"What Happens When. . .?"

“What happens when…?”

Life can change for the better or worse at a moment’s notice. While we cannot prepare for many situations we will encounter along the way, having some basic knowledge ahead of time can make dealing with them easier. Because many middle-aged people in our community have the privilege of having their aging parents living longer than ever, we thought it would be helpful to answer some questions that may come up as your loved ones age and prepare for end-of-life.

Q- My mom lives in Addison County and I live out-of-state.  She has recently been diagnosed with a terminal disease and I cannot be with her all the time. What should I do first?

A: Patient referrals to hospice come from their physicians. If your mom has a serious diagnosis and has not already been referred to hospice care, we recommend that you call your mom’s physician and discuss whether a referral to hospice care is appropriate. If the answer is “yes”, and the physician has had a discussion with your mom about her prognosis, the physician will send a referral to ACHHH. This agency will contact your mom promptly and arrange for an intake visit. A member of the hospice team will meet with your mom and work to develop a plan of care to best meet her needs. She will receive kind, skilled, compassionate care in her own home for as long as possible.

Q: Who will provide care for my loved one while she is a hospice patient?

A: Hospice provides an interdisciplinary team which may include registered nurses, a palliative care physician, social workers, home health aides, trained volunteers and hospice chaplains. Hospice nurses provide medical care including pain and symptom management. Social workers assist patients and families prior to death and follow up at scheduled intervals with family members for the first year following death.  Hospice Volunteer Services provides companionship, respite for family members and help with practical matters like shopping and transportation. The Wellspring hospice singers or other musicians from Hospice Volunteer Services visit patients at any stage and provide bedside music. Hospice chaplains assist patients and families with spiritual needs at the end-of-life.  The inter-disciplinary hospice team meets on a weekly basis and reviews the care plan for each and every hospice patient, because every patient is unique. As situations change the care plan is re-assessed and updated with input from the patient, family members and the care team. It should be noted that the hospice team does not provide 24 hour direct care, and in order to stay in the home, a patient needs to have a family member or paid caregiver living with her.

Q: My loved one lives alone but staying in the home is not practical or even possible. She requires hospice care. Are there any other community resources that can help?

A: In Addison County we are fortunate to have Addison Respite Care Home (ARCH) rooms located at both The University of Vermont Network Porter Medical Center (The Estuary) and Helen Porter Rehabilitation and Nursing facilities. These are rooms designed to accommodate people who need end-of-life care but cannot remain in their homes. Each room offers a home-like environment, hand-made furniture and quilts, pull-out sleep chairs for family members and a music system. Patients who are admitted to ARCH and the Estuary rooms are cared for by employees of the hospital and nursing home as well as ACHHH nurses and hospice volunteers.

Q: What should I do if my loved one passes away at home?

A: Do not panic! If your loved one is not under hospice care, you should call 911 and await further instructions from emergency medical and law enforcement personnel.   They will assist you in having your loved one transported to the hospital emergency room where a doctor will make a pronouncement of death.

Q: Is the process different if my loved one was being cared for by the hospice team?

A: Yes! One of the main benefits of hospice care for families is that at the time of death you only need to call Addison County Home Health and Hospice. ACHHH has an answering service which operates after normal business hours. The on-call nurse can go out at any hour to attend to your loved one at the time of death and make the necessary pronouncement. She will assist with preparing the family for next steps. If a person is being cared for by hospice and dies at home, there is no need to call 911.

Q: Once my loved one passes away, is my relationship with the hospice team over?

A: No.  Bereavement support is available from ACHHH and Hospice Volunteer Services. ACHHH provides individual bereavement counseling for family members of our hospice patients and HVS offers both individual and group bereavement support services.


A Hospice Heart

A Hospice Heart      ~Laurie Borden, Associate Program Director

         In Honor of Hospice Volunteers, Garden Party, 5/24/2018  

We are devoted to our volunteers.  You bravely walk into the unknown,

into the depths of the dying process, with your souls open to possibility. 

We offer our gratitude for you each and every day, when we understand

how you transform the world of the patients and families you visit.

Love is a sacred action, which comes so naturally as yu walk the path of

a hospice volunteer.  There is no greater art, avocation or aspiration

than to touch others with your care, your crdibility and your

compassion as we travel on this journey.


                 Deep within us

beats a home

         for our most authentic selves.

Here lives our need

        to hold our most vulnerable others.

We meet on the thresold


                 our simple beings, pausing






                                    until all melts into one

                                    a single hospice heart.


We hope your screens let you seen half a heart or an angel wing.




Celebrating HVS Volunteers

What if . . .      ~Priscilla Baker, Program Director

         In honor of hospice Volunteers, Garden Party 5/24/18

What if there were no hospice volunteers?

What if there was no one to sit at your bedside,

Or bring in your lunch tray,

Or drive you out to the lake on a sunny day,

Or read poems, tell you the local news,

Or sing those songs, you listened to in high school?


What if you had to go it alone?

Watching your daughter, day by day,

Grow more exhausted,

Watch the same TV shows, over and over,

Game shows and Gunsmoke,

Watch the same of crack in the ceiling

Wondering and worrying, that it's growing longer.


What if you woke up from your nap

And felt the presence of someone by your recliner,

With nothing else to do but sit with you?

What if new ears listened to the same old stories

And then asked for another one?

What if you dared to talk about how it feels

To have your lifetime coming to an end

Without someone saying, "Don't takl like that,"

Or "Don't worry, nothing's going to happen."


What if you reach out and someone takes your hand?

That's all.

Just takes your hand while together

You breathe in the silence between you

As you drift off to sleep.




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. 


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.