Common Hospice Diagnoses

Hospice of the Midwest is here for you – 24/7/365.

Choosing Hospice is often a difficult decision. We help lead this conversation and can ease the anxiety of the transition from cure to comfort for patients who are appropriate for hospice care. If two or more of these potential indicators are present, hospice should be considered.

Common Hospice Diagnoses

End Stages of: Cancer, Heart Disease/CHF, Pulmonary Disease/COPD, Dementia/Alzheimer’s Disease, Neurological Disease/CVA, Renal Disease & Liver Disease.

If your loved one is requiring increased assistance with Activities of Daily Living (ADLs) such as bathing, dressing, grooming, oral care, toileting, transferring to their bed/chair, walking, eating, etc.; this may be an indicator that hospice should be considered.

Additional indicators include:

  • Muscle Loss/Weakening or Weakness
  • Multiple Falls
  • Multiple ER Visits/Hospitalizations
  • Recurrent/Multiple Infections
  • Altered Mental Status
  • Unintentional Mental Status
  • Unintentional Weight Loss
  • Difficulty at Mealtime
  • Increasing Shortness of Breath
  • Multiple Medication/Frequent Medication Changes
  • Sleeping Longer/Napping More
  • Skin Breakdown/Wounds
  • Other Diagnoses that Contribute to Decline

If you have questions about the hospice benefit or when to elect your benefit, please contact Hospice of the Midwest at 515-218-2143 (Johnston, IA) · 641-323-2047 (Grinnell, IA) · 641-332-3006 (Guthrie Center, IA) · 651-344-1040 (Woodbury, MN).

One Word: Hospice

One word… One word that’s the most solidifying word you will ever hear. A word that can often be misinterpreted.

One word… Hospice.

This means you are dying. Maybe not dying today, tomorrow or the next day – but it is a word not many want to hear. As a hospice liaison, helping people understand to not be afraid is part of what makes my job so rewarding. Watching potential patients and their family member begin to ease as I explain the role of hospice is an incredible feeling.

As a hospice liaison, I help ease all your previous notions about what we do and assure you that we are here to help.

Hospice doesn’t mean you will die tomorrow. It does not mean you will be taken off all your medications or stay home while waiting for the end. What it does mean is that you have a terminal illness and instead of continuing to seek aggressive treatment, it is better for you to be comfortable and have a quality of life with loved ones, however that may be defined by you.

It is shown that a hospice patient lives more comfortably when: a nurse visits to manage pain and symptoms, a home health aide provides personal care, a social worker assists with community resources and counseling, a chaplain offers spiritual support, volunteers play cards with and a physician oversees it all to ensure you are as comfortable as possible for however long that may be.

That one word… Hospice. Let’s look at it in a more positive way, focusing on the benefits we can offer a patient and their family.

So, I ask both professionals and patients – Why would you not want to live more comfortably with support from hospice?

-Tracy Wagoner, Hospice Liaison

Employee Testimony | Beth Rasmussen

Our employees are the heart and soul of our hospice organization. We appreciate their kind words and love hearing about their experiences with Hospice of the Midwest!

“Working for hospice of the Midwest has been one of the best decisions of my life. I feel my medical background (medical assistant, HCA, CNA, CMA) has prepared me for the role of a hospice aide. I love the one-on-one contact and listening to clients’ stories about their life experiences. I especially enjoy the stories our veterans share with me. My goal for each visit is to make each patient’s day just a little better and brighter. I always rejoice when some patients’ health improves, and they are discharged from hospice. Usually though, I help them and their loved ones through the dying process.

Due to this virus affecting family visitations, I feel my job is more important than ever. I may be patient’s last contact before they gain their angel wings. The relationships we develop as caregivers becomes very important.

It is a privilege and honor to work with our amazing team, who truly cares about our clients and each other. If someone is sick or schedules need covered, teammates are quick to respond. With dedication, compassion and a caring attitude, I truly feel I make a difference at Hospice of the Midwest.”

-Beth Rasmussen, CNA | Hospice Aide with Hospice of the Midwest

Employee Testimony | Jeri Shufelt

Our employees are the heart and soul of our hospice organization. We appreciate their kind words and love hearing about their experiences with Hospice of the Midwest!

“I would like to say how wonderful it is working with Hospice of the Midwest and Abode Healthcare. I have only been here four months, but the team here in Minnesota is so cohesive, friendly, warm, and dedicated to the work we do. They get excited with every new admission and looks forward to new challenges. Our team’s compassion and caring shows through the sadness they feel at not being able to see our patients in person or as frequently as they used to due to this pandemic. It is amazing. The culture is open, honest, fun, professional, exciting, innovative… What more can I say? This is a great place to work.”

– Jeri Shufelt, RN | Clinical Director at Hospice of the Midwest Minnesota

Our COVID-19 Response: A Letter from Our CEO Mike McMaude

To the Abode Healthcare Community,

I hope this note finds you and your loved ones safe and healthy. The COVID-19 pandemic is affecting each of us in different ways. As we navigate the current situation together, I want to provide an update on the steps we have taken to be there for our community, our employees, and our patients.

All of us at Abode Healthcare are focused on providing the highest quality of care to our patients. I provided an update at the end of March outlining the changes we implemented to prioritize safe patient care in this new environment. Every decision we have made, and continue to make, has been based on the priority of the health and wellbeing of our patients and employees.

I am deeply grateful for our employees who display incredible dedication by continuing to fulfill their commitment to our patients during this especially challenging time. These individuals, and everyone working on the frontlines of care, deserve to feel protected, confident, and taken care of.

In recent weeks we have made informed decisions and taken actions that ultimately support and benefit our entire community:

  • PPE: At the first sign of COVID-19, we prioritized spending where it’s needed most and to date, have purchased $1 million of Personal Protection Equipment (PPE) so no one reported to work without protection. I’m proud to say that we’ve not had to turn down any patients due to lack of PPE. We’ve even been able to assist other homecare and hospice organizations, and hospitals serving the Navajo nation as well as other underserved populations, in providing supplies for their employees by donating thousands of PPE items. In addition to our company’s commitment, several executives on our team have made personal PPE donations for local health organizations so they can work safely.
  • Paid Leave: To support employees who risk their own health and safety to care for patients, we instituted a special paid-time-off policy modeled after the Families First Coronavirus Response Act designated for companies with fewer than 500 employees. In Abode’s plan, employees receive unlimited leave for issues relating to COVID-19, including a newly instituted emergency paid time off (EPTO) benefit that is in addition to the PTO employees accrue with regular benefits. These additional benefits allow employees to potentially recover from COVID-19, care for a family member who is ill with the virus, or care for children whose schools and daycares have closed.
  • Business Investment: Rather than cut back, we’ve leaned into the business to make sure that we are even better prepared to care for patients. Some of these actions include:
    • Building out our telehealth and remote care solutions
    • Retaining a dedicated, talented workforce
    • Hiring new employees and growing our team locally and nationally
    • Expanding our team’s knowledge with the addition of an infectious disease physician, Dr. Shannon Thorn
  • Charitable Donations: As we have every year, we continue to support charitable organizations in our communities. That will not stop just because of COVID-19. Support for neighbors, near and far, is needed now more than ever.

I am extremely proud of how everyone at Abode has reacted and handled the unique situation that the COVID-19 pandemic has presented. It’s difficult to adequately express my appreciation for our community—patients, employees, and partners. I have been reminded, once again, what an incredible organization we have—one that is driven by a common purpose of caring for, and serving, vulnerable patients. Every member of our team has come together to do what’s right, and I thank you. We look forward to continuing to work together and supporting each other through this challenging time.

Stay safe and healthy,

Mike

Celebrating Nurses | Barbara Jacobsen

Hospice of the Midwest is celebrating nurses during the Month of May! Meet Barbara and learn about her passion for nursing as she explains her “why.”

“I chose nursing simply because I love people, especially the geriatric community. I have a lot of prior experience with long-term care, and hospice always caught my eye when experiencing it in those settings. When I finally graduated nursing school, I knew I wanted to be a hospice nurse.

A friend talked to me about this company, and I decided to give it a go. It is one of the best decisions I have ever made. Hospice is hard because you know your patient’s end result; however, you create a bond with them and their family that is indescribable, and still talk to many of the families.  

With hospice, you get a lot of one-on-one time with your patient, so you truly get to know them as a person. You aren’t supposed to become attached, but this is impossible. We are with these people at their most vulnerable times and guiding families through each step of the way, and attachments happen, on both ends. In most other nursing settings, you do not get the opportunity to create these bonds. 

I continue to thrive in this company because I have people around me who support and encourage. They give constructive criticism when necessary & help find solutions.”

Celebrating Nurses | Jane McCurdy

Hospice of the Midwest is celebrating nurses during the month of May! Meet Jane and learn about her passion for nursing as she explains her “why.”

“I was lucky enough to be the first LPN/HHA at Hospice of the Midwest in Johnston, IA. I had always done long-term care, and my affinity for the end of life was the reason I went back to Hospice from a Long-Term Care facility. I have been a nurse since 1979, retired from the field, and now work a day and a half in the Johnston office. I love this because I still get to see the staff who lovingly care for their Hospice patients. 

I became a nurse as I wanted to make a difference one life at a time. I tell everyone when they say “Oh, Hospice would be so hard!” that I ALWAYS received more than I gave. You never can measure the gift of being invited into someone’s last days and hours. That is sacred time, and an honor.

Each day, all our staff makes a difference, whether they realize it or not, and I am proud of the entire staff at Hospice of the Midwest!”

Happy Nurses Day!

Today, we recognize our nurses for their hard work, support, and compassion. Because of you, we live in a happier, healthier world. Happy Nurses Day!

Your hard work and dedication does not go unnoticed. Now, more than ever, we appreciate you!

COVID-19 & Hospice

Pandemic Relief via legislation, CMS waivers, and enforcement discretion

  • Telehealth
  • Waived requirement to use volunteers
  • Waive non-core services (physical, occupational, and speech pathology) *hospice only
  • Waive on-site visits for hospice aide supervision

Telehealth and Telephonic Visits

  • CMS permits hospices to provide telehealth to a Medicare patient receiving routine home care during the emergency period, if it is feasible and appropriate to do so.
  • Face-to-face encounters for purposed of patient recertification for the Medicare hospice benefit can now be conducted via telehealth (must be 2-way audio-visual)
  • Must be physician-ordered and on the plan of care

In an effort to protect patients, some SNF, LTC, hospice, and other facilities are limiting the number of visits that Abode Healthcare staff may make to patients in their care. Some patients are even requesting fewer in-person visits to reduce their exposure to the outside world.

Abode Healthcare understands and joins in these protection measures by offering telehealth visits. In some cases where access has been limited or is desired, Abode staff are utilizing telehealth on a weekly or bi-weekly basis in order to maintain contact with high-risk patients.

In all cases, telehealth visits are meant to be supplementary to in-person patient visits. Telehealth visits should not replace in-person visits altogether.

Telehealth Tools

Our commitment, as always, is to serve our patients as best we can. Our clinical team has been trained in effective ways to utilize telehealth systems to streamline patient care through our own remote access system using the following tools:

  • Phone: Abode Healthcare staff may conduct remote visits with patients through phone calls.
  • Video: Abode Healthcare staff may conduct remote visits with patients through Doxy.me. (All F2F between NPs or MDs, DOs must be done through a 2-way type of technology. This is for both HH and Hospice)
  • me can be utilized via tablets or phone and has been selected by Abode due to the ease of use for both the clinician and the patient/family/caregiver as well as its ability to capture/validate that the tele visit occurred, and its security features.

Though telehealth is never our first choice, it is the right choice during this time. Abode Healthcare continues to partner with providers to preserve the health and wellbeing of all of our patients.

COVID-19 & Home Health

Pandemic Relief via legislation, CMS waivers, and enforcement discretion

  • Telehealth
  • Waived requirement to use volunteers
  • Face to Face encounters to establish HH services
  • Non-physician practitioners (NNP) certification authority accelerated

Telehealth and Telephonic Visits

  • CMS permits HHAs to provide all necessary telehealth during the emergency period
  • Must be physician-ordered and on the plan of care
  • Does not replace in-person visits (telehealth or telephonic visits are not billable visits)
  • Allows for HHA to supplement in person visits for patients who might refuse more frequent visits or senior living or other congregate living facilities that might be restricting access to HHA personnel.
  • The Home Health Face to Face visit may also be provided by telehealth but must be performed utilizing 2-way audio and visual programs.

In an effort to protect patients, some SNF, LTC, hospice, and other facilities are limiting the number of visits that Abode Healthcare staff may make to patients in their care. Some patients are even requesting fewer in-person visits to reduce their exposure to the outside world.

Abode Healthcare understands and joins in these protection measures by offering telehealth visits. In some cases where access has been limited or is desired, Abode staff are utilizing telehealth on a weekly or bi-weekly basis in order to maintain contact with high-risk patients.

In all cases, telehealth visits are meant to be supplementary to in-person patient visits. Telehealth visits should not replace in-person visits altogether.

Telehealth Tools

Our commitment, as always, is to serve our patients as best we can. Our clinical team has been trained in effective ways to utilize telehealth systems to streamline patient care through our own remote access system using the following tools:

  • Phone: Abode Healthcare staff may conduct remote visits with patients through phone calls.
  • Video: Abode Healthcare staff may conduct remote visits with patients through Doxy.me. (All F2F between NPs or MDs, DOs must be done through a 2-way type of technology. This is for both HH and Hospice)
  • me can be utilized via tablets or phone and has been selected by Abode due to the ease of use for both the clinician and the patient/family/caregiver as well as its ability to capture/validate that the tele visit occurred, and its security features.

Though telehealth is never our first choice, it is the right choice during this time. Abode Healthcare continues to partner with providers to preserve the health and wellbeing of all of our patients.

Though telehealth is never our first choice, it is the right choice during this time. Abode Healthcare continues to partner with providers to preserve the health and wellbeing of all of our patients.

CMS clarification on homebound status for COVID-19 patients and those at high risk of contracting:

Non-Physician Home Health Certification Authority

  • Allows patient to be under the care of an NPP to the extent permitted under state law
  • NPP= Nurse Practitioner (NP, ARNP), Physician Assistant (PA) and Clinical Nurse Specialist (CNS)
  • Authorities
  • Order Home Health Services
  • Establish and review POC (Plan of Care)
  • Certify and recertify eligibility
  • CMS utilizing discretionary authority not to enforce rules
  • Must also check state HHA licensure for any barriers to implement
  • CARES Act makes this relief permanent, but CMS needs to implement

For more information, contact Jon Wilder.