“Do not go gentle into that good night, Old age should burn and rave at close of day.”
Despite the sentiments of Welsh poet Dylan Thomas, there are those at East End Hospice in Westhampton Beach who “would wish all a gentle departure” from this earth, according to consultant Helen Proud.
To that end, the organization has spread its wings beyond its core mission of offering end-of-life care to individuals and is now bringing its services to terminal patients and their families in area nursing homes. San Simeon by the Sound Center for Nursing and Rehabilitation in Greenport is the latest local facility to invite hospice workers to train staff and work with terminal patients.
Although San Simeon hasn’t yet had a patient who opted for hospice care, staff there have been trained by hospice workers, who stand ready to offer specific patient plans of care should the need arise. That can include visits by hospice nurses, social workers, aides and hospice volunteers, said Ms. Proud.
She worked for the Suffolk County Department of Health Services for years before she retired and became an East End Hospice volunteer in the early 1990s. That experience led to her current part-time consulting position in which she assists with creating contracts between hospital and nursing home facilities to offer hospice services to their patients.
When San Simeon administrator Priscilla DeMasi suggested an alliance last year, Ms. Proud jumped in. A number of families inquiring about care for their loved ones at San Simeon had asked whether hospice care was part of the center’s program. That prompted Ms. DeMasi to explore an alliance.
“Let’s move on it,” was Ms. Proud’s response. “We’re all part of the same community.”
It took between nine months and a year to get all the paperwork in order, Ms. DeMasi said. The Suffolk County Department of Health Services had to approve San Simeon as a site for hospice care under East End Hospice’s license, she said.
East End Hospice pays San Simeon for the services the center’s staff provides to hospice patients. The funding comes largely through Medicare and Medicaid payments to East End Hospice, Ms. DeMasi said.
Training for San Simeon staff in hospice practices was “wonderful,” Ms. DeMasi said.
San Simeon has the kind of spirit in providing services to its residents that East End Hospice has always embraced, Ms. Proud said.
“We are very, very happy to have this arrangement with East End Hospice,” Ms. DeMasi said. “We look at it as an extension of what we can offer to our residents.”
East End Hospice has had similar arrangements with Riverhead Care Center, Peconic Bay Medical Center’s skilled nursing facility, Peconic Landing and Hampton Care Center, Ms. Proud said. Other hospice patients, who remain in their homes, are able to obtain services from trained home health aides and staff.
By working with local nursing homes, patients can receive hospice care within their own communities, Ms. Proud said.
In addition to providing pain management assistance, hospice offers emotional and spiritual support and respite care for family caretakers of terminal patients living at home. Hospice workers maintain communications with a patient’s primary care physician and offer counseling to families during treatment and bereavement help after a patient dies.
At a recent training session, medical personnel and aides at San Simeon watched a video that explored how to deal with hospice patients’ spiritual needs during end-of-life care.
The heart of the lesson was the recognition that not everyone needs to discuss spiritual matters with the clergy but it’s important to give all patients an opportunity to talk about their thoughts, fears and expectations.
For many, it’s an opportunity to talk about the meaning of their lives so they can “die an appropriate death,” said Dr. Kenneth Doka, a professor of gerontology at the graduate school of The College of New Rochelle and a consultant to the Hospice Foundation of America.
“We have to tread very carefully,” said Rabbi Gary Fink, a pastoral counselor and chaplain at Montgomery Hospice in Rockville, Md. Some patients want help in working through issues that cause them distress while others don’t, he said.
The goal should be to find what will work for each patient to “gentle this journey,” he said.