Friday
May182018

HVS Begins 35th Year

35 years ago, a group of community members had a vision for providing better care to families, neighbors and friends who were facing death, but, at that time, with little support.  They met, consulted with others, made a plan, incorporated, established ongoing guidance with a volunteer Board, and put out the call for community member who felt inspired to become trained hospice volunteers.  The first class of volunteers met for 10 weeks in the summer of 1983.

 

In 2004, a new kind of volunteer program took root: singers who would rehearse regularly and sing for those who are dying, wherever they live.  Wellspring has been singing at bedsides, community care homes, memorial services and hospice events ever since. 

 

Because volunteers (patient care providers, Board members, Wellspring singers and office helpers) are the heart and soul of who we are, we want to begin our celebration of the first 35 years with YOU, our faithful and compassionate volunteers.  We hope you will join us for a garden party next Thursday, May 24, 4-5:30pm. 

Friday
Apr272018

Living with Dying

Lets Talk About Hospice Myths 

More and more information is being written about the hospice care, consumers need to know the basics in order to take advantage of this benefit.

Hospice is comprehensive medical care provided to patients who have advanced illness when cure is not possible and life expectancy is estimated to be approximately 6 months or fewer. High quality care continues to be provided, with a goal of moving away from a “medicalized” experience with burdensome interventions.  In its place is attentive, whole person care, focusing on maximizing quality of life and comfort while minimizing suffering. Hospice care recognizes that death is a natural part of life, and helps to prepare and support patients and families as changes in body and spirit occur.  

Hospice care is provided by an interdisciplinary team, which commonly includes primary care providers, the hospice medical director, nurses, chaplains, home health aids, social workers, and volunteers. This team helps to develop and implement a care plan that recognizes the unique needs of each patient and their family. Good communication among patient, family and the Hospice team is essential as many questions occur and occasionally unexpected issues can arise.  There are many Myths and misconceptions about Hospice. Here are a couple:

 

Myth #1

“When you go on hospice, they give you morphine and you die.”

Signing onto Hospice is about LIVING; living the best you can for as long as you can. A core commitment of the team is to assess all forms of suffering which can be emotional, spiritual, psychological and physical.

Hospice teams have expertise in managing these symptoms in a variety of ways, including medications.

Opioid medication like morphine can be a powerful tool for common symptoms in life limiting illness including shortness of breath and pain. Side effects are minimized and managed with careful dosing. When used appropriately in terminal illness, these medications do not lead to addiction or other significant negative effects.

When death is near, new or worsening symptoms can arise quickly which benefit from expert evaluation and thoughtful titration of medications. Sometimes, patients are referred to hospice so late that there are active physical symptoms that require a rapid treatment response. The goal is always to improve comfort, to honor the natural process of dying, and not to hasten death.

 

Myth #2

“When you sign onto hospice we will have someone in our home providing care all the time”.

When you sign onto hospice you will have a team of providers (nurse, personal care aide, social worker, chaplain, volunteers) helping to care for you. They will visit based on your individual care needs, but are not with you around the clock. The hospice team will teach family members what they need to know in order to care for their loved one at home.  The Hospice team is always available for telephone support, and for any urgent needs that arise.  It is important for the patient, family and Hospice team to have good communication around care expectations and concerns. Some families want more visits from the team, while others prefer more privacy and fewer visits.   The care plan and visit frequency may change throughout an illness. The goal is for the Hospice team to understand individual hopes and worries, and to do their very best to address these issues.

Friday
Apr272018

Living with Dying -2

This edition’s author is Dr. Diana Barnard, Palliative Care Physician, UVM/Porter Medical Center and Addison County Home Health & Hospice.

Lets talk (some more) about hospice:

“Enrolling in Hospice when you have a life-limiting or terminal illness makes it possible for both patient and caregiver to gain medical and nursing help as well as essential emotional support. Working with us in a mutual, respectful way, our Hospice nurse set up a flexible, effective treatment plan for my husband, and I no longer had to try to be Florence Nightingale. Instead, my husband and I were able to focus on the quality of life and comfort and peace that each day brought us. “ ~Andrea Perham, Middlebury

 

Myth #3

 “Going onto Hospice means giving up my privacy and having strangers judging how I live”

When you enroll in hospice, meeting your physical, emotional and spiritual needs in a familiar setting is the goal. Your team of providers will have specialized training in identifying your unique values, and in providing care that helps you live as well as you can on your terms. A variety of therapies may be offered, but you will decide which ones are right for you. One of the many benefits of enrolling in hospice when you have months to live is that there will be time for you and your team to get to know each other well and to deepen understanding of your priorities.

Its normal for people to be nervous about having people you don’t know in your personal space at such a tender time. Individuals who work in Hospice have visited hundreds of homes across Addison County. These care providers are well aware of the diversity of circumstances in which we live. Hospice teams understand that it is a privilege to be invited into a person’s home and will respect your home, your privacy and your dignity.

 

Myth # 4

When you sign onto Hospice, it means giving up Hope.

Birth and death are natural parts of our life cycle. In between these transitions, most people want to live as long and as well as possible. When diagnosed with a terminal illness, most people hope for a cure. There is nothing wrong with that! Its crucial to remember that hope is much more powerful than any disease, and there is always more hope to be found if we are willing look for it. If you limit yourself to only one hope, you may miss the opportunity to spend time and energy on what matters most to you. Hope can literally transform the experience of dying. Hospice is about embracing hope. Hospice teams are specially trained to help bring to life your other hopes: sharing memories with family, having your pain well managed, completing personal goals, having a peaceful death, and more. There is no end to hope.

 

“Hope” is the thing with feathers -

That perches in the soul -

And sings the tune without the words -

And never stops - at all.

-Emily Dickinson

Friday
Apr272018

New Hospice Chaplain

Addison County has been very fortunate to have Gary Lewis serve as the Hospice Chaplain for over 20 years.  As hospice chaplain, Gary shared his warmth, his humor, his compassion and his personal story throughout our community, providing peace and comfort to many. We are truly grateful for the gifts he has bestowed upon our patients, families, caregivers and volunteers.  At the end of 2017, Gary stepped down as Hospice Chaplain. 

We are fortunate to have another remarkable man begin his tenure as our new Hospice Chaplain, Stephen Payne.  In his own words, Stephen tells us a little about himself. 

All of us are aware at some level or another that our individual lives will come to an end.  It is rather easy to ignore this fact for quite some time, at least until age, serious illness, or the death of someone we love brings the whole topic to the surface.

          I have recently inherited the position of chaplain with the Addison County Home Health & Hospice (ACHHH) organization.  What qualifications does a chaplain need?  The short answer is...I'll know better as time passes and I continue to learn my way around!  Presently, I can look back over my 24 years of pastoral ministry for hints at what people might be thinking and feeling as the end of life approaches.  My congregations have experienced their full share of loss and grief at the death of members of the church family, neighbors, and friends.  In my personal life, the deaths of my grandmother after a LONG struggle with dementia and my dad after a much quicker course of a different form of the disease (and at only 2 years older than I am presently!) have given me much time to think about what the mortality of human beings means.

      I am descended from generations of New England Puritans, Vermont Congregationalists, a French Canadian Catholic branch of the family, and Quakers who settled the hills of Lincoln very early on.  In my own life, I've explored a number of denominations and enjoy the ideas that all people bring to spiritual discussions.  I believe that all of us have pieces of the truth and can always learn from others.

          Beyond that, I bring my knowledge of Addison County people to the job.  I've lived here all my life, save for a few years in Pennsylvania to attend seminary and a couple of other shorter adventures.  I am descended from generations of Vermonters...mostly farmers...and am very familiar with most of our Yankee idiosyncrasies.  Quite often, many of us are guilty of...or at least accustomed to...holding in our emotions.  However, when coming face to face with questions and feelings we may have avoided until late in our lives, perhaps you, or someone you know, may like to explore some ideas with a neutral person.  I would hope that I can be that person for both the patients and families of folks who find themselves making use of the many services offered by ACHHH.  I am beginning to find my footing as I listen on a weekly basis as nurses and other caregivers discuss ways to better serve their patients.  I have also been aware of the many services offered by the Hospice Volunteer Services (HVS) and am impressed by their dedication.  I've learned of the work done by those who pushed for the creation of the ARCH (Addison Respite Care Home) rooms at both Helen Porter Rehabilitation & Nursing and Porter Hospital to be used by patients at the end of life along with their family and friends.

          I hope to become more involved in all aspects of the whole end of life process as it plays out in the life of individuals within our Addison County community.  I look forward to being of service alongside all of these folks who have been serving their neighbors and friends for so long and so well.

Friday
Apr272018

Green Burial

My question is about Green Burial.   I feel that if one knows in advance what procedures will be followed when one dies, it may be easier to go in peace.  Awhile ago we had a general meeting at Champlain Valley Unitarian Universalist Society that explained what Green Burial is and some of the things we need to work towards.  What is the current status of this effort?   Every time I pass a pleasant rural cemetery now I wonder if it is ever going to be Green!  So I am just wondering where it all stands at this time.    ~Jeannie Van Order

Here is a response from Michelle Acciavatti, a green burial educator and co-founder of the non-profit Green Burial Vermont, dedicated to promoting socially and environmentally conscious burial practices in Vermont.

As of 2017, a person can be buried unembalmed, in a biodegradable container or shroud, at a depth of at least 3.5 feet, in land managed in an ecologically sound manner, without a vault. This marks a return to how many Vermonters were buried well into the 20th century. However, because Vermont has comprehensive rules regarding placement and management of a new cemetery or addition and each cemetery determines their own by-laws, at this time no cemetery is prepared to create green burial areas that would accommodate this burial practice. The most important thing people can do to help green burial move forward is to contact their local cemetery commission and let them know they want a green burial so that logistical discussions can start taking place. Cemeteries in Vermont need to know just how important green burials are to the communities they serve.

Michelle is founder of Ending Well which helps people “plan, prepare and experience their own good death.” She can be reached at michelle@ending-well.com.

 

Here is another response from Ron Slabaugh, a hospice volunteer who has trained with Beth Knox as a home funeral guide.  He is part of the state-wide organization – Green Burial Vermont:

I have been advising people to approach the sexton of a cemetery they are interested in, asking if that cemetery would allow a green burial. I know of one instance of someone doing this and the cemetery charged an extra $100 for their lots for the purpose of adding more soil in a decade to maintain the cemetery level for mechanized mowing.

I have a friend who knows where he would like to be buried and would like that cemetery to establish a green burial section (“hybrid cemetery” in the lingo of the Green Burial Counsel) and perhaps plant it as a wild flower meadow, with paths and using natural field stones for grave markers. He attended the last meeting of the cemetery commission to inquire about this and they agreed to consider it.  If enough of us start asking, it might happen. Once one or two cemeteries create a green burial section, their experience can help make it easier for other cemeteries.

 

Resources:     Dying Green – film (available to watch or buy from Amazon)  

Grave Matters - book, Mark Harris from the HVS Lending Library