Some Valley families might believe hospice care options are limited.
However, the options aren’t as limited as one might think, according to spokespeople. When Valley families need hospice care, they often don’t know where to begin and don’t understand how hospice works.
Jared Leuer is a local franchise owner for Right at Home, an in-home health care and assistance agency. He says the COVID-19 pandemic helped many Valley residents not only prefer to not have themselves or family members at hospitals the minimal time necessary, especially for hospice, but also have renewed their appreciation for being able to die at home, when possible.
“We’ve seen a permanent effect from COVID-19,” Leuer said. “Valley people have seen how tough it is to keep medical facilities free of germs and infections and fully staffed, and there is just so much more flexibility to in-home care.”
The Arizona Department of Health Services doesn’t keep statistics on hospice use or any preferences or trends. Independent Newsmedia talked to a pair of people who work in the industry who are seeing hospice care in the Valley change, from different perspectives.
Leuer, who’s only been a franchise owner for short time but has worked for Right at Home for eight years, says he understands the limitations of Valley adults with their own children, careers and lack of medical knowledge that leads many to going with live-in assisted living or facilities with hospice care.
However, for households who can have one person at home — such as a work-from-home employee — visiting health agencies can make those situations more manageable.
“A small company that sends people to your home can really feel like a personal connection,” he said.
That’s especially true, Leuer said, when it comes to palliative care, or semi-intensive outpatient care for patients who are declining and bedridden, but not yet at end-of-life, round-the-clock care stage.
“Palliative care might only involve once-a-week visits,” Leuer said. “But it can still provide comfort, mind- and spirit-stimulating interaction, and monitor for decline signals like weight loss or sleeping more than 12 hours in a row.”
Lin Sue Flood of Hospice of the Valley said her organization was able to have close family members visit with patients throughout the pandemic, amid statewide government restrictions that applied to other types of facilities.
"Patients do not live in our inpatient units," she said. "They are for short-term acute care. We could safely do this because our inpatient units all have an additional outside entrance. We provided PPE and ensured that all safety protocols were followed. This allowed families to be together at the end of life, which was not the case in hospital settings."
Flood said Medicare Part A picks up the cost of hospice care for most patients. Medicare’s website defines hospice as “a program of care and support for people who are terminally ill (with a life expectancy of 6 months or less, if the illness runs its normal course) and their families.”
“A lot of people don’t know that they have a choice when it comes to hospice,” Flood said. “There are about 200 in Arizona. Families should ask questions to understand services, expertise and quality of care before choosing a hospice provider.”
She said families should talk openly in advance of making a hospice decision and may also wish to consult family, friends and co-workers about their hospice experiences before choosing a provider..
Flood said many families with a loved one who’s been declining in health have been managing on their own, but reach a point where they need a hospice care team to walk alongside and provide physical, emotional, social and spiritual support.
Leuer points out that hospice care, while intended to support end-of-life or care for very low-functioning patients, isn’t always followed by death. His own father emerged from hospice care in Albuquerque to enjoy more years of life and spend some time with his grandchildren.
Nationally, death is not a guaranteed outcome of hospice, according to a study cited by The Mesothelioma Center. It showed 17.4% of Medicare participants enrolled in hospice were discharged alive in 2019.
The center also said the top five most common principal diagnoses for patients in hospice in 2019 were, in order of prevalence, dementia (including Alzheimer’s and Parkinson’s diseases), respiratory illness, circulatory or heart illness, strokes and cancer.
The National Hospice and Palliative Care Organization says there were about 1.72 million Americans in hospice care at one point in 2020, the first year of COVID-19. The year-over-year increase from 2019 was by about 110,000 patients, or double the increases seen each year from 2016-19.
Leuer said he recently read an AARP survey that showed 75% of Americans older than 50 would prefer to live out their last days in their homes.
“Death can be a beautiful thing,” Leuer said. “Please talk about it while you can. It’s so important to talk about these things while our elders are still healthy enough to communicate. The earlier, the better. Know your family’s wishes, and tell them yours.”
We’d like to invite our readers to submit their civil comments, pro or con, on this issue. Email AZOpinions@iniusa.org.
Jason W. Brooks is a News editor for the Daily Independent and the Chandler Independent.
He covers the Chandler area for both yourvalley.net and the monthly print edition while writing for and assisting in the production of the Daily Independent.
Brooks is a well-traveled journalist who has documented life in small American communities in nearly all U.S. time zones.
Born in Washington, D.C. and raised there and in suburban Los Angeles, he has covered community news in California, New Mexico, Arkansas, Iowa, Nebraska and northern Arizona.
By 
