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Happy Anniversary, Hospice of the Foothills!

February 11, 2019

This year is a wonderful and significant year for Hospice of the Foothills! We’re celebrating our 40th year serving this community. There was a lot going on in our world 40 years ago. It was a difficult time in America with economic and geopolitical challenges. But, in the midst of such turmoil, something wonderful was happening. The national hospice movement was officially recognized by President Jimmy Carter in 1978, giving rise to a transformative experience for those facing life-limiting illnesses. Hospice of the Foothills (HOF) was right at the forefront of this important shift in healthcare.

Like most early hospice care providers, HOF began as an all-volunteer organization in 1979, serving Nevada and Placer Counties. The availability of hospice care in the home was gratefully welcomed by dozens of families throughout the region. But it didn’t take long before the small staff of volunteers was overwhelmed by the growing need for compassionate end-of-life care. In 1981, HOF moved headquarters from Auburn to Grass Valley, and narrowed the service area to Nevada County and surrounding communities. By the late 1980’s, the patient census was steadily increasing, and it was clear HOF needed to advance staff and practices to the next level. Thanks to the fundraising efforts of Friends of Hospice, and two revenue generating Hospice Gift & Thrift stores, HOF was able to hire their first full-time executive director, a registered nurse, and a half-time social worker.

From that point on, HOF never looked back. Today, we serve over 500 patients and families each year. Our Bereavement Programs serve hundreds more, whether or not their loved-ones received care from HOF. We’ve had many milestones along the way and a few challenges to overcome. But today, in this 40th anniversary year, Hospice of the Foothills stands strong. It’s been our pleasure to serve this community for the last 40 years, and we look forward to many more to come.

Just Do It

October 2, 2018

Benjamin Franklin wrote, “In this world nothing can be said to be certain, except death and taxes”. If something is certain, shouldn’t we talk about it? There’s a lot of discussion and debate around taxes. Yet, there’s a social taboo when talking about death, whether it be our own or that of a loved one.

It’s certainly true that some topics are easier to talk about than others. Even families who love a good debate or discussion can find themselves at a loss for words when someone brings up the topic every adult needs to consider, regardless of our age. How do we feel about choices and care around the end of life? How much have we thought about it or planned? What do we want? What do we absolutely not want? What are we worried about? Who will decide for us if we cannot? Too often, these conversations don’t take place until there is no time left for honest discussion and planning.

While it’s only human to want to avoid thinking about unpleasant subjects, it’s important to consider what would happen if you became unable to make decisions for yourself due to life-threatening injury or terminal illness. End-of-life decisions are best considered before a medical crisis and then documented in an Advance Directive. Advance Directives are legal documents that allow someone to put their healthcare wishes in writing and appoint someone they trust to make decisions for them, should they become incapacitated. By making our own end-of-life choices clear, we can remove the emotional turmoil and stress our loved ones experience during a trying time, while trying to make difficult decisions on our behalf. As much as we’ve heard how important it is to have such a document, 63% of American adults don’t have one!

So, what is it that keeps us from having these important and necessary conversations with our loved ones. Fear of upsetting our family members? Reluctance to speak of our eventual deaths for fear of hastening its occurrence? Fear of sounding morbid? Not knowing how to start the conversation? Whatever the reason, in the words of the sports powerhouse, Nike, ‘just do it’! It’s important to face our fear or break through the barriers and have real conversations about end-of-life choices. Engaging in conversations before a crisis occurs will ultimately save time, costs, stress, guesswork and potentially harmful family disagreements. If we can begin to normalize talking about dying while people are still healthy, we will have made a significant contribution to our family’s well-being and peace of mind.

It takes time to change the way we approach the topic of end-of-life planning and death. Willingness to have transparent, meaningful conversations will benefit everyone involved. The more we normalize and plan for death, the more we can get on with life!

There are many online resources to help navigate end-of-life planning. Two of the most popular are The Conversation Project (theconversationproject.org) or Five Wishes (fivewishes.org). Hospice of the Foothills would also be happy to come speak to your organization or club about Advance Directives.

Don’t Wait Until It’s Too Late

October 2, 2018

In recent years, hospice programs across the country have experienced an epidemic of late admissions. These are patients who are referred to hospice just a few days or hours before their deaths, and are in a state of acute medical, emotional and family crisis.

Waiting too long to enroll in hospice will diminish a patient’s ability to enjoy both quality and quantity of life. Even though the Medicare hospice benefit is designed to cover the final six months of life, half of all hospice patients nationwide are enrolled less than three weeks before their deaths and 37 percent spend less than a week in hospice.

Some patients are referred so late that the hospice team must rush to perform an emergency admission to see them before they die. This problem of late admissions has forced crisis management and hurried attempts to maximize quality of life in the few precious hours or days before the patient dies.

This crisis-management approach is in sharp contrast to the hospice ideal of building relationships, managing pain, facilitating meaningful emotional closure for significant relationships, and enabling a peaceful dying experience for the patient and grief support for his or her loved ones. Both the patient and the family miss out on the full benefit of hospice care by waiting too long to access support. They also may not have time to address important issues such as wills, end-of-life wishes and financial arrangements. Such unaddressed concerns can magnify the natural fears and anxieties that patients and families experience at this time.

Hospice professionals know from experience how much calmer the patient’s dying process can be with support, making the final chapter of this patient’s life comfortable, peaceful and satisfying, if time permits. That complaint is echoed countless times by bereaved family members in hospice grief support groups: “If only we had known about hospice sooner”.

Why are hospice admissions delayed?

Part of the answer lies in the widely held notion that a hospice referral is “giving up” — even though studies indicate that patients often live longer with symptom management. In fact, many hospice patients find the progression of their disease stabilizes and they are no longer in need of hospice services.

Physicians may also be reluctant to acknowledge the “failure” of their care and resist initiating difficult conversations with terminally ill patients, encouraging them to call hospice. Fortunately, anyone can initiate a hospice referral by calling Hospice of the Foothills for an eligibility assessment. If the patient does not yet meet the Medicare standards for hospice care but are in need of palliative (comfort) care and support, a referral can be made to Foothills Palliative Care Consultants.

Late hospice referrals

When a patient is referred late to hospice, just days or even hours before death, the burden of symptoms from the illness and the side-effects of aggressive treatment likely have multiplied to such a point that everything seems to be going wrong at once, both in the patient’s physical condition and in the family dynamics (emotionally and spiritually).

Late referrals can disrupt the patient’s care at a most stressful time, rather than allowing for a more orderly transition and a relationship of trust to develop between the hospice team and the patient. In some cases, the crisis may land the patient in the hospital and even preclude the opportunity to die at home, which research has revealed is the preferred choice.

Hospice of the Foothills has been servicing the end-of-life needs in our community for the past 39 years. Our goal is to enable our patients to value each day and to live fully during their time remaining. We understand that it is important to make the end-of-life journey a gentle, loving and peaceful experience for our patients and their loved ones.

It is important to also mention that all hospices are not associated or connected. Some are nonprofit community run organizations, while others are for-profit franchise corporations. Hospice of the Foothills is pleased to have served our community as a nonprofit, community run hospice for the past 39 years. We rely on community support through monetary donations, estate gifts or gift & thrift store sales and never bill our patients for care related to their terminal diagnosis.

For questions about the right time to access hospice or palliative care, call Hospice of the Foothills at 530-272-5739. Unlike other hospice providers, all of our services are provided locally. We are your friends and neighbors and we care about our community.

Hospice of the Foothills: Ask for us by name!

May 14, 2018

Did you know all hospices are not the same? It’s very common for people to think that hospices are all affiliated; particularly if there are multiple hospice providers serving the same area.  Your doctor may make a recommendation, but the choice is yours! Since you have the right to choose, why not choose the best.

So, how do you know which hospice provider is right for you? Here are some questions that may guide you when assessing a hospice provider.  1) Are they a for-profit or nonprofit?  If for-profit, who owns them?  Are they a franchise?   2) Are the physicians and nurses, certified in hospice or palliative care?  3) How do they measure and track quality?  Is there any way to view their results?  4) How are patient/family concerns handled?  5) What processes are in place to ensure the entire care team is up-to-date on your family members care?  6)  Are doctors, nurses and/or social workers available 24 hours a day, seven days a week?  7) How long has the hospice been in operation and is it local? 8) What kind of bereavement services do they offer and are they local?  9) What screening and type of training do hospice volunteers receive before they are placed with patients and families?  10) Is the hospice a We Honor Veterans partner?  If so, what level?

Not all hospices share the same level of excellence and the differences may be very important to you or your family. At Hospice of the Foothills, we welcome your calls to learn more about our programs and services.  Our care teams are career hospice professionals and are experts in providing end-of-life care.  Plans of care are individualized to each patient and family to ensure the needs of the whole family are addressed.  All of our programs and services are provided locally.  Our care teams and dedicated volunteers are your friends, neighbors and family members.  With 39 years of service, Hospice of the Foothills is uniquely able to draw upon the knowledge gained from serving thousands of our community’s patients and families.  We have a 98.56% ranking for family satisfaction on Medicare’s Hospice Compare www.medicare.gov/hospicecompare. and have been designated as a ‘Best Practice Agency’, ranked in the top 25% of hospices in the country. For the highest quality of hospice care available in our community, ask for Hospice of the Foothills by name!