Consistent

with the national averages, 80 percent of the group's hospice patients

are helped at their homes. "Home" is considered the person's

residence, which can include a nursing home or other care facility. Portsbridge

accepts Medicare and Medicaid patients, as well as those with private

insurance, including HMO's. The group also accepts charitable donations

through its nonprofit organization.

Wilson notes,

"The concept of a hospice is frequently misunderstood." In fact,

hospice is not a place, it is a concept. The person is treated, not the

disease, and quality of life is emphasized, not the duration of life.

Hospice care is typically available to those who have six months or less

to live.

Portsbridge

Hospice's vision statement explains the concept in part: "To impart

dignity to our patients and their loved ones by providing patient care

of the highest quality." The group provides support for the patient

physically, emotionally and spiritually. They also work closely with friends

and relatives, providing much needed support as they deal with grief,

stress and other issues.

Wilson summed

up her thoughts regarding hospice by saying, "We value life an believe

hospice care is a means to address end of life issues with dignity, compassion

and expertise."

Educational

programs, grief counseling and community outreach are offered to the public

at no cost. Cynthia Brasswell, director of the Portsbridge Community Education

Department, is passionate about hospice. She said, "I can't stop

talking about it."

She and Wilson

gave a brief explanation of the "circle of care" utilized by

the hospice in caring for patients and their families. Initially, a registered

nurse visits with the individual and their family members or whoever else

the patient would like involved. The nurse asks questions and provides

information and facts to them, letting them know "the goal is not

to cure, but to make them feel the best they can." The patient is

asked what they would do if they were well - and then, per Wilson, "we

try to help them do it." Afterwards, a team of caregivers is pulled

together and a care plan is developed.

The team includes

a physician medical director, social worker, bereavement counselor, Chaplain,

home care aides, a registered nurse and volunteers. The patient's physician

is also involved and is asked to approve the plan of care developed by

the interdisciplinary team.

The team looks

at all the needs of the patient and the family when developing the plan.

Wilson shared that "about 95 percent want to be able to stay at home

as long as they will not be a burden to their family."

Brasswell said,

"We tailor each care plan to the individual, making sure each persons

needs are met." Wilson told of some things that had been provided

to patients. One wanted a 60-inch TV in the room, while another asked

for a drafting table so the grandfather could draft a book for his grandchildren.

One woman wanted

to be baptized, and a pool was purchased at Wal-mart and set up in the

room. Wilson said that was the easy part. "We couldn't figure out

how to get the water out afterwards."

She continued,

"The end of life is not a time to refuse people anything they want."

Some common

issues the team helps patients with includes issues with family members,

estrangement from their church, financial concerns, pain management, medical

needs and answers to questions. Options are given regarding the many decisions

that the individual and their families may need to make such as who will

have decision making power in later stages if needed and what to do if

they are no longer able to eat. Legal issues are addressed if they have

not been previously taken care of.

In addition

to emotional support, practical assistance is given to the family regarding

funeral planning, legal issues, death pronouncements and other related

areas.

A chaplain

is available to "tap into whatever spiritual recourses people need

to help them get through," per Wilson.

Bereavement

counseling is provided to family members for up to a year after the patient's

death at no charge. As Brasswell noted, "We get paid, only in a different

way."

Eunice Farris,

RN, BSN, sums up the attitude of most, if not all, of the staff at Portsbridge

regarding their commitment, "It's a gift, a ministry. And it is a

continuous learning experience."

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