April 12, 2002

Vanderbilt teams with Alive Hospice for new program

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John Nash spoke to Dr. Herbert Meltzer last week at a seminar with residents, graduate students and faculty of the Psychiatry department. (photo by Dana Johnson)

Vanderbilt teams with Alive Hospice for new program

Alive Hospice, Inc. and Vanderbilt Home Care Services, Inc. have teamed up to create a new services program for terminally ill patients who do not meet Medicare requirements for hospice care or home care. Known as the Hospice/Home Care Transitions Program, this free service will pair clients with trained volunteers to help meet end-of-life needs.

“There are many patients each year who fall through the cracks because they don’t qualify for either hospice or home care,” said Jan Jones, president and CEO of Alive Hospice, Inc. But these people still have needs like anyone else. Our goal is to meet as many of their needs as possible through this program.”

Medicare requires that patients wanting hospice care must have less than six months to live and agree to receive only palliative care for their illnesses. Any aggressive or curative treatments do not fall under Medicare hospice regulations. As for home health care, Medicare requires that patients must be homebound and demonstrate a clear need for skilled care.

Vanderbilt’s role will be to provide leadership and necessary resources to support the program, as well as guidance from its experience in home care services. The program’s steering committee is composed of administrators from both institutions.

“There are many patients who don’t fully meet either criteria,” said Jones. “Maybe they have only six months to live, but still want aggressive treatment in hopes of a cure. Or perhaps they need skilled care, but are not debilitated to the point of being homebound. Through this program, our clients can be in touch with a member of the community who can provide support during this time in their life.”

Volunteers will receive 16 hours of training to prepare them for providing services. While they will not provide actual skilled care to the clients, volunteers can assist in other areas such as daily errands, homemaking tasks, companionship, transportation to the doctor’s office, spiritual needs, and child life activities.

If the client already has a primary caregiver at home, then the volunteer may provide respite care to afford brief periods of relief to the caregiver. Other ways volunteers can help is through discussing end-of-life issues, helping write a living will, and putting the patient in touch with community resources to meet lifelong dreams.

“So many times, all these patients want is someone to talk to before they reach the end stages,” said Jones. “They want to bring closure to their life, but are often referred to hospice or home care so late that they don’t even have time to think about these issues. Instead, they’re in crisis mode until the very end. The result is unresolved grief for the patients and their families.

“Our volunteers will be able to provide grief support starting at an earlier stage. They can help families cope with their impending loss and facilitate a peaceful death for the patient.”

This is the pilot year for the transitions program, funded by a grant from the Memorial Foundation. The program has several clients now and is working for future funding to support up to 100 patients.

“In the future, we hope to provide the clients in the transitions program with more service options,” said Laura Beth Brown, RN, vice president of Vanderbilt Home Care. “We’re looking at collaborating with churches and parish nursing programs, as well as working with reimbursement parties to expand coverage. All the while, we’re aiming to provide this program at no cost to our clients.”

“We’re the first program of our kind in this region and we’re very excited about its potential,” said Jones. “I see it as a wonderful opportunity to fulfill our missions in life.”