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The day Ken,* 81, entered St. Luke’s Hospice, doctors told his family he’d need a feeding tube to continue life saving treatment. Ken had come to St. Luke’s Emergency Department and was diagnosed with aspiration pneumonia. His two sons and two daughters knew Ken would never choose life with a feeding tube. They stopped his IV antibiotics on September 15, 2011. It was time to let his illness take its natural course and focus on keeping him comfortable. The hospital was the best place for Ken to spend his last days because he needed round-the-clock nursing care to manage his changing symptoms. Getting to that point had been both gradual and unexpected. He’d suffered cardiac issues over the years and was living in an assisted-living apartment when, midsummer 2011, a urinary tract infection sent him to the hospital. For the first time, Ken didn’t recognize his son and daughters. He required nursing home care. He began frequent emergency room visits. “This was new and difficult for all of us,” said Ken’s daughter, Lisa*.
St. Luke’s wants to offer the best end-of-life care possible in a setting designed to bring dignity and comfort during an individual’s last days of life. When Ken’s healthcare team switched to hospice mode, Ken remained in the same room he’d used since being admitted to St. Luke’s this last time. The room was small and Ken’s 11 family members hardly fit inside. The nursing unit was active, so they kept the door closed for privacy. After Ken’s IV pain medication failed, his family watched helplessly as his pain increased on oral medications. “Medical nurses are trained to ask for a number on a pain scale for administering medications. Dad simply could not provide this number, between his dementia, confusion, lethargy and fever,” Lisa explained. He became restless and agitated. Specialized hospice nurses and doctors became involved in Ken’s care. They assessed what was working with his medications, changed what wasn’t working and found the best solution. “Finally he was comfortable, calm and peaceful,” Lisa said. * Names have been changed to maintain family privacy
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St. Luke’s Healthcare Foundation is working to create our community’s first dedicated Hospice Inpatient Unit in St. Luke’s Hospital.
When the end-of-life journey involves the hospital End-of-life care – hospice – is about embracing life and living the best way possible. It looks and feels different from a routine hospital stay. It’s often sudden. An illness quickly worsens; an emergency turns into the unimaginable.
Someone we love begins the end-of-life process at the hospital. Not at home. Not at a hospice facility. At the hospital, where hospice generally lasts a week or less. It’s a time when every moment matters.
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Join us in
Embracing Life A Capital Campaign for St. Luke’s Hospice Inpatient Unit
$2.5 million for construction; $1 million for the endowment.
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“St. Luke’s Hospice provides care wherever it is most appropriate for the patient and his or her family. Sometimes the best place for a patient to receive care is in the hospital, because the patient requires a higher-level of care than can be provided at home.” Dr. James Bell, medical director, St. Luke’s Hospice
Hospice at St. Luke’s today Hospice patients who should not be transferred to a hospice care facility or patients and families who feel more comfortable receiving hospice at St. Luke’s are cared for on multiple units across the hospital. These units are not ideal for end-of-life care. • The environment can be institutional. • There’s little room and few amenities for families. • Care is duplicated between floor nurses and hospice staff.
Total Number of General Inpatients Served
240 230 220 210 200 190 180 170
______________________________________ ______________________________________ ______________________________________ ______________________________________ ______________________________________ ______________________________________ ______________________________________ ______________________________________ 2007
2008
2009
2010
2011
Total Number of General Inpatients Served
• Families feel isolated, watching other patients heal and go home. • Other families and patients on the nursing unit perceive “everyone on this unit is dying.” In spite of these circumstances, the number of general inpatient hospice recipients at St. Luke’s Hospital has risen by 20 percent in the last five years. It is projected that between 2007 and the end of 2011, patients using St. Luke’s Hospice services will have increased by 56 percent.
The graph shows the increase in the number of patients St. Luke’s Hospice has admitted into the hospital to receive general inpatient hospice care during their last days.
These numbers will continue to rise as baby boomers age. By 2035, 20 percent of the U.S. population will be over 65 years old. It is critical for St. Luke’s to create the area’s first dedicated Hospice Inpatient Unit in order to meet the needs and future demands of our patients.
Annually, the Hospice Inpatient Unit will serve nearly 220 patients and families.
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Embracing our future Family-friendly
Specialized staff
The Hospice Inpatient Unit at St. Luke’s will give families facing end-of-life challenges a peaceful, homelike environment.
Experts with extensive hospice training will be on staff 24 hours a day, seven days a week. In 2010, one-third of the patients in hospice (219 people) qualified for general inpatient care at St. Luke’s. The hospital can be the best place for our loved ones to receive care during their final days.
Larger patient rooms — will allow families to stay with loved ones around the clock. Each room will have sleeping accommodations and a private bathroom where family members can shower. Gathering space — will offer grieving families room to share experiences with one another, including other grieving families, and access to amenities not typical on a hospital floor. The family lounge will have an aquarium and computer station; the kitchenette will include a family dining area. There will be a laundry room, children’s area and grief resources. Private areas — will give family members space to seek comfort and visit with hospice doctors, nurses, aides, chaplains, social workers, volunteers and music, massage and pet therapists.
Hospice is needed at the hospital when pain medications and high-level care must be provided by nurses, doctors and staff during situations such as: • A patient on a ventilator shifts from curative care to comfort care. It is virtually impossible to send the patient elsewhere and maintain comfort. • A patient with a severe, life-threatening condition who’s treated in St. Luke’s Emergency Department will not recover. Family members prefer not to transfer the patient across town or leave the hospital because the patient may pass or decline during transport. • A hospital patient is too fragile or unstable to be transferred.
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St. Luke’s wants to offer the best end-of-life care possible in a setting designed to bring dignity and comfort during an individual’s last days of life.
Additional hospice services In addition to serving patients who can’t go home or be transferred to another care facility during their last days, St. Luke’s Hospice Inpatient Unit will provide high-level hospice services for: • Respite care – offering breaks to caregivers at home, for up to five days at a time. For example, a husband caring for his wife with ALS brings her to the hospital for five days once a month so he can rest and reconnect with family and friends. Or a daughter brings her dad to respite care while she attends a family reunion. • Symptom management – to give current hospice patients suffering tremendous pain or other symptoms in their home the option of being admitted to the hospital
for pain management during an average three-day stay. For example, a woman in a nursing home experiences severe breathing difficulties and is brought to the hospital. A hospice physician visits her throughout the day and modifies her treatment until her breathing improves. She’s released back to the nursing home because her symptoms can continue to be managed there. • Residential care – is an option for hospice patients who don’t want to die at home. For example, a man who’s been cared for at home by his wife for several months takes a turn for the worse. He doesn’t want his wife to feel responsible for his death. He asks to be admitted into the Hospice Inpatient Unit as a residential patient.
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The costs for hospice care Hospice care is free to those receiving care—whether it’s in the hospital or at home. The hospital charges St. Luke’s Hospice, which in turn charges Medicare and private insurance. Frequently, insurance doesn’t cover the cost of all the services a patient receives, which can include: • Nursing
• Music, pet and massage therapy
• Social work
• Physical, occupational or speech therapy
• Chaplain
• Oxygen and expensive medications, such as chemotherapy for symptom management (not curative)
• Aides
• Volunteer companionship Hospice works with the patient to receive the right care at the right time in the right place, regardless of reimbursement by Medicare or private insurance. Generous donations to the Hospice Endowment through the St. Luke’s Health Care Foundation will allow patients to receive care that otherwise would be cost prohibitive to the program, such as radiation therapy or a patient with no insurance coverage.
Hospice Inpatient Unit cost estimation Architect and Engineer Fees Construction Equipment/Furniture Total
$75,000 $1,747,587 $664,000 $2,486,587
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“Every hospital should ideally have a hospice inpatient unit as it provides a place for people to die with dignity and their family a private and comforting environment to grieve.” Dr. James Bell, medical director, St. Luke’s Hospice
You can help make a difference Peace of mind is important for families as they experience the avalanche of emotion during their loved one’s last days. “My dad just needed comfort and peace. If he would have been in a specific hospice unit with specially trained staff, he would have benefitted immeasurably,” said Lisa about her father Ken’s last days on a medical floor at St. Luke’s.
The Hospice Inpatient Unit will help provide the best hospice care possible. Life should end with dignity, whether it happens at home or in the hospital. The family likewise would have been more comfortable in a dedicated hospice unit. Jackie*, another of Ken’s daughters, said, “It would have been great to be in a quiet area and have access to hospice staff at various times during the day versus only when they were making rounds.” She would have liked a more spacious room, an area for her family to gather for meals or snacks and more comfortable sleeping arrangements to allow family members to stay at her father’s bedside 24 hours a day. * Names have been changed to maintain family privacy
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Help us Embrace Life St. Luke’s Health Care Foundation’s goal is to raise $2.5 million for construction; and $1 million for the Hospice Inpatient Unit Endowment. When St. Luke’s Hospice was formed, the leadership at St. Luke’s Hospital promised no family would be charged for the services provided. Operational and philanthropic support ensures everyone receives the treatment they deserve – regardless of their ability to pay. The endowment will be used specifically to help cover the unreimbursed costs for the patients who were on the Hospice Inpatient Unit.
Your financial support will allow this promise to be carried out.
Embracing Life: Recognition All donors, regardless of the size of contribution will be acknowledged in the Foundation’s Annual Report to the community. All contributions of $5,000 or more will be recognized in a permanent display at the St. Luke’s Hospice Inpatient Unit.
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“What lies behind us and what lies before us are tiny matters compared to what lies within us.� Ralph Waldo Emerson
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855 A Avenue NE, Suite 105 Cedar Rapids, IA 52402 319/369-7716 stlukesfoundation.com
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