Hospice is not a place, but a concept of care. The concept -- focus on caring, not curing.
"Hospice has let me continue to care for Chuck at home," said Lettie Cale. Cale's husband, Charles, suffers from Alzheimer's disease.
The Payson couple signed up with Payson's Rural Teams of Arizona Hospice and Palliative Care in January 2003.
The Cale home is visited twice a week by Certified Nursing Assistant Rose Baker, and Registered Nurse Case Manager Greg Potter.
"I've been able to get equipment and supplies through hospice," Cale said. "We have a hospital bed and wheelchair. We get Chuck's medicines delivered to the door. They've taught me how to take better care of him."
She said if she needs a break or has to take care of things away from home, she gives hospice 48 hours notice and they will have someone come to stay with her husband while she is away.
"If he falls, I just have to call hospice," Cale said.
Lorna Hansen, patient care administrator, said RTA Hospice and Palliative Care makes use of the Citizen Assist Program through the Town of Payson Fire Department to help with lifting patients who have fallen.
The help hospice receives from the fire department is only one of the service crossovers that keeps the program running smoothly.
"We interface with many different community agencies," said Vicki Dietz, regional executive director, overseeing both the Payson and White Mountain RTA Hospice and Palliative Care programs. "We work with the nursing homes, hospital, home health agency and funeral home."
"It's not about dying, it's about living," Dietz said. "It's about quality of life for people with serious illnesses."
In fact, according to Hansen, 20 to 25 percent of the clients of RTA Hospice and Palliative Care get to discharge status. The diseases, which were considered to be terminal for these patients, improve so much, the person can be discharged to a different level of care.
"Our philosophy is everyone deserves the same level of care, no matter what," Hansen said. "Our services are fully driven by the patient. We make them and what they want the center of what we do."
The families of patients are also served by hospice.
Dietz knows how important that part of the work is from personal experience.
"My grandmother died alone in a nursing home before I became involved in hospice," Dietz said. "When I found out about hospice, I realized how much it would have helped her and the whole family if we'd known about it."
Hansen saw the difference hospice makes in the lives of family members through a recent encounter with a woman she met in a cancer support group.
"She was really distraught," Hansen said. "Her mother was in a group home for Alzheimer's patients in the Valley and she was up here. She was being torn about the time she was here and the time she spent with her mother. I suggested she get in touch with hospice. She didn't know hospice could go into group homes with its services. The next time I saw her, she was just beaming and said her mother had never been happier."
Dietz said the hospice services to the family are a huge relief to the caregivers.
"We're there for whatever's needed by the patient and their family, including bereavement counseling, which is provided for up to a year after the death of a patient," Hansen said. "And it starts at the very beginning. Our people care so much. We become almost like family and so we go through the loss with them."
Dietz said it was important that people take advantage of hospice services much sooner than they usually do. She said, too often the doctor does not sign the necessary papers to put a patient in hospice care until they are very near the end of life. She said with Medicare, the doctor has to sign papers that state the patient will die within six months or sooner, if their disease follows its natural course.
"Because they wait so long to move to hospice care, instead of continuing to live for six months, the patient will often die within only three weeks," Dietz said. "That is not enough time for the patient and their family to get the full benefit of all hospice offers."
She said with hospice in the picture sooner, there also are cost savings.
"If there's a symptom change, they call us and we go to them and take care of things," Dietz said. "We don't have the ambulance rides, the emergency room visits, the hospitalizations. We want our patients to live as fully as possible through the aging process. The physical, emotional, spiritual and financial aspects of their life are all addressed."
"We want the patient to receive what they need and desire," Hansen said.
RTA Hospice and Palliative Care in Payson has 58 employees, both full- and part-time, plus a volunteer corps of about 30. There are three doctors involved: Dr. Ray Hatch is with hospice full-time, while Drs. David Glow and Michael Lowe work part-time, visiting homes, nursing homes and the hospital. More than 100 patients are receiving services from the organization.
In the future, hospice will be able to provide care for more people. This year, the Rim Country Hospice Foundation started construction on a new hospice house at 511 S. Mud Springs Road. Once completed, RTA Hospice will operate out of that facility. It is expected to be ready for occupancy by summer 2004, Dietz said.
"It takes a special type of person to work in hospice," Hansen said. "The people we have are the best because they are so considerate and they believe in what they're doing."
"It's a mission," Dietz said. She said hospice has served about 3,000 people in the last 10 years.
She said she wants to make sure the public knows that hospice is not just for cancer patients and the services offered are not restricted to six months.
"We had a woman who joined us when she was 97 and we lost her a few days after her 101st birthday," Hansen said. "With the extra care and attention hospice provides, we intervene and can extend a patient's life."
A patient in the final phase of life may receive hospice care for as long as necessary, so long as a physician certifies the individual continues to meet eligibility requirements, according to material from the National Hospice and Palliative Care Organization.
For more information about RTA Hospice and Palliative Care, contact Dietz at (928) 472-6340.