chs2020 – Page 8 – Blog Posts

A Hospice Nurse Shares Her Sweet Secret

When first starting her career in nursing, Carol Tickel was a licensed practical nurse at a skilled nursing home. After a couple of years, the transplanted resident of Delaware made the decision to advance her education and become a registered nurse. One of her assignments was to write a paper about the ethics healthcare professionals face based on the teachings of Swiss-American psychiatrist Elisabeth Kübler-Ross, who penned the trailblazing book “On Death and Dying.” This class project turned out to be the springboard that changed the course of Carol’s career and led her to become a hospice nurse.

Why Become a Hospice Nurse?

What aspect of the assigned paper proved to have such a profound effect on Carol that she decided to pursue a career path to become a hospice nurse?

“At the nursing home, I was surrounded by healthcare professionals who would push their thoughts and feelings about end-of-life decisions onto their patients,” confessed Carol, who plans to retire at the end of 2017. “I felt strongly that patients and families should be allowed to think on their own. It was important to honor their wishes.

“I became a hospice nurse to help educate patients and families so they would know all their options, and have the ability to stand up for themselves and not be swayed by any opinions I might have personally,” added Carol.

Back in 1993, Carol joined LifePath Hospice as a hospice nurse and never looked back. Today as a clinical manager, Carol leads two different home teams, Ruby and Pediatrics, composed of hospice nurses, hospice aides, social workers and chaplains.

“The best part of being a hospice nurse is helping patients and families navigate a very difficult time in their lives. And by managing teams, I enjoy supporting my staff. It is always exciting to watch them grow professionally.”

Never Underestimate the Power of …

While it is true that by day she assists her staff in helping patients and families navigate end-of-life choices, many LifePath Hospice employees know about Carol’s other secret passion: chocolate. We aren’t necessarily talking about chocolate consumption. Instead, Carol loves creating chocolate masterpieces.

“It was in Toms River, New Jersey, where I first discovered my love for making chocolate,” related Carol, who rarely eats any chocolate. “It was the mid-1970s. My girlfriend and I found a chocolate mold and decided to try it. We were both hooked to the point of hosting chocolate parties—just imagine a Tupperware party but all with chocolate and you get the picture.”

During the course of the past 40+ years, Carol has acquired more than 200 different chocolate molds from big box craft stores like Michaels, JoAnn and Walmart to crafters on Etsy. She shared that her biggest chocolate-creating regret was making close to 230 soccer balls for Easter one year. On the other hand, her proudest and most challenging accomplishment was a church, which even included stained-glass windows, made entirely of chocolate for her son’s wedding.

“Although I don’t enjoy the mess that making chocolate can create, I get a sense of joy from the expression on someone’s face when they first see what I made for them entirely out of chocolate,” concluded Carol.

At Chapters Health System and its affiliates—Good Shepherd Hospice, HPH Hospice and LifePath Hospice, every day is devoted to educating our patients and keeping them in the place they call home. We are dedicated to ensuring that patients, young and old alike, and their families are able to make educated decisions about important healthcare matters. For more information, please call our helpful Chapters Health team at 1.866.204.8611 or send an email to info@chaptershealth.org.

About Phoebe Ochman

Phoebe Ochman, Director of Corporate Communications for Chapters Health System, manages all content and communications for the not-for-profit organization.

How to Make Chocolate without Fuss

With more than 40 years of experience under her belt, Carol is definitely an expert in making chocolate treats from simple bite-size morsels to intricate masterpieces. She emphasized that it is truly not as difficult as one would imagine.

If chocolate making sounds like a hobby you’d like to try, here are some tried-and-true tips Carol shared to get you started.

When using a mold, make sure it isn’t wet. Between batches, the mold should be meticulously dried. Even better would be to have a back-up mold on hand. And don’t use any type of vegetable oil/cooking spray.
Melting chocolate into liquid form can be accomplished in either a microwave or by using a double boiler.
If you happen to burn the chocolate when melting, do not use the batch. Throw it out and start again.
When you get some overflow of chocolate around the edge of the mold shape, use a paring knife to cut the flash at the edge.
When using white chocolate for your creation, add a little shortening. It will make your final chocolate harder.

POLST: Honoring Patients’ Values and Preferences

People who develop life-limiting medical conditions have long been encouraged to complete advance directives such as living wills and designation of health care surrogate forms. Such documents are intended to provide some degree of assurance that end-of-life care wishes are honored. All too often, though, these tools fail to achieve that goal. That’s why “Physician Order for Life Sustaining Treatment” or POLST was created.

POLST Creation

Unfortunately, sometimes living wills and health care surrogate designations do not work. This may be because the completed documents are not available or were never completed. Some advance directives may be vague and open to various interpretations. In some instances, even properly completed documents are not honored.

In previous generations, life expectancy was shorter and options for care, more limited. Today, our patients are living longer with increased frailty. At the same time, the options for care continue to grow. We need a better approach to assure that patients’ preferences are honored.

In the 1990s, the medical ethics community in Oregon created a task force to address this issue. As a result, a new tool for honoring patients’ wishes was developed. We know this as “Physician Orders for Life Sustaining Treatment” or POLST. Because we are committed to honoring our patients’ preferences for end-of-life care, Chapters Health System is now offering this type of advance directive to our hospice patients who might benefit.

How Does POLST Work?

POLST is a physician medical order form representing a patient’s medical care preferences. The process starts with advance care planning conversations between patients, their families and a trained healthcare professional such as a physician, nurse practitioner, nurse, social worker or chaplain. The discussion addresses:

specific disease
treatment options
benefits and alternatives to various treatments
what to expect as the disease progresses
goals of care and
patient values

Next, a conversation focusing on treatment preferences can take place.

Other patient wishes are discussed including:

cardiopulmonary resuscitation (CPR)
relocation to another level of care such as a hospital
use of mechanical ventilation
administration of antibiotics and IV fluids and
use of artificial nutrition (tube feedings)

The POLST form is completed and signed by the patient and the physician, making it an actionable medical order that will be honored within the Chapters Health and its affiliates—Good Shepherd Hospice, HPH Hospice and LifePath Hospice. The patient’s wishes and preferences are translated into a medical order.

Changing One’s Mind

Over time, circumstances change for all of us. That is especially true for those who are affected by serious illness or frailty. A document that may have accurately expressed a patient’s wishes for care may, therefore, need to be reconsidered. For this reason, it is recommended that the POLST document be reviewed any time there is a change in the patient’s health status or level of care. If care preferences have changed, this document can be changed or revoked as required.

Although the medical orders are only necessarily valid within the hospice, the form serves as an advisory document to community partners and shares the end-of-life choices that Chapters Health patients have made.

Patients who are no longer able to communicate their own wishes may still benefit from having a completed POLST. Under those circumstances, a healthcare professional can complete this form based on the legal representative’s understanding of the patient’s wishes. The decision maker may then sign the form on behalf of the patient.

This tool to help honor patients’ wishes has now been adopted in many states and healthcare systems, and the list continues to grow. Although no advance directive is perfect, POLST appears to be a large step forward. We are pleased to be able to provide assurance to our patients that their preferences for care will be honored.

What You’d Like to Read about in Future Posts

On “DRops of Wisdom,” we want to feature posts with subject matter that would be of interest to you. Please leave a comment or drop us an email with your ideas.

At Chapters Health System, every day is devoted to educating our patients and keeping them in the place they call home. We are dedicated to ensuring that patients, young and old alike, and their families are able to make educated decisions about important healthcare matters. For more information, please call our helpful Chapters Health team at 1.866.204.8611 or send an email to info@chaptershealth.org.

Stewart W. Stein, MD

Associate Vice President of Medical Services, Chapters Health System

As the associate vice president of medical services at Chapters Health System, Stewart W. Stein, MD, bring more than three decades of experience as a physician. His extensive background in end-of-life care and a commitment to the delivery of exceptional hospice services are of great benefit to the patients and families. Dr. Stein joined the organization in January 2011.

He previously served as chief medical officer and medical director at Nathan Adelson Hospice in Las Vegas, Nevada. Dr. Stein also provided geriatric, rehabilitative and hospice care for patients in home settings and skilled-nursing facilities as a staff physician with the Kaiser Permanente Department of Continuing Care in San Diego, California.

Dr. Stein is board certified by the American Board of Hospice and Palliative Medicine and was a scholar in residence at the Center for Palliative Studies with San Diego Hospice.

Dr. Stein is a Florida native who was born in Jacksonville and attended the University of Florida, where he earned his Bachelor of Science and medical degrees. He completed his medical internship and residency programs at the University of California at San Diego’s University Hospital.

From Soothing Lavender to Puppy Dog Tails, Revisiting Complementary Therapy

From soothing lavender aromatherapy to a comforting touch to visits from licensed four-legged therapy friends, these types of complementary therapy allow hospice patients and families to get comfort outside the box of the traditional. In June, we first introduced you to complementary therapy in an overview that you can read here. In part II, we took a deeper dive into the topics of tai chi and yoga as forms of complementary therapy. Today we are revisiting complementary therapy in order to share some other options that can provide comfort and relaxation to hospice patients and their families.

Revisiting Complementary Therapy to Increase Comfort

In revisiting complementary therapy, there are some options that can assist patients, caregivers and families in reducing the stress and anxiety often associated with life-limiting illnesses and end-of-life care.

Aromatherapy

Aromatherapy practice uses fragrant, essential oils to produce an individual therapeutic response. Benefits come from inhaling the essential oil scent. And depending on the essential oil, it can be applied directly on skin, diluted (for instance, with coconut oil) or full strength.

The following are some of benefits of aromatherapy:

Promotes relaxation
Reduces anxiety, stress and tension
Improves sleep and well-being

In the American Journal of Hospice and Palliative Medicine, University of Nevada researchers published the results of their study as to whether lavender aromatherapy positively affected hospice patients. They discovered a small but positive change in anxiety, depression and sense of well-being with aromatherapy.

Comfort Touch

The power of the human touch is well-known. Think back to your childhood when you fell on the playground and skinned your knee. Your parent was there to make sure you were okay with a gentle and reassuring touch. It was comforting to know they had your back.

As we age, the desire to seek comfort tends to intensify—especially for those who have life-limiting illnesses or battle pain. That’s where the complementary therapy known as Comfort Touch can help.

It is a form of acupressure that can relieve pain and promote relaxation. It is important to note that Comfort Touch is not massage but rather gentle and rhythmic pressure specifically used on hands and feet.

Pet Therapy

On any given day, community members who visit the hospice houses at Good Shepherd Hospice, HPH Hospice and LifePath Hospice probably meet a pet volunteer. Accompanied by their human parent, pet volunteers bring joy and peace to many patients at the houses, but also visit patients wherever they call home. Certified and trained animals visit patients and families to provide a different type of care.

Studies have demonstrated that pet therapy can provide immediate benefits, psychological and physiological, to hospice patients and seniors. One study in the Journal of Palliative Care showed that a miniature poodle, which became a resident at a hospice inpatient facility, improved morale and interactions between staff and patients.

Therapy animals, especially dogs, interact with patients and families to reduce the anxiety, depression and fatigue that often accompany chronic and advanced illnesses.

In order to visit patients and families, animals and their owners/handlers must undergo a screening and certification process. It is important to test animals’ temperaments in order to determine how well they will react with adults, children, loud noises, walkers and wheelchairs.

About Phoebe Ochman

Phoebe Ochman, Director of Corporate Communications for Chapters Health System, manages all content and communications for the not-for-profit organization.

Did You Know?

Here are 5 fun facts about aromatherapy:

Aromatherapy is not something new. We can trace its history back to Egypt in 3500 BC, when fragrant herbs were first used for religious rituals, in cosmetics and as medicine. From ancient Egypt, the popularity of aromatherapy expanded across the Mediterranean to Greece.
Hippocrates, known for the Hippocratic Oath, used essential oils to treat his patients.
Modern-day aromatherapy was an accidental discovery by chemist Rene Maurice Gattefossé in France sometime in the 1920s. He burned his hand, and the only available item to help treat was lavender. Surprisingly enough, his wound healed quickly.
It seems like an oxymoron, but essentials oils are NOT oils. Why aren’t they? In order to be classified as oil, a substance must contain fatty acids, which essential oils do not. Aromatherapy essentials oils are very concentrated plant extracts that enjoy qualities that are often described as medicinal.

Even though essential oils come in very tiny bottles, the amount of plant extract needed to make the oil is quite high. For instance, more than 150 pounds of lavender flowers are needed to make 16 ounces of lavender essential oil; and for 16 ounces of peppermint oil, 250 pounds of peppermint leaves are necessary.

How to Make a Patient Happy: Fishing Trip Fulfills a Patient’s Wish

C.S. Lewis said, “You are never too old to set a new goal or dream a new dream.” As retirement becomes close to a reality, many people look forward to doing the things they never had the opportunity or time to do when they were constrained by work and family obligations. Some set the goal to spend more time with grandchildren or even take up a new hobby. And others dream about traveling. As the day fast approached, Robert Hughes dreamed and looked forward to fishing. If the mood struck, Robert could even go on a daily fishing trip if he wished.

Unfortunately, before he had a chance to enjoy his retirement, Robert was diagnosed with lung cancer. Following an emergency tracheostomy, he was admitted to the Somers Hospice House in Sebring, Florida.

“He retired, got sick and hasn’t yet gone fishing. All he wants is to go fishing,” Robert’s daughter, Brianna, cried to night-shift nurse Cyndi Grothe.

With that utterance, the wheels were set in motion to make Robert’s retirement wish come true.

Making the Fishing Trip Happen

Employees at Good Shepherd Hospice were honored to have the opportunity to make the most of life and fulfill a patient’s wish to go fishing.

The Somers Hospice House team came together and quickly jumped into action. Cyndi contacted Good Shepherd Hospice Regional Director Jennifer Forde late that night and relayed her conversation with Brianna. The next morning, Jennifer reached out to Dr. Cheri McCue, who lives on Lake Jackson and was able to pull together the resources for a fishing trip that day! One pontoon boat could accommodate Robert and his family (including yellow lab, Jake), a wheeled walker and oxygen tank, as well as a few Good Shepherd Hospice staff members and their hosts.

The pontoon boat set out with two other boats late in the day, and the fishing challenge was on.

Robert and his crew won the competition with five fish, of which Robert caught three. Once back at the hospice house and settled into bed, Robert received a trophy for the most fish caught for the day and a framed photo of him with his daughter and son-in-law from the excursion. Robert and his family were so thankful for the fishing trip opportunity along with the care he received since his admission to hospice.

Thank you to all the Good Shepherd Hospice staff and friends who helped to make this special trip possible for Robert and his family, and allowing Lewis’ words to ring true. Your countless efforts and willingness to go above and beyond for patients and their loved ones demonstrate the true spirit of the hospice mission.

About Phoebe Ochman

Phoebe Ochman, Director of Corporate Communications for Chapters Health System, manages all content and communications for the not-for-profit organization.

4 Tips on Lake Bass Fishing in Florida

When people think of Florida, they tend to picture white sandy beaches and deep-sea fishing on the Gulf of Mexico or in the Atlantic Ocean. These delightful imaginings go hand in hand for many who plan their vacations to the Sunshine State. But did you know that some of the best places to go fishing, particularly bass fishing, are in the more than 30,000 lakes in Florida?

If you live in the state or are planning a trip to Florida and like to fish, here are four tips that can make your journey successful and enjoyable:

Go shallow to deep. Bass are not preferential when it comes to where they like to hang out. You can find them in plain sight in the shallow waters of lakes or near boat docks. However, heading out to deeper waters can bring better results. A school of bass typically prefers deep water, and you’ll have more bites in less time versus shallow-water spots.
Fish early. It is smart to rise and shine early in the morning to catch the best bass. Even though bass can easily survive in warm water, they prefer to feed in the morning when the water tends to be cooler.
Bait counts. If you want to catch the biggest bass of the day, try using live, wild shiners (type of small silver fish) as your bait. Live shiners (and crayfish too) attract minnows that encourage the larger bass to take the bait.
Check shoreline vegetation. Many of the lakes in Florida possess vegetation at the shoreline. Bass like to feed on the vegetation, and at the same time, the lushness provides excellent cover from predators. The best way to lure bass hanging out in shallow water vegetation is to drop your line into a spot where there’s an opening in the undergrowth. In addition, check out where two types of vegetation meet or where the lake’s bottom changes.

DRops of Wisdom

Today we are officially launching Chapters Health System doctors’ blog titled “DRops of Wisdom.” Twice a month we will bring you posts by our physicians about a variety of medical topics, in a sense, their medical drops of wisdom.

Kicking Off DRops of Wisdom

We kick off “DRops of Wisdom” with Dr. Ronald Schonwetter, who is the Chief Medical Officer for Chapters Health System.

Mission-Driven Service: Open Access

At Chapters Health including our affiliates—Good Shepherd Hospice, HPH Hospice and LifePath Hospice, we are driven by our mission to be able to provide support and care for people in our community with or affected by advanced illness . We are dedicated to offering services and programs that improve quality of life for our patients.

This is why we offer an Open Access therapeutic approach so patients don’t have to choose between receiving hospice services that help improve their quality of life or palliative care that brings them comfort from pain and symptoms. Open Access prevents re-hospitalizations, and patients and families both benefit.

Chapters Health has offered this model for 20 years, and we are among the few hospice programs across the country that do. With our Open Access, palliative measures may include chemotherapy, radiation therapy, cardiovascular infusion, intravenous antibiotics, and even ventilators for a short period of time. Traditional hospice organizations do not offer these palliative interventions, which many view as aggressive.

Some of these interventions are offered in home settings. Vitals are not monitored like they might be in a hospital setting. These measures are in place to provide comfort. Our Open Access approach simply supports our philosophy of maximizing and focusing on quality of life and patient comfort.

As long as patients have a prognosis of 6 months or less, we will work with their family physician or specialist in facilitating an educated decision as to the best approach. Patients do NOT need to make a choice to stop treatment as there’s another viable option for them—Open Access.

Prognosis Crystal Ball

It is challenging for physicians to predict prognosis, especially for patients with chronic and often times debilitating illnesses and diseases, like Alzheimer’s disease. Prognosis is almost like having a crystal ball and trying to foretell the future. However, the guidelines that Medicare sets for hospice eligibility do a pretty good job. If physicians follow these guidelines in order to refer patients, they are 90 percent accurate in their assessment.

Unfortunately, patients wait too long to be referred to hospice. Many only access services when they only have days to live instead of the 6 months from the time they might have been first referred to hospice. We often hear that patients do not opt for hospice out of fear. They wrongly believe that they aren’t ready for hospice and equate this care option with giving up.

Hospice is not a death sentence, and research supports this statement. In a 2016 study published in Cancer, the group’s findings suggest that choosing to die at home actually helps terminal cancer patients live longer. In fact, this observation was also reported back in 2010 by the New England Journal of Medicine.

At Chapters Health, we have lengthy discussions with patients about what they want to achieve. We focus on what is valuable to them and their families. With hospice, often times, patients and families discover that they still have ample time to make life meaningful. We want to lessen the instances where we hear patients and families say that they wish they would have known about hospice earlier. We’d like to replace that feedback with “we are glad that we were able to make the most of life thanks to Chapters Health.”

What You’d Like to Read about in Future Posts

On “DRops of Wisdom,” we want to feature posts with subject matter that would be of interest to you. Please leave a comment or drop us an email with your ideas.

More about Our Drops of Wisdom Author

Ronald S. Schonwetter, MD, FACP, AGSF, FAAHPM, is certified in Internal Medicine and Hospice and Palliative Medicine by the American Board of Internal Medicine. He also previously earned certification as a medical director, a hospice administrator and in geriatric medicine.

Dr. Schonwetter earned his medical degree from the University of South Florida (USF) College of Medicine. He completed his internship and residency programs in the area of Internal Medicine at the Baylor College of Medicine in Houston. In addition, Dr. Schonwetter completed a two-year fellowship in geriatric medicine at Baylor College of Medicine and The Veterans Administration Medical Center in Houston. He previously served as professor and division director of Geriatric Medicine at the USF College of Medicine as well as director of the Geriatric Medicine Fellowship Program.

Dr. Schonwetter has held various positions with the American Board of Hospice and Palliative Medicine including serving as the board’s chair, and the American Academy of Hospice and Palliative Medicine, serving as the academy’s president in 2006.

Forever Young: Volunteer at Any Age

From needing to fulfill a community service requirement to the desire to help others to wanting to keep active, people arrive at the decision to volunteer for a number of reasons. Volunteers come in all shapes and sizes; and there are even four-legged volunteers! Then add to the mix that people can volunteer at any age: teenagers, college students, working professionals and retirees.

Volunteer at Any Age

At the Lakeland Hospice House every Tuesday and Friday afternoon, like clockwork, patients and visitors can expect to see the friendly face of Comfort Care Volunteer Betty Sutton. Years ago, Betty lost the love of her life, her husband, Bob, to Alzheimer’s disease and knew the value of home assistance.

The Ohio State University tenured professor turned to Good Shepherd Hospice for additional support and home care when her daughter Ruth was diagnosed with advanced Multiple Sclerosis.

After three years of volunteering, Good Shepherd Hospice and the staff at the hospice house have truly become Betty’s family. Naturally, when Betty recently turned 95 years young, her birthday celebration took place in the family café. When asked to share her secret to living so long, The Estates at Carpenters resident replied, “I’ve done everything I’ve wanted so I just keep breathing.”

Why She Enjoys Volunteering

There are many life adventures and stories that Betty draws from to help foster a bond with the patients and families she meets on her hospice house rounds. She’s had loss in her life and knows firsthand what it is like to watch a loved one slowly disappear. She knows the frustration of not being able to do anything but be present for loved ones in their time of need.

“There was a husband and wife I visited at the hospice house. The next day was their 72nd wedding anniversary, and the husband was having a difficult time knowing that his wife may not live till the next morning,” shared Betty whose English Literature doctorate thesis was titled The Long Shadow of John Dryden. “I sat and talked with this man as he showed me their wedding pictures. I asked him if he knew how lucky he was to have such a wonderful woman at his side for so many years. He did. And wouldn’t you know it, but they were able to celebrate their wedding anniversary together before she died a couple of days later.”

Betty enjoys volunteering because she knows she has helped people through a rough time or two. “I plan to continue volunteering as long as I have my marbles and am mobile,” confessed Betty. “I wake up happy on the mornings I volunteer and the following day because I was at Good Shepherd Hospice making a difference.”

Betty is a true testament to the statement that a person can volunteer at any age.

About Phoebe Ochman

Phoebe Ochman, Director of Corporate Communications for Chapters Health System, manages all content and communications for the not-for-profit organization.

What Makes a Great Volunteer?

Do You Have These 5 Characteristics?

Many of the same traits that make great employees also factor into making great volunteers. After all, when you look at volunteers, you should see them as an extension of your employee base with the same core values and the desire to achieve organizational goals. In the case of Chapters Health System, our employees and volunteers work together to ensure that support and care are provided to those in the community affected with or by advanced illness.

The following are the top five characteristics that make a volunteer great.

Right Mindset: At our hospices, each and every volunteer helps by offering an extra smile and another pair of hands, much like they would naturally assist a friend or neighbor. The right mindset is simply the willingness to help.
Professionalism Infused with Passion: No matter how our volunteers spend their time, they are always professional in any setting. Volunteers help make sure our patients’ remaining days, as well as the lives of their families, are filled with the warmth and special attention they deserve.
Ability to Collaborate: Volunteers work closely with our employees to form a cohesive team to assist and guide patients and families on the end-of-life journey. Teamwork is essential. The efforts of the entire team working together make the difference.
Reliability: Although our hospice volunteers can provide office support, such as making phone calls to patients, copying, filing and helping with mailings, many visit patients and families in their homes. These individuals come to expect the companionship and support provided along with other assistance, such as reading, running errands and playing games. Patients and families count on volunteers at this difficult time in their lives, so they must be reliable.
Constant Champion: Hospice volunteers know firsthand what a difference they make in the quality of others’ lives. They spread the word by inviting friends to join them as volunteers or to follow Chapters Health on FaceBook, Twitter and other social media channels. They represent the organization at events and participate in speaking opportunities. Volunteers champion the cause everywhere they go—a living, breathing ambassador to how rewarding it is to volunteer for hospice.

If you have these characteristics, please consider becoming a volunteer for Chapters Health or any of our affiliates—Good Shepherd Hospice, HPH Hospice and LifePath Hospice. It’s as easy as filling out an application, just click here. We’d love to have you, and as you learned from Betty, you can volunteer at any age!

Healthcare Policy Change: Making Our Voices Heard

From left to right: Jenna Paladino (Paladino Public Affairs), Liz Brown (Rep. Kathy Castor’s assistant) and Cheryl Hamilton (Chief Operating Officer, Chapters Health System)

Today marks the end of Virtual Hill Week, which is sponsored every year by the Hospice Action Network. This is a time set aside annually for people across the United States to virtually join the more than 230 advocates—physicians, nurses, social workers, chaplains, home health aides, volunteers and lobbyists—who converge on our nation’s capital for the Advocacy Intensive. Supporters made their voices heard in advocating for healthcare policy change on behalf of hospice and palliative care.

Healthcare Policy Change

This year’s advocacy efforts were focused on the Patient Choice and Quality Act (H.R.2797/S.1334) and the Rural Access to Hospice Act (HR1828/Senate980) to prompt healthcare policy change.

With bipartisan sponsorship from Reps. Earl Blumenauer and Phil Roe and Sens. Mark. R. Warner and Johnny Isakson, the Patient Choice and Quality Act outlines a palliative care model with the following benefits:

Builds a team approach to care featuring a doctor, nurse, social worker and palliative care specialist
Allows 24/7 access to care, which would include a care coordinator
Requires face-to-face visits with a nurse
Provides additional resources for education about advance care planning
Improves portability of advance directives, which specifically requires providers to follow an individual’s preferences, regardless of the state or care site

The Rural Access to Hospice Act also has support from both Republicans and Democrats and is sponsored by Reps. Lynn Jenkins and Ron Kind, and Sens. Shelley Moore Capito and Jeanne Shaheen. This bill corrects a glitch in the law and thus allows patients receiving hospice care through rural health clinics to keep their family physician. Patients wouldn’t need to forego the physician who might have cared for them for many years in order to access hospice care.

How Successful was This Effort?

“Our efforts this year in Washington were quite successful,” said Jenna Paladino of Paladino Public Affairs, LLC, who represents Chapters Health System to the Florida legislature and Congress. “We gained bipartisan co-sponsorship for both the Patient Choice and Quality Act and the Rural Access to Hospice Act. With this type of healthcare policy change, patients benefit with improved and earlier access to hospice care and coordination. Our advocacy efforts were like the calm during a storm. There was no need for heightened emotions or a lengthy debate, as our efforts did not involve a budget request. We were able to demonstrate a need with a solution.”

With a dedication and willingness to speak out in support of hospice to decision makers, Chapters Health has a vital leadership voice on public policy serving the entire end-of-life care spectrum. “A healthcare organization has to identify pertinent issues, rally the troops,” said Ms. Paladino. “Chapters Health has a great network of supporters willing and able to educate our state and federal representatives on the benefits of hospice and why they need to support our issues.”

Living in the United States, it is hard not to notice that the healthcare environment is forever evolving—with changes taking place at both state and federal levels. Therefore, it is more important than ever for a community-based provider like Chapters Health to maintain a strong presence in both Tallahassee and Washington, D.C.

Everyone is an Advocate

Every day at Chapters Health and our affiliates—Good Shepherd Hospice, HPH Hospice and LifePath Hospice—physicians, nurses, volunteers and clinicians act as advocates for hospice and palliative care.

“They might not think of themselves as advocates, but just by virtue of the experience they’ve had and the stories they can tell, they have a strong impact on our elected officials,” shared Ms. Paladino. “Advocacy is an ongoing effort through which Chapters Health maintains a seat at the table with decision makers and community leaders.”

It’s important that elected representatives understand the many extra benefits and services a not-for-profit organization like Chapters Health provides that don’t fall under Medicare, Medicaid or private insurance reimbursement. These services are completely funded by our donors and include bereavement programs for children and adults, grief counseling for schools and employers and an open-access policy that allows patients who are receiving expensive treatments normally associated with curative care to benefit from hospice care.

“There’s been a seismic shift away from traditional ways to prompt healthcare policy change,” noted Ms. Paladino. “Today, community members can make a profound difference to public policy by sharing comments, photos and stories about hospice on social media rather than making phone calls or sending emails. Government officials recognize the power and reach tweets, retweets and posts make, and want to be accountable to their constituents back home. It is easier than ever to make our voices heard.”

About Phoebe Ochman

Phoebe Ochman, Director of Corporate Communications for Chapters Health System, manages all content and communications for the not-for-profit organization.

Top 3 Things to Know Today

The top three takeaway messages from hospice and palliative care legislation today are that it is vitally important to:

Preserve the hospice benefit, i.e., the full package.
Expand palliative care with awareness and education.
Make it a priority as a family to have open discussion about end-of-life desires and wishes. Don’t wait for the government to intervene.

Serving the Community Beyond Our Mission

When physicians suggest hospice care to patients and their families, it can be shocking and scary at the same time. At Chapters Health System, hospice care is viewed as an opportunity to take each of our patients by the hand and lead them gently through the end-of-life process. It’s our mission to offer programs and services that meet the needs of our patients and families. But we don’t stop there. It is our overarching objective to exceed expectations and serve the community beyond our mission.

Beyond Our Mission

Every day at Chapters Health and our affiliates—Good Shepherd Hospice, HPH Hospice and LifePath Hospice, we care for patients and their families when they are most vulnerable. Our goal is to take a time when most feel sad, overwhelmed and often frightened, and instead use patience, empathy and compassion to make it therapeutic and cathartic. By providing outstanding hospice services, along with palliative care and home health, we are able to go beyond our mission and make a difference to our service area’s economic well-being.

“Simply by helping people with life-limiting illnesses figure out how to live as long as they can productively manage—and in a more fulfilling way—we contribute to the overall strength of both families and the community,” said Jack Kolosky, Chief Operating Office at Moffitt Cancer Center and past chair of the Chapters Health Board.

Chapters Health programs and services contribute in a positive way to the quality of life in Citrus, Hardee, Hernando, Highlands, Hillsborough, Pasco, Pinellas and Polk counties. This helps attract new employers to set up shop, and new residents to live and work in these eight counties. In turn, Chapters Health has become a recognized contributor and participant in each community’s overall economic life.

Serving the community in order to go beyond our mission takes different forms. Whether talking about medications for our pharmacies, food and furnishings for office and facilities, or building and maintaining our hospice houses, Chapters Health reinvests in our communities.

“Our focus is really local to the communities we serve,” said Philip D. Wegman, Vice President at Furr & Wegman Architects in Lakeland. “And we do it continually over time, and not just once.”

Benefiting Families, Benefiting the Economy

The mission of Chapters Health is to provide the right care by the right people at the right time. But beyond this vital care, we have a demonstrable impact on the economic health of the communities we’re privileged to serve.

Every one of the goods and services that Chapters Health purchases—drugs and medical supplies, office space and equipment, even the gasoline that allows our caregivers make regular visits to patients—ripples throughout the local economy, resulting in the creation of jobs and revenue for hundreds of other businesses.

Using accepted economic models, the ripple effect of the economic activity generated by Chapters Health creates between 2,250 to 3,100 additional jobs in the local market and produces more than $340 million in additional economic activity.

For those whom Chapters Health serves who are already living here, our supportive bereavement services help keep grieving children in school and parents on the job as they cope with loss. We know that the grief and bereavement care we provide to children and adults who have suffered the loss of loved ones results in lower absenteeism rates at school and work, higher productivity and a healthier emotional well-being.

“The affiliates of Chapters Health are vital, homegrown, not-for-profit entities that spend the vast majority of their money in purchasing goods and services locally,” concluded Phillip Walker, a Lakeland-based Allstate Insurance agent and member of the Good Shepherd Hospice Board of Directors. “We have woven ourselves into the very fabric of our community over the years—which is why whenever I mention the name of Good Shepherd Hospice to people, I always hear positive feedback.”

About Phoebe Ochman

Phoebe Ochman, Director of Corporate Communications for Chapters Health System, manages all content and communications for the not-for-profit organization.

Community Partners

Chapters Health works closely with several community organizations and businesses.

American Legion works with wartime veterans, mentors youth, advocates patriotism and honors all service members and veterans.
Banfield Foundation is the charity created by Banfield Pet Hospital to enhance the wellness of pets in various communities across the country.
Elder Options ensures that older Americans have access to information, resources and assistance.
Dream Foundation is the adult version of the Make-a-Wish Foundation and thus makes end-of-life wishes come true for this population.
Feeding Pasco provides nourishment to Pasco County’s seniors.
Kiwanis is dedicated to improving the world, one child and community at a time.
One Community Now Stand Down is a community-based intervention program for homeless veterans.
Trader Joe’s donates flowers daily to Chapters Health for hospice patients and their families.
United Way improves lives by tapping into the caring power of our communities.

Why He Cares About Sharing Music with Hospice Patients

Early on in childhood, we are taught we have five senses: sight, hearing, smell, taste and touch. As little tikes, our senses were slowly fine-tuned as we saw our kindergarten classmates, heard our parents’ encouraging words, smelled the flowers in a window box, salivated in anticipation of tasting a Sunday morning stack of pancakes, and knew that when we rested our heads on the pillow to expect a goodnight hug and kiss from Mom. As time marches on and we age, so do our senses. When we bid adieu to this world, what is the last sense to go? Hearing. Therefore, it is easy to understand how important this sense can be for people at the end of life. And that’s why sharing music with hospice patients can be a valuable resource in their care.

Sharing Music with Hospice Patients

Meet Father Christian Villagomeza, who knows firsthand how sharing music with hospice patients can affect care. Not only does Father Christian spiritually assist patients, primarily at LifePath Hospice, but when appropriate and with family permission, he introduces music into the care mix.

“Sharing music with hospice patients can truly be a blessing,” said Father Christian. “It helps to establish rapport and provides a special bond. Music is a great way to put patients and families as ease at this time in their lives.”

If visitors happen to be at the Melech Hospice House in Temple Terrace they might catch a glimpse of Father Christian with his guitar at various times throughout the week. Although he happens to personally own a couple of guitars, this particular instrument is quite special. In 2004, when Father Christian was a member of one of LifePath Hospice’s home teams, he had a patient who owned a guitar. The gentleman would strum the strings of the guitar but not really play any music. In his chats with this man, Father Christian found out something interesting.

“I discovered that my patient had the guitar for a very long time but never learned how to play,” shared Father Christian. “In our time together, even though it was difficult for the patient due to his illness, he still tried to learn how to play his guitar.”

Over the years, Father Christian has met many people in the community. One particular family came to mind due to an invitation to attend and play the guitar at a funeral service. When he arrived, Father Christian was shocked to discover a surprise leaning up next to the coffin: his friend’s guitar. “Attached to the guitar was a note with explicit instructions that said no one should touch the guitar but me. My friend wanted me to have his guitar, “said Father Christian with a smile as he recalled the day. “Then I played this guitar during the service and honored his wishes.”

Since that day, the inherited guitar has been played to spread the joy of music to others. “What is quite an interesting and unexplainable fact is that I have not changed the guitar strings in more than a decade, and it is still in tune,” confessed the Father Christian. “There’s a higher meaning going on.”

Not Just About the Guitar

Over the course of any calendar year, music is present at all the affiliates of Chapters Health—Good Shepherd Hospice, HPH Hospice and LifePath Hospice. From employees who tinkle the ivory on a keyboard and volunteers who serenade soothing tunes on a harp to community members who strum the strings of a dulcimer and groups who bring the holidays to patients by singing Christmas carols, music makes a difference.

Music touches everyone in personal and unique ways. Music helps patients and families recall a time in their lives when their hearts were filled with joy and fond memories. Additionally, a study published in the American Journal of Hospice and Palliative Medicine found that the multidimensional nature of music resonates with the needs of patients at the end of life.

“I find that music is an antidote to nervousness especially when the patient and family are faced with end-of-life situations,” stated Father Christian. “Music decreases and defuses anxiety across generations.”

A group at Case Western Reserve University confirmed Father Christian’s observations. The researchers provided music 20 minutes daily for three days, and it significantly decreased anxiety in the hospice cancer patients participating in the study.

The benefits of music can extend well beyond the end of life of a hospice patient. According to Father Christian, once a loved one passes, the family finds comfort and solace in music. “For families and friends left behind, music and meaningful songs help the grieving process,” concluded Father Christian.

About Phoebe Ochman

Phoebe Ochman, Director of Corporate Communications for Chapters Health System, manages all content and communications for the not-for-profit organization.

A Video is Worth a Thousand Words

It’s no surprise that Father Christian has loved music his entire life. And believe it or not, he is a self-taught musician. Actually, Father Christian plays by ear as he can’t read sheet music.

At the tender age of 5, Father Christian asked for a guitar. His father went to the store and returned with an accordion. “I was disappointed that I didn’t get a guitar, but I learned how to play the accordion,” reflected the chaplain. “After the accordion came a ukulele, and finally I did get a guitar.”

When asked to name his favorite song, Father Christian confessed that his musical interests and tastes reside in many different genres and it was difficult to choose. But when pressed, he said Jim Croce’s “Say I Love You with a Song.”

Going Green: Recycle and Repurpose at Life’s Treasures

When you think of the color green, what images come to mind? Do you think of the rolling hills and lush landscape of Ireland? Maybe you picture Kermit the Frog singing “It’s Not Easy Being Green?” Or in this day and age, do you imagine large recycling bins filled to the brim with bottles, cans and plastic containers? And yet, there’s a rare and different picture that can come to mind: It’s going green with a unique spin by recycling and repurposing items from a thrift store.

Going Green at Life’s Treasures

You can’t escape the fact that going green seems to be a mantra across the globe these days. In every community, people band together in an effort to make the planet better and enhance the quality of life by leaving smaller carbon footprints. Recycling materials rather than sending them to landfills is a philosophy embraced by Chapters Health System and its five Life’s Treasures Thrift Stores. The stores are not only great places to shop for gently used clothing, accessories, furniture and housewares, but they also help recycle, repurpose and reuse merchandise.

Recycle Events

Twice a year, Life’s Treasures Thrift Stores partner with Ramm Recycling and Urban E Recycling to hold recycling drives. During these events, people can bring outdated or broken computers, keyboards, monitors, internal components, servers, cell phones, printers, fax machines, home audio equipment, DVD players and VCRs. Televisions are the only items that aren’t accepted. Besides taking these listed items off of your hands, the recycling events also offer free data destruction.

Repurpose to Up-cycle and Pay it Forward

There’s a saying; “One man’s trash is another man’s treasure.” This sentiment is brought into the spotlight almost daily at Life’s Treasures Thrift Stores. Items donated to the stores are a constant and rich resource for crafty people and hobbyists searching for treasures at the Brandon, Carrollwood, New Port Richey, South Tampa and Zephryhills locations. From clothing and accessories to housewares and furniture, old items are lovingly given a new life and sometimes a new purpose.

“Crafters look for fabric goods, such as linens and clothing, to make quilts, scarves and other accessories. Donated furniture is a much-sought-after item that hobbyists regularly seek out,” said Alice Walsh, Director of Life’s Treasures Thrift Stores. “They’ll strip down a dresser, repaint or stencil it and update it with new hardware. So instead of being hauled off to the local junkyard, the item goes into a bedroom or dorm room.”

In addition, Life’s Treasures Thrift Stores hold regular crafts workshops conducted by staff and volunteers. Attendees can learn how to repurpose items like old china, glasses and wine bottle corks to give them new life.

“Our thrift stores provide a place for the community to donate items in support of our mission to provide care to people affected by advanced illness so they can make the most of life,” added Anne Ferrell, Development Coordinator for Chapters Health. “Being able to do all of this by going green is an additional—and gratifying—contribution that Life’s Treasures Thrift Stores make to our communities.”

About Phoebe Ochman

Phoebe Ochman, Director of Corporate Communications for Chapters Health System, manages all content and communications for the not-for-profit organization.

10 Ways to Go Green without Breaking the Bank

There are many ways you can support the effort of going green that won’t negatively impact your wallet. Here are some of our favorites:

Rethink plastic bag disposal: Take your plastic bags back to the grocery store, or better still, use reusable cloth grocery bags for shopping.
Consolidate errands: When you have lots of errands to run, group them together by location: less gas equals fewer emissions. If able, walk or bike to accomplish tasks close to home or work.
Power down: At the end of the day, turn off your monitor and computer. This practice saves energy.
Split a gallon: If you drink milk, buy a gallon and split the milk in half—half a gallon goes in the refrigerator and freeze the remaining half. By splitting a gallon, you decrease the amount of plastic used for two half-gallon containers.
Go electronic: For bills, switch to electronic invoices and bill paying, which decreases paper usage and postage costs. And if you’re set to travel, think about e-tickets and opt for electronic boarding passes. Going electronic helps save trees and decreases the possibility of misplacing travel documents.
Drink up again: Instead of drinking water from plastic bottles, increase your daily water consumption with a reusable water bottle.
Check out from the library: If you still like the feel of reading from an actual book, check out a best seller from the library instead of purchasing new. Or feel free to browse and download some e-titles from the library.
Wash full loads in cold water. Refrain from washing small loads of laundry, and in hot water. Clothes still get clean in cold water, and you save energy and water when you can do a full load.
Unplug your cell phone when charged to capacity. You don’t need to keep your cell phone charging once it’s at 100 percent. By keeping it plugged in, you are wasting electricity.
Flip your printing. If you’ve printed something on computer paper and no longer need it, just simply flip it over and print something else on the other side.