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End-of-Life Care in the Home

by Steven Raymond, Director of Client Services

Other than by traumatic accident, the elderly may face their final days in one of two forms. They may simply be at that age where their biologic clock is winding down, commonly referred to as “Death by Natural Causes.”

Or, seniors may be confronted by a terminal illness or condition, such as cancer or heart failure, in which case Hospice Care augmented by Home Care is an option that should be considered.

End-of-Life Care in the Home is the most desired choice for many people, whether by terminal illness or natural causes. Central Coast Senior Services, Inc. can assist you in either situation. We are committed to providing the professional and compassionate care you need to be able to make the choice to die at home for yourself or your loved one.

Facing Death by Natural Causes

It is a very human act to finally pass from old age in your own home. If this is your choice, our skilled and compassionate Home Care Coordinators and Personal Attendants will closely support and care for you and your family each step of the way.

One of the real challenges in supporting a loved one during end-of-life care at home is the energy and skill required to provide bedside care, such as toileting, bathing, grooming, meal preparation, feeding, laundry, the changing of bed linens, and meeting these needs throughout a 24-hour day. Our Personal Attendants will take care of the fundamental bedside needs that can be very difficult for family members to assume. We can do this full-time, part-time, or as Respite Care to give Family Caregivers an occasional break from the responsibility of daily care. (see more on Respite Care)

Facing Death from Terminal Illness

Individuals diagnosed with a terminal illness face some of the most difficult questions a human being can face. They do so within the context of:

• Their spiritual, religious and existential beliefs;
• The degree to which they suffer physically from the disease and from medical treatment;
• Emotions such as fear, anger, denial, depression, grief, and existential uncertainty; and,
• With the profound heart pulls and multiple concerns for family, friends and community.

The decision process is never simple, and it is always so completely individual.

One of the decisions is whether to continue the medical battle until the very end, or at some point to stop medical treatment and focus upon other life concerns.

If the prognosis for life is estimated at six months or less, then Medicare or Medi-Cal coverage is available for Hospice, which provides periodic visits by RN’s, social workers, home health aides, and religious or secular counseling. In addition, the family can receive bereavement support for a year after the passing of their loved one.

Hospice Services are ordered by a physician and provided by a licensed Hospice Agency. In Monterey County we have three licensed Hospice Agencies: Central Coast VNA and Hospice, Hospice of the Central Coast, and Heartland Hospice, which is a local branch of a national chain.

At Central Coast Senior Services, Inc., we sometimes have existing clients who choose to enlist Hospice during the end-stage of a terminal illness. At other times, Hospice Agencies refer clients to us. In either case, our Home Care Coordinators work closely with the Hospice team of nurses, social workers and therapists to meet your needs, and to ensure consistency of care in the implementation of Hospice orders. Our Personal Attendants provide the professional bedside care we discussed earlier, allowing the client and family to be free from those concerns.

Most people, whether they pass by disease or by natural causes, hope to be able to depart gracefully. For our clients who choose to die at home, we seek to create a home environment where such a death is possible. We strive to provide a safe haven that supports the dying and their families with a true sense of control, comfort, choice, and dignity during their final days together.

Link here to Central Coast VNA & Hospice: VNA’s hospice means you will be involved with our compassionate and knowledgeable staff, and participating in a health care model long considered to be the standard for excellence in care at the end of life.

The VNA Hospice team approach capitalizes on the combined expertise, knowledge and skills of our staff to provide the best care for you or your loved one. Our services include:

• Hospice Transitional Care Coordinators (RN’s) to assist patients/families with the transition from hospital to home
• Medical expertise on pain and symptom management
• ELNEC (End of Life Nursing Education Consortium) trained nurses who are leading the way with innovative comfort care procedures at home such as peritoneal drains and Sub Q infusions
• Medical Social Work, Chaplain and volunteer services to provide ongoing support through the illness
• Individualized plan of care that utilizes a multidisciplinary team approach

Hospice evaluations are available 24 hours, 7 days a week.

Call VNA hospice for more information at (831) 758-4200.

Link here to Hospice of the Central Coast:

Hospice of the Central Coast serves the residents of Monterey and San Benito counties.   Hospice care is provided wherever the person calls home;  this may be in the family home, a residential care, assisted living, or skilled nursing facility. Hospice of the Central Coast is a team of experts committed to this process.  As one of the founders of hospice service in the United States, we have a dedicated team of nurses, physicians, social workers, aides, spiritual counselors and volunteers to help make this challenging time a peaceful and meaningful journey for everyone involved.  We are proud to have the highest accreditation for hospice care through The Joint Commission as well as being Medicare certified.

“Life is a journey, and this part of your journey can be filled with care and compassion, devotion and direction.  It’s easy to feel lost, but you don’t have to lose yourself.”

Link here to Compassionate Care Alliance: CCA provides access to comprehensive information and resources on end of life care, and seeks to raise public awareness and create opportunities for dialogue about end of life issues, care choices and planning.

Link here to Hospice Foundation: Hospice Foundation is a local non-profit philanthropy that accepts community donations to help fund hospice and other end-of-life care services in Monterey County and San Benito County.  Donations are a vital source of Hospice Foundation’s grants to local nonprofit care providers.  This funding helps these organizations develop, sustain, and innovate programs and services for people at the end of life and their families.

Click here to see a video from AARP’s Elinor Ginsler on Familes Discussing End-of-Life Care