2021 YEAR IN REVIEW

171 Members ~ Funds Raised: $85,500

• • Extended Stay Fund – $15,000
    Many patients and families struggle with incredibly difficult caregiving decisions and the physical demands of caregiving, while faced with financial burdens throughout a terminal illness. Often rapid physical and mental decline coupled with escalating symptoms such as pain, nausea, restlessness, agitation, shortness of breath and constipation bring patients to the Inpatient Center for management of uncontrolled symptoms. While Medicare pays for care in the Inpatient Center when receiving treatment for unmanaged symptoms, once those symptoms are under control, Medicare no longer pays for care in the Inpatient Center. Plans are made to transfer the patient to their home or to a senior living facility. In some circumstances, the Inpatient Center remains the most appropriate setting for continued care for a period of time or until a patient’s death. Hospice & Community Care’s Extended Stay Program offers these patients and families the opportunity to privately pay for room and board to continue care in the Inpatient Center when Medicare no longer covers room and board. For some patients and families the room and board charge is a viable option, but others do not have the financial resources to privately pay and also have limited options for care in another setting. The Inpatient Center provides immense relief from the angst and feelings of helplessness our patients and families experience, when confronted with caregiving decisions and financial challenges during an incredibly difficult time. Our patients and families are the direct beneficiary of the Extended Stay Fund.
  • Handmade Gowns, Pillows, and Blankets for Inpatient Center – $2,250
    Hospice & Community Care has a group of volunteers who sew gowns for patients in the Inpatient Center. These handmade gowns outlast those that are store-bought, are more attractive due to fabric choices, and last longer in the high heat laundry. The gowns are also cost-effective as purchased gowns cost $36 each and handmade gowns cost $15. Volunteers are also able to make neck pillows, heavy fleece covers, and fleece blankets. This grant would provide for gowns, pillows, and blankets for the Inpatient Center for one year.
  • Reusable Bed Pads for Home Hospice Patients –  $2,500
    Reusable bed pads are one of the most overlooked items needed in the home hospice setting. A reusable bed pad can be more comfortable for the patient and for the family and caregivers. Some patients’ families buy disposable ones for their convenience, however, these have a tendency to rip, break and make more work for the patient and caregivers. This causes unnecessary rolling/repositioning, pain, and effort for our patients and caregivers – in a time when this should be the last thing they are worried about.  Every patient we serve could benefit from having two reusable bed pads which can be taken to the homes when needed, laundered in the home, and used to help reduce anxiety, stress and pain. The reusable bed pads could be distributed on an as-needed basis pending interdisciplinary team’s assessment of the patient’s and family’s needs so that they are used sparingly and can reach more households.
  • Gift Cards –  $7,000                                                                                                               
    These grocery store cards are a great support to our patients and families who often struggle financially with costs associated with managing a life-limiting illness or the loss of financial support from the patient or loved ones leaving work to care for the patient. They may allow families to divert funds usually used for food to other necessities like rent and utilities. Having these cards is a great support for staff who can then provide tangible assistance to families that are struggling financially. The cards are generally disbursed in $100 increments with social work supervisors completing a review of each request prior to approval.
  • Medline Powered Base Stand Assist Lift with Slings – $2,844
    Healthcare workers experience some of the highest rates of occupational injuries of any industry. Because patient moves and transfers are strenuous on staff, patients also risk potential injury from improper handling. Research shows assistive technology and a safe handling program help reduce potential injuries, while improving the quality of patient care. Medline’s lifts and stand assists give caregivers safe and secure support for lifting, transferring and ambulating patients. The majority of the patients cared for in the Inpatient Center have some degree of debility requiring staff assistance for personal care, repositioning, transferring, and walking. All the bending, crouching, leaning, and lifting that goes with manually handling patients takes its toll on our staff. Safe handling programs and assistive technology, such as total lifts and stand assists, can lower the risk of injuries while improving the quality of patient care. Presently, the Inpatient Center utilizes total lifts and glide sheet/repositioning devices for patients requiring total assistance. However, the Inpatient Center does not have a Stand Assist Lift to safely and comfortably support patients with sit to stand transfers. The Powered Base Stand Assist Lift from Medline provides the technology to safely transfer patients up to 500 pounds, protecting both the staff and the patient. Medline also provides staff with a Patient Safe Handling Video Series to make patient handling safer and easier through education, training and the correct use of lifting and repositioning equipment.
  • Hospital Bed Sheets – $3,000 
    Many patients benefit from utilizing an adjustable electric hospital bed for comfort, care provision, ease and safety. Sheets for these beds are Twin XL, and many families do not have them available. Some families do not have the financial means to acquire them. Using sheets that are larger (full or queen), while providing a cover, can pose a safety concern and fall risk. These funds will be used to purchase Twin XL sheet sets for those families that cannot otherwise obtain them. Neutral and dark colors will be purchased. Two sets will be provided per family to allow laundering.
  • Pulmonary Support –  $15,000
    Some of our most compromised patients are those with advanced pulmonary or respiratory disease such as COPD or chronic obstructive pulmonary disease, emphysema and pulmonary fibrosis. Approximately 9% of patients have a primary pulmonary diagnosis, and an additional 43% have respiratory disease as a secondary diagnosis. This accounts for over 2,000 patients in a given year. To achieve optimal management of symptoms of labored breathing, air hunger, wheezing, shortness of breath or congestion, other treatment options, in addition to medications, have been required. Oxygen is not unusual, but there are advanced delivery mechanisms to provide pressure to push air into stiffened, frail airways. Without these additional mechanisms patients can struggle and suffer. BiPAP (pressurized air pushed into breathing tubes), ventilator, percussion vest (used to break up consolidated, thickened mucous/secretions to help relieve congestion when a deep cough is not possible), or Airvo (humidifies and hyper-concentrates oxygen with forced delivery) may be used to aid respiratory function, and require the intervention of a respiratory therapist. In the first quarter of 2021, nearly $11,000 was spent to meet these needs. These funds will be used to offset these extraordinary methods and related therapy and equipment.
  • Medisets for Patients – $2,200                                                                                               
    Medication safety is a major concern for patients, families and staff.  Many patients struggle to remember when to take which medication. Without an organized system, doses can be missed, duplicated or taken incorrectly. Providing a Mediset, a special medication container to keep medications organized, to patients and families to support safe medication practice in the home has proven valuable. The Mediset will have our logo and 24-hr phone number printed on them. Nurses instruct on use and fill as needed.
  • Supportive Care – $8,000
    Supportive Care provides symptom management and support to patients that are not yet ready or willing to have Hospice services. This is not covered by insurance, Medicare, or Medicaid; thus, services must be billed to the patient. Hospice & Community Care has a generous Fee Reduction Program that limits the patient’s portion of the bill.  However, for some patients, this small portion can be a financial hardship and prevent them from receiving Supportive Care. The Women’s Giving Circle Grant has previously allowed us to cover the patient portion of the bill for those patients who need Supportive Care, but are unable to cover their portion. The Medicare Care Choices pilot has ended as of 6/30/2021. Historically, this had covered the cost of Supportive Care for approximately 25% of our patients.  We will no longer have this revenue option and will depend more on community support, including the Women’s Giving Circle, to help patients receive services.
  • Ambulance Assistance Fund – $5,000                                                                                 
    Access to the full range of Hospice & Community Care services is an essential component of the hospice continuum of care. Patients who have Medicare and Medical Assistance coverage for their hospice services automatically have access to ambulance services to the Inpatient Center or hospital for symptom management. Because ambulance transportation is not part of the covered services under hospice private insurance, patients must pay out of pocket for this transportation. Patients with no insurance must also utilize private funds to pay for transport. During a period of crisis, patients and families are required to choose between paying for the cost of transportation to the Inpatient Center and remaining at home to manage distressing symptoms. When faced with the potential up front ambulance cost of $650 or more, many families in this situation decline to transfer their loved one to the Center. In addition, the past two years have brought on an increase in non-contracted ambulance service needs for home hospice and nursing home patients. There are times when our contracted ambulance provider is unavailable for transport and those patients are then directed to call 911 and receive transport from a different ambulance provider. In nursing homes, even though we continue to provide education and information about using our contracted ambulance for Hospice patients, the nursing home will often call their contracted EMS provider or the first available provider, even though the nursing home is not billed for that transport and Hospice is. These out of contract transports cost four times the contracted transport.
  • Dementia Resources – $2,000                                                                                                    
    Hospice & Community Care’s Dementia Resource Team continues to focus on creating meaningful visits with our dementia patients as well as identifying innovative ways to increase their quality of life and reduce dementia-related symptoms, including restlessness and agitation. The Women’s Giving Circle has allowed our team to trial a variety of different resources with our patients. We would like to purchase some additional items that have been successful in the past (automated cats and dogs) as well as purchase some new items (weighted blankets and CD players for music and stories) to trial with dementia patients.
  • Wound Care Specialty Course – $1,840       
    I often care for patients at different levels of care and many of those patients suffer with painful wounds. Currently, when a patient has a wound need, the process would be to collaborate with the Hospice & Community Care Nurse Practitioner, who is wound care certified, during Home Hospice wound rounds in one of our skilled care facilities. I feel that obtaining my wound care certification, particularly as a male RN would be beneficial to Hospice & Community Care patients. Not only would I have the ability to evaluate patient wounds, but could also recommend a plan of care, at the same time alleviating the burden of having to call in the Nurse Practitioner and sometimes provide an added level of comfort to my male patients. This certification will enable me to provide the best palliative approach to wound care for our patients.
  • Pathways Center for Grief & Loss – $7,500
    The Pathways Center for Grief & Loss is a core service of Hospice & Community Care which is available to anyone in the community, at no cost, through any type of death, regardless of whether the family accessed hospice services. Bereavement services include individual counseling, loss-specific support groups, and unique support opportunities for those who are coping with loss due to illness or tragic losses as a result of suicide, opioids or other substance abuse. During the pandemic, bereavement support was offered via online Zoom technology and via the telephone. In 2020, the Pathways Center served over 9,000 bereaved individuals and offered 89 support groups via Zoom. While we have begun offering in-person groups and individual counseling in Lancaster and York counties, the Pathways Center will continue offering some Zoom options that have been popular and successful, including for family members who live out of the community. The Pathways Center provides an average of 20 groups a month in the spring and fall, provides training on grief and loss to a wide variety of professionals and lay persons in the community and is called upon as a resource for information and support after sudden unexpected death in the community. The Pathways Center for Grief & Loss services are only possible due to generous community support. A grant from the Women’s Giving Circle would help ensure comprehensive bereavement support continues to be available to all in need.
  • Seating Solutions – $7,500
    This successful grant last year secured funding to allow us to rent and purchase optimized seating and promote safety and comfort for many patients. The main seating solutions we purchased and rented were: Lift chairs, which provide means to engage with family, while elevating legs, and the powered lift makes it possible to become erect. Low air loss cushions prevented worsening of wounds on tailbones and buttocks, and Specialized seating (Broda or other) supported enhanced quality of life as facility residents could comfortably and safely participate in activities or receive visitors. The previous funds were successfully employed and exhausted by June 1, 2021.  Last year, over 450 patients needed special cushions or seating, and currently 47 patients are using specialty chairs.  I am requesting funding to lease these specialty seating options for patients in the coming year.  Leasing is less expensive than purchasing, and we are able to receive items quicker when leasing, as well as return them when they are no longer needed.  Purchasing these items would only occur when leasing was not an option.  I estimate that 550 patients can be helped in the coming year with special cushions and 150 patients would benefit from having specialty chairs.
  • Spill Proof Mugs for Inpatient Center Patients – $1,170
    Funding is requested to purchase 250 spill-proof mugs for patients receiving care at the Bob Fryer & Family Inpatient Center and for patients to take home as they transition from the Inpatient Center. The mugs are clear, double-handled, spill-proof mugs with lids that can fit a straw and also have a “sippy cup” spout. Families often ask if they can have, or purchase, these mugs as they transition to home due to their ease of use. Patients are able to retain greater independence and dignity as the spill-proof mug helps to avoid spills on clothing and bedding, while caregivers can wash the mugs with ease. We would like to have a supply of mugs to be used in the Inpatient Center, to give to patients and families who are transitioning home and to share with Home Hospice teams as needed. A supply of 250 mugs will last two years.
  • International Normalized Ratio Coagulation Machine – $1,500
    The York Office is in need of a second INR (International Normalized Ratio) Coagulation Machine. This machine provides a simple, painless way for the patient to receive a blood test instead of by traditional venipuncture, which is often difficult to obtain on patients who may already be emaciated and dehydrated. The INR machine is used to determine the effects of oral anticoagulants on the clotting system. It is important to monitor the INR regularly to ensure a correct dose of warfarin or other anticoagulants. Frequent monitoring helps to balance the risk of excessive bleeding against the risk of clotting. As the number of patients being cared for in York increase, there has been an increase in the frequency of patients needing an INR test on the same day. It has been challenging to share the current machine – arranging our patient visiting schedules with the other nursing staff, making extra trips to and from the office to pick up and deliver the machine, or arranging meetings on the road to make the exchange. Having a second machine would be greatly beneficial to our patients and our staff.
  • Clinical Patient Special Needs Fund – $1,196
    The Clinical Patient Special Needs Fund is an existing fund that supports a wide variety of items, services and experiences for our patients and their families. We are seeking additional funding to continue to have funds available to support some of the very unique needs for patient care as well as assistance with meeting patient’s hopes and wishes. As an example, in the past year, we had a patient from Puerto Rico who was deaf and recently moved here for his family to care for him. His family did not know sign language and spoke little English. We arranged two in-person sign language interpreters who could sign to the patient and speak Spanish. In another case, a patient wished to take a trip but was experiencing significant swelling of his extremities that was not responsive to our normal interventions. We used the fund to purchase specialized equipment to manage the swelling. These types of services and equipment are often expensive and out of the scope of what Medicare and insurance companies will reimburse. This Fund also allows staff to access funding more quickly than other sources, when time is limited.

For a history of the projects funded through the Women’s Giving Circle, click here.