In this episode of Connecting the Community, Affinity CEO, Chris Zayid takes a deep dive into hospice care with Vilija Wlosinski, from Open Arms Hospice.
Learn what is hospice care, who is eligible for hospice care, how long can hospice care be, and what are the benefits of hospice care.
Watch the podcast above or read the transcript below. This transcript has been edited for length and clarity.
Chris: Hi! Welcome to our show Connecting the Community with Chris. We have an exciting podcast guest today from Open Arms Hospice – Vilija Wlosinski.
Vilja: Thank you Chris.
Chris: So happy to have you. So, tell us Vilja, how did you get into hospice care?
Vilja: Thank you for asking that very important question. My hospice Journey started about six years ago with my father having hospice with another hospice company, and I learned more about hospice and what the importance of hospice was. But one thing I learned out of that journey is how important it is to learn about hospice early on so that you could provide the resources for the family like me.
As I was going through taking care of my father, if I would have had those resources ahead of time, I would have started the hospice journey much earlier and provided him more levels of comfort and care and provided myself some time, to be able to spend that quality time with my father. My hospice journey started about five years ago and I’ve been actually working with different hospices in the last three years.
It started as educating individuals in the community about hospice and the importance of hospice and to start having that conversation early on so families are equipped with the resources they need.
Chris: I feel like a lot of our caregivers and individuals in the community had that experience with their parents, or a friend, or a family member, or a neighbor and that inspired them to be able to care for people. And I believe it could be one of the best type of experiences you could ever go through. The best caretakers really feel gratified that they’re able to be in that position, to be able to care for that individual. It’s really a blessing to not only be able to feel that way but also to make it your career.
Tell us, what is the definition of hospice care?
Vilja: Wow! The one-million-dollar question everyone wants to know. What is hospice? Often that topic is confusing. Most people don’t want to talk about it. You go to social gatherings, who wants to bring up the topic of hospice? They have that fear of unknown, the anxiety, “oh, hospice, end of life, taboo!” But it necessarily doesn’t have to be that negative tone.
Hospice has so many benefits, has so many resources to support the family and yourself as you’re going through the end-of-life care. And as long as we have education out there, we can provide that to the families. So, Hospice Care is a type of Health Care that focuses on the palliative care of the terminally ill patients who usually have six months or less to live and it assists them with the pain and comfort management, pain, and symptom management, attending to their spiritual needs, their social needs, their end-of-life needs. They also help provide comfort and support, and grief support for their families as they transition because as you know Chris, it’s not just the individual going through the Hospice Care, the whole family walks with them alongside.
Chris: How do you know when someone is actually eligible, when it’s time to actually receive Hospice Care?
Vilija: It’s a good question. With hospice there’s a couple of determining factors. First of all, you have to be diagnosed with a terminal illness of six months or less of your prognosis of your end-of-life care, and that is usually determined by your medical primary care physician. Then, you also have to ask yourself, do you want any more curative treatment with that? If you deny yourself curative treatment alongside of the hospice, then you’re definitely eligible to qualify for hospice and the doctor will do the evaluation. He will provide you the qualifications for entering the hospice and then they would work with the hospice medical director and the staff, and both of them will determine the qualifications needed for Hospice Care.
The main purpose is to have a life limiting illness of six months or less with the prognosis of end-of-life care and it would be a disease that could be like cancer, any of the long-terminal diseases that we have today. That’s basically what starts with the doctors referral, physicians order, and then from there on they include the whole interdisciplinary team. The interdisciplinary team consists of the physician, the hospice medical director, the nurses, the social workers, the spiritual care team, the bereavement team, the grief counselors, other therapists – like music therapy, pet therapy are vital aspects of this team.
The volunteers are a big component of this whole team to help with that extra layer of support and aides.
Chris: Let’s paint the picture for everyone. What can they expect from all these disciplines? Is there a scheduled appointment and how long are they typically? What type of experience is someone going to go through with all those professionals?
Vilija: Upon the referral process starting, there is usually an individualized care plan that’s created by the interdisciplinary team and this team composed of all these professionals that I mentioned, they just sit around with the medical director to discuss and figure out what is the best ideal care plan for that person going through hospice. It is scheduled appointments; they will come in and do visits. Aides will come in possibly once or twice a week to give showers, daily medication review needs for the patient, the nurses will come over and review to make sure that the patient is in comfortable position, is managing the pain. The doctor will review all of that as well.
In the care plan we have social workers who are advocates. They come in and help support the family and the patient to help them promote and get additional resources and support in the community, to help facilitate that process of what’s needed to help them get further end-of-life care. Volunteers help support the families.
Chris: So, some of these Care Professionals are coming in at one day? So, two or three are coming in at one day.
Vilija: Correct. They’re scheduled appointments but they can come at different times.
Chris: So, no one’s alone during this process.
Chris: You’re not alone when you are caring for your loved one and when you are limited on resources. Sounds like always someone coming in.
Vilija: Absolutely! And it’s the layer of the team. They are there to support and guide you through this whole navigation of the process of end-of-life.
Chris: Do you provide Round the Clock care?
Vilija: We are available 24 hours. Hospice Care is available on call after administration offices are closed, seven days a week, and 24 hours a day. Most hospices have nurses available to respond to a call, to help with any questions or critical care, and the nurses will respond. We’re there to help assist and determine if our nurses need to be sent out to assist with the pain management, 24 hours of care. Some hospice programs even have chaplains that come out and social workers as well on call.
I want to differentiate that we’re also there available 24 hours but we’re not there present 24 hours. So we’re available 24 hours. If someone needs to call us with questions, with coaching, with pain management, our teams are there to help.
Chris: What if someone needs round the clock care and the times that you are not scheduled to be there? How does Home Care fit in in this type of scenario when someone’s receiving hospice care?
Vilija: Home Care plays a vital part in this picture with hospice. That’s why a lot of hospices or all hospices work alongside home care, private duty home care to assist with that additional layer of support and care because we’re available to come for consult and to help out with pain management, but we’re not there in the house 24/7. Therefore, a Home Care Agency will provide an aide who will come out there and be there within the 24-hour shift if needed or during the shift that the patient requires, and we will work closely with that aide to provide them with the tools, the resources, education they may need to become that extra layer of support for a family, so that the patient is feeling comfortable and their symptoms are being managed appropriately and the families are feeling comfortable as they transition.
Chris: What are the benefits for a person that is affected and needs care? What’s the benefits of receiving hospice care?
Vilija: The actual individual patient who’s receiving hospice care and is eligible for hospice care, the moment they sign up on hospice, they receive first of all pain management and comfort care. That’s the key thing because through the end-of-life process, with the disease, we often go through changes physically as well as emotionally. It can be very painful, it can be sudden, it can be uncomfortable.
So, our medical team will come in – the nurses and the doctors, and they’ll manage and they’ll create a plan to figure out how to manage those symptoms. So, that’s where the benefits will be – their symptoms will be managed appropriately, according to what the family decides and what the individual who’s going through the process feels would be most appropriate.
Another layer that the patient will be able to receive is like music therapy. Now we’re talking about the spiritual and the emotional side of hospice and bringing them in some comfort by listening to some soothing music by a music professional, music therapist at the bedside. That is an amazing experience that an individual will receive. Pet therapy is another addition that we can provide to help support that extra layer of comfort for the patient.
Chris: I’ve sat in rooms with music therapies and it’s truly inspiring. It’s so nice and it’s soothing. Sometimes the client can’t even communicate anymore, but they can hear, so it’s good to make sure that we always provide them with dignity during this process as well.
What about the families? They are also receiving care in essence in the long run. How are the family members actually receiving benefits receiving Hospice Care?
Vilija: As we all know, it’s not just the individual going through this hospice journey, the family unit itself is going through this hospice journey together. We all experience fear, anxiety, the unknown. Let’s face it! We’re all going to die someday. But how we prepare for our end-of-life is our choice and how we can be empowered to make the choices that will be more comfortable for ourselves and for our families.
The families are able to get that extra layer of support for grief counseling. Social workers will work closely with them to provide additional resources for them so that they get educated and learn how the grieving process starts, how to navigate those feelings, bereavement as well, after death. In fact, there’s bereavement teams that can be serviced after the individual passes for up to a year. They will be covered to help support those types of transitions, so the family receives that extra layer of spiritual and grief counseling as they go through this transition.
Chris: How long is typically Hospice Care received? I’ve heard the word used throughout the years – they can graduate from hospice, which means they can have hospice care and then actually stop hospice care. Can you give us a little example?
Vilija: We’ve got to be very careful on how we use the word graduated, because people use that term loosely, but they definitely don’t graduate.
They’re not declining according to Medicare guidelines. So, they might be at a standstill or at a plateau and that’s when the doctors will come out and the medical team will be evaluating and assessing them according to Medicare guidelines and benefits. Hospice is one of the benefits for Medicare and they will be able to cover that and be able to help support the families to provide that extra care that we talked about earlier.
Usually it’s a 90-day period, and it’s two 90-day periods – that’s where that six months end-of-life care we always determine. So, the two ninety-day periods of Medicare under Medicare guidelines, that would be the evaluation period.
So, at that time, the team will then re-evaluate. They would stop if there’s not a significant decline according to the assessments and the evaluation and Medicare guidelines, they will then discontinue the hospice care temporarily and can revisit after 60 days. And then at 60 days they can go look through that or 90 days and determine the next, because sometimes there’s a significant fall or a new diagnosis that brings with it more of a decline in the progress of the disease.
Chris: How should a family member begin inquiring about Hospice Care? What’s the first thing to do to be able to contact an organization like yours?
Vilija: For example, at Open Arms Hospice we have this brochure here and you can reach us directly at our main number which is 248-516-3978. We’re located here on 10 Mile in Novi, and you can contact us directly at the main office. Our team will be able to help assist with the referral process to get the admission started or you can contact one of our Community Liaisons or account managers like myself and we can assist you with that process as well.