Hospice offers end-of life planning to community

Hospice's census rose 59% with program

Hospices sometimes find it challenging to meet a community's needs in end of life planning and bereavement services, since these are only a small part of the services a hospice provides.

But there are many benefits to expanding this area of outreach, as one Virginia hospice discovered after it opened last year, the Center for Hope & Outreach Services, a program where anyone in the community could receive bereavement services, counseling, assistance with end of life planning, and education about hospice care.

Blue Ridge Hospice in Winchester, VA, has found that an extension of community outreach and end-of-life planning has resulted in a 71% increase in its daily census, from 81 patients to 139 patients, since the center opened last August.

"We're trying to educate the community and provide resources to them about the process of planning to make end-of-life decisions," says Lynn Gray, LCSW, director of clinical services.

The hospice opened the Center for Hope as an expansion of existing grief and life planning services, says director Pamela Richards, LCSW.

For 25 years, Blue Ridge Hospice has provided grief support for people who have lost a family member in the hospice's care, she notes.

"We mail out grief support material every two or three months and offer individual counseling," Richards says. "What we've found is there are many people who needed more than that, and there are community members who would call us for grief support after someone they loved died suddenly and was not a hospice patient."

In just the past four years, the number of calls for grief counseling has increased by nearly one-third, she reports.

With a federal grant, the hospice opened the Center for Hope as a free-standing grief center that provides one-on-one counseling, family counseling, group counseling, and serves as a resource center where people can come in and get materials on grief and loss, Richards says.

The center has been so successful from the start that the hospice made plans to open two more Center for Hope sites, she says.

"The center's reception is fun by volunteers, and we have two full-time therapists and a part-time bereavement counselor," Richards says. "We also have one spiritual counselor, who is employed by Blue Ridge Hospice."

Word has spread quickly about the center's services: Through the first week of May, the center had received 529 calls from people who had experienced a loss and wanted help, Gray says.

The hospice's bereavement staff will screen calls to make the appropriate referral, she adds.

"As we continue to educate the community about our services and the word gets out about these services, the contacts grow and grow," Gray says.

"The local hospital refers people to us if they've had a loss in the emergency room," Gray adds. "And lately, long-term care facilities have referred their staff to us after they experience the loss of a long-time patient."

When the center was initiated, hospice outreach staff made 300 community contacts in six months, spending an hour discussing the center's services with funeral home directors and others, Richards says.

To save resources, the center is located within a satellite office that is used by hospice staff.

"It's located in a 100-year-old home on Main Street," Richards says. "There's a curved banister, high ceilings, wood floors, and we turned the downstairs into two individual counseling rooms, a child's play therapy room, and a group counseling room that's located in an old living room parlor."

The atmosphere is cozy and comfortable, and there's always hot tea brewing. The waiting room is filled with resource material, and there's a lending library as well, Richards says.

"It's a safe place to come and talk about your feelings," Richards says. "We have sound machines in every room by the door, and we've laid carpet and hung quilts, made by volunteers, on the walls."

Also the doors are solid wood, so the counseling rooms are soundproof, she adds.

Hospice clinical staff work in the upstairs rooms.

"The staff who work out of that office live in that area, and if there's some kind of traumatic death in the community, the next morning the staff can talk about what's going on and be prepared for fielding phone calls from the community," Gray says. "They also might help local schools and police officers who might have responded to an emergency call."

Having the bereavement staff working in the same building as the clinical staff provides continuity, Gray adds.

The center's resource material has been translated into Spanish, and this has helped with outreach to the area's Hispanic community, Richards says. "We have had a significant focus on the Hispanic community and have a growing number of Hispanic referrals now," she says.

"We are convinced the center has increased awareness of hospice," Richards says. "It was a great lesson for us about how a well-organized outreach program can help you get out and educate the community."

The center's grant funding has ended, but there's the possibility of more grant money, she notes.

Meantime, the hospice is absorbing its costs into the general budget, Richards says.

The center accepts private insurance, as well as fees on a sliding scale, but it will serve clients regardless of their ability to pay, Gray says.

Family members of a hospice patient still receive bereavement services at no charge, but when someone is referred to the Center for Hope, there is expanded counseling that can be provided at a fee as small as $15 for a session to people who cannot afford to pay more, Richards says. "If they come here for end-of-life care and don't have insurance or resources, we still provide care, and it comes from the patient care fund," she explains. "We're always doing fundraising events for that patient care fund."