age 85 or older. Called the “oldest old” by the National Institutes on Aging (NIA), they constitute the most quickly growing segment of the U.S. population. And now think about how many people you know who are in their 90s and maybe have passed the 100 mark? My sweet father-in-law moved in to our home when he was 93 and lived with us for three years – until he died at our home with care and hospice support. This scenario is not unusual. And think about the health implications in the oldest old with the frailty and other challenges that come from living to that age.
*Home care means many things. There are home health agencies certified by Medicare and Medicaid. These are agencies that provide what are called “intermittent” visits by nurses, aides, therapists and/or social workers. These services are provided under a physician-directed plan of care. There are specific rules related to coverage and care provided and like any medical insurance program, there are covered and non-covered services. There are also private duty organizations that provide services, such as a “shift” of 4 or 8 hours. In this instance, a family may contact a number of organizations to obtain an aide to be with and care for a family member who might have personal care needs, such as a need for assistance with bathing, dressing and/or meal preparation. There are also home care services that are provided to very ill or technology-dependent people at home, and they may need specialized nursing care, such as that provided by a registered nurse.
*Lack of enough trained caregivers. According to the Bureau of Labor Statistics, (BLS) home health aides and personal care aides are two of the fastest growing jobs. In fact, according to the BLS, their job outlook, defined as the projected numeric change in employment from 2016-2026, is 41 percent; which is much faster than average. The employment increase is estimated at 1,208,800 more aides! Varying factors contribute to organizations having trouble finding and then retaining more aides.
*Chronic conditions and the growing complexity of care. According to the Centers for Medicare and Medicaid Services, it is estimated that 117 million adults have one or more chronic health conditions, and one in four adults have two or more chronic health conditions. These conditions can include cardiovascular (heart) conditions, such as heart failure, respiratory (breathing) conditions such as COPD (chronic obstructive pulmonary disease) or asthma, arthritis, cancer, depression, diabetes and more. Such chronic diseases also demand trained caregivers to help people better manage their health conditions.
*People wanting to age in place. This may be their home or may be an assisted living residence. It was not so long ago that people were cared for primarily at home and oftentimes died at home. Many patients receive care in their homes through the Medicare hospice benefit. In fact, most hospice care is provided in the home setting. Wanting to age in place is a great goal, although it may not always be realistic, depending on the person, the care needs and safety concerns.
So all these kinds of care at home are home care and are increasing the need for these specialized services. The term “home” becomes flexible as people seek the “best” situation for themselves and their loved ones to age in place. There is no question that home care is more complicated than people think. When finding care for yourself or a loved one, ask for (and check) references, read reviews and do your homework. Some of the best knowledge is local, so ask your neighbors and friends who they have worked with when care was needed for their family member.
Tina Marrelli, MSN, MA, RN, FAAN is the author of the Handbook of Home Health Standards: Quality, Documentation, and Reimbursement (6th edition, 2018) and A Guide for Caregiving: What’s Next? Planning for Safety, Quality, and Compassionate Care for Your Loved One and Yourself.
Those in hospice need additional care
Published in Picayune Item by Leah McEwen
Those who are in hospice care often have many needs, but don’t always have access to the assistance required.
One of my grandmothers developed Alzheimer’s about ten years ago and lived with it for several years. She was in her 60s when she received the diagnosis. While the onset of the illness was slow, when it worsened, it became unmanageable.
She forgot who we were, disappeared from her home several times and eventually became a danger to herself. As her condition worsened, she also developed several other illnesses, which made taking care of her impossible for my grandfather. Thankfully, my family was able to pay for outside help to provide the care she needed until she passed away.
Unfortunately, this isn’t the case for everyone. Many elderly adults don’t have family to care for them, and do not have the funds to pay for outside help such as a nursing facility or in-house nurse.
Many hospice services fill this gap by providing care that is paid for through donations, or government programs like Medicare and Medicaid. There are also non-profit organizations that can provide everyday necessities like groceries.
I recently met a man in his early nineties who had saved enough money to pay for his livelihood until he reached 85-years-old. He said he hadn’t expected to live past that point, but when he did, he found himself penniless and with no one to turn to.
With the help of local volunteers and nonprofit organizations who discovered his need, he was relocated to a better home, his utilities were paid and he was provided with groceries and medical coverage.
Organizations that help elderly adults and hospice patients in need improve the quality of life for patients and their families.
Better Sleep for Stressed-Out Caregivers
Those who care for people at the end of their lives tend to struggle to sleep well. Lack of sleep makes it challenging to care effectively, respond appropriately to emergent situations, and give loving care. When you are a caregiver or working with caregivers, it’s important to consider sleep.
Caregivers May Struggle to Sleep
While anecdotal evidence suggests that almost all caregivers of end-of-life patients struggle with sleep, there’s not a lot of research available on how to effectively help them. The general consensus seems to be that (1) caregivers usually don’t sleep well, (2) current strategies for helping people sleep often aren’t effective for them or aren’t something they can implement because of their caregiving situations, and (3) there’s a need for more research to help this population.
Another study suggests some reasons why caregivers might struggle with sleep. These include a disturbed sleep routine, because many caregivers are up with their patients in the night, attending to their needs or simply checking on them.
Caregiving can also be a burden, and many caregivers end up in a depression. It’s difficult to watch a loved one deteriorate before your very eyes. Finally, many caregivers struggle with physical health issues of their own, often due to their caregiving tasks. They may be too sedentary, eat poorly or have other underlying health issues that affect their sleep.
Simply understanding why caregivers don’t get enough sleep may be the first step toward helping them rest. Here are some tips that may promote sleep.
Getting Better Sleep
Getting good rest can be tricky for caregivers, but here are some things that can help.
Re-think the sleep schedule. If the patient always wakes or needs checking in the night, a caregiver can do their best to try to get at least 3 hours of sleep on each side of a wake-up. This schedule can mean going to bed earlier or sleeping in but will help caregivers get the deep sleep and the REM sleep that they need to function well.
Get a comfortable bed. There’s not much worse than trying to sleep on a poor-quality mattress. While a caregiver’s time and money are valuable, it’s worth the effort and expense to find a mattress that they want to fall into at night.
Make the bedroom dark and quiet. This setup promotes sleep and makes it less likely that the caregiver will wake up prematurely or lie awake in bed, unable to sleep.
If you are a caregiver or you are working with caregivers, know that sleep shouldn’t be negotiable. Somehow, caregivers need to figure out how to get the rest that they need.
‘They Deserve It’: In Foster Homes, Veterans Are Cared For Like Family
By Patricia Kime for Kaiser Health News
With the motto “Where Heroes Meet Angels,” a small Veterans Affairs effort pairs vets in need of nursing home care with caregivers willing to share their homes.
Ralph Stepney’s home on a quiet street in north Baltimore has a welcoming front porch and large rooms, with plenty of space for his comfortable recliner and vast collection of action movies. The house is owned by Joann West, a licensed caregiver who shares it with Stepney and his fellow Vietnam War veteran Frank Hundt.
“There is no place that I’d rather be. … I love the quiet of living here, the help we get. I thank the Lord every year that I am here,” Stepney, 73, said.
Caregiver Joann West calls taking care of veterans Ralph Stepney (left) and Frank Hundt at her home in Baltimore a “joy.” “They deserve it,” she says. (Lynne Shallcross/KHN)
It’s a far cry from a decade ago, when Stepney was homeless and “didn’t care about anything.” His diabetes went unchecked and he had suffered a stroke — a medical event that landed him at the Baltimore Veterans Affairs Medical Center.
After having part of his foot amputated, Stepney moved into long-term nursing home care at a VA medical facility, where he thought he’d remain — until he became a candidate for a small VA effort that puts aging veterans in private homes: the Medical Foster Home program.
The $20.7 million-per-year program provides housing and care for more than 1,000 veterans in 42 states and Puerto Rico, serving as an alternative to nursing home care for those who cannot live safely on their own. Veterans pay their caregivers $1,500 to $3,000 a month, depending on location, saving the government about $10,000 a month in nursing home care. It has been difficult to scale up, though, because the VA accepts only foster homes that meet strict qualifications.