Small hospice tries to accomplish big things

Lake Superior Hospice takes on end-of-life care

Being surrounded by caring individuals is an important part of hospice and palliative care. Lake Superior Hospice, based in Marquette, has special programs for people in their end stages of life. (Journal file photo)

MARQUETTE — People always need emotional, physical and spiritual support, but an end-of-life scenario brings special needs.

This is when hospice care can be a blessing, with palliative care adding another dimension to a sometimes difficult situation.

Sue Kitti is CEO of Lake Superior Hospice, located at 914 W. Baraga Ave. LSH, which began in 1979 and serves a 40-mile radius, is unique in the region in that it’s a nonprofit, she said.

It also recently received a grant for special programs, “Transitions” and “Journeys,” that take care to a different level.

In keeping with the hospice philosophy, staff focuses on specialized care that helps patients, families and friends during the final stages of an illness.

Hospice is for individuals who have been diagnosed having with six months or less to live.

That doesn’t mean living out their days in an institutionalized setting.

“We want to keep the patients in their home, wherever that home is,” Kitti said. “That’s where most patients want to be when they’re nearing end of life.”

Clients, she said, are served in their homes or places like Mill Creek Senior Living Community or the Jacobetti Home for Veterans. They also can use their own physicians in addition to an LSH staff member.

LSH has social workers, people specializing in spiritual care and a team of volunteers. The team approach, she said, involves meeting every two weeks to establish a plan to care for a patient, which is updated.

Julie Higbie, LSH clinical director, said: “We are analyzing every little bit of work that we’re doing and trying to make the best of that person’s life. We’re always looking at quality of life.”

LSH staff, she pointed out, is not there to cure their medical problem.

“That’s not what we’re there for,” Higbie said. “We are there to make the best of their days.”

Palliative care involves making patients more comfortable in non-medical ways, such as helping them write letters and even arranging weddings.

For example, Kitti said a patient wanted to marry his girlfriend, so LSH helped out, with an LSH chaplain performing the ceremony.

“We do a lot of different things that’s not just that nursing care or not just pain management,” Kitti said.

Linda Carlson, a registered nurse for LSH, said staff arranged a fishing trip for a veteran who loved to fish. In another instance, a social worker wrote to Kellogg’s, which sent Tony the Tiger memorabilia to another veteran.

Needs also change day by day.

“It’s all about caring, and caring is about the symptom management,” Carlson said. “What’s the problem today? What can we do today to make things better?”

Kitti said that at the end of life, often family issues need to be resolved.

These can involve challenges with family dynamics and even getting people to see their loved ones to resolve these issues, which is the job of the social work and spiritual care staff, she said.

In at least one way, though, hospice is the same as regular medical care., and that involves insurance coverage.

Higbie said insurance covers hospice care provided in a home, which hopefully is outside a hospital setting.

Kitti said that with the Affordable Care Act, staff has seen higher co-pays and deductibles, although coverage is paid in full if patients are on Medicare or Medicaid, for example.

“If somebody is a younger patient and they have private insurance, that insurance will cover it, but the patient still has a co-pay and a deductible, and very often that’s just beyond their means to be able to cover that,” Kitti said.

As a nonprofit, LSH conducts fundraisers to cover that uncompensated care.

“We don’t turn anybody away based on their ability to pay,” Kitti said.

Ruth Almen, LSH director of community relations and program development, acknowledged that people under 65 are dying, and they don’t have Medicare.

“We’re not going to turn people away, so what that means is we’ve got to figure out another way to get that money in, so all the fundraisers, the donations, those kind of things are really crucial because it allows us, again, to serve anybody who comes to us and is in need of that support and care,” Almen said.

LSH, according to Kitti, is on the board of Trillium House, a proposed hospice facility along Northland Drive in Marquette.

“We’re working really hard to get that home built,” Kitti said.

Another challenge for LSH is its small size.

What is helping LSH, Almen said, is a $441,000 grant it received in December from the Michigan Health Endowment Fund. That grant runs through November 2018.

The money, she said, will be used to expand LSH’s community-based palliative care program by creating new ones for people who “graduate” from hospice.

“That six-month delineation to get you in is about insurance,” Almen said. “So people get too healthy for insurance to cover pure hospice but people still need services. It’s not like they’re cured or anything else.”

She said LSH has developed programs for those types of people, “Transitions” and “Journeys.”

Higbie said staff continues to monitor whether patients still are eligible for Medicare dollars.

“If they are not declining, if they’re doing well and maintaining their own, perhaps we will ‘graduate’ them out,” Higbie said.

The Journeys program is for the “graduates” whose conditions have stabilized and no longer meet hospice criteria, but would benefit from ongoing support services.

The Transitions program is for people who are not homebound — a Medicare requirement for home health care — but still have chronic illnesses.

A nurse still will perform home visits and make follow-up telephone calls for patients to be aware of the issues they face, among other services.

“We’re going to provide oversight and care,” Carlson said.

Almen said that’s good for the patient but a “huge piece” for the family or caregivers, whether they’re close or far away.

It also can keep people out of the emergency room by helping them get their affairs in order and take care of things before they evolve into a crisis, she said.

“When you have access to a nurse, in general, it’s a huge difference in your life,” Almen said.

Another facet of the grant, she said, focuses on educating the community on anticipatory grief, acknowledging people experience loss all the time.

LSH offers other grief-support services as well as education for the community.

Higbie said LSH works with nursing and medical students, for example, plus it’s hosting the Upper Great Lakes Palliative Care and Hospice Conference Oct. 24-25 at Northern Michigan University.

The event, which will include speakers, will offer continuing education. Another goal is to create a network of hospice-care providers throughout the Upper Peninsula and possibly the northern Lower Peninsula that can meet regularly.

Carlson said: “We’re focused on quality of life, and providing that special caring.”

For more information, call LSH at 906-225-8860 or visit www.lakesuperiorhospice.org.

Christie Bleck can be reached at 906-228-2500, ext. 250. Her email address is cbleck@miningjournal.net.