Keeping the Spark Alive: Hospice Care
93-year old Margaret Miskovich endured a terrible fall that broke both her legs and left her extremely frightened. Margaret was also suffering from dementia with varying degrees of lucidity. She was residing in a long-term care facility in northern Virginia. Despite the best efforts of the community staff members, managing Margaret’s pain and easing her fears was becoming more difficult.
“Pain management had been a constant struggle,” said Margaret’s daughter-in-law, Robbie. So was the relatively simple act of changing the linens or any other movement that might suggest to Margaret that she was falling again. When Margaret developed pneumonia and her health declined further, her physician, Dr. Anil Patel, recommended that the family consider hospice care. They knew that hospice care was available in the home, but they were surprised to learn that home can include assisted living or long-term care facilities, or even hospitals.
Luckily, Margaret lived at one of several area facilities that participate in Capital Hospice’s Centers of Excellence, a new program designed to make hospice care more accessible in long-term care facilities.
“The American Medical Directors Association has indicated that a significant percentage of nursing home residents may be hospice eligible. Our goal is to make access to hospice expertise easy,” said J. Cameron Muir, M.D., Capital Hospice Vice President of Medical Services. Hospice experts are able to offer end-of-life care and pain management specially tailored to the patient’s needs, as well as grief support to the family and long-term care facility staff, who often become part of a resident’s extended family.
For instance, when Capital Hospice’s Georgine Tedrow, an RN with advanced training in pain and symptom management, began to work with Margaret and her family, she recommended changes to her care plan. Georgine also recommended changes in Margaret’s medication to better manage her pain. And she changed her physical therapy goals to make them more realistic. At her suggestion, a Capital Hospice chaplain came to visit Margaret to address her spiritual needs. And when Margaret became agitated by people in or near her room, Georgine told her it was okay to ask them to quiet down or leave.
Robbie found that Georgine’s expertise and self-assurance inspired confidence in her mother-in-law. When Margaret was feeling better, she began calling Georgine “the boss.” Robbie related that during the next couple of months Margaret was comfortable enough to become quite social again.
Margaret died in late December 2004, her pain under control, her family at ease with her care and by her side. Robbie says Capital Hospice left an indelible mark on her family: “It affected my mother-in-law’s overall quality of life. At one point, I’d look into her eyes and the spark seemed to be gone. Then it returned. That’s what hospice did.”