Do You Need Community Based Hospice or In-Patient Rehabilitation?

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By Victor Montour

When someone suffers from an injury or medical trauma, they may need to live at a rehabilitation center or skilled nursing facility for a short period of time. The goal for most people going to in-patient rehabilitation is to help the patient return to his/her maximum functional potential after suffering a life-altering event.

When someone is diagnosed with a life limiting disease they may need to look at a community based hospice. The goal for patients going into hospice is to provide physical, emotional and spiritual support to the patient and family while they enjoy life at home with family and friends while the patient’s disease process continues on a natural course.

In-patient rehabilitation is a rehabilitation service offered to people in a residential setting, rather than to people who travel to a clinic for rehabilitation appointments. These facilities are called skilled nursing facilities (SNF) or In-patient Physical Rehabilitation Centers. In-patient facilities could be located inside a hospital or senior housing, such as assisted living facilities and nursing homes.

These centers provide around-the-clock treatment and supervision. The patient’s progress is continuously monitored. In some cases, in-patient treatment programs stand a better chance of success for patients. Some common types of ailments that might be best treated (check with your doctor for the best advice) include:

  • Fractures
  • Joint injury or replacement
  • Aneurysm
  • Neurological conditions
  • Stroke
  • Arthritis of the spine and other joints
  • Brain injury
  • Nerve impingement
  • Amputation

Community based hospice services are offered to people in a residential home or home like setting. Hospice care can all so be provided in some community facilities. Some of these facilities are called skilled nursing facilities (SNF), senior housing, or assisted living facilities.

Most community based hospice care is provided at home — with a family member typically serving as the primary caregiver.  Medicare has strict clinical guidelines a patient must meet in order to receive hospice care in a hospital setting. This type of hospice care is very rare and should never be considered as the first line of treatment. Some common types of medical conditions that might be best treated in hospice (again check with your doctor for the best advice) include:

  • Stroke
  • Cancer
  • Chronic Obstructive Pulmonary Disease (COPD)
  • Congestive Heart Failure (CHF)
  • Amyotrophic Lateral Sclerosis (ALS)
  • Alzheimer’s
  • Liver Failure
  • Renal Failure
  • Amputation

 

Duration of in-patient rehabilitation treatment varies depending on the severity of the condition and potential for improvement. The key words being potential for improvement. Families and patients should ask their doctors what the potential for improvement is for any treatment. If improvement is low or a decline in health continues then the next question should be, what about hospice?

Generally, significant results can be achieved in either program as long as you are placed in the appropriate program at the optimal time. People should enter into hospice as quickly as they do going into rehab. Hospice care should be a timely choice not a last resort. Currently this concept seems to differ widely depending on the condition being treated and the patient’s involvement in his/her care.

Many times, I see patients going to rehab who have a terminal diagnosis. I always ask myself, is this patient informed? Do they understand their diagnosis? Do they understand the diagnosis they have is terminal? Do they know they could spend their time with loved ones enjoying life instead of being alone or with strangers in a rehab facility?

As healthcare is everchanging it is the patient’s responsibility to know their diagnosis, to know best treatment options and to know when a diagnosis is terminal. Patient’s need to drive the conversation on what they want for care. Ask is hospice or rehab more appropriate? Ask what is the potential of cure or rehab? Let your doctor know what ‘enough’ looks like to you. Talk to your doctor about what you’re willing to do in rehab and what you’re not willing to do. You have to say ‘enough is enough’ when the time comes, so why not prepare people ahead of time.  I have seen many people with a terminal diagnosis sent to rehab and even continue until death because they weren’t fully aware of the choices they had.

You are in charge of your healthcare so take charge and research your options. Educate others on what you want, when you want it.

 

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A Precious Journey

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By Victor Montour

As a community liaison for Front Range Hospice and Palliative Care I’m blessed with many opportunities to meet some wonderful people. Just recently I was asked to meet with the patient and the family at one of our area hospitals to discuss palliative care and what services are provided with Community Based Palliative Care.

The next day I was called by the patient’s son and asked to come to the home to discuss hospice services. When I arrived at the patient’s home he was sitting outside enjoying the morning air, the fresh smell of the morning dew was heavy. I sat with the patient, his son, daughter-in-law and his daughter called in from out of state. I first talked with the patient to establish his goals for medical care. It was profound to discover the patient was asking for someone to talk with him openly and honest about his prognosis. He also was clear that his largest fear was losing his mind. He wanted to remain sharp and in control. After a long conversation with him and his family, reviewing the pros and cons of seeking treatment, the patient wanted to start hospice care.

Over the last week the team from Front Range Hospice and Palliative Care provided legendary end of life care. The patient was placed on daily Registered Nursing (RN) visits to ensure maximum comfort was obtained and maintained. The RN’s were called out to the home, as needed, a number of times day and night to help manage the patient’s terminal agitation. (To learn more about terminal restlessness / agitation read our blog “A Major Distressful Symptom in The Dying”) The nursing team from Front Range Hospice and Palliative Care provided endless support to the patient and the family.

A final call from the family came in the middle of the night informing the on-call nurse that the patient had passed away peacefully in his bed. The nurse made her way to the home and provided one last time the support this family came to expect from our team. The nurse completed her nursing functions and then turned to the family and sat with them a bit and provided them the reassurance they needed to hear.

As a liaison I frequently get calls from families for assistance of various kinds. I received a call from the patient’s daughter-in-law asking to meet with me at 10:00 am. I was asked to come to the home to meet in person with the family. When I arrived, I had the pleasure of meeting with the patient’s daughter from out of town, the son and daughter-in law. The three of them shared with me their experience while on this journey with their father. The wonderful things that the family had to say were just amazing.

They all agreed that their hospice RN Haley was the perfect nurse for their dad. She was amazing, they recounted with me how Haley helped their father get into his camper one last time. They shared that he loved his camper and spent more time in there than the house. The family voiced they will never forget this selfless act of kindness shown to their father.

As we talked more, the family made special mention of RN Heather. Heather brought them a sense of calm with her soft tone and warm smile. They shared that they felt Heather was there just for them, they never felt rushed or felt like she was in a hurry to move onto her next patient.

I could go on and on about this meeting and list every team member that provided legendary care to this patient and family. Over all the meeting was wonderful, they were impacted by this journey they traveled with us in such a positive way that they wanted to share their story. It was important for them to tell their truth and to validate how this experience has impacted them and us forever.

The end of life journey doesn’t have to be a scary. It can be filled with love, laughter, goodbyes and most of all wonderful memories till the end.

 

All of us at Front Range Hospice and Palliative Care send out heart felt thank you to this family and all of the other families for allowing us to be apart of this special time. It is an honor to be at your side during the most intimate time in your life.

If you would like more information about Front Range Hospice please call 303-957-3101 or 970-776-8080 or email us at info@frhospice.com

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Community Based Palliative Care: How does it work?

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By Victor Montour

Palliative Care (pronounced pal-lee-uh-tiv) is specialized medical care for people with serious illness. This type of care is focused on providing relief from the symptoms and stress of a serious illness. The goal is to improve quality of life for both the patient and the family.

Community Based Palliative care is provided by a specially-trained team of doctors, nurses and other specialists who work together with a patient’s and their doctors to provide an extra layer of support. It is appropriate at any age and at any stage in a serious illness, and it can be provided along with curative treatment.

  1. Where do I receive palliative care?

Palliative care is provided in a variety of settings including the hospital, outpatient clinic, at home, in assisted livings and nursing homes.

  1. Does my insurance pay for community based palliative care?

Most insurance plans, including Medicare cover palliative care. If costs concern you ask our liaison for a copy of our how to verify your insurance coverage form.

  1. How do I know if community based palliative care is right for me?

Community based palliative care may be right for you if you suffer from pain, stress or other symptoms due to a serious illness. Serious illnesses may include cancer, heart disease, lung disease, kidney disease, Alzheimer’s, amyotrophic lateral sclerosis (ALS), multiple sclerosis, Parkinson’s and many more. Palliative care can be provided at any stage of an illness and along with treatment meant to cure you.

  1. What can I expect from a community based palliative care program?

You can expect relief from symptoms such as pain, shortness of breath, fatigue, constipation, nausea, loss of appetite and difficulty sleeping. Palliative care helps you carry on with your daily life. It improves your ability to go through medical treatments. It helps you better understand your condition and your choices for medical care. In short, you can expect the best possible quality of life.

  1. Who provides community based palliative care?

Community based palliative care is provided by a team including palliative care doctors, nurses and other specialists.

  1. How does community based palliative care work with my own doctor?

The community based palliative care team works in partnership with your own doctor to provide an extra layer of support for you and your family. The team provides expert symptom management, extra time for communication about goals and treatment options, and help navigating the health system.

  1. How do I get community based palliative care?

Ask for it! Tell your doctors and nurses that you would like a referral to Front Range Hospice and Palliative Care for palliative services. Our liaison will contact you for a no obligation informational.

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Happy Nurses Week

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Nurses all over the country take pride in the fact that the public has rated nursing as the most honest and ethical profession for the past 16 years. Nurse’s commitment to protecting, promoting, and improving health care for all is well recognized, and they serve the public in a wide range of roles and work settings. Therefore, it is only fitting that we take one week each year to celebrate the nursing profession and the vital roles nurses play in health care.

I would use two words to describe a nurse. Nurses are Caring and Compassionate people.  You see, nurses encounter patients from all walks of life, many of whom are afraid of judgment they may receive from the medical community for one reason or another. A nurse can change a patient’s entire perspective by “showing them nurses value caring and compassion above all else,”

Nurses not only care for their patients they all so care for other nurses. Nurses inspire and mentor other nurses by providing them a springboard to elevate their practice and scope of other nurses and healthcare professionals they work with. They do so by recognizing the potential in people. This is just one way nurses inspire others in healthcare.

Nurses are innovators and act as agents of change to drive processes and policy and leverage technology to prove better, more affordable care for individuals and the community. Nurses have influenced innovation in the industry so much that the American Nurses Association (ANA) has updated the ANA scope and standards of practice document that calls for all nurses to be leaders within the profession, working to influence policies and encourage innovation (ANA, 2015a).

Lastly nurses are Influential; nurses must see themselves as professionals with the responsibility to influence current and future healthcare delivery systems. The nursing profession is based on the science of human health and the science of caring. It operates from a framework that values all people in a holistic way and seeks to foster and advance people’s health throughout their lifespans and across all levels of society. Through policy work, nurses can and do influence practice standards and processes to assure quality of care. Nurses who influence policy help shape the care that will be provided today and tomorrow.

Front Range Hospice and Palliative Care would like to take a moment to send a very warm THANK YOU and HAPPY NURSES WEEK to all the wonderful nurses who inspire, innovate and influence those who are currently working, retired, and those just starting out their journey into the healthcare profession.

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April is Stress Awareness Month

stress

By Victor Montour

The last month has been a bit stressful for me. In an effort to manage my stress I went on line looking for some great advice or ideas I could use to help decrease my stress level. Just like all of you, from time to time we feel stressed. If we leave this stress unchecked, it tends to be a real joy-killer. This, of course, makes it harder for us to live Complaint-Free, happy lives. Did you know stress can also lead to a number of major health problems, ranging anywhere from anxiety to severe depression, from mild acne to life-threatening heart attacks, so it is easy to see why it is so vitally important to keep life’s major stressors in check.

This blog comes at a good time being April is National Stress-Awareness Month, I thought this is perfect, I can share with you what I found on line to help me manage my stress. Now I know some of the items I list you may find silly or something you wouldn’t do. The important message in this blog is for you to manage your stress in a healthy way. So, here is a list I found on line of 10 positive ways you can respond to the stress in your life and keep your own stress levels in check or at a minimum.

Health

Taking control of your personal health can make a great difference in the amount of stress you feel. The best way to reclaim control of your life is by taking charge of your body. Whether it is through diet, exercise, or simply getting that checkup you’ve been putting off, let April be the month you put yourself back in control.

Change

It can be as simple as clearing the clutter off your desk or as elaborate as taking a well-deserved vacation, the important thing is that you do something different. Even a small change can make a big difference when it comes to stress.
 

Live in the Moment

Most folks live their entire lives in yesterday or tomorrow. In truth, however, there is only now. Focusing on this perfect moment, right now, provides a magical escape from the disappointment of what once was and the fear of what might be, and leaves stress stuck in a time warp.
Talk to Yourself

Sometimes a good pep talk is all that is needed to keep stress at bay. Maybe it is high time you gave yourself one by affirming what is right with your life instead of dwelling on what’s wrong
Get the Giggles

It’s true; laughter really is the best medicine. Watch a funny show or video, tell a funny joke, or go to a card shop and read funny cards. Whatever it takes, give yourself time for laughter each and every day.

 

Meditate

A still mind is a stress-free mind, so take a deep breath, quiet your thoughts and let the stress melt away. Even ten minutes of meditation done daily for the next 30 days will do wonders for releasing stress in your life.

 

Journal

Every evening for the next 30 days spend a few minutes reflecting on the day you just experienced and list five things about the day that delighted you.
 

Positive Spin

No matter what challenge you may be facing, do your best to think about it positively and then let that new positive mindset become your focal point.
Helping Others

Sometimes the best way to deal with stress is by providing relief to someone else. Putting your focus on others takes the focus off your own challenges leading to less rumination and stress. So, look around you, see who needs a hand up, and then offer yours.
I hope you find some of the items on this list helpful. If you or someone you know would like more information about stress and stress management, please contact your primary care doctor. Your primary care doctor will be able to direct you to other resources in your community.

 

 

By Victor Montour

The last month has been a bit stressful for me. In an effort to manage my stress I went on line looking for some great advice or ideas I could use to help decrease my stress level. Just like all of you, from time to time we feel stressed. If we leave this stress unchecked, it tends to be a real joy-killer. This, of course, makes it harder for us to live Complaint-Free, happy lives. Did you know stress can also lead to a number of major health problems, ranging anywhere from anxiety to severe depression, from mild acne to life-threatening heart attacks, so it is easy to see why it is so vitally important to keep life’s major stressors in check.

This blog comes at a good time being April is National Stress-Awareness Month, I thought this is perfect, I can share with you what I found on line to help me manage my stress. Now I know some of the items I list you may find silly or something you wouldn’t do. The important message in this blog is for you to manage your stress in a healthy way. So, here is a list I found on line of 10 positive ways you can respond to the stress in your life and keep your own stress levels in check or at a minimum.

Health: Taking control of your personal health can make a great difference in the amount of stress you feel. The best way to reclaim control of your life is by taking charge of your body. Whether it is through diet, exercise, or simply getting that checkup you’ve been putting off, let April be the month you put yourself back in control.

Change: It can be as simple as clearing the clutter off your desk or as elaborate as taking a well-deserved vacation, the important thing is that you do something different. Even a small change can make a big difference when it comes to stress.

Live in the Moment: Most folks live their entire lives in yesterday or tomorrow. In truth, however, there is only now. Focusing on this perfect moment, right now, provides a magical escape from the disappointment of what once was and the fear of what might be, and leaves stress stuck in a time warp.

Talk to Yourself: Sometimes a good pep talk is all that is needed to keep stress at bay. Maybe it is high time you gave yourself one by affirming what is right with your life instead of dwelling on what’s wrong

Get the Giggles: It’s true; laughter really is the best medicine. Watch a funny show or video, tell a funny joke, or go to a card shop and read funny cards. Whatever it takes, give yourself time for laughter each and every day.

Meditate: A still mind is a stress-free mind, so take a deep breath, quiet your thoughts and let the stress melt away. Even ten minutes of meditation done daily for the next 30 days will do wonders for releasing stress in your life.

 Journal: Every evening for the next 30 days spend a few minutes reflecting on the day you just experienced and list five things about the day that delighted you.

Positive Spin: No matter what challenge you may be facing, do your best to think about it positively and then let that new positive mindset become your focal point.

Helping Others:Sometimes the best way to deal with stress is by providing relief to someone else. Putting your focus on others takes the focus off your own challenges leading to less rumination and stress. So, look around you, see who needs a hand up, and then offer yours.

I hope you find some of the items on this list helpful. If you or someone you know would like more information about stress and stress management, please contact your primary care doctor. Your primary care doctor will be able to direct you to other resources in your community.

 

 

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National Doctors Day

a-tribute-to-physicians-on-national-doctors-day

By: Victor Montour

Doctors can sometimes be under-appreciated, but today seeks to combat that. March 30th marks National Doctors’ Day and it’s the perfect opportunity to thank your own doctor or physician for their service.

The annual event was first celebrated March 30, 1933, when Eudora Brown Almond, wife of Dr. Charles B. Almond, set a day aside to honor physicians. From those beginnings in Winder, Georgia, the celebration spread, and the House and Senate officially declared March 30 “National Doctors’ Day” in 1990.

This Year Front Range Hospice and Palliative Care would like to take this opportunity to thank all of our community physician partners. Your dedication to quality medical end of life care is appreciated. We would also like to take a moment to say a special thank you to Dr. Gregory Maeder the Front Range Hospice Medical Director.

Greg Maeder, MD, MBA, Medical Director 

Dr. Maeder attended the University of Cincinnati College of Medicine and completed residency at the St Anthony Family Medicine Residency. He currently works in advanced wound care and hyperbaric medicine as well as graduate medical education for resident physicians. He also serves as the medical director for Goodness Health Group, specializing in post-acute and long-term care. His philosophy of care centers on offering patients the best treatment options and honoring patient autonomy.

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Happy Social Workers Month

2018-socialworkmonth-logo

As we continue with Social Worker Appreciation Month, we wanted to express how grateful we are for the hard work and tireless dedication of our Social Workers at Front Range Hospice and Palliative Care.  Our Social Workers are the people holding the hands of the patients and families in our care who may be sad or missing their families, helping families work through unstable times, and connecting individuals and families with community-based support services to help them take advantage of the opportunities available to them now and in the future.

Social Workers are the ones encouraging families and individuals to do better, even when they feel the weight of the world on their shoulders. In short, Social Workers are a lifeline for so many families who have no one else to turn to.

This year we hope you will take a moment with us to recognize all the work Social Workers do to better the lives of people in our communities. Many times, a week I hear “you have to be an angel to work in hospice and palliative care”. Well our Social Workers are the unsung heroes of hospice and palliative care. Our hospice and palliative care Social Workers work tirelessly to make the impossible happen. They do this with very little recognition. I mean how many times do you hear people talk about the Social Worker who helped them navigate the stress, depression or financial challenges caused from caring for a sick or dying loved one. Not often, most of the time it’s the nurse who gets all the credit. Our hospice and palliative care Social Workers don’t like being in the spotlight. They prefer the spotlight be on the success and wellbeing their patients are experiencing from their services. Well this month we would like to move our hospice and palliative care Social Workers from the shadows of care and move them up front in direct sunlight for you all enjoy. Please take a moment to learn a little bit about our hospice and palliative care Social Workers. They are amazing individuals who truly make best days possible for all of our patients.

 

Tyyne Andrews, LCSW, South Team Hospice Social Worker 

Tyyne Andrews graduated from Eastern Michigan University with a Bachelor of Social Work degree in 1996. After working for a couple years in chemical dependency she went back to school and got a Master of Social Work degree from the University of Michigan. She has worked in health care as a medical Social Worker since then and finds that her passion is working with those facing chronic or terminal illnesses and supporting the person and their loved ones through the challenges that go along with these types of health crises.

Tyyne moved to Colorado in 2010 and likes to take retreat in the high mountains of the Rockies a couple times a year. When the weather is good she likes to bike and hike with her close companions.

She loves working at Front Range Hospice and Palliative Care and is very grateful to work with such a kind and caring group of people whose hearts are in the right place.

 

Nicole Brandon, MSW, Palliative Care Social Worker and North Team Hospice Social Worker

Nicole Brandon graduated from Canisius College with a double major in psychology and criminal justice. After graduation Nicole completed her graduates’ degree at the University of Denver in 2002. Nicole worked for Child Protection Services in Gilpin County for a short period of time after graduation. Prior to becoming a Social Worker Nicole worked as a head start and preschool teacher and supervisor. Nicole loves being a Social Worker because she feels like she is making a difference in people’s lives. She loves the feeling of giving back to the communities she serves.  Nicole loves to spend time with her three daughters and baking sweet treats for family and friends.

Nicole loves being a part of the Front Range Hospice and Palliative Care. She loves the team work approach to care and the kind and loving people she gets to work with every day. Nicole says hospice is her true calling and she doesn’t see herself working anywhere else.

 

Pam Ware, MSW, LCSW, Owner and Administrator of Front Range Hospice.

Pam graduated from California State College in Fullerton with a B.A. in Psychology and San Diego State University with a Masters in Social Work. Pam moved to Colorado in 1995 and worked in acute care hospitals as an oncology Social Worker. After working closely preparing many patients and their family to make the decision to stop aggressive treatment and choose hospice care she was given the opportunity to run a hospice in Denver in 2003. In 2006, she took her life savings, moved to Erie and started Front Range Hospice. Front Range Hospice and Palliative Care represents Pam’s belief that everyone deserves a dignified death. Her staff is highly trained and the standards of the agency are voluntarily the highest in the industry.

We would be truly lost without the dedication and compassion of our hospice and palliative care Social Workers. Please join us in commending and thanking these individuals who continue to make profound differences in the lives of families across the front-range and beyond.

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