Kosciusko Home Care & Hospice has changed the focus of its programming to offer palliative care, and on Wednesday the nonprofit organization held a ribbon-cutting ceremony with the Kosciusko Chamber of Commerce for the changes.
“We’ve moved away from what people would consider traditional wellness home care, meaning those patients who come home after a surgical procedure or maybe they’ve had a knee or hip replacement, they need some in-home therapy, but they’re going to get better and go off our services,” explained KHCH Executive Director Glenn Hall. “In Kosciusko County today, anybody who needs palliative care, which is those patients who either have chronic illness, those patients who may be terminally ill but they want to continue to pursue aggressive treatment, today those patients have to go to a palliative clinic in either Fort Wayne, Goshen, South Bend. There’s nobody providing in-home palliative care in Kosciusko County.”
He said palliative care is that service for those patients that are either chronically ill, and maybe they’re terminal and not pursuing aggressive treatment, but perhaps they’re mentally not ready for hospice care yet.
“The path that we would hope would be that we would admit a patient to palliative care, where we’re treating them in the home; skilled nursing visits, they can still get therapies if they want; all of the things that home care would provide, but then as their condition deteriorates or as their disease process continues and they become ready for hospice care, that they would just move into hospice with us,” Hall said.
Shelley Holderman, KHCH clinical community liaison, said a person needs to have a chronic disease process for palliative care. “A lot of our patients are oxygen-dependent; people who generally have a year or less – only God knows how long we have – but whereas, they say, hospice is six months or less,” she said.
Hall said those in palliative care are fighting to live, but may not get any better.
“Our goal is to help them maintain as long as they can. That’s also the goal of hospice. You know, a lot of people, and I hesitate to say it this way … people equate hospice with death. Well, hospice is about comfort care for those who are dying. It’s not about helping people die. It’s about helping people live comfortably until they die,” Hall said.
He said KHCH is all about often treating the family and the caregivers as much or more than the patient because they’re the ones that need the support and encouragement and to know what to watch for as their loved one’s condition changes.
“And so, at the end of 2021, we just made a conscious decision – for a variety of reasons, health care is changing, reimbursement is changing, hard to get staff – so we looked at what does Kosciusko County need and they needed in-home palliative care,” Hall said.
KHCH has four full-time nurses and two part-time nurses and has not added any staff.
“Actually, because of the change in programming, we were able to fulfill what we think we need with the current staff we had,” Hall said. “Now, we did have some staff leave just by attrition. One of our former nurses retired. A couple of nurses left just because it was time.”
Holderman said she was a nurse and she moved into the clinical community liaison position. Hall said she does some of KHCH’s marketing, specifically to their referral services and helping them understand what is palliative care and what KHCH can offer and hospice.
One of the full-time home care nurses is being cross-trained for hospice and the hospice nurses are being cross-trained for palliative care, which is still considered home care.
“The other thing we did do, and I think it’s important to mention, is we kept all of our (Veterans Affairs) patients. So our VA patients, who were kind of getting traditional home care, we kept those because, number one, we feel it’s very important to support our veterans and, number two, most of them are chronically ill. So we kept our VA patients,” Hall said.
The goal is to have five palliative care patients on a daily basis. Hall said they’ve been close a couple of times but patients come and go because they either go off service altogether or move to hospice or they die.
“Our budget for hospice is an average of 30 patients per day, and then we’re consistently running about 14 to 15 VA patients every day,” he said.
Hospice also has about 12 to 13 volunteers.
“We also offer a homemaker to come in once a week to help with light housekeeping. We offer home health aides to come in and help with bathing and just some basic daily living,” Holderman said. “We offer spiritual care because that is a huge component of both palliative and hospice care. We offer a physical therapist, an occupational therapist and in a few months we’ll be offering pet therapy.”
She said they have a little dog that’s in training now to be a therapy dog.
“The other thing that is exciting about palliative care is that even our social workers, who normally work on the hospice side, they can now see our palliative care patients. That’s critical for helping them navigate all this health care system,” Hall said.
Including medication, dental and the help center, Kosciusko Home Care & Hospice has about 30 staff members, including administrative staff.
This is a trial year for palliative care, Hall said, so they’re going to see how it goes.
“Obviously, we have to look at our competitors in the marketplace. Today, there is no one else offering palliative care in-home in Kosciusko County. Ideally, we would love to grow, but we also know that it’s hard to get help. Being a nonprofit agency, I can’t compete with the salaries and wages and referral bonuses and sign-on bonuses of the bigger health systems, so we have to deal with those economies of scale that just aren’t available to us,” Hall said.
KHCH has been in the Health Services Pavilion at 1515 Provident Drive, Warsaw, since it opened with no plans to change that, Hall said. KHCH’s phone number is 574-372-3401. The website can be found at https://koshomecare.org/.
He said, “I just want people to know that, number one, I have an amazing staff and as much as it is a profession, it really is for palliative and hospice caregivers, it’s a calling and it’s a passion. It really is a labor of love for our community.”
“And being local, we can be there much quicker than some of these larger facilities. We can be there in a heartbeat,” Holderman said.
After the ribbon-cutting ceremony, Holderman announced that KHCH is organizing a race called the “Kosciusko Home Care Hospice Comfort Zone 5K.” Hall said it will be their very first, and hopefully annual, fundraiser. It will be Sept. 24 from 9 to 11 a.m. and there will be door prizes.
“It’s just going to be a great time,” Holderman said.
Hall said it will be family friendly to help raise money for Kosciusko Home Care & Hospice.