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Hospice ‘A Godsend’ for Siouxland Family

Jun 24, 2015 08:18PM ● By MED Magazine

By Alex Strauss

Amy Macfarlane’s mother, who was in her 80s at the time, began having trouble not long after Macfarlane’s father died. Like many people who eventually end up turning to hospice for help, Macfarlane did not even realize how much she had been doing for her mother – and the toll it was taking on her – until after hospice stepped in.

“My mother was living alone at the time and had been diagnosed with colorectal cancer,” recalls Macfarlane. “My dad had had the physical issues and we did not realize before he died that my mom had a lot of dementia.”

Macfarlane, a wife and mother, was working as Community Relations Director at a senior community in the Sioux City area. Between duties at home and at work, she was stopping by her mother’s independent living apartment at another nearby senior community every day to do things like ensure she was taking her medicine and remind her to go eat. After her mother got a colostomy bag, things got even harder.

“That is the point at which caregiving really got difficult for me because you’re no longer really acting like a daughter,” says Macfarlane.

Enter Hospice of Siouxland. Family physician, Carol Roge, MD, who also happens to be Macfarlane’s own doctor, neighbor, and friend, made the referral.

“By the time I refer them to hospice, patients have already come through a long period of 

 being told what to do, where to go, what test to take, what treatment to have,” says Dr. Roge. “Hospice is a way to give control back to the patient. It also allows family members to stop being caregivers and just be family members again.”

As Macfarlane found, it can also give a great deal of stress relief and peace of mind.

“You can feel very alone and not even realize it until hospice steps in,” she says. After a hospice nurse began stopping by three times a week to help with various daily tasks, Macfarlane was able to breathe a sigh of relief and even travel occasionally – something she hadn’t done for years.

“The thing that was so great is that they let you stay in the driver’s seat,” she says. “They asked me about everything that I was doing for my mother. And then Renee would call me after she visited. She would say her blood pressure is good, we had her take her meds, changed the bad, etc. She really became my ‘significant other’.”

“Every time I refer someone to hospice and the family comes to see me later they say ‘Oh my gosh, I wish we had done that earlier!’” says Dr. Roge. Unfortunately, she says, too many physicians may be reluctant to have what she calls ‘The Big Conversation’ that can open the door for hospice.

“I think a lot of physicians are not comfortable saying ‘You’re nearing the end of your life. Nothing we are going to do is going to extend your life by very much. Do you really want to go through this or do you want to have comfort and be with your family and enjoy your remaining weeks or months?’” she says.

Medicare will pay for hospice care, whether at home, or in a long-term care facility, but it is reserved for patients who are believed to have less than six months to live and are no longer having curative treatment. Patients are reassessed every three months and can be taken off hospice if their prognosis improves. In the case of Macfarlane’s mother, her hospice nurse continued to visit her even after she fell and was moved from the independent unit to the hospice wing of her care facility.

“It was a godsend and I would not have even known that this was available if it hadn’t been for Dr. Roge,” says Macfarlane, who now, several years after her mother’s death, sits on the Hospice of Siouxland board. “Hospice helped make something that was so sad a little more bittersweet.”