Wednesday, November 7, 2001

Portsbridge Hospice serves Fayette

Walk through the doors of the Portsbridge Hospice headquarters in Fayetteville and you are almost immediately enveloped in the warm, caring and joyful attitude of the staff. Talk to any one of the many dedicated individuals for a few minutes and your attitudes regarding death may change dramatically.

Portsbridge was the dream child of the current administrator, Mary Jo Wilson, RN, and Mike Mahon, who is no longer involved in day-to-day operations. After Mahon's brother died of a lingering terminal illness, he decided there must be a better way to die. He and Wilson put their heads together and Portsbridge was born. The pair opened their first hospice in Dunwoody in 1993.

The hospice was started and is owned and operated by registered nurses. Since 1993 it has grown considerably. They now have 60 RNs and 112 employees and the patient base has grown from 9 to 150. In addition to their corporate and homecare office in Fayetteville, the group has four other locations. The Riverdale Inpatient hospice was opened in 1995, the Cartersville Homecare location was opened in 1999 and the Conyers Inpatient and Homecare site opened in 2000.

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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