END OF LIFE CARE
LAH sends resources back to community
By JIMMY GALVAN

Name the only non-profit hospice center located in Jasper that has been serving the area for 14 years?

If you said Lakes Area Hospice, go to the head of the class.

"We provide non-profit hospice care, the only one of its kind in the area. All our resources go back into the community," said LAH executive director Jeannette H. Coffield. "We know people and we live here. All of our staff lives here.

"We are going to be in this community five to 10 years from now," Coffield said. "The competition can only make you better."

LAH has faced new competition from for-profit hospices that have entered the Jasper market seeking to stake a claim to the hospice market.

"We are going to be here - we are a part of this community," Coffield said.

LAH is part of the Texas Non-profit Hospice Alliance

Coffield said hospice care deals with "end of life care."

Hospice care is for terminally ill patients and aims at palliative care and supporting the emotional and spiritual needs of both the patient and the family, within whatever setting is most appropriate.

A hospice is not a place people go to die. LAH's slogan is, "It's about how you LIVE."

Most patients remain in their own homes as long as possible; others may be in nursing homes or hospitals.

Palliative care is defined as relieving or soothing symptoms (from Latin palliare - to cloak). Palliative care aims at improving the quality of life, controlling pain, easing the psychological and spiritual fears of dying, and supporting the family through the grieving process.

Dr. Elisabeth Kubler Ross is credited with the inspiration for the hospice movement

with her book On Death

and Dying, wherein she describes the five stages of grief: denial, anger, bargaining, depression, acceptance.

The hospice movement took off in the early 80's when Congress approved Medicare and Medicaid funding. In the early 90's, nursing homes were included in the funding program.

"The definition is if the disease takes its normal course death can occur in six months," Coffield said. "And we don't know when anybody is going to die because we have had patients with us for more than six months."

Coffield said the misconception of hospice care is that it deals only with cancer patients, but she said it is for any end-of-life care.

The need for hospice care came when the Jasper Hospital District recognized the need for it.

"I was on the only woman on the board and inherited the job of pulling folks together who I thought might be interested in getting it going," Coffield said.

Through a grant from the Temple Foundation, the Lakes Area Hospice was formed. A board of directors was formed and soon the hospice was taking care of its first patients.

A 501©3 certification was filed with the federal government and LAH is overseen by the board of directors, who serve on the board at no pay.

In a for profit hospice care center, stockholders receive any profits from the business operation.

"If we make any kind of profit, we see a lot of charitytype patients and we use those funds to take care of those people," Coffield said.

LAH also operates a thrift store on Water Street. Coffield said many times if families have their belongings destroyed in fires, they are allowed to come to the store and get any clothing they can use.

Coffield said before a patient is admitted into the program two physicians need to certify that the patient meets the criteria for hospice care.

She said Medicare and Medicaid that patients are required to meet guidelines before they are eligible for hospice care.

LAH is allowed to file on patients' medical insurances and Medicare has established $100 per day that hospices can file on for care.

She said Medicare defined hospice care as a managed care situation but the difference is that with home health, the patient is responsible for medications.

"Out of that money, we have to pay for the nurses to go out, pay the chaplain, home health aide, buy all the medications and any supplies that are related to that diagnosis," Coffield said. "Out of that money, we pay for all these services."

For those without insurance, Coffield said the patient is accepted and all nursing care is provided. She said some help is sought from churches to pay for medications for these patients.

She said once a patient is accepted, a plan of care is established.

"We look at what the needs are for that person and their whole family," Coffield said. "Once we get them on board and maintained, then we might not have to visit them every day."

During a week in January, LAH lost three patients including one that lived on the river bottom.

"He had to be brought out by his family to the ambulance but that's how he wanted to live and we love that," Coffield said. "We try to encourage whatever they want to do."

She said once the death is pronounced by the nurse, they will stay with the family and prepare the body for the funeral home's arrival to claim the body.

"The nurse will stay with the family to make sure everything is alright with them," Coffield said. "Hospice care is very labor intensive in the beginning and at the end it can be difficult.

"When you are receiving a per diem, you might not be doing anything one day and the next day there could be a very intense activity going on," Coffield said.