Hospice and Palliative Care handling more dementia cases amongst St. Lawrence County baby boomers
By MATT LINDSEY
POTSDAM -- Hospice and Palliative Care of St. Lawrence Valley is dealing with more cases of dementia as baby boomers are nearing the end of their lives.
“There is definitely an increase in dementia and Alzheimer’s cases we are seeing,” said Ruth Fishbeck, executive director.Hospice started in 1983 as a group of volunteers who took on the task of assisting one family at a time. They relied solely on donations, and operated out of donated space.
Hospice now cares for around 80 to 85 people daily and around 500 annually in St. Lawrence County. They are funded through a Medicare program which helps pay for services and equipment. That money is not enough to cover all costs, so donations are important to keep the program running, Fishbeck said.
“Everyone will deal with death and it’s up to us to support them,” she said. “People want to die in a place and manner of their choosing. Most people want to die at home and die with dignity.”
Palliative care is the easing of pain and suffering. It applies to hospice patients who don’t have long to live, but it also now applies to people who have a condition that will not be cured, such as diabetes or heart, lung or kidney failure.
Hospice also provides services to schools during times of tragedy, nursing homes and caregivers.
“People should know there is a place – it’s our specialty – the program is for most anyone and we provide everything we can,” she said.
Dementia Cases Growing
When Hospice and Palliative Care of St. Lawrence Valley commenced 33 years ago, nearly all patients were dying of cancer. Today, about 44 percent of patients have cancer.
Along with dementia, Fishbeck said they are treating people more for problems related to diabetes, the brain, heart and lungs.
“The baby boomers are going to change healthcare,” she said. “We need to take a look at people aged 50 to 70 years old and how Dementia-like diseases will affect their lives and their families.”
The issue with treating dementia is that people can live 10-15 years with it before hospice can offer its services.
“It’s harder to predict the last six months,” she said.
Dementia and Alzheimer’s patients need to meet nearly all criteria to be eligible by government standards for hospice assistance. Criteria include being bedbound, loss of ability to communicate, and weight loss.
“You have to be pretty far along,” Fishbeck said.
There are times hospice cannot accept a dementia patient because of Medicare standards.
“There are very specific rules and it may look like we aren’t taking someone in – but we would have to pay the bills if Medicare determined someone wasn't eligible,” she said. “That would jeopardize our ability to serve all people.”
Volunteers and Fundraising
“Medicare doesn't cover all of it,” she said. “We couldn't do it without the support of the community.”
“It’s a substantial amount,” she said. Fishbeck said around $400,000 was raised this past year to help defray the cost of care.
The same rate is charged to every patient and everyone is eligible.
For those under age 65, all private insurance is accepted and a sliding scale option is offered the uninsured.
“We do not deny anyone who is eligible,” Fishbeck said.
Palliative care is the easing of pain and suffering. It applies to patients who don’t have long to live and those who have a medical condition that will not be cured, such as diabetes or heart, lung or kidney failure. Those are conditions which require constant care, but which don’t lead to imminent death of the patient.
To be eligible for hospice care, a person must be certified by their primary care physician that they have a disease that if it runs its normal course they will have six months or less to live.
“They can’t be seeking chemotherapy – it is for people who have decided that nothing is working and are taking control of the end of their life,” she said.
Volunteers help hospice out quite a bit during the year.
“We want volunteers as they add a special dimension to our services,” she said. “Volunteers are the backbone of the whole movement that started 30 or 40 years ago.”
Fishbeck said they have about 60-80 volunteers at any given time.
Volunteers are trained, with quarterly training sessions offered, the next being in January.
Volunteers can talk with patients, read to them, feed them, run errands and provide the family with a needed break from the situation. For those who want to volunteer but are uncomfortable going into homes, office work is another option.
For info about volunteering contact Kay at 265-3105.
Hospice and Palliative Care of St. Lawrence Valley will broadcast its 8th annual Radiothon Dec. 1. The Radiothon will air on WMSA/1340, WLFK/95.3, and WQTK 92.7.
County Coverage 24-7
Hospice has 68 employees including a medical director, RNs, LPNs, social workers, home health aides office workers and a chaplain.
RNs typically go in once a week to do a physical assessment and can make medicine dosage adjustments. LPNs can perform many medical tasks including changing catheters and wound care.
Home health aides can perform bathing duties, trim fingernails and other duties tht make a patient feel more comfortable, she said.
Social workers help families through the process of dealing with the death itself, paperwork, and offer needed support services to make the death easier to deal with.
Chaplains go into homes and provide whatever religious or spiritual needs a person desires.
“The chaplains are always respectful – they don't go in preaching religion – they will provide whatever is meaningful to the patient from prayer to just sitting a listening,” Fishbeck said.
Workers will even go into homes during holidays to meet the needs of patients.
“We also have 24-7 nurse coverage so if a family has a concern in the middle of the night they can get in touch with someone,” Fishbeck said. “The nurse will go to the death no matter when it happens to make the experience less scary for the family.”
Hospice’s medical director is Dr. Gary Berk and their doctor is Dr. Sandra McCloy, who formerly practiced in Canton.
Dr. Berk has special training in treatments designed to keep patients comfortable and pain free. Dr. Berk works closely with our nurses. For instance, if on a home visit a nurse feels that a change in medication is advisable, he or she can call the doctor and get a prescription that day.
“People often think they won't get to see their regular doctor – that is not true,” she said.
Fishbeck said patients remain under the care and are still are in contact with their primary care physician while being assisted by hospice.
Dr. McCloy will make in-home visits when needed.