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Hospice — between hospital and home

Hospice care can often be a net for the terminally ill and their families. Those who offer the program strive to restore the dignity of the patient going through the final stages of a terminal disease while alleviating some of the stress and grief of the families facing the imminent passing of a loved one.

Those at Smoky Mountain Home Health & Hospice (SMHHH) concentrate much of their efforts on providing care “in the home.”

“Hospice is an extensive health care program that offers physical, emotional and spiritual support for terminally ill patients and their families. It restores the hope and dignity often robbed of severely ill patients and focuses on the quality of life,” said Morgan Payne, with Smoky Mountain Home Health & Hospice.

Skilled doctors, nurses, nursing assistants, social workers, chaplains and volunteers work together to provide extra care for the special needs of those with terminal illnesses.

Just some of the hospice services offered through SMHHH include pain management, skilled nursing, physician and medical social services. Physical, speech, respiratory and infusion therapies are also offered. The facility provides respite care, bereavement and spiritual counseling for the family as well.

Smoky Mountain Home Health & Hospice provides medical directors on staff. A portion of the care includes personal follow-up visits for 13 months.

Every aspect of the patient’s day-to-day needs is met with this program. The patient and family learn through dietary counseling, for instance, the types of foods that will enhance the effects of the medications and which might be detrimental.

The facility provides education to fit each specific requirement and offers such basic necessities as medical supplies and equipment.

Smoky Mountain provides hospice aides and volunteers who, Payne says, is the backbone of the hospice team.

“They form close bonds with patients and family members, because patients often tell volunteers things they feel they can’t tell their loved ones. Family members may confide concerns to the volunteer that they’d rather not share with the terminally ill patient.

“When important things go unsaid, survivors may feel guilty for a long time. Volunteers open the way for people to talk honestly to each other,” said Payne.

The Center for Hospice Care recommends visiting patients. However, when the end of life is near, it may be best for only close family members and loved ones to visit.

The ‘quality’ of this time is very important, as it allows opportunities for shared joy, reconciliation and love to occur.

Often, gifts like flowers or sweet treats are fine for those able to converse and interact. If you are not sure, ask a caregiver, hospice aide or medical professional what might be appropriate. It never hurts to be sure, especially if the patient has respiratory or digestive issues.

Photographs of pets and people who are unable to visit can also be good choices.

Those able to read might like a book or magazine. Music can be an excellent gift for anyone except those with hearing problems.

Even in the last stages, when a patient is not fully conscious or able to speak, hearing a favorite piece of music can have a positive impact.

However, the Center recommends that the best gift you can bring is your companionship and conversation.

Those visiting loved ones in hospice worry about what topics might be off-limits. Many first-time visitors assume that conversation with a hospice patient will be awkward or stilted, or that the person they are visiting will be upset or distressed. This is not usually true, according to the Center.

“Most hospice patients have plenty to talk about. They might want to remember happier times you shared together, or want to know how other people are doing. They might want to make sure you haven’t forgotten a precious moment or tell you about a piece of family history,” states literature from the Center for Hospice Care.

Some visitors worry whether to bring children along. According to the Center, children should be included, in most cases.

“Although many parents have an understandable desire to shield their children from death, it is often better to include them. Talk to them in an age-appropriate way about what is happening and what is going to happen and let them see and talk to their love ones in hospice care,” states the literature.

It can be beneficial for the patients to have children to talk with, especially when it is an elderly person who is in hospice. The Center recommends bringing photographs from birthday parties and sports events. Allow the kids to talk to the patient “as naturally as possible.”

The literature does recommend that the parent stay in the room if visiting a very ill person. Make sure the children do not touch any medical equipment.

And, cut the visit short if the patient becomes sleepy or agitated.

Hospice services are reimbursable by Medicare, TennCare and most private insurance plans, once the patient meets eligibility requirements.

For more information about Smoky Mountain Home Health & Hospice or to volunteer, call 423-626-2622.