House Calls

FAL 2018

House Calls Magazine is a quarterly publication that focuses on health and wellness. It includes a wide assortment of articles with topics on the latest health and wellness information, nutrition, safety, lifestyles, and more.

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Even though nearly 45 percent of all U.S. deaths occur under hospice care, many patients only take advantage of this end- of-life care for a few short weeks or days, notes the National Hospice and Palliative Care Organization (NHPCO). However, "those families who use hospice services for months prior to their loved one's passing are the same ones who report the most benefi t from our support," explains Dr. Tiffany Richter, Roper St. Francis Healthcare's Medical Director of Hospice. The reason, perhaps, is that many people don't fully understand what hospice is. "Hospice focuses on caring, not curing," explains the NHPCO. (Palliative care also focuses on providing comfort but can start at the outset of a diagnosis, whereas hospice begins when curative treatment is no longer an option.) Hospice care concentrates on the quality and dignity of the time a person has remaining, enabling that patient to spend the end of his or her life alert, pain- free, and enjoying as many days as possible. "Together, an interdisciplinary team consisting of physicians, nurses, social workers, chaplains, and aides takes a holistic approach to meet the physical, emotional, and spiritual needs of patients and their families," explains Dr. Richter. The method came about in the mid-1900s, when physicians began to realize that terminally ill patients experienced more dignifi ed deaths when able to make decisions regarding the fi nal chapters of their lives. "When a patient is no longer fi ghting drug side effects and is able to let go of the stress of seeking a cure, they have more energy to focus on their quality of life," explains Bonnie Mello, Director of Home Care Services at Roper St. Francis Healthcare. In fact, a 2007 Journal of Pain and Symptom Management study found that hospice patients extended their life by an average of 29 days versus patients not enrolled in hospice. (Another Johns Hopkins Medicine study conducted in 2010 noted that lung cancer patients getting palliative care showed a longer median survival of 2.7 months.) "We fi nd that the more time spent in hospice, the more prepared the patient and loved ones are to make appropriate arrangements, deal with any unresolved issues or concerns, and cope with the loss," adds Mello. In 2016, the mean hospice stay for Medicare patients was 71 days, with nearly half (45.9 percent) receiving services for longer than a month. Following a patient's death, hospice continues with bereavement support for the family for at least one year. Typically, patients receive hospice care in their private residences (be it home or a long-term care facility), with family members acting as the primary caregivers guided by the support of on-call staff and volunteers. The hospice team makes regular visits to "I wish we had called hospice earlier." Hospice administrators and caregivers hear this comment all too frequently. Many families navigating the complexities of a terminal diagnosis or a life-limiting illness falsely assume that hospice services are appropriate only during the active stages of a loved one's passing. P H O T O G R A P H S ( D R . R I C H T E R ) B Y S A R A H A L S A T I & ( F A C I L I T Y ) B Y L I L I A M O N T E R O Dr. Tiff any Richter A PLACE TO CALL HOME In August 2018, Roper St. Francis Healthcare acquired a 20-bed inpatient facility in Mount Pleasant formerly managed by Hospice of Charleston. The Roper Hospice Cottage has been designed with the warmth and comfort of home in mind. To eliminate the sterile hospital aesthetic, medical necessities have been made inconspicuous. For example, cozy hospital beds look like those in regular bedrooms, and artwork conceals medical equipment like supplemental oxygen supply. Window seats and bookshelves also add to the homey atmosphere. Volunteers regularly play musical instruments and arrange fl owers for the halls. "The Cottage is a unique and special gift to the Charleston community," says Dr. Richter. "If patients need aggressive symptom management, they can receive a higher level of care in a beautiful, peaceful facility." they can receive a higher level of care in a beautiful, peaceful facility." have been made inconspicuous. For example, cozy hospital beds look like those in regular bedrooms, and artwork conceals medical equipment like supplemental oxygen supply. Window seats and bookshelves also add to the homey atmosphere. Volunteers regularly play musical instruments and arrange fl owers for the halls. "The Cottage is a unique and special gift to the Charleston community," says Dr. Richter. "If patients need aggressive symptom management, they can receive a higher level of care in a beautiful, peaceful facility." "Our goals are to control symptoms, educate families, and eventually transfer hospice care to the patients' homes." — DR. TIFFANY RICHTER 36 { fall 2018 } h o u s e c a l l s

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