The end of life is just as important as the beginning of life — let’s talk with Chapters Health Hospice

Hospice care can be a tough subject for a lot of people, but thinking ahead and knowing what’s available could be a major help when the time comes.

Vivian Dodge, executive director of Chapters Health Hospice in Monroe County, joined Good Morning Keys on KeysTalk 96.9/102.5FM this morning to discuss what the organization offers.

Chapters Health Hospice has been in the Keys for more than a year, providing hospice services for an unmet need. Chapters Health is a non-profit hospice and serves Key West to Key Largo.

Staff members will go to the individual’s home and work with the patient and the family network as well.

Dodge said, “The end of life is equally as important as the beginning of life.”

Mike Stapleford of KeysTalk 96.9/102.5FM noted, “I actually had some first-hand experience with hospice previously with a family member and it is very much the care of the family as well as the patient that hospice takes on.”

“Correct,” Dodge agreed. “We can manage someone’s pain or any symptom they have like nausea/vomiting or shortness of breath, but it’s the family’s journey as well and there’s a lot of emotions and feelings that they go through that we can provide support and help them through their journey.”

Hospice is not just for the last days of life. It can be days, weeks or months. Individuals and families are entitled to hospice care for up to six months — or sometimes even longer, if they meet the eligibility requirements.

Symptoms are managed. Funeral arrangements are discussed. Estranged families are even brought back together.

Dodge said, “The goal of hospice is not to prolong life or hasten the dying process, but it’s to maximize the patient’s quality of life as they travel along this trajectory or their final chapter and I think that’s what’s really important.”

A lot of it is about the individual’s wishes and choices for how to traverse this final journey.

Hospice sees patients wherever they reside — a nursing home, the hospital, a boat, a camper, a condo, etc.

It is an important field for staff and volunteers.

Dodge said, “I’m a registered nurse and I have been in nursing for over 40 years and I have spent the last 20 years in hospice. I love the philosophy of making sure that everyone who is at that point in their life is treated with respect, making sure that their symptoms are managed, that they are comfortable and that we’re helping them resolve and complete any of their final wishes. I think it’s really important to end life that way and there’s so much that you can do for an individual or a family to make this chapter more meaningful.”

Chapters Health Hospice has helped patients who wanted to watch the sunset on their dock or take a drive up and down the Keys one last time in their convertible.

Dodge said, “I think hospice speaks to me because I think patients who are under hospice, even patients who are dying who are not under hospice, want the three Ts. Truth, touch and time and I think hospice gives that to the individual and the family and their network of friends.”

The organization is always looking for volunteers. Roles include administrative tasks, helping at events as well as companionship volunteers to visit with patients and play cards or even just talk .

One avenue of volunteers is focused on veterans. Chapters Health Hospice has a valor program for veterans who need hospice. The group welcomes veteran volunteers who could relate to veterans in the hospice program.

Dodge explained, “Our valor program honors veterans and first responders and it’s our way of saying thank you and acknowledging the sacrifices that they have made for not only our community, but for our country. It’s a wonderful recognition pinning ceremony and we can invite whomever the individual wishes. It’s a beautiful and touching ceremony and I would love to have some of the veterans join us in some of in some of these ceremonies.”

A referral for hospice can come from anyone — the individual, the family, the doctor, the nursing home or the hospital. Chapters Health Hospice will then go out and evaluate the patient.

There are no definitive steps to follow that are required to be included in hospice, but some criteria is considered on a case by case basis, depending on the individual’s diagnosis or condition.

What’s happened in the last six month is also considered. Is the patient becoming more frail? Are they falling more? Do they tend to go back into the ER time and time again for exacerbation of their conditions? Are they losing weight? Are they beginning to lose their appetite?

Was there an acute event that results in them never returning to their baseline health?

Dodge said, “That’s where our team who are experts in hospice care along with the community providers can help determine maybe it’s time for hospice. We tend to get more referrals in the last few days, but we can do so much more for the patient and the family if we have months to work with them and make them manage their symptoms and work with the family to get funeral arrangements in place, all of those things that take time. At the last day or two of life, it becomes a crisis and it’s very difficult for the family, so earlier is always better.”

Some people think by the time hospice is discussed, it means nothing more can be done or that hospice is considered giving up.

Dodge said, “I would like to challenge everyone to think differently. It is actually another option of care. It’s another alternative care model that we have in our health care industry and when a cure is no longer an option, there is still a great deal that hospice can do to control symptoms, provide comfort and support. It means that we’re allowing the patient and the family and giving them the assistance, the comfort that they need and deserve. I just want to have everyone think it’s another continuum of care in our health care industry that focuses on serious and life-limiting illnesses.”

For more information about Chapters Health Hospice, call 305-396-8100 or log onto