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Hospice at Home: Determining End of Life Services with TLC

Kellee Svancara is VNA of Ohio’s Hospice Clinical Manager, serving for the past two years overseeing and managing all aspects of our home healthcare hospice program. Prior to this position, she served as an RN and case manager in the field. She has been a part of our healthcare team for eight years and in her current position for the past two. 

In order for a patient to be admitted into VNA of Ohio’s Hospice program, they must fulfill certain requirements and be in need of end-of-life care services. Once admitted to VNA of Ohio Hospice, Svancara’s takes on patient care coordination after hospice admission. She organizes all patient visit orders and medications. She also works with our staff to gain recertifications and compliance requirements. 

2. How do your patients find hospice care?  

Many of our patients are referred to our hospice care by our own VNA of Ohio home healthcare nurses but we do receive patients from local hospitals and skilled nursing facilities, as well.  

We typically serve elderly patients facing cancer or chronic lung disease (COPD) and Medicare has instituted strict regulations for approval.   

In order for a patient to be admitted into VNA of Ohio’s Hospice program, they must fulfill particular requirements and be in need of end-of-life care services.

My job is to coordinate the hospice admission process, visit orders, medications, staff recertifications, and compliance. 

3. Do you work with any other service areas within the VNA of OH?

Our hospice program includes 2 social workers, 2 chaplains, home health aides, massage therapists, and nurses. 
The only mandatory hospice offering is nursing care, the others are made available to patients but are not required. 

 4. What are the complicated aspects of your role?

I’ve found that others find grief and loss and death to be extremely difficult circumstances to deal with and I know this is a fact for many. However, I find the services we offer patients and their families to be more helpful than sad. I’ve been a hospice nurse for 10 years and it is my passion. There are so many benefits to being cared for by our hospice program and we offer great support to people. 

A very complicated part of my position is countering general misconceptions about hospice. Medicare dictates a very specific regimen of services that we can offer as part of our program. This does not include 24-hour care for your loved one once they become eligible for hospice. Rather, we follow a specific task list and our service visits last about 60 minutes total. Sometimes we add on a little more time when we triage a specific situation, but that is not typical and is often on a nurse’s own time. 

Our hospice nurses’ required treatment plan includes a complete a head-to-toe assessment, wound care management, medications management, and helping decide if any changes are needed for prescriptions and consulting our hospice medical director to do so. If new symptoms develop as the patient’s disease progresses, we can help treat these symptoms such as dizziness, stomachache, and pain. Our hospice aides can assist patients in bathing, changing them, and daily care such as shaving but they cannot complete other tasks like laundry or running errands. 

Patients and their families need to understand that they need to coordinate with private duty caretakers to receive more significant support services. Because there are restrictions on what hospice includes, this often causes frustration. I try to help those that reach out gain a better understanding of what constitutes our hospice services and understand that these services are limited. 

5. What are the positive aspects or lessons you have learned from your hospice care work?

I really love being there for patients and their families and making end of life peaceful. I try to take away as many burdens as I can for my patients and my team does a phenomenal job. The VNA of Ohio has some of the best nurses out in the field, some phenomenal players who work on their own and know what to do to help patients. They are so independent and caring for those who really need it!

Do you believe someone you love qualifies for hospice services? Would you like to learn more about the comfort VNA of Ohio Hospice Services provide?

Contact us to learn more about our services.