Transcription:
Hospice Care. It Is So Hard to Know When to Call

Scott Webb (Host): When you're seeking comfort, not a cure for yourself or a family member, hospice care providers specialize in giving compassionate support that helps to make every moment of life the best it can be. There is no doubt, however, that reaching out to hospice care can be a difficult call to make. That's why we're here talking with Dr. Jodi McGraw, Family Medicine Physician and Medical Director for Homecare and Hospice at Upland Hills Health in Dodgeville, Wisconsin. This is the Inspire Health podcast from Upland Hills Health. I'm Scott Webb, Dr. McGraw, you've been a Family Medicine Doctor for many years. You're also the Medical Director for Homecare and Hospice at Upland Hills Health. Please tell us about that role and what that entails.

Jodi McGraw, M.D. (Guest): I work with the Upland Hills Health Hospice and Homecare team. And I'm the Medical Director. We have a team of excellent medical professionals that are here when you or someone you love is facing end of life questions, please call our Upland Hills Health Hospice team. We're here to help and serve and answer any questions that you have.

Host: Yeah. And Hospice care is Medical care that is provided when a person is at the end of life yet, I would imagine that it's hard to predict. Right? So, how do you know when it's time for a person to receive hospice care?

Dr. McGraw: The decision for hospice care is really a personal decision for each individual. That decision is best made with the patient and their own team or family physician, or a group of doctors helping care for them, when end of life care choices are being faced and you're looking at less than six months expected survival time. That's a good time to consider hospice care. Often patients wait till the last minute or come onboard at the end and we are happy to help at any point, but really people start to qualify when the life expectancy or end of life decision-making starts to look like a six month or less interval.

Host: I see, so six months or less. And as I mentioned before we got rolling here that, you know, my folks are in their seventies and this is not a decision that I'm confronting, you know, now, or yet. And maybe I never will have to do that, but I would imagine it must be a very hard decision for an individual or a family to make. Maybe you can just kind of take us through what that process is like.

Dr. McGraw: So, when end of life decision making comes down to six months or less, you know again, that is a really hard time coming to those decisions. And some people want to seek treatment. We have fabulous medical care and sometimes the care is more than the patient wants, or sometimes the treatments that are available have been exhausted and are no longer working and I'll make up the situation of, you know, chemotherapy in a cancer patient, if things start to progress and they run out of treatment options or surgical, or other interventions are no longer options, we want to be here to help people during that really difficult time. The hospice team is a multidisciplinary team.

We are a group of people that work together to help and serve. The process for initiating the hospice referral can either come directly from the patient, calling the Upland Hills Health Hospice team and asking for information or an informational visit, or we can get a referral from the patient's physician or team of physicians.

Whatever way works best, we're happy to help with all of those intake options. And then the intake coordinator, we have a nurse who's an intake coordinator and she will reach out to the patient and the family and coordinate for an intake or informational visit to make sure that the patient qualifies for hospice. Once that determination is made, that they qualify, then we set up the process for doing the new referral and getting the teams set up to visit with the patient and start the medical services. Our team consists of, like I mentioned, a multi-disciplinary group of people. We have a Director of Hospice, who's an RN, Michelle, a Hospice Medical Director is myself. We work with a group of advanced nurse practitioners that do home visits and check on patients.

We have a group of wonderful nurses that are caring, compassionate, and do the home visits, checking on the patient's needs, meeting their medical needs, the patient's physician is always kept in the role. We update the primary care physician. The team looks for that person to stay involved and participating in the care.

We have a social worker, Shannon, who not only helps with coordinating the social services that are involved, but also give support and bereavement counseling. We have some physical and occupational therapists as well as spiritual support. The spiritual support is non-denominational. It's a hospice chaplain, and it can be either religious support or just plain spiritual support. Not everyone is looking for a religious experience. Sometimes they just want to visit their spirituality and Pastor Jim Drawsty works with the United Methodist church in Dodgeville and with Grace in Ridgeway, but he also is our spiritual support as a hospice chaplain.

There are a group of home health aids that go to the house and help with bathing and grooming and communication support, that they can sit and visit with the patient. We have a group of volunteers that can sit with patients, visit with them, keep them company, read with them, do puzzles or games with them.

So, really it's a very robust group of medical professionals and volunteers that are here to serve the people in our communities and the people that, you know and love and our friends and neighbors, we want the best for them when it comes to end of life care. It is a really difficult time.

Host: Yeah, it really does sound like an amazing team. And I've spoken with Shannon before, and she's amazing. And you mentioned spirituality and religion there. And I wanted to ask you, you know, with the many different cultural backgrounds and religious traditions that are observed by people; how do hospice providers navigate through all of that?

Dr. McGraw: Thank you for asking that. That is a good question. We have diverse backgrounds and cultural and religious traditions within our communities. And we want to respect all of those beliefs and backgrounds. Hospice providers are really a special type of person. They take the individual patient's needs into consideration and try to respect the values and beliefs that, that patient and their family have as we go through the hospice and comfort process with end of life care. Our goal is to serve the patient in the way that best suits their needs and beliefs while providing comfort. And when it comes to end of life care, our goal is everyone dies with dignity. That people have comfort, that there's no suffering, that we want to do our best to support the patient through that process, but equally so, we want to be there for the family.

It's a difficult time on the family as well. And back years ago, my mom was a hospice patient and my mom and dad called and chose Upland Hills Health Hospice for their choice for my mom's care. And I can remember being with my mom in the living room as she was going through end of life care. And the hospice team was involved and wonderful at supporting her and kept her comfortable.

And I can remember one day when I was sitting with her in the living room and my dad was in the kitchen and the hospice nurse came in and just a really special group of people, you know they saw my dad sitting there, went to him and asked how he was and checked in with him before they even came to visit with myself and my mom in the living room.

And I really thought that was a really special way of caring and showing caring is keeping that communication and open with the family and keeping that support for the family is so important as we go through some of the most difficult times. So, really excellent, special group of people that respect and will support various backgrounds, cultural, religious. We're here to help and serve everyone.

Host: Yeah, help and serve everyone. And I really do appreciate as I'm sure listeners do, you sharing that personal story. Obviously, not a great time for your family, but a fond memory that you knew that, you know, you were going to be in good hands, that your family would be in good hands. And when it comes to hospice services, as we know people have options, there's more than one agency providing hospice services in most areas. So, how should people select a hospice provider? What are the important things to look for?

Dr. McGraw: Yes, there are several hospice agencies. We are lucky to have so many wonderful choices all around us. The Upland Hills Health team is just a special group of people. I think one of the unique things is, that we also have pharmacy and pharmacist is on our hospice team with Upland Hills Health.

And so, middle of the night, if you have a pain crisis, for instance, that family and that patient can call our hospice nurse and they will come to the home and help in a pain crisis to give comfort and pain medicine. And that's a really special, unique service that Upland Hills Health can offer is, you know, they will do home visits even in the middle of the night, in the middle of a pain crisis to make sure that no one suffers, to make sure that everyone gets comfort. So, really special kind of work that our team does. And having gone through the hospice process with my mom and seeing what a great team they were, made me also feel like when Dr. Barry at that time was the Hospice Director for Upland Hills Health and a wonderful Medical Director for our team and seeing, and going through that as a family member also, made me realize when the opportunity came up for me to be part of this team, I thought what a great team to be a part of. What a wonderful team to, be able to work with and to share and help other people through that difficult process. And so in honor to Dr. Barry and the team of people that precede our current team, just all excellent.

And lots of, you know, great opportunities for help with the Upland Hills Health Hospice team. So, when you get to that difficult time, please reach out to your doctor. You can call our team, request Upland Hills Health Hospice. Wonderful group of professionals here to help and serve.

Host: Yeah, you all definitely are for sure. And I have appreciated this conversation. It's been educational. The takeaway for me as, maybe even for listeners is really just how compassionate you are. As we close here, if one of our listeners out there has been diagnosed with a terminal illness or is caring for a loved one whose life is likely measured in weeks or months as we've discussed, rather than years, what remaining advice do you have for them?

Dr. McGraw: Work with your doctor, work with your team of professionals. When you get to that point where treatment is no longer option, an option or your goal is to transition to comfort instead of aggressive care, reach out to us. Our team is here. Please call Upland Hills Health Hospice. Our number is 608-930-7210.

That'll get you to the Upland Hills Health Hospice office, and you can talk to one of the receptionists there and initiate that process. Your doctor can place a referral. Again, there are lots of great choices out there. We have an exceptional group of people at Upland Hills Health Hospice. So please ask for us by name and call.

We are here to help and serve, and we work with our friends in the community and the other agencies. We work with your physician, with your family, and our goal is comfort. And doing everything we can to make sure that the time that any of us have left, that when you're in that hospice or that less than six months phase, that we want to make your days the best possible. We want you to have comfort. We want you to be able to do and enjoy the things that matter most to you, with respecting cultural and religious diversity and backgrounds. We're here for you. Please call us. We will have a great team on hand to help.

Host: Yeah, you definitely will. And Dr. McGraw, thank you so much for your time today. This has been a really lovely conversation and I appreciate your time and you stay well.

Dr. McGraw: Thank you. Thank you so much.

Host: That's Dr. Jodi McGraw, Family Medicine Physician and Medical Director for Homecare and Hospice at Upland Hills Health. For more podcasts like this, go to uplandhillshealth.org and search podcasts.

And if you found this podcast to be helpful, please share on your social channels. This is the Inspire Health podcast from Upland Hills Health. I'm Scott Webb. Stay well.