Hospice News Spring 2016

Hospice News S PRING 2 0 1 6

Love & Loss Continued affection for those we lose

The Hospice Taboo How some will ‘die’ to avoid hospice

Facing Change A key to survival

Brookings Health System Hospice Receives Deficiency-Free Survey from State Department of Health

Brookings Health System Hospice’s most recent survey conducted by the South Dakota Department of Health resulted in zero deficiencies cited, placing the hospice program at the top of the class for hospices statewide.

“Feedback from the department of health’s survey indicates we are providing high-quality end-of-life care to hospice patients,” said Home Health and Hospice Director Lynne Kaufmann.

“Our care team has strong communication between disciplines and does an excellent job of documenting patient records.”

Brookings Health System Hospice would like to acknowledge with appreciation the following donations (received January through March 2016): In Memory of Donald Hoffman

Marjorie Hoffman In Memory of Nellie Krogman

Judean Hewitt

Kenneth & Molly Gross In Memory of Barb Krumrei

Hazel Landman & Lavae Ruby Donation from

Winsor Township Charity Fund

Every 3 years state surveyors examine all areas of hospice care according to Medicare guidelines.

Surveyors accompany select care providers on patient visits, examining proper infection control, communication with patients and families, continuity of care and family/patient satisfaction.

The department of health also reviews patient records and examines policies and training. It also ensures Brookings Health System Hospice follows all Medicare guidelines for the agency’s volunteer and bereavement programs.

With over 20 years of experience, Brookings Health System’s hospice provides local nurses, volunteers, chaplain, social worker and 24-hour support to help care for patients facing end-of-life.

For more information on hospice, or to request services, please call (605) 696-7700 or visit www.brookingshealth.org/Hospice.

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brookingshealth.org

Loving What

DEATH Can Touch Working in hospice gives one an opportunity to witness what is often a moving scene of love and affection.

A daughter tells her mother, ”The best in me came from you.” She kisses her mother’s cheek. A week later the mother dies.

A family gathers to decide what to do to make it easier for the caregiver, their father, who is caring for their very ill and dying mother. There is some disagreement, but the love and concern for the parents is obvious. The decision to move the mother to a nursing home is wrenching for all.

A granddaughter holds her grandmother’s hand. The grandmother is non-responsive. The granddaughter’s devotion is very evident as she wipes a wisp of hair from her grandmother’s moist head and keeps vigil.

A family surrounds the bedside of their dying family member. They tell stories, chuckle at some, sit as close as they can and touch the one who is dying. The love in the room is palpable. The room feels like a holy place.

We love even though we may experience the loss of the object of our love. We love outrageously! We love one who then dies. We love a friend who moves away and the phone calls just aren’t the same as face-to-face visits. We love a dog that waits for us at the door, tail wagging joyfully, and then dies because of old age and infirmities. Our friendly neighbor moves to another town and the new one keeps to himself.

Mavis Gehant Hospice Social Worker

This is a poem written in the 12th century. The identity of the author is unknown.

For Those Who Have Died ‘Tis a fearful thing To love What death can touch.

To love, to hope, to dream, And oh, to lose.

A thing for fools, this, Love, But a holy thing, To love what death can touch.

For your life has lived in me; Your laugh once lifted me; Your word was a gift to me.

To remember this brings painful joy.

‘Tis a human thing, love, A holy thing, To love What death can touch.

(Cited in The Wild Edge of Sorrow by Francis Weller)

There are many occasions for grieving. Some are small; others large and overwhelming. It mounts up. And if we have already been dealing with loss, the additional losses rub raw the old ones we thought had healed over.

But we continue to love those whom we may very well lose. We may even choose to love someone new.

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Change As winter melts away and spring blows in, we are reminded that to survive we must face change. I attended two funerals this last month and wondered how both surviving 80-plus year old men/widowers Richard P. Holm MD

were going to handle the loss of their spouses and all that is about to change.

No question, survival depends on their capacity to change. I hope that they would, over time, take the opportunity to connect more with friends, their grandchildren, the people in their church, and spend more time with new or long put-off hobbies, while appropriately mourning their loss for a time‌ and then moving on.

But then again, the death of a wife and the adjustments needed to go on might be too daunting, and could take one or both of them out in short order.

It is not an uncommon story that after the death of a spouse, the elderly partner dies within the month. Sometimes this comes as the result of a particular type of heart failure that follows severe emotional loss, sometimes from malnutrition and dehydration when depression causes one to stop eating, sometimes there is no explanation, and sometimes the remaining spouse dies from suicide.

Some may perceive the spousal-team dying so closely together as a romantic elderly Romeo and Juliet-like love-story, so poignant and heart warming. But the truth is that it may be an unnecessary death that could have been prevented.

No caring and compassionate person would want their partner to follow them so closely into the grave. When love is true, then they would want the one left behind to see that change is an opportunity to continue on in another way, to find fresh interests, to discover new joy.

Other life changes can be similarly challenging, such as having a new diagnosis of cancer, moving out of a home in which one had lived for many years, suffering a financial crisis, and so on.

We know that the ability to handle change is like working and stretching a muscle. If you don’t use it, you will lose it. Stagnation can cause rigidity, weakness, despondency, death, but movement can cause flexibility, strength, happiness, life.

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As spring blows in, we are reminded that to survive we must face change, and then we can be alive to see summer again.

brookingshealth.org

Dying to Avoid Hospice In my visits with patients some are eager to share their views of death and dying. For others, it’s taboo. A few years ago I met with a patient who was suffering from a lengthy illness which had become terminal.

At a care conference I learned that hospice had been discussed with her by her doctor but she declined admission. As I entered her hospital room for a visit later that day I wondered if hospice would come up.

It did. As we discussed her illness and prognosis she shared with me her doctor’s suggestion about being admitted to hospice. She was angry about it. So I asked her, “What does hospice mean to you?” She looked me in the eye and said, “It’s a death sentence.” She went on to tell me that she would do anything to avoid going into hospice and I believed her.

This woman feared hospice so much I believe she would have died to avoid it. She had a perception and she didn’t want to talk about it.

So we didn’t.

Let’s be honest: talking about death makes most of us uncomfortable.

So we go to great lengths to avoid the discussion. Some even take the extreme of denying death altogether.

Whether a person acknowledges death or not, the fact of the matter is that people die. You will die and I will die. It’s that simple. Since everyone’s doing it, you would think having a healthy discussion about death and dying would be easy. Apparently it’s not. The following observations suggest that we are failing to come to grips with death and dying in our country: 1) Eighty percent of Americans do not put their personal affairs in order before they die. 2) In 2009, Medicare paid $55 billion just for doctor and hospital bills for the last two months of patient’s lives even though 20-30 percent of these expenses had little to no meaningful impact. 3) Due to perceptions of failure, many doctors are reluctant to recommend hospice. As a result, the average hospice care stay is just two

weeks. 4) A vast majority of Americans say they want to die at home but 75% die in a hospital or nursing home. 5) Only about 5% of Americans pre-plan their end of life rituals. So as you can see, there is a cost to death denial.

Gregg TeBeest Chaplain

Since my thesis for this article is that talking about death is healthy, what’s good about it? The following observations are primarily for hospice patients but apply to all since we’re all in various stages of dying. Talking about death: 1) enables me to explore my beliefs about what happens when I die (Where do I go when I die or is this body all there is?); 2) may open the door for expressions of love and forgiveness among my loved ones and bring us closer together; 3) may help my loved ones to explore their beliefs and feelings about their own mortality; 4) empowers me to plan and achieve goals for my hospice and post mortem care (Do I want to stay at home through my dying process? How can I achieve that? Do I want a funeral and what kind do I want?); 5) removes the burden of responsibility from my loved ones; 6) leads me to acceptance as I transition into my dying process.

I often wonder about the death denying patient I spoke with. How did she and her family manage her dying process? If she had the chance to do it over again, would she be more open to talking about it? Would she actually approach the dying process differently, perhaps with the help of a caring hospice team? Taking the opportunity to explore her own thoughts and feelings may have provided her with a measure of comfort and even peace. As it was she continued on in a state of fear, silence, and paralysis. I wonder. Which approach is better?

Excerpts for this article were taken from “Why We Need to Talk About Dying” by Judith Johnson, Huffpost, 08/17/2010.

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PROGRESS LIVES HERE Hospital Expansion & Renovation Project Capital Campaign

Foundation Exceeds Capital Campaign Target announced its lead donation of $1 million. Later in the year, Brookings County pledged $750,000 and the City of Brookings earmarked the same amount in its 2017-27 Community Reinvestment Plan. Dale Larson, the Larson Family Foundation and Larson Manufacturing donated a total of $925,000, creating a solid foundation for the campaign to build upon.

Brookings Health System Foundation announced in January it exceeded its $4.6 million hospital expansion and renovation capital campaign goal.

“On behalf of Brookings Health System and the Foundation, thank you for investing in our campaign and supporting our future,” said Brookings Health System President and CEO Jason Merkley. “Our vision is becoming a reality and we are very excited about the forthcoming changes. However, something you will not see changing is our approach to delivering the same high quality, compassionate and personalized care and service you have come to expect from Brookings Health System.”

According to Foundation board chair David Kneip and immediate past chair Roberta Olson, the Foundation reached its capital campaign goal in only nine months, thanks in part to a recent anonymous matching gift.

“This was really an incredible effort to think that over 400 generous entities and individuals came together to support this community project in that short amount of time,” said Kneip.

“We want to thank everyone who gave to the campaign, with special thanks to lead donor First Bank & Trust for getting us started,” added Olson.

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“First Bank & Trust is proud to make this financial commitment and delighted to see this broad-based community investment in Brookings Health System,” said President and CEO Kevin Tetzlaff. “Supporting health care initiatives focused on retaining local, high quality, personalized care aligns well with our organization’s values, and has been a long-time priority of the Fishback family.”

In July 1906, the Brookings Hospital Company, incorporated by Horace Fishback Sr., George Sexauer, Dr. F.E. Boyden and Dr. B.T. Green, purchased a site in the Morehouse Addition of Brookings to build a community hospital.

In 1935 the hospital was sold to the City of Brookings and the first hospital board was created. Members included founders’ sons, Horace Fishback Jr. and Elmer Sexauer, who each served on the board for over 20 years.

“As members of a family with longtime ties to the Brookings area, my brother Bob and I are pleased with the results of this campaign,” said Van Fishback. “Strong medical care is a critical component to a thriving and healthy community.”

Brookings Health System Foundation continues to accept campaign donations. Donors giving $1,000+ will be included on the renovated hospital’s donor wall. To contribute to the campaign, contact Foundation Director Barb Anderson at (605) 696-8855 or e-mail foundation@brookingshealth.org.

The capital campaign kicked-off its public phase at the project’s groundbreaking ceremony this past July where First Bank & Trust

brookingshealth.org

Brookings Healthcare Auxiliary Donates $1,500 to Home Health & Hospice

Lynne Kaufmann, Home Health & Hospice Director, receives donation from Auxiliary members

Brookings Healthcare Auxiliary recently donated $1,500 to Brookings Health System’s Home Health and Hospice programs to purchase a specialized, portable patient monitoring system sensitive enough to take the pulse and blood oxygenation level of adults with poor circulation and infants.

The system, called a pulse oximeter, offers attachment choices for home health and hospice nurses to take accurate readings from patients.

“The standard method of taking pulse and oxygenation readings is with a finger clip,” said Home Services Director Lynne Kaufmann. “Premature babies and babies born with heart conditions that we visit in the home are too small for the finger clip. The new monitoring system allows our nurses to take readings from babies’ feet. Adult patients with chronic obstructive pulmonary disease (COPD) or

congestive heart failure may not have enough blood volume in their finger to take a reading with a finger clip.

For them, our nursing staff can use ear clip attachments.”

Accurate pulse and blood oxygenation readings help home care providers assess the heart’s ability to pump oxygenated blood and determine the need for supplemental oxygen.

Brookings Health System Home Services provide highquality health care and support in the home seven days a week. Local nurses, local aides, a local social worker and a local chaplain work with patients, their families and their physicians to tailor a home care plan.

For more information on home services, or to request services, please call (605) 696-7700 or visit www.brookingshealth.org/Home.

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300 Twenty-Second Avenue Brookings, SD 57006 ADDRESS SERVICE REQUESTED

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Hospice News is published by Brookings Health System. This publication in no way seeks to serve as substitute for professional medical care. Consult your physician before undertaking any form of medical treatment or adopting any exercise program or dietary guidelines.

We Extend Sympathy to the families of patients lost through March 2016: Joanne Bach

11/23/58–2/13/16

Phyllis Boyd

7/8/30–1/12/16

Barbara Krumrei Charles Larson

8/2/47–3/15/16 9/3/29–2/7/16

Charles Dahl, Jr.

4/19/49–1/31/16

William McCracken

8/28/37–3/6/16

Virginia Gunderson

3/17/28–1/26/16

Eugene Miller

5/4/38–3/19/16

Elaine Hanson

7/1/30–1/23/16

Ray Moe

10/18/20–3/5/16

Mildred Henriksen

1/8/14–1/30/16

Robert Peters

7/28/36–3/12/16

Donald Hoffman

2/5/29–3/15/16

Katherine Sipe

11/11/49–1/14/16

Barbara Howey

10/28/41–3/31/16

Percy Sutton

4/3/24–3/27/16

Jean Ingemansen

9/10/26–1/20/16

Anne Vandenberg

12/23/17–3/28/16

Nellie Krogmann

6/16/18–3/5/16

Henrietta Volkers

12/7/17–3/25/16