Hospice Offers Comfort & Dignity

Story by Michelle Brosco Christian

By the time a family calls for or is referred to hospice for assistance, the family is usually in crisis. But once hospice steps in, families often feel a great sense of relief.

"We know that when people are calling us about coming into hospice, it's such a difficult time for families," said Lynn Bonde, executive director of the Calvert Hospice. "We are guests in people's homes - there to care for someone who is precious to them. How we do what we do is as critical as what we do. Sometimes, the best gift we have to offer is our presence."

Hospice has evolved from a volunteer-run organization to today's comprehensive, end-of-life care program that combines modern medicine with simple human kindness.

Although many people erroneously equate hospice solely with the elderly or cancer patients, hospice services are for people of all ages who are diagnosed with any life-limiting medical condition including cancer, heart disease, respiratory or pulmonary conditions, kidney failure, Alzheimer's, dementia, AIDS or other diagnoses, said Dixie Poe, CEO of the Charles County Hospice.

Many don't realize that hospice patients receive pain and symptom management, usually at no cost to them, and also volunteer assistance, pastoral visits and bereavement programs to help both patients and their families.

Hospices also offer the community many low- to no-cost support programs such as grief support for a family for up to 13 months after a family member's death and children's bereavement camps. It's also little-known that hospices provide community bereavement services, whether a family was involved with hospice or not, Bonde said.

"Someone is available to go out 24/7. Someone's always on call … that's part of the presence - we're always there - there's always someone to talk to," Bonde said.

Helping Hospice Help Families

All three Southern Maryland hospices are not-for-profit, said Kathy Franzen, director of Hospice of St. Mary's. The organizations depend heavily on funds raised through community events and memorial contributions.

Franzen explained the cost of patient care can be very expensive. Despite the high cost of treatment, hospice will not turn anyone away even if they cannot afford the care, said Poe.

"The federal government is cutting reimbursements," said Franzen. "Every year they look at the Medicare hospice reimbursement and make adjustments. The increase we're going to get this year won't even cover the cost of staff mileage, not to mention continued increases in the cost of quality palliative care."

"With (federal) funding reductions over the next three years, we'll have to be very cognizant about being very efficient," Poe said.

Bonde, Franzen and Poe's organizations all depend on the generosity of citizen donations at events such as their holiday season Festival of Trees, all held at the end of November.

Hospice Houses on the Rise

While hospices most often provide assistance in a patient's own home with primary care by family members, there are many circumstances where a patient may need a hospice house because the family cannot provide the care.

Poe gave the example of a young mother who was in hospice and had three young children. She said the woman's husband couldn't manage to work, take care of the household, and care for the children and his sick wife. These are the types of cases, Poe said, where families would greatly benefit from the hospice houses that all three Southern Maryland hospices are working to build.

"The nuclear family is more split up now," said Poe. "There are those families who want to bring a family member home, but don't have the manpower."

One of the benefits of a hospice house, said Poe, is "they look like a home, not like a hospital and they have trained staff" there at all times.

Construction has already begun on the Burnett-Calvert Hospice House on Sixes Road in Prince Frederick. Bonde said the six-bed house should be open by next fall. So far, the community has raised $1.25 million, a state matching grant provided $150,000 and the Calvert County commissioners provided $150,000.

The St. Mary's hospice has also broken ground on its six-bed house in Callaway. The St. Mary's County commissioners, working with the state, gave 23 wooded acres for the project, said Franzen. The St. Mary's house is on schedule to open next spring or early summer, she said.

Charles County's hospice house still needs a location, but design plans have been donated and the state has given $100,000. Plans include a six-to-eight-bed home with possible expansion to 10 beds. Current administrative offices would be incorporated into the hospice house location, said Poe.

Bonde said hospice houses across the country are nearly all "big-time deficit operators." Since hospice houses assist patients regardless of their ability to pay for room and board (not covered by insurance), the costs are high. "Having staff 24 hours, seven days a week to care for patients with at least two people on site is hugely expensive," said Bonde.

Today, so many people have had a hospice experience in the community, said Poe. More and more families choose hospice care probably because hospice staffs are known for their ability to provide comfort and dignity to terminally ill patients and their families.

"Every situation is different - we recognize that we may have seen the death of a grandmother 197 times, but we have never been a part of this death of this grandmother for this family," said Bonde.