Time to warm up the crystal ball, and kick off the annual roundup of trends to watch in hospice for 2018. Some of them are encouraging; others we’re just going to have to grin and bear. Hopefully all of them will support us in the vital work we do as a new generation of people with different needs and expectations around the end of life experience become our patients.
Here’s what I and others see coming down the pike:
1. How we die – and where – will continue to change. The people we served in hospice used to be (and to some extent, still are) the Greatest Generation. But now the first wave of Baby Boomers are approaching the end of life, and their needs and wants are very different than those of their generally more stoic and matter of fact parents. We’ll see increasing demand for support for living – and dying – in place, as well as experimental and alternative therapies, spirituality, and new kinds of communities as the...
In honor of the beautiful holiday of Thanksgiving I want to share a story about saying "thank you". Have you ever had a friend that simply made you want to be a better person just by knowing them? Laura Carmichael was that person for me. Ms. Laura was my role model for living a purposeful life, enjoying each day, giving back in small and large ways and always saying “Thank You”.
Laura had the corner market on writing “thank you” notes. Her notes were legendary, no sooner had the gift been delivered, than she was at the post office with her thank you note ready to mail. Ms. Laura probably had heavenly choirs singing each time her delicate fingers hit the typewriter keys. She penned her notes until her hands had such a tremor that at age 101 she couldn’t write legibly so used the trusty Royal.
For over 60 years Ms. Laura clipped the good news from the local newspaper, accomplishments by ordinary people, and sent them a...
Come back with me to November 22, 1995. I'm standing next to the bedside of one of the most beloved people in my life... my brother Michael, and he's dying.
It's painful to watch him wasting away. The sense of helplessness is profound. And yet he is surrounded by this wonderful group of people in this hospice facility who are making the experience of death one of dignity and grace instead of fear and despair.
On that day in 1995, I had been a Hospice Administrator for over 10 years. I could tell you the rules and regulations, the staffing patterns, and the budget. Hospice was in my head. It was my job.
But on that day... that day in 1995, standing next to my brothers bed, hospice came into my heart. And I have never been the same.
In my three decades of working in hospice, all across the U.S., I've discovered there are certain things that separate good hospices from great hospices. And it usually doesn't have...
Why do you get up in the morning? Why do you go to work each day? It is simply for the paychex? Or the insurance? Or is it because you too want to make a difference in the world? And I would ask you... are you making a difference? What is it that you are doing each day to ease suffering and empower others.
Let's talk about empowering others. It comes in all sorts of ways. As part of my consulting work, i facilitate workshops and retreats, and I love this kind of work because it allows me to see people with appreciative eyes. When we talk about our superpowers, we are not talking about x-ray vision, or leaping tall buildings, but rather the special strengths we bring to our teams. The qualities of character or personality we bring to our teams are often characterized are often shrug off as "it's just who we are".
At a recent workshop with a senior team, I asked them what they liked best about their job. One of...
Mission, Purpose and Passion.
The last of these is PASSION. So if you Mission is your overarching architecture of the building, and the purpose is what you are doing inside that building, then PASSION is the electricity that runs it.
Mission and Purpose without PASSION is like having the logs in the fireplace and not having a match to get it started.
PASSION is the energy that's needed to move your Mission forward, because when all three are present, and they are all in alignment ... it really is magic.
Work becomes easy, obstacles melt away, challenges become opportunities, and work is something you do because it is your life, not because it is your job.
When I was working at the Health Services, I thought being a clinical nurse practitioner would be terrific. My personal Mission of serving those in need was present, my Purpose of improving the health of those in served was being met, but I didn't have any PASSION. There was no spark to ignite...
Clip from Patti Moore's interview with Gretchenn Brown
Patti: You've been at the top of your game for nearly 30 years.
Well again, I think it's the culture. You have to build a culture where it matters, and where you are embarrassed or humiliated by having a bad review.
You know what I always say... "there are no do-overs in hospice". If you get it wrong, people talk about service recovery, but we have a service that can't be recovered. And so trying to impress that urgency upon folks.
And it doesn't mean that, you can't be in this big with that many staff, that you don't have disappointments. But to me they are heartbreaking... and I want them to be heartbreaking for the team and the site leader and not just for me, and I think that they are what connects with...
November is National Hospice Month; a month in which the nation’s attention should be on the wonderful care and support hospice organizations provide to dying people and their loved ones. Unfortunately, this month we are still reeling from Time magazine’s October 25th article, No One is Coming: Hospice Patients Abandoned at Death’s Door.
I have dedicated my professional life to working in hospice care, to helping people and organizations be their best, and the vast majority of hospices strive every day to do just that. But for those whose experiences of neglect and unanswered phone calls are the basis of the Time article, our track record and good intentions mean nothing.
In response to the piece, the President and CEO of the National Hospice and Palliative Care Organization Edo Banach wrote in part in his letter to the membership, “…The authors cite 3,200 complaints filed with state officials in the past five years. During that period,...
Image Above: Tom Petty receiving a distinguished achievement award from University of Florida First Lady Chris Machen
I Won’t Back Down is one of the best-known songs written and performed by Tom Petty, Rock and Roll Hall of Fame legend and leader of the Heartbreakers, who died suddenly this past October 3rd. Like all of his music, it resonated for me, and it’s not a stretch to say that the Heartbreakers have been the sound track of my life.
Gainesville, Florida has been my home for nearly all of my adult life. I love this town, the people, the beauty of the environment and the University of Florida. Tom was our native son: He and two of his band mates from the Heartbreakers grew up in Gainesville, developed their sound here and still have family here. Tom’s first cousin Sadie Darnell is our current sheriff.
When I talk with my clients lately, it seems nearly everyone has been grappling with a decrease in census. Are people just not dying as frequently as in the past? Are other providers stepping up to offer similar types of care thus sidestepping hospice or is it some other mysterious thing that is happening?!
We pursue referrals in all kinds of ways; we pass out brochures at doctor’s offices, assisted living communities, and senior centers; we give logo pens to discharge planners who we hope will call us looking for hospice care. We may pay search engines to put our ads above other results, when people go online to search phrases like “hospice near me”. These are all solid strategies – but do they go far enough?
Part of the challenge in engaging the community is that we’re balkanized in the public imagination because of the function we serve. It’s not news that people are by and large afraid of death – and though we as hospice...
Thank you all for your kind support over the past couple of weeks. Irma packed a wallop on the entire state of Florida. She was unpredictable in her exact path and her girth was so wide she reached from the Atlantic to the Gulf, wider than any hurricane ever to set an eye on the shores our Sunshine State. She left only the far western tip of the panhandle untouched by her fury.
The lessons Irma provided were valuable and I hope to keep them alive much longer than it takes to rebuild from her destruction. What do you take with you when you fear your home might be severely damaged or destroyed? I have often thought about this, photos, letters, mementos, clothes? I discovered, when it came right down to it, there wasn’t much I needed.
My responsibility was to be sure my 93-year-old mother in law was safe and out of harm’s way so we flew to Nashville, a wonderful city with generous people and wonderful food! I had a few hours to pack before we left and wondered...