(upbeat music) - And hello and welcome to Forum 360, a program with a global outlook.

We're gonna get down to a local view.

I'm your host Bill Steven Saus.

And we have a guest today and a very serious topic to discuss.

Our guest Is Lynn Hermensky, from the Hospice of the Western Reserve.

And it's good to have you here on Forum 360.

- Great to be here, thank you so much for having me.

- One of the most serious topics I've ever talked about on our program is death and dying and how we are treating our loved ones and our patients.

And this is why we're going to talk about hospice.

Our area is the Western Reserve.

So we are fortunate to have an organization that is basically branched out throughout the Western Reserve region.

- That's correct.

- And it is Hospice of the Western Reserve.

Lynn, tell us a little bit about your involvement, how you got involved in this program, the Hospice of the Western Reserve.

- Absolutely, and thank you again for having me on with this topic.

A lot of people are so afraid of the word, hospice, and talking about hospice.

And my job as a provider relations manager for Hospice of the Western Reserve is providing education to the community, the Western Reserve community, to let them know that, you know, don't be afraid of hospice.

It's a wonderful service that can help people at end of life.

And how I got involved, I was working in assisted living with people with Alzheimer's and memory loss.

And hospice came in, Hospice of the Western Reserve came in a lot and I saw what they offered and what they were doing to help the residents every day.

And we couldn't have done it without them.

And it was just a wonderful, just watching how they came in to provide care to people at end of life.

I really, that's when I became very involved, and as soon as there was a position open, I knew that I wanted to make a difference in people's lives, at end of lives.

- Now this is a global topic and it actually started in England as I was researching, late 1960s, 1967 through 69, a registered nurse from England, Dame Cicely Saunders, Cicely Saunders was the founder of the concept of hospice.

- That's correct.

- So bring us up to date from that global outlook, how it started, and brought down here to Northeast Ohio.

- So it's interesting because Dame Cicely Saunders had a very close friend who died a very painful death due to cancer.

And she watched how there wasn't a lot of support, there was a lot of pain, there wasn't a lot of, you know- - Support.

- Just support at end of life.

And she said, we can do better than this.

And she started the national modern day hospice movement, which has been wonderful.

So making sure that nobody's alone at end of life, making sure nobody's in pain at end of life, and making sure people are living out the quality of life that they deserve at end of life.

So it's been amazing how hospice has changed through the years.

- I've been reading, there was a couple national organizations that have been raising awareness and bringing people's attention to hospice.

There's a National Hospice and Palliative Care Organization, NHPCO.

- Yes.

- And then the National Hospice Foundation, and they did a study saying approximately in 2020, they believe that almost 40% of all dying patients at the end of life in the United States are using hospice care now.

Explain between palliative care and hospice care.

- Absolutely, and that's a great question.

There's a lot of confusion around it.

So with hospice care, it's for people that have an illness, a diagnosis, whether it be cancer, heart disease, lung disease, stroke, kidney disease, Alzheimer's disease, there's all different kind of diagnosis that can lead to, end of life, terminal diagnosis.

So hospice comes into play, usually, when a physician says there's about six months or less time.

And again, the services come to either the person's home or an assisted living, like we talked about, nursing home, and then we have some hospice houses as well.

So hospice kind of supports end of life.

They provide a nurse, they provide a physician, if they don't have one, spiritual care, we have home care aides that can come in, social workers, a full team that comes and supports the person at end of life.

- So it's interdisciplinary.

- It is absolutely.

- In the medical field.

- Correct.

- And in the support field.

- So palliative care is a little bit different.

Palliative care is for people that aren't quite ready for hospice care yet.

So maybe they're diagnosed with a disease, but they have a little longer than six months to live.

And so they could have years to still live with their disease, but they just need additional support, and kind of consulting as what is happening with the disease and how to keep from going in and out of the hospital and really suffering at home.

So palliative care can come in and offer those great, you know, social worker or nurse to help guide the person with the illness.

Also, palliative care is great if somebody comes off hospice.

And I think that's a huge myth, people think once you're on hospice care, that's it.

And I see every day during our team meetings that people graduate from hospice.

- And you have sometimes miraculous healing.

- Yeah, yeah, so when they come off- - Medication that really provides the assistance they need and brings them way up in terms of care.

- It's just not their time.

But we don't wanna go away completely.

So the palliative care program is a great option for them.

- There was a quote by Dame Cicely Saunders, the nurse in England who founded the concept of hospice, and the quote is you matter because of who you are, you matter to the last moment of your life.

And we will do all we can in hospice, not only to help you die peacefully, but all so to live until you die.

- Absolutely, absolutely.

- And that was her concept.

What are some other observations that Hospice of the Western Reserve have been able to use and then put together a program?

I notice you have some programs- - Yes.

- New programs.

- Yes, absolutely.

So we have, Hospice of the Western Reserve has all kinds of innovative programs, specialized to diseases.

And then we have some programs that set us apart from other hospices in the area.

And I know a couple of the things that we do, newer programs, is our end of life doula program.

So have you heard the terminology doula for births?

- Okay.

- For, you know, a doula comes in when somebody's having a baby and kind of plan, what does that look like?

What does the birth look like?

Who do you wanna be surrounded?

This is very similar, but it's for end of life.

- Okay.

- And so it's planning that end of life, which nobody wants to talk about or do.

- So that would be let's say obstetric doctors, physicians, would do the doulas for the young mothers.

- Yes, correct.

- And the families, but pain management physicians, physicians that are geriatric doctors, that are working with the elder care folks, they have a doula program also.

- Yes, correct, so it's an end of life doula.

And hospice care isn't just for geriatrics though.

I think that's another myth.

We do treat all ages, so pediatrics through geriatrics.

So very important, depending on what people are diagnosed with, we can help young adults as well, and we've helped children too, but you know, the families...

But the end of life doula program is really diving into end of life, me asking you, how do you see end of life?

Who do you wanna be surrounded by?

Where do you want to be at?

What can we do to make this just a great experience and a meaningful experience to you, focusing again on quality of life.

We do things like life stories, legacy work, and then talk about again, who do you want at your bedside at the end?

- I see you have a program that, it's dear to my heart because I'm a pet owner.

For years a pet owner of dogs.

And this is called the Pet Piece of Mind Program.

- Pet Peace of Mind.

So this is important too, because at end of life, how we talked about who do you want by your side at end of life?

A lot of times we want our furry friends, they bring us peace, they bring us comfort.

And we have a whole pet therapy program where we can take pets to visit patients.

Whether they be at home or in a assisted living or a nursing home, they might be in one of our hospice houses.

We bring pets in to bring just that meaning and that comfort at end of life.

So with this, this is a program for people that actually have their own pets.

And they're not able to take care of the them because of what's going on with their illness.

So we have a group of volunteers that will come in and they can take the pets for a walk, they can take the pets for a vet, they can run out and get food for the pets.

And then once the patient passes away, they're able to help to rehome the pets.

And that's a huge, if you're at end of life and everything's kind of, you're trying to plan for the future, it's just a huge weight off of their shoulder that will help them for this.

- Now let's talk a little bit again about the funding for someone going into a hospice care program.

Obviously we have hospitals, we have Medicare, so again, Medicare, Medicaid, veterans aid, VA, private insurance, - Insurance, correct.

- And are the costs hard to deal with, or have you found that people- - Not at all.

- Are provided, federal government also makes sure that the hospice has been provided for.

- Correct, correct.

And hospice is covered by Medicare, by insurance, and it really, you know, it's a benefit that is available to people.

And the nice thing about the hospice benefit is it covers any equipment that you need for your diagnosis.

It covers any medications that you need for your diagnosis.

So actually people on the hospice benefit financially, it helps greatly.

And just to be able to have the care team that comes in to provide support.

- The various folks that are involved.

Now we're talking about families also, because the families and the loved ones, coworkers, loved ones that have worked and lived with these folks for years that are in hospice care, you have grief counseling, you provide, as a matter of fact, the most current newsletter you've put out to people, see the Hospice of the Western Reserve Newsletter, it is about grief.

- It is, right.

So the nice thing, not only with hospice care, having the support or at home for the patient, but also we don't just take care of the patient, but we take care of the entire family, and that's including close friends as well, and make sure that they're supported as well.

So we answer a lot of questions.

At end of life, there's so many questions.

And so we help with that.

Then once a patient passes, we actually stay on board with the family to get them through the grieving process.

And it's interesting, we like to stay at least 13 months.

Do you wanna take a guess, why 13 months?

- Why 13 months?

- At least 13 months because we wanna get everybody through the first- - Year?

- Holidays and then get them through that one year anniversary.

- Very good to remember.

- And there's some families that, after a couple weeks, they'll say, you know, we're okay, thank you for checking in.

But then there's those families too, that the grief continues on and we wanna make sure that we're there to support them as well.

- Excellent.

- But the grief support is not just for our patients' families.

So we're a not for profit organization, and we offer our grief support to the community as well.

- Excellent.

- Which is wonderful.

So we offer things like support groups And in the center of this, I don't know if you saw, you know, there's all different, there's parent loss, there's child loss, there's- - [Bill] Many things to focus on.

- Coping after the holidays, February's a tough month, you know?

There's COVID 19 loss.

- [Bill] Right, we'll talk about that shortly.

- Yeah, yeah.

- You're listening and watching Forum 360, a program with a global outlook and a local view.

And our topic today in our program is death and dying and hospice care.

Our guest is Lynn Hermensky from the Hospice of the Western Reserve.

And I'm Bill Steven Saus, your host.

Lynn, we're gonna go back and reflect on the differences that you find between hospice care and palliative care again.

we talked about it earlier.

the World Health Organization, the United Nations, the World Health Organization, the WHO, a global organization talks about palliative care, saying it's medical caregiving, this is their concept, approach to optimize the quality of life.

Now, I think that's a key concept, we'll talk about that in a moment.

And to mitigate suffering for people with serious diseases and improve the situation for patient and families associated with life threatening illnesses.

So again, talk about hospice, which started in England, late 1960s, and migrated around the world, but here in the United States and bringing it local, our local view, once again, discuss those two concepts, the hospice care and palliative care.

- Okay, so hospice care again, it's really, and it's six, you know, the guidelines are six months or less time period.

Which a physician tells us that.

And we've had people that have been on hospice for years.

So I don't want people to think that there's a time clock that goes down because people, like I said before- - [Bill] Could change.

- They can graduate from hospice 'cause they do better.

Or they can also, you know, live for years.

And so when they come off of that hospice benefit, palliative care is there to help support them.

Or if they're not quite ready for hospice care, but again, they're really struggling at home, they're in and out of the hospital.

Palliative care is a great program for them.

Or if people are really fighting hospice care, they need it, but they're scared.

And a lot of people are scared.

And I think for families who have had hospice services before, they understand, and they embrace it, but there are still so many people that haven't experienced it.

And I know our initiative is to get them on services sooner rather than later.

The number one thing our families tell us over and over again is we wish we would've called sooner.

And I tell people, you don't have to decide, oh, am I palliative or am I hospice care?

We're gonna come, free of charge, do an assessment, speak with your physician and come up with the best care plan for you, to be able to offer the services.

And you know, the majority of our folks are at home, they wanna stay in the home environment, but we have a lot that are in assisted living, there's a lot in nursing homes.

And then we have our three inpatient units as well.

Which is a great alternative.

- Where are the locations?

- Yeah, great question.

- For your organization?

- So we have an hospice inpatient unit in Westlake, beautiful park like- - Crocker Road area.

- Yes, right off of Crocker-Bassett.

We have one in Euclid, right next to Euclid Hospital, that overlooks the lake, it's beautiful.

Every room has just a beautiful view of the lake.

And then we have in Medina off of Route 18- - By Windfall there.

- Yes it's right by windfall.

- I-71.

- Yes.

- And state route 18.

- And that facility was temporarily closed down due to COVID 19, and we just reopened, and it has been close to full every week, which means we are serving a need in that community.

So it's just great that the people have that.

And those hospice inpatient units are used for respite stay.

So if the caregivers at home need a little bit of a break, which you do, being a caregiver's 24/7, so sometimes you need a break.

It's also for people that maybe have symptom management that needs to be done.

So instead of going to a hospital to get that done, they can actually come to one of our inpatient units.

- Now you're an independent organization, hospice, they're also hospice organizations with hospitals, affiliated with hospital like Cleveland Clinic- - [Lynn] Correct, yes.

- The larger hospitals, have their own facilities.

- [Lynn] That is correct, yes.

- So it's just one of the many programs, the Hospice of the Western Reserve, provides the treatment.

- We are working with University Hospitals- - University hospital, one of the other larger, University Hospital's one of the larger hospitals in Ohio.

And I suppose the rest of Ohio also has, in Central Ohio, and Southern Ohio, Northwestern Ohio, they also have similar programs.

- Correct, correct, and how they're different, some are for profit, we're of course not for profit, - [Bill] Non-profit.

- And 43 years we've been doing this for, if you can believe that.

- Now, hospice, as we talked a little earlier, for those people that just tuned in, interdisciplinary, team approach, you've got physicians, physical therapists, skilled nursing, registered nurses, licensed practical nurses and so forth, psychologists, social workers, chaplain, spiritual.

- Yes.

- People engaging in spiritual counseling and diet, dieticians, because there's a change in diet, and what people consume.

So give us a little bit of more information on how you get your team together.

- Yeah, and like you said, it's transdisciplinary.

So everybody has their key role, taking care of not only the patient, but the family.

And so we have teams that go into the homes.

We have teams that go into facilities, teams that work solely in our inpatient units.

So depending on where they reside, we take our whole team to them, which is great.

One thing that is not on there, which is huge, is our volunteers that help us.

Oh, the angels among us.

So we have volunteers, thousands of volunteers, that help to support this team, and they can do, we have volunteer hair dressers, volunteer attorneys, volunteers that do pet therapy, aroma therapy, music therapy, art therapy.

- Wow, how do you train your volunteers, or how do you-?

- We have a full training program.

So I urge the listeners today, if you have some free time and really wanna make a difference people's lives, we do all of the training and continuous education.

So they're constantly being trained.

- Very good.

- I know these two, you know, programs, the doula program, the Pet Peace of Mind Program, you know, recruiting for that.

Veteran volunteers, so we're always looking for veterans that are able to support other veterans at end of life.

And the volunteer program is great.

I will tell you my mom was an emergency room nurse for over 30 years and she just came trained to do the end of life doula program, which is great.

- I know my wife was a oncology nurse.

- Yeah, we talked about that, yes.

- And many of her patients eventually went to hospice.

And so hospice care is that special kind of care.

And I said earlier, there's that term, quality of life, How does that, describe what that means to you and some of your coworkers?

- And there's a tagline that I love that says hospice is not giving up, hospice is taking control.

And really what that means is you're leading this team that comes to help you to say what quality of life is for you at end of life.

Where do you want to be at end of life?

How do you wanna be supported?

Who do you want by your side?

And then utilizing moments to remember, where we say, what's something that you wanna do before you passed away?

- Your bucket list.

- Exactly, exactly.

- Your bucket list.

- Final desire.

- Yeah.

We had a woman who went to watch the Cleveland Indians right before they turned to Guardians, and had just a great trip.

We've gone to Cavs games, casinos, fishing trips, meals to remember.

- [Bill] So there are some visits and outgoing, leaving the home?

- And quality, not focusing on the illness, but focusing on what life we have left and how we're gonna make the absolute best of it.

- Have you experienced like one or two, without going too much in detail, what are some, maybe one or two of the most memorable experiences with patients?

- That we've had, so one of the things which is another new program is called, Flight to Remember.

So a lot of times at end of life, people are bed bound, they're not getting out of their house as much, but we ask them what is something that you still want to see before you pass away?

So we're able to utilize drone technology, that can fly to see them, and they can be at their bed with like an iPad or a computer and they can go to where they've wanted to go.

So we had a family that wanted to go back to Punderson, because I guess the family went camping there, - [Bill] The Big Park, Northeast Ohio.

- Yeah, so we were able to fly over Punderson Park.

We had another family who had built a log cabin in Pennsylvania, and they couldn't make the trip, but they wanted to see it one last time.

So we actually partnered with someone in Pennsylvania that was able to drive up the driveway, just like they were in car, go around the building.

And we've even gone as far as Italy for a family, which is amazing.

And so that really, again, going above and beyond and making dreams come true for people at end of life, it's really something.

- And you were talking about personalizing the patient and the family, personalizing, based on the disease, you talked about Alzheimer's, and you talked about cancer.

So there are various type of diseases that we associate with terminal illnesses.

And how do you manage the different, knowing that there will be different symptoms?

- Absolutely, and everybody's gonna be different anyway.

And so we look at what the disease, you know, how they're doing with the disease, what education we can get, but everybody's kind of a little bit different, everybody's pain is a little bit different, everybody's needs are different.

And so we're really able to hone in on the specialized program for cardiovascular disease, and Alzheimer's disease, and really hone in and meet their needs at end of life and offer a lot of education, education is huge.

- So if you Google Hospice of the Western Reserve, or if you're in this area, hospicewr.org.

So it's the www.hospicewr, for Western Reserve, .org.

And you have a toll free number, 800-707-8921, which covers the whole Northeast Ohio area.

Thank you.

So many people can benefit.

- Absolutely.

- We've just gotta minute or so or two to finally discuss the people that they don't wanna give up their daily lives, right.

And yet families need help, and that's where hospice comes in, correct?

- Absolutely.

- Hospice care.

- And I tell people, you know, make the call, it's probably gonna be one of the hardest calls that you make, but make the call, see if your loved one's appropriate for hospice, and anybody can call anytime.

It doesn't have to be a physician that makes the referral, you know, you can call the number, explain the situation, and we can see if you're eligible for hospice or palliative care services.

- It is good to have a physician, perhaps contact your physician first.

- Sure, yeah.

- Or a nurse is family oriented, and they will probably try to find you a program like a hospice.

- Absolutely.

- Again, this is one of the most serious programs I've ever had to deal with.

- I know, I know.

- But thank you, Lynn Hermensky for providing all this information.

- You're welcome, thank you.

- You're just one of many in the state of Ohio, that provides hospice care, and you were able to talk about the family, you were able to talk about the patient, and it's family centered.

And if there are any questions again, you can call 800-707-8921.

We appreciate your being a part of our Forum 360 program.

- And we're always looking for volunteers too.

So if anybody's interested in that.

- Thank you very much for being a part of our audience at Forum 360 and viewing this very serious topic of hospice, thank you very much.

- [Announcer] Forum 360 is brought to you by John S. and James L. Knight Foundation, the Akron Community Foundation, Hudson Community Television, The Rubber City Radio Group, Shaw Jewish Community Center of Akron, Blue Green, Electric Impulse Communications, and Forum 360 supporters.

(upbeat music)