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Social Workers Essential for Holistic Care

SocialWorkers

In 2015, the social workers at Ohio’s Hospice of Dayton made 11,933 visits to patients and families. Social workers play a central role in holistic hospice care that addresses the physical, emotional, psychological and spiritual needs of patients facing the end-of-life and of those who love them and are facing loss.

Social workers focus on enhancing quality of life concerns for patients, families and caregivers. Among other things:

  • They help families connect with valuable community resources, including meals on wheels, in-home caregiver support and financial assistance.
  • They educate and inform family caregivers so they feel confident in caring for their loved one.
  • They help patient and family openly discuss their fears and concerns.
  • They help smooth the way when patients need to transition from one living environment to another.
  • They serve as advocates for patients, helping to identify and plan so patients can achieve their end-of-life goals.
  • They assist with completing advance directives, insurance claims and with funeral planning.
  • They help assure that children receive the services and support they need when facing the loss of a loved one.

Social workers are knowledgeable and comfortable working with ethnic, cultural, and economic diversity. They are familiar with and can help patients and families as they navigate complex health care systems.

While accomplishing all these things, social workers also provide emotional support and understanding as families face the difficult challenge of saying goodbye and learning to live with a new ‘normal’ after the loss of a loved one.

 

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PARO – A Positive Substitute for Pet Therapy

Some people complain that technology can be dehumanizing. Those people have not yet had the privilege of meeting PARO.

PARO is the nickname of an advanced interactive therapeutic robot that is being used at Ohio’s Hospice of Dayton with patients. Designed to look like an adorable baby harp seal and covered with synthetic fur, PARO is loaded with sensors in his long whiskers and entire body, enabling him to react to sound, light and touch. PARO blinks his eyes, moves his head, makes sounds and reacts as a real animal does when interacting with a human. PARO evokes the same emotional pleasure as a pet therapy animal but can serve patients in situations where real animals cannot.

Ohio’s Hospice of Dayton added two of the baby seal robots to the clinical team a few years ago as part of an innovative approach to patient care. For patients in settings that do not permit animals, such as nursing homes, PARO is a tool to encourage patient interaction.

Occupational Therapist Angelene Volpatti highlights how PARO affected one patient. “The patient was well-educated and confined to a wheelchair in a nursing home. Her children were literally all over the country – Alaska, Florida and Washington state. They spoke frequently by phone, but conversations were limited mostly to what the patient had to eat and how she was feeling.

During our first meeting I discovered the family were animal lovers and always had pets. Pet therapy was not offered by the nursing home, so we brought PARO to visit. The patient responded to PARO just like she would a pet, speaking to him and petting him, smiling and enjoying PARO’s reactions. She immediately relaxed and was less physically contracted. The conversations with her children became more rich, as she talked about PARO and together they reminisced about pets.”

Research with PARO has shown that patients experience a reduced heart rate, reduced blood pressure and are more calm after interacting with the robotic seal. They engage in more social interaction. Such positive outcomes, without the potential side-effects of pharmaceutical interventions, are convincing evidence of the value of robotic therapy.

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Stories Resonate When We Need Them Most

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“In times of difficulty, we tell the stories again. If there’s a crisis, we tell the stories. It’s a human need; it strengthens our souls.”

So begins a nuanced discussion about listening and sharing – for patient and care giver – by a leading authority on developing simple but crucial tools that enable coping and meaning in end-of-life scenarios.

Dr. Rachel Naomi Remen, clinical professor of family and community medicine at the University of California San Francisco and clinical professor at Wright State University Boonshoft School of Medicine, recently conducted a daylong seminar for hospice professionals at Ohio’s Hospice of Dayton.

Participants in “Reclaiming Awe: A workshop on Mystery, Meaning and Resilience for Hospice Professionals” were reminded of the wonder and lessons to be learned working with people on the edge of life. “The whole purpose of the workshop was to bring more meaning to your work,” said Angelene Volpatti, an occupational therapist who works with hospice patients in their homes. “I learned practical tools,” Volpatti said, such as breath awareness. “If you don’t have meaning in your work you will burn out,” she said.

After the workshop, Dr. Remen, a pioneer of the Relationship Centered Care and Integrative Medicine, discussed her journey of restoring medicine as a calling and work of healing. A student in the 1960s of the human potential movement at the Esalen Institute in Big Sur, Ca., Dr. Remen delved into transpersonal and humanistic psychology. She said she was “taken” with the idea that value, integrity and meaning could be infused into dire and chronic diagnoses.

“When I finished with training I wanted to work with patients like myself” (she was diagnosed with Crohn’s disease 63 years ago) living with chronic illness, she said. “Even if you couldn’t fix the disease you could have a meaningful life.” She sought patients who could not find relief from conventional medicine. “I went to the medical community and asked for the patients who were taking up all their time. The first (doctor) said, ‘There is nothing I can do with them. If you want to take them off my hands, you can see all my patients.’ I had a full practice in a month and a half. They, as medical people, had nothing to offer them.” Dr. Remen said she began what she calls ‘generous listening.’ “I discovered what an important thing it is to be a human being. I found what it is to find meaning, wisdom and love. I discovered how much better they were living than their doctors.”

Then, the mysterious and deadly disease AIDS struck.

“It was like a war zone. People were afraid to touch. We didn’t know what we were dealing with. The half-life of a hospice nurse was about six weeks,” Dr. Remen said. “You would come to work on Monday and you and your team were assigned seven patients – the most creative people – and by Friday they were dead. When you came in Monday, you had another seven. People couldn’t do it.”
Dr. Remen was asked to help the people who were helping the AIDS population. “I didn’t know how to do that, but I was interested, and did some research.”

The night before a presentation, she had a dream.

“It was a group, facing outward toward San Francisco, the battle zone, sending waves of strength,” she said. “In the middle was a black hole, and if you stepped back, you’d fall into the hole.” Dr. Remen felt the group needed to “turn around and take care of each other. We were each so alone with this epidemic. If we turned around, as a community, we could do this together.” What she discovered, she said, is that the strength “is in the stories, the learning that was going on among us. So, on Friday, when everyone had died, we spent a few hours sharing the pieces of those lives, finding who each other was, and was important. The turnover stopped.”

“When we live at the edge of things – such places as hospice, war, medical epidemics – that’s where we learn what really matters.”
Dr. Remen said today’s corporate concerns about the bottom line and cost containment can inhibit these important caregiver practices.
Dr. Remen said it is an “interesting time in medicine.” She noted how high numbers of physicians are “depressed, drug-addicted, committing suicide. This has been a challenge, to look at medical education. Why are doctors so vulnerable and suffering compassion overload? We must be able to live the meaning of your work – to see meaning like you see color – and ask what is evoked by this disease? What does this tell us about the patient?”

She said one can feel “grateful to be with those people, you can be strengthened and fed. When people experience their work as having individualized meaning, that you can make a difference, there is low incidence of burnout.” Dr. Remen believes “becoming present, being able to live ‘in the neighborhood of yourself’ but seeing what is in front of yourself, is not about doing anything different, but seeing things in new ways.”

Social worker Michael Kammer, who works at the Hospice House in Dayton, said Dr. Remen’s workshop gave him “a refreshing sense of mission, and was a reminder of why I’m doing this.”

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Dr. Wendy Schmitz Named Medical Director of Inpatient Care

Ohio’s Hospice of Dayton has announced the appointment of Dr. Wendy Schmitz to serve as Medical Director for Inpatient Care. wendy_schmitz

Dr. Schmitz joined the Hospice of Dayton medical staff as a Clinical Medical Director in July 2008. She earned her medical degree at the Medical School of Loma Linda University, Loma Linda, California and completed her residency at Kettering Medical Center, where she was a Weiffenbach Scholar. She is board certified in Internal Medicine and Hospice and Palliative Medicine. Prior to joining Hospice of Dayton, Dr. Schmitz served as a hospitalist with South Dayton Acute Care Consultants at Miami Valley Hospital and had also served as medical director of sub-acute care units with Arbors of Dayton Long Term Care, Carriage by the Lake Nursing Home, and Hickory Creek Nursing Home.

In announcing the new role Dr. Schmitz will assume overseeing inpatient care, Ohio’s Hospice of Dayton Chief Medical Officer Dr. Ruth Thomson noted “Dr. Schmitz has a wealth of experience and has provided exemplary clinical expertise and leadership in our Hospice inpatient settings throughout her tenure with Ohio’s Hospice of Dayton. She has embraced the concept of palliative procedures, which has greatly improved the comfort and care of our patients needing these services.”

Dr. Schmitz will continue to provide direct patient care as well as take on new medical leadership responsibilities. She is also spearheading an international physician exchange partnership through Care Partners International with the goal of establishing hospice care services in a partnership in Ecuador.

Staff Members Present at Midwest Care Alliance 2015 Annual Conference

During the 2015 Midwest Care Alliance Annual Conference held in Columbus, Ohio, ten members of Ohio’s Hospice will lead multiple educational programs. The following programs will be presented by Ohio’s Hospice of Dayton staff members:

  • Kathy Van Pelt, RN, MSN, CHPN presents “Warriors at Ease: Trauma Sensitive Yoga and Meditation”;
  • Jeff Lycan, RN, MS, and Ruth Thomson, DO, FACOI, FAAHPM, HMDC, both part of the Senior Leadership Team, will discuss “Hot Topics in End-of-Life Care”;
  • Vice President Kim Vesey, RN, presents “The Most Important Person on the Hospice Team is YOU (and Everyone Else)!”;
  • Physicians Cleanne Cass, CO, FAAHPC, FAAFP, and Ruth Thomson, DO FACOI, FAAPM, HMDC, and Pharmacist Rebecca Bledsoe will discuss “Universal Precautions for Drug Diversion and Misuse in Hospice: Could an Ounce of Prevention Be Worth a Pound of Cure?”;
  • Dr. Cass and Lorin Yolch, PhaD, CGP, FASCP, DeltaCare RX, will present “Oncological Emergencies and Advanced Symptom Management of Cancer Patients”;
  • Nancy Trimble, PhD, RN, ANP-BC, ACHPN, and recipient of MCA 2015 Professional of the Year award, will present “Geriatric Pharmacotherapy”; and,
  • Education Department Director Julie Wickline, RN, BSN, CHPN, and Chief HR and Compliance Officer Amy Wagner, BS, CHC, will lead an interactive program on “What’s My Line? Improving Care Through Occupational Cultural Awareness.”

Please stop and say hello to one of the friendly faces from the Ohio’s Hospice team if you will be a part of this year’s conference!

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State Organization Honors Clinical Team Liaison, Dr. Nancy Trimble

Dr. Nancy Trimble Named MCA 2015 Professional of the Year

Dr. Nancy Trimble Named MCA 2015 Professional of the Year

Ohio’s Hospice of Dayton Clinical Team Liaison Nancy Trimble, PhD, RN, ANP-BC, ACHPN, will be honored as Professional of the Year by the Midwest Care Alliance on November 5 in Columbus.

The Midwest Care Alliance (MCA) is a non-profit that promotes hospice care and to supports the growth and development of provider programs through education, advocacy and technical information. 
Their Professional of the Year Award is recognition for home, hospice and palliative care professionals by home, hospice and palliative care professionals. This award recognizes individual MCA members who have made
 significant and repeated achievements in home, hospice and palliative care, particularly on a state level. Award recipients are visionaries who demonstrate creativity, courage, and their work has made a substantial difference in one or more of the following areas: exceptional service, program creation, administrative development, innovative research or educational advancement.

Dr. Trimble has five years of service at Ohio’s Hospice of Dayton. She is an expert in geriatrics and geriatric pharmacotherapy and is active in the American Nurses Association, Sigma Theta Tau, and District 10 Ohio Nurses Association where she has served in multiple leadership roles. She is certified as a trainer in end-of-life education and is a valued educator in the clinical community. Dr. Trimble is also an active member of her own church community and serves on the board of the Fairborn Senior Center, as adjunct faculty for Indiana Wesleyan University and guest speaker for Wright State School of Nursing students.

Ohio’s Hospice of Dayton is a non-profit hospice provider and has served patients and families in the Miami Valley for nearly 40 years in their homes, extended care and assisted living facilities and the Hospice House location in Dayton.  Grief support services are available to the entire community through the Pathways of Hope grief support center. Ohio’s Hospice of Dayton serves over 600 patients and families daily, achieving national recognition for innovative services and outstanding care. It is a member of Ohio’s Hospice, a partnership of mission-driven, non-profit hospices in Ohio committed to a shared mission and vision of strengthening and preserving community-based hospices.

Dr. Ruth Thomson Achieves Fellowship Status

Ruth Thomson, D.O., Vice President of Medical Care with Hospice of Dayton, has achieved one of the highest honors the American Academy of Hospice and Palliative Medicine can bestow.  Dr. Thomson has earned recognition as a Fellow of the American Academy of Hospice and Palliative Medicine.

Fellowship is an honor achieved by those physicians whose professional activity is devoted to the practice of hospice and/or palliative medicine. Fellows of the Academy are required to be board certified, members of AAHPM for 5 years and active within the Academy. These individuals request and voluntarily submit applications for Fellowship. In so doing, they are inviting an evaluation of their practice by their peers of their personal integrity, knowledge of the field, professional accomplishment, and demonstrated scholarship.

Dr. Thomson joins Hospice of Dayton colleague Cleanne Cass, D.O., in achieving the advanced recognition as a Fellow by demonstrating significant commitment to the field of hospice and palliative medicine.