Clarion Forest VNA Hospice Considers Physical, Emotional, Psychological, and Spiritual Situations

Ron Wilshire

Ron Wilshire

Published October 15, 2017 4:40 am
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CLARION, Pa. (EYT) — There is a good reason why the Clarion Forest VNA Hospice is rated in the top five percent of all hospices in the United States.  

(Pictured above: Jill Over, CEO of Clarion Forest VNA.)

The local VNA has offered hospice services since 1994 and adheres to national standards that help ensure patients and their families that they receive the best care.

Hospice is care that is provided to individuals whose life expectancy is limited due to illness.

Jill Over told exploreClarion.com, “We all want to receive the very best healthcare available to us, especially as we near the end of life,”

“We see patients wherever they call home, including personal care homes and nursing homes in our service area.”

“If you and your physician have decided the time is right for hospice care, you have the right to request Clarion Forest VNA Hospice,” Over explained.

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[Pictured above from left: Cheryl Elslager (Hospice Nurse Educator), Beth Cook (Director of Hospice and Palliative Care), Dr. Robert Luderer (Hospice Medical Director), Randy Evans (Hospice Chaplain), Sue Evans (Bereavement Counselor), Ruth Stewart (Medical Social Worker), and Linda Erwin (Registered Nurse).]

Director of Clarion Forest VNA Hospice Beth Cook said, “One of the main things is we try to keep them comfortable and at home.”

“The criteria is that two physicians need to sign off that a patient is appropriate for hospice and has a prognosis of six months or less to live if the disease takes its normal trajectory.”

However, a patient can be with hospice for longer than six months.  After the six-month period, the hospice medical director or hospital physician sees if the patient still meets the criteria because some of the diseases’ processes are hard to determine.

“There are actually four levels of care, but primarily the care is in patient’s home — wherever they call home.” 

“We have several services. We have the nurses, the hospice aides, we do personal care and bathing, and have homemakers who can go in and do light housekeeping and that type of thing and chores.  We also have our chaplain for spiritual care, our social worker, as well for counseling and community resources. We have our bereavement counselor who does participator grief and the after-death bereavement and counseling that goes up to 13 months.”

Hospice referrals come from many different resources, including families, nursing home facilities, hospitals, and neighbors; although, anybody can refer someone to hospice.

“We look at signs and symptoms, testing, and clinical findings of what’s going on with them and progress notes about what the physician feels the prognosis is for the patient. We also look at their functional level and if they have had a decline.”

Most insurances — Medicare, commercial insurance, and medical assistance — have a hospice benefit, so there isn’t any cost to the patient for the services of the VNA Hospice workers who are sent into a patent’s home or a nursing home, according to Cook.

“We cover medications and supplies that are related to the patient’s terminal prognosis. We also cover equipment such as commodes, hospital beds, Hoyer lifts, sit to stand lifts, bedside tables, oxygen, nebulizers—a lot of equipment.”

The current number of patients under hospice is 20, but there are times when the number of patients has reached from 30 to 40.

“It all depends, and that’s the nature of what we do.  Sometimes we are getting admits, and sometimes the deaths all come at one time.  Our nurses sometimes operate in a crisis mode.” 

“About 30 to 40 percent of the patients that we admit for hospice care live less than a week. This typically only allows time for helping people in a crisis situation, rather than the time to develop a relationship with the patient and the patient’s family, making sure the patient has the highest quality of life possible and that the family is prepared to cope with the coming changes in their life as a family.”

“There’s a lot of anticipatory grief that comes with that.  Can you imagine being diagnosed with an end-stage lung cancer or something? You’ve had the treatment, nothing’s working, and then you’re enrolled in hospice.”

“If we can get in there sooner, then we can work with the family and patient to have a ‘good’ death to be controlled and comfortable and peaceful with the impending death. We can control symptoms if they only have a few days left, or if they have two months left, but it’s better for the patient and family if we get in there sooner than when they’re in a crisis mode.”

Sometimes, it’s not all physical.

There are a lot of symptoms that hospice can try to control such as pain, agitation, restlessness, and anxiety. 

“We look at and assess their physical, emotional, psychological, and spiritual situation because sometimes that pain isn’t all physical. There’s a lot that goes into spiritual pain.”

Bereavement services are available prior to the death of a loved one and continue after death. Services include individual and family grief counseling, grief support groups and workshops, home visits, and others.

A memorial service is held once a year.

“It is not just for hospice patients, but for any of our patients who have had Clarion Forest VNA, and we go back two years. We send the invitation to their families and usually have it at a local church.  It’s really nice because we read the names; they come up and honor the patient and memory of the patient either by lighting a candle or placing a flower in the front.  Our staff does a circle of light at the end in honor of our patients.  We also do a butterfly release in the spring or summer. Anybody in the community can participate if they lost somebody, or if they want to honor someone who is still alive they can do that.”

Hospice was founded by volunteers years ago and still plays an important part of the operation.

“Volunteers do patient care, and they help out in the office doing some clerical work, and they also help out with grief groups and our bereavement program. They receive training, and a lot of them have gone through this with their own loved ones.  All of them pass background checks.”

Another plus for Clarion Forest VNA is that there are a good number of employees who have been there for years.

“We have some nurses that have been here from 20 to 25 years.  It takes a special person to deal with hospice patients.  They don’t all come with that experience, but they all come to hospice and end of life care wanting to do that piece of it.”

Grief groups also serve the community, accepting anyone who has had their loved one pass away, even if they were not a VNA patient.  Cook said VNA feels strongly about offering that community support.

“We’re here for the community, and we’re not going anywhere,” said Cook.  “We want to give back to the community.”

VNA Hospice provides service throughout Clarion, Forest, and Jefferson counties.

For more information, call 814-297-8400, or visit Clarion Forest VNA website here.

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