VitalCare Hospice

Caring Passionately

Hospice is at the very heart of VitalCare. Our company was founded as a nonprofit hospice program in 1982, and our feelings about hospice have grown ever stronger over the years.

From our humble beginnings in Cheboygan with one nurse and one social worker, our program has grown over the past quarter-century, and we have spread the good news of comfort and fullness of life through hospice. We now have a staff of 50 skilled, compassionate and dedicated individuals, and although we now serve communities from M-32 in Alpena and Gaylord to St. Mary’s River in Sault Ste. Marie, we are still passionate about hospice, because we know that hospice brings extraordinary value to people's lives.

Hospice – a Different Kind of Care
Hospice is a program of special care at end of life. When we have a disease that is not curable, or when we reach a very old age and our bodies begin to fail, curative therapies are no longer effective. At this point, traditional Western medicine is not optimal for us, because its focus is cure.

When we cannot be cured, we still may have a great deal of life remaining. The objective is to live as long and well as possible. No one can say how long a person will live. And during the remainder of our lives, we need a different kind of care.

We need a model of care that will help us understand this stage of our lives, because it, too, is meant to be lived fully. And it, too, has lessons for us to experience and share.

We need a model of care that will alleviate whatever symptoms we experience so that we can enjoy our lives.

We need a model of care where nurses can spend extra time with us to answer our questions so that we are not worried about the future, where pain and symptoms are eliminated and physical comfort is emphasized.

We need a model of care that treats us and our family members, a model of care that understands that our worries about our family’s future has a genuine and legitimate impact on our frame of mind and our personal comfort at end of life. We need to know that they will be cared for when we die. We need a different model of care.

Hospice is that different model of care.

Congress recognized the need for this model of care in 1982 and made hospice care a benefit for Medicare beneficiaries.

Hospice care includes the following team of care providers. All patients have nurses who interact with physicians. Other levels of care are a matter of patient and family choice.

• Physicians
• Visiting hospice nurses
• Hospice aides
• Hospice social workers
• Pharmacists
• Respiratory Therapists
• Spiritual Supporters
• Trained Volunteers for companionship or respite

People often endure a great deal of pain and discomfort while pursuing a cure. Hospice is a time and place where pain and discomfort are not acceptable. Hospice nurses certified in pain and symptom management possess the knowledge and skills to identify the source of pain--bone, organ or nerve—and to work with physicians and pharmacists to achieve patient comfort rapidly and assuredly.

Hospice care is most frequently provided in the patient’s home, but can also be received by patients in hospitals, skilled nursing facilities, or adult foster care homes

Learning More About Hospice
If you would like to know more about hospice and whether it is right for you, call our Referral Center at 800-342-7711. They will have a visiting hospice nurse call you to set up an appointment for a visit. The nurse will come to your home, answer your questions, and explain hospice to you. There is no cost or obligation for this visit.

Frequently Asked Questions (FAQs)

Q. Isn’t enrolling in hospice giving up?
A. Definitely not. Hospice is about living every day of life fully, without pain or symptoms. Research suggests that hospice patients actually live longer than patients who do not choose hospice. This may be because hospice patients, relieved of pain and symptoms, can enjoy life. See an Internet link below to review the scholarly article related to this.

Link: Research Shows That Hospice Patients Live Longer
To review a scholarly article that reports on research showing that hospice patients frequently live longer than non-hospice patients, go to the following link: Diagnosis-related statistics appear at page 7 of this article. http://www.nhpco.org/files/public/jpsm_costarticle_0904.pdf

Q. What is the Medicare hospice benefit?
A. Under the Medicare hospice benefit, patients receive care from the members of the hospice team, as noted above. Symptoms, such as nausea, are treated. Pain is monitored, anticipated and controlled. Hospice nurses assess the patient’s condition, visiting as often as the family requires. A hospice nurse is available by phone at all times, and they will visit as frequently as the patient’s and family’s needs require. They answer questions for family members and educate them about the patient’s care and current condition.

Hospice aides may come to the home to assist with whatever needs the patient and family may have. They can bathe the patient and change bed linens. They can assist with personal care. Often, patients and family members are more comfortable having hospice aides assist with toileting and bathing than having family members provide this personal care.

Hospice social workers listen to patient and family concerns and help families sort through issues. They are supportive members of the hospice team on whom family members rely. Hospice social workers can provide one-on-one therapeutic counseling, can help families connect with a variety of helpful resources, and can provide bereavement support and counseling for family members for more than a year after a patient’s death. Hospice social workers provide superb emotional support for families who take advantage of this benefit.

If patients would like to speak with a spiritual counselor, their own pastor or a hospice chaplain can spend time with them and support them. These are purely personal preferences, and hospice facilitates their choice.

Trained volunteers can help patients and families by running errands and by providing respite care, staying with patients while family members conduct their personal business. Sometimes, it’s nice for an elderly patient to have someone of their own generation simply visit with them for an afternoon. People of the same generation have many memories in common, and recalling these events brings pleasure to both parties and helps patients recall and ponder happy moments in their lives.

The Medicare hospice benefit also covers any medications related to the terminal diagnosis, and any medical equipment that patients may require, such as oxygen or a hospital bed.

Thirteen months of bereavement support for family members or caregivers is also part of the hospice benefit.

Most commercial insurances, such as Blue Cross, provide a hospice benefit that is similar to Medicare’s benefit.

If you do not have insurance and cannot afford to pay for hospice services, we will still provide you with hospice care.

Q. Who is eligible for hospice?
A. The general definition of hospice eligibility is being at end of life, meaning months rather than years of life expectancy. If your doctor does not believe that any curative interventions would change your prognosis, or if you decide that you do not want to pursue any additional curative therapies, then you are appropriate for hospice admission.

Q. Is hospice just for cancer patients?
A. No. About 50 percent of hospice patients have cancer. Others have congestive heart failure (CHF), chronic obstructive pulmonary disease (COPD), renal (kidney) failure, end-stage Alzheimer’s Disease, or other end-stage conditions. Hospice eligibility is not connected to any diagnosis.

Q. Does everyone have pain at end of life?
A. No. Only about half of patients at end of life ever experience pain, and those that do, experience it at different levels. In addition, advances in medical science over the past 20 years now make it possible to control pain. If you recall watching someone die a very painful death in the past, this could be a frightening prospect for you. You will not experience that today, if you have the right hospice.

Q. Are there differences between hospice programs?
A. Yes. While all Medicare-certified hospice programs follow Medicare guidelines, there are differences in the pain and symptom management skills of hospice staff. Be sure to look for a hospice that has nurses certified in pain and symptom management. These are nurses with a bachelor’s degree in nursing who have studied beyond their degree and passed a rigorous national exam. These nurses have the knowledge and skills to keep people comfortable. VitalCare’s hospice nurses pursue this certification, and have many years of hospice experience individually and collectively.

Be sure to ask about the hospice experience level of a hospice program’s nursing staff. Hospice nursing is highly specialized, and nurses practicing in other settings or programs need to gain experience in hospice and pursue certification in order to be optimally effective. A good hospice program will team up seasoned hospice nurses with nurses new to hospice care while they are learning their new role..

Q. Is it better to die in a hospital?
A. Where people die is a matter of personal preference. Most people prefer to live their lives independently in the comfort of their own homes, surrounded by their loved ones and their possessions. The hospice team can provide care in any setting.

Q. What if I get well? Do I have to stay in hospice?
A. No. You simply revoke your hospice benefit and return to your regular Medicare health benefit. We have had patients whose conditions improved, and they didn’t need hospice for a number of years afterward. Your decision to utilize your Medicare hospice benefit is entirely up to you at all times.

Q. Do I have to stay at home if I'm a hospice patient?
A. Absolutely not! Patients are encouraged to stay actively engaged with life. That’s the goal of hospice, this different model of care. Get out there and enjoy life! If you need assistance to do that, hospice is there to help.

Recently, our hospice team helped make a 90-year-old’s dream come true. He wanted to go hunting in the woods again. His hospice social worker packed a picnic lunch, the patient’s wheelchair, his oxygen and his favorite gun, and staff helped him dress warmly. She invited a hospice volunteer along to help, and she invited his grandson at the patient’s request. Then he told them the exact spot he wanted to be in, and that’s where they went for an afternoon. This gentleman relived all his good times in the woods, and his grandson gained an invaluable memory he will treasure for the rest of his life. Stay at home? Not unless you want to.

Q. Does hospice practice mercy killing?
A. Absolutely not! Hospice neither hastens nor postpones death. Hospice workers possess a strong belief in the sanctity of life and believe that taking excellent care of people and keeping them comfortable may help them live longer and definitely will help them live better. Remember, hospice nurses know how to keep people comfortable, so that they want to live.

Send your questions to us at health@vitalcare.org.