Family Hospice and Palliative Care

Operation Respect: A New Program
for Veterans and Their Families

By Rafael Sciullo, MA, LCSW, MS

Pennsylvania has one of the highest populations of Veterans in the U.S. with 1.1 millions residents having served. Of that number, 25% call Western Pennsylvania home.
Family Hospice and Palliative Care is taking up the charge of responsibility to support Veterans and their loved ones by launching Operation Respect, a comprehensive hospice and palliative care program designed to meet the growing needs of these treasured families.
For a variety of reasons, the consensus among providers from both the Veterans Administration (VA) and hospice is that this population has been underserved at end of life. Strengthening the collaboration with the VA and educating ourselves about the prevalent physical, emotional and spiritual issues that Veterans and their families face has informed the design of a program that can respond effectively to the magnitude of the need.
Hospice’s attention to the individual’s body, mind and spirit encourages exploration of concerns that distinguish the needs of the Veteran with life-limiting illness from other patient populations. Factors affecting the Veteran’s end of life journey include age, whether enlisted or drafted, branch of service, rank and combat or POW experience. Consequently, veterans and their caregivers may face an array of challenges – limited social and financial resources, a reluctance to admit pain, he tpossibility of complications with medications, post-traumatic stress disorder and newly recognized ailments that are combat or service related.
Operation Respect provides support from an interdisciplinary team of caring professionals including physicians, nurses, social workers, spiritual and bereavement counselors, and therapists certified in speech, art, music, pet and massage therapy. The team crafts a personalized plan of care that that considers the impact of military experience and enables Veterans and their caregivers to live fully each day with confidence, optimism and comfort.
Data indicates that 85% of Veterans do not receive care through the Veterans Administration (VA) system. Accordingly, one of the objectives of Operation Respect is to bridge the Veteran’s care at end-of-life with the specialized resources, programs and entitlements available both nationally and locally through the VA, if desired by patient and family. These offerings include inpatient palliative care, in-home aide services and funeral/burial arrangements.
Camaraderie amongst Veterans is another component of the program’s design. To be side by side with one who shares similarly powerful experiences is a significant comfort. Operation Respect trains those who have served in the armed forces as volunteers to companion with their fellow Veterans. This can open a window to an important kind of healing, a sharing of experiences that some Veterans have denied themselves for many years.
Likewise, Operation Respect affords Veterans and their families the opportunity to share and preserve the story of the Veteran’s life and service in a DVD, audio recording or memory book. The process of assembling one’s personal history can revive a sense of purpose and stimulate mentally and emotionally both the Veteran and those who love him.
Of all Americans who will pass away this year, more than one-quarter will be Veterans of our armed services. Furthermore, 39% of Veterans in this region are 65 and older, compared to 12% nationally. With so many Veterans aging, and with the United States actively involved in combat abroad, it is more crucial than ever that support be available to this population.
Family Hospice and Palliative Care is honored by our Veterans’ service and by the opportunity to serve in return those who have given much on our behalf.

Rafael J. Sciullo, MA, LCSW, MS, is President and CEO of Family Hospice and Palliative Care. He may be reached at rsciullo@familyhospice.com or at (412) 572-8800.

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Helping Yourself While You Are Grieving

Recognizing that grief and mourning after the death of a loved one is a typical reaction with a wide range of emotions, one might next ask, "How do I help myself cope with everyday life while I am mourning?" Some suggestions include:
• Educate yourself about grief and grief responses by reading about grief or attending a grief support group. Talking with trained spiritual, medical and mental health professionals is also a way of meeting this educational need.
• You should take care of your physical needs by eating a healthy and balanced diet, getting the exercise your physician suggests and by getting adequate sleep.
• Be sure to recognize your need to avoid stress. Use quiet time to relax and rest. Surround yourself with loved ones and friends who know how to LISTEN! Remember if you ask someone to listen to you and they tell you how you should feel, they are not listening!
• Keeping a private journal allows you the opportunity to let out your feelings. In your journal, you could write a letter to the person who died and tell them how you feel. You can use your journal to write about the many things you want to remember about your loved one. Allowing yourself to write and express your emotions helps you to recognize if you are moving forward or backwards in your grief work.
• Creating a ritual which gives you permission to grieve can be helpful. Examples are visiting the cemetery, a candle lighting memorial, or a get together of family and friends to talk about your loved one.
• Use your faith and spiritual belief system to bring yourself comfort. It is not unusual to have spiritual questions after a loss. Turn to your spiritual mentors for discussion and exploration of those questions.
If you have been practicing positive coping skills, but you find yourself wondering, "Am I doing this right?" Remember we all grieve differently. There is no "right or wrong" way to grieve. We do need to acknowledge, however, that emotions presented in an extreme or intense manner which interfere with everyday functioning may warrant a professional intervention.
For example, it is not unusual to experience anger after a death. It is not unusual to want to express that anger. However if your anger is pushing people away, you may want to consider talking with a counselor, physician or pastor who has an understanding of grief work.
If feelings of depression are intense, leading to feelings of helplessness, worthlessness or suicidal ideations, one must not feel they will "snap out of it." They must talk with a health care provider immediately.
Your grief journey may not be what you expected. Hospice Care of the Washington Hospital offers regularly scheduled support groups to assist in the grieving process.

If you would like to attend a Support Group, contact Alice Teagarden, Certified Grief Counselor, Hospice Care of The Washington Hospital, at (724) 250-4500.

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Hospice Care – 'A Benefit That Should Not Be Wasted'

If you were in a seemingly overwhelming situation, and knew that help was available but just ignored it, wouldn't that be a little puzzling? That's why Kathy Triebe is trying to persuade people to take advantage of hospice care.
"I would probably encourage anyone whose family member is eligible for the hospice to utilize that benefit, because hospice is there to give you support – not only the physical support and education to teach about what's going on and how to care for the patient, but also the emotional support through spiritual care and bereavement. I just feel it's a benefit that should not be wasted, but too many people do not use it."
Triebe is transitioning from Director of Professional Services for Heartland Hospice in Irwin, to being the Administrator at Heartland's new facility in Somerset. Triebe said she currently directs the clinical side of the hospice, managing all of the staff, and "making sure that the care we provide is the kind of care we want to provide, which is top-notch."
That care comes from all levels, from the home health aids who assist with daily activities such as feeding or bathing; to the nurses who do a complete assessment of each patient on each visit and manage symptoms as they come up; to the social workers and chaplains who provide counseling both during the illness and following death.
Triebe said, too, that the care is provided in private homes, personal care homes, assisted-living facilities, and hospitals – "wherever the patients call home." She added, "We provide quality care to patients so that they can have optimal quality of life, with comfort and dignity to the end."
So if hospice care encompasses all of this, why wouldn't somebody take advantage of it? "I think a lot of it is ignorance that the benefit is available," Triebe said. "Many people feel that hospice is available only for cancer diagnosis." However, she explained, it's potentially for anyone who reaches the point in a terminal illness with a prognosis of six months or less. She detailed more reasons for not using it: "Sometimes it's denial. Or sometimes people think, 'I promised to take care of Mum,' and they feel guilty if they're unable to do so.
"But by getting help, you're able to give better care."

For more information, visit www.hcr-manorcare.com.

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For more articles, download the Spring '10 issue (PDF)