Live Vibrantly - November 29, 2022
By Amanda Ranowsky
When faced with a life-limiting diagnosis, we might find it difficult to make the choice to pursue hospice care. The reluctance many of us might understandably feel about this decision is usually rooted in pervasive misconceptions about hospice and the feeling that this means “the end.”
For starters, opting to go on hospice does not mean we are giving up on life.
“There is so much life to live, even if you’re facing a life-limiting illness,” said Dr. Margaret Gloria, Medical Director of Goodwin Hospice. “And that is exactly what hospice is all about. I have had hospice patients finish books they were writing, go on family cruises and travel.”
Dr. Gloria made these statements during a recent interview on “Great Day Washington.” Her interview is just one of many ways Goodwin Hospice seeks to correct common misunderstandings about hospice care so that people might embrace this benefit when needed. In this way, Goodwin Hospice aligns with the theme of this year’s National Hospice and Palliative Care Month – “meeting you where you are.”
According to the National Hospice and Palliative Care Organization (NHPCO), this theme can take on three types of meanings: “literally through serving them in the comfort of their own homes, spiritually in tailoring support to their unique beliefs or emotionally by helping them to understand that choosing hospice does not mean giving up hope or quality of life.”
While all members of the Goodwin Hospice team meet people in all these ways every day, two members of the team focus on the emotional aspect – they strive to help people understand what hospice is and what it really means to choose hospice. They are Patty Lyle and Aaron Zajdel.
Patty Lyle, RN, serves as admissions manager for Goodwin Hospice. In her role, Patty supervises every referral and call that comes into Goodwin Hospice until the patient is admitted. Her work involves helping people to understand the services hospice provides, and whether or not it’s time for someone to enroll in hospice.
“I always ask the question, ‘what’s most important to you right now?’” said Patty.
She continued, “Hospice is for people who are no longer seeking aggressive treatment for disease process and who are ready to allow for a natural death at home. Hospice isn’t the answer for everyone. A lot of people still want to continue aggressive treatment.”
At Goodwin Living, we offer a special service called Care Connections. This program provides care coordination and planning to residents of Goodwin Living communities and patients of Goodwin Home Health. It supports those who have been diagnosed with certain chronic conditions such as Parkinson’s Disease, COPD or various types of cancer. By connecting them with a social worker, Caring Connections seeks to help them understand their diagnosis, plan for future treatment and coordinate any care they might need.
Aaron Zajdel, LCSW, works as a care connections manager. In his role, Aaron provides careful guidance to residents of Goodwin Living communities.
“I work with residents to review what their goals of care are in the context of chronic diagnoses – things that we know are not going to go away or be cured,” said Aaron. “I talk to them about what will bring them the best quality of life, wherever they are and wherever they want to be.”
Through Care Connections, Aaron learns what kinds of care these residents want and puts things in place for them to receive care. “Our goal is to stabilize their health until they are eligible for hospice,” he said.
Aaron also explained that he guides residents through careful conversations about hospice. He starts by asking them simply if they know what hospice is and if they are open to considering it when the time comes.
“By having those kinds of conversations before it’s an emergency or before someone is in the hospital,” Aaron said, “we can put a lot of things in place to adhere to an individual’s wishes as much as we can.”
Aaron advises everyone to have these types of conversations with family and closest friends. By discussing these details, we can make plans and ensue things are in place so that we can all have more comfort and confidence in the future.
“In a perfect world, everyone would have advanced medical directives, a living will and a durable power of attorney so their wishes are known and can be honored,” he said.
Advance directives allow your loved ones and medical care providers to know your preferences for medical treatment, should you be unable to speak for yourself. The living will and durable power of attorney are part of these directives.
A living will advises medical personnel what procedures you want if you need emergency treatment while dying or permanently unconscious. A durable power of attorney for health care names the person who will make medical decisions for you if you are unable to make them for yourself.
“There’s a lot that we can do while the person is still capable of making decisions,” said Aaron. “Then, if conditions change and a person is not able to make those decisions, we’re not making decisions in the moment; we are simply implementing the individual’s wishes.”
It’s easier to make decisions when you have all the facts. That’s where Patty comes in.
In addition to her role as admissions manager, Patty leads seminars in various settings, including assisted living and nursing care communities. Her seminars aim to educate people about hospice.
“When I give talks in places like churches and community groups, I cover the basics of hospice – what it is and isn’t, how to access it, what’s involved and who pays for it,” she said.
Patty shared that one common misconception is that hospice is custodial care, meaning someone is there to provide round-the-clock care. “Hospice is a service to oversee that the proper care is always provided and that the family or caregivers know what to do and have the supplies they need,” she explained. Hospice does not step in to offer full-time caregiving, though Goodwin Hospice is available 24/7 by phone if a patient or loved one has questions or concerns, or if the patient’s condition is changing and their loved ones are trying to understand what is happening.
In assisted living and nursing care settings, where patients have access to medical and personal care, Patty provides education to staff members. “I talk to them about some of the myths of hospice, and about what makes people eligible for hospice,” she said. “Someone becomes eligible for hospice when a physician certifies that they have six months or less. It’s not just people who are in their final days of life, which can look very different from someone who still has six months.”
Her seminars are also opportunities to reassure those staff members. “Sometimes people think we’re coming in because we think they’re not doing a good job, or that we’re there to take over,” she said.
As in home settings, the hospice team does not take over caregiving in assisted living or nursing care settings. “I talk to those team members about how we partner with them as opposed to coming in and telling them what to do.”
Patty also noted the importance of relationships with these caregivers. “All our team members are constantly building relationships,” said Patty. “Those relationships build trust, and that’s hugely important.”
“It’s the same with families,” she continued. “When you’re dealing with loved ones with hospice, you have to build the relationship before they can trust your directions.”
Through education and partnerships, Goodwin Hospice seeks to meet people where they are and ease them through the transition to hospice. The conversations that Patty and Aaron have every day help people to plan for the future and put excellent care and services in place. In her segment on “Great Day Washington”, Dr. Gloria emphasized the value of these conversations.
“It’s really important to have a conversation early. It’s important to have open conversations about what really is important to you and what your wishes are at end of life,” she said. “One of the most common points of feedback that I hear from patients and families is ‘I wish we’d called sooner,’ and that just breaks my heart.”
If you are considering hospice for yourself or a loved one, we encourage you to begin a conversation Goodwin Hospice at 703.578.7108 or visit the NHPCO website to find a hospice provider in your area.
As Marketing & Communications Specialist, Amanda Ranowsky partners with colleagues throughout Goodwin Living to tell our stories and raise brand awareness. From printed collateral to digital marketing, Amanda covers many bases. Before joining GHI, Amanda worked for a small, family-owned business where she gained experience in content marketing. Amanda’s creative expression extends beyond the office. She is an active member of community theater and chorus groups.