Media Relations

WHAD-Delafield/Milwaukee
As reported by Shamane Mills, WHA/WERN-Madison

A report shows the time patients spend in hospice care is far less than Medicare will pay for. Some say it's so short that patients don't get the full benefits from this end-of-life care.

Hospice care is designed to ease pain and provide emotional support for those who are dying. The average stay nationally is less than 30 days and a report by the National Hospice and Palliative Care Organization indicates more than a third of patients die or are discharged in less than a week.

The director of Access for Agrace HospiceCare in Madison, Lisa Sherven, says that's not enough time to adequately support and prepare the dying patient and their family. She says less than a week to provide hospice care is really crisis management.

One factor cited by physicians, for short hospice stays, is a family's desire to keep a dying relative alive because they don't know the patient's wishes.

Advance directives are a way to do that and the House health reform bill would reimburse doctors who discuss what kind of end of life care patients want.

Sherven says they've reached out to doctors and the public about the need to plan ahead. And in the last three years, the agency has seen improvement. More hospice patients are alive longer.

She says the average length of stay for hospice patients in Dane and Rock Counties is about 70 days, compared to the national average of 30 days.

Medicare pays for up to six months of hospice care.

November 4, 2009

As reported by Shelly Birkelo in the Janesville Gazette

If the 2009 holidays will be the first without your loved one, the season might bring more sadness than joy.

Getting into the holiday spirit after losing a loved one can be especially painful for those who are grieving, said Gordon Lynch, Agrace HospiceCare grief counselor.

“When people lose someone they have a history of traditions with, it’s often difficult to celebrate because it can bring up those memories and the pain of the loss,’’ he said.

That’s why Agrace HospiceCare is offering a Holiday Grief and Remembrance seminar with time for questions and answers Tuesday, Nov. 10, at its Janesville office.

The first year when a person loses someone is the most difficult, Lynch said.

“When that person is not there, there’s a void,’’ he said.

So people have to work through those feelings regarding their lost loved one, Lynch said.

To cope with the loss, he said, there should be structure to the day along with realistic expectations.

“Have plans ahead of time, accept feelings and process them, and attend whatever functions you feel comfortable with,’’ Lynch said.

Another coping strategy is to create a memorial or ritual, Lynch said, that can take on all different forms. That might include giving money to charity in memory of your loved one, lighting a candle for that special person or making an ornament or quilt in their memory.

Talking about a loved one and sharing stories also can be helpful, Lynch said.

“It’s really unique to the individual and what they want to do to provide some memorial to their loved one,” he said.

It’s also important people take care of themselves by getting enough rest and eating well. They also need to have friends and family close to them who understand what they’re going through and are supportive, Lynch said.

“Take one day at a time to make it through the holidays,” he said. “Keep things simple and know your limits.”

In addition, support groups are listed on www.agracehospicecare.org that are open to the public, Lynch said.

Agrace HospiceCare also offers a holiday remembrance program, which will be from 2 to 3:30 p.m. Sunday, Nov. 8, at St. William Catholic Church. The program is open to the community and its patient families for support. It will feature readings, songs and people coming together and remembering their loved ones.

September 25, 2009

As reported in The Madison, WI Rotary News

Author and hospice nurse Maggie Callanan spoke movingly and compassionately about learning from the dying and listening to what they are telling us. Contrary to death being a negative event it can be seen as the start of the last chapter of life and a chance to reconcile, teach, heal and celebrate a life. To illustrate what she meant she told several stories about dying persons.

In the first, the dying person spoke about needing to “get in line.” At first, her caregiver thought medication was causing her tohallucinate; however, on further exploration by the hospice nurse it was found that she was communicating that her daughter, who had died years earlier, was waiting in line for her. She was telling the caregivers metaphorically that she was ready to die. When the hospice nurse asked what was preventing her from “getting in line” the patient expressed concern for her husband – what would he do after she was gone? He was encouraged to tell her that he had made plans (which he was previously reluctant to share for fear of distressing her) to live with a son and travel with a friend. Learning of this information, the wife soon passed peacefully – her work was done, and her beloved husband would be okay. The husband, too, gained peace that he would eventually be “getting in line” and seeing her again.

Ms. Callanan’s message was also that when a dying person speaks what seems to be nonsense they are speaking in metaphor and to communicate with them you also need to enter and explore the metaphor to fully understand and communicate. As caregivers we need to be open to what is trying to be communicated and ask questions to determine what the dying are trying to teach.

There is also the need to understand symbolic behavior. A son was caring for his dying mother who had dementia. She would often throw her legs out of bed but the son would just tuck her in. On one occasion he asked where she was going. The mother told him she was “going to dance with Bobby.” Bobby was her deceased husband. The point was when we don’t understand something we should ask more questions instead of assuming unexplainable behavior.

Another story was told of a gregarious Irishman who always tried to get the last laugh between himself and a good friend, who happened to be a priest. While the Irishman was in a coma the priest was asked to say a private Mass for the family in the patient’s room. During the homily, when the priest asked the question of why this good man had to die, the patient suddenly became conscious and said “Because I can’t take any more of your bad sermons!” Shortly, thereafter, he died peacefully and having had the last laugh and his family celebrated his life in the manner the Irishman would have appreciated! Ms. Callanan used this story to illustrate that as we live life so do we die. Pay attention to the life the dying person has led, and use that as a frame of reference for how he wants to die.

In the last story, Ms. Callanan related that of a prodigal son. The mother of a large family was starting to linger and talked about the need to “feed the horses,” and she needed help “finding the feed.” It turned out, there was a son who had gotten into trouble through his whole life and had been forgotten by the family. Before his mother died, she was able to communicate that not only did she want her son to be with her before she died, but she wanted the family to come together and share a meal with the troubled son. While they ate a meal, she passed away peacefully.

Ms. Callanan used the metaphor that the dying are the teachers, and we are the students. Be open to what they are saying, ask questions and listen.

Our thanks to Maggie Callanan for her moving presentation and to Kevin Hoffman for this review article.