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...
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...
Image Above: Beach sand magnified 250 times
Last time, I wrote about the importance of taking a moment and “taking a knee” to acknowledge the human being in our care; of looking beyond the chart, if you will, to honor our common humanity. It’s easy to lose sight of that when care providers are running on empty, overwhelmed and skating on the edge of frustration as so many do. And yet, we too are only human, and some days, that doesn’t feel like enough. I’d been thinking a lot about that this past week – and then this poem found its way into my inbox, sent along via a friend. Coincidence? I think not.
It takes the words of someone as thoughtful and caring as Heidi O’Neil to remind us of the profound and – yes - holy nature of what we undertake in caring for the dying, and to remind us how much they give us in the process. They are our teachers.
Image Above: Dr Ariel Malamud and Patti on a hike with the Alembic Institute group outside Santa Fe, NM
A recent email from my physician friend Dr. Ariel Malamud, a Gastroenterologist in a large metropolitan health system resonated powerfully with me, and I wanted to share it with you, with his kind permission.
He begins by describing how moved he was when, during his daughter’s lacrosse game after a player was injured, the members of both teams silently took a knee and focused on the injured player while she was tended to by the medics and referees. He goes on to say,
“…The practice of medicine has an important challenge: the physician must attend to the needs of the sick using acquired knowledge and experience and updated skills without lacking the sensitivity to kneel mentally for the hurt human being…
Many health systems promote this with inspirational conferences once in a while. There is a need to rather make it part of the institutional culture. And...
Image Above: From the Kaiser Philanthropy Institute, design by Christy Whitney
Courage, passion, commitment, communication, humility – these make every list of critical leadership skills, and they’re certainly required in abundance of anyone who leads or manages in hospice. But to me, the most important gift is the ability to inspire and motivate those around you. Why? Hospice work is demanding, physically and emotionally – but patients and their families need you to bring 100% of your skills, compassion, and stamina to work every day. Keeping our people inspired to be their best, most compassionate selves requires us to model that behavior – to walk the walk – in how we deal with them.
How do you inspire? By remembering why you’re there, and sharing that why with your staff; by getting out of your office and into the field; by being a mentor more than a taskmaster, and sharing stories of staff successes.
What’s Your Story? If someone...
Have you heard the term "nurses eat their young"? Generally, that phrase describes the rough treatment new nurses are subjected to by more experienced peers when we enter the profession, but sometimes in my work I’ve seen it used as a management style. It’s counterproductive, it’s damaging, it undermines both the worker and the work – and it needs to stop.
I'm not sure what it is about some nurses or supervisors who believe that continually focusing on what people do wrong will motivate an improvement in skills or behavior. Perhaps it is the scientific perfectionist in them that has no tolerance for mistakes. Maybe that’s the way they themselves were disciplined or trained, so it’s the only management style they know. For myself, I know I’ve always learned best when I've been encouraged - even when I made a mistake - rather than berated for what I did wrong. I believe that’s true of most of us.
I’m not suggesting that stern...