South Florida Hospital News
Thursday September 21, 2017
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October 2005 - Volume 2 - Issue 4

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Every Day, I Go Home a Better Person

There is more to hospice than clinical care. In fact, 30 percent of Ann Adams-Hove’s work begins after the patient has died.

Adams-Hove, who has been a social worker with VITAS Innovative Hospice Care® of Broward for seven years, finds she’s not always greeted with open arms. "People think I’m coming to check that the house is clean," she says. "That’s not it at all. I’m their advocate, their comforter, the bonus. I’m there to say, ‘How can I help you?’ Once they get to know me, their defenses go down. Then they say, ‘It’s so sad that we have to be terminally ill to get this service.’"

Adams-Hove provides emotional support and concrete services to VITAS patients and families. She sees new patients within the first 48 hours of admission to the hospice program. "Our guidelines say we have 10 days, but we at VITAS work fast," she says. "We all know we’re going to die, but having a loved one enter hospice can throw the family into emotional upheaval. That first psychosocial assessment is important."

Adams-Hove sees the patient and family as a unit. It may be an elderly person with a spouse or with grown children in distant cities. It may be a father with young children still at home. Whatever the combination, it is how they interact at the end of life that concerns Adams-Hove. The patient may have strong family or community support systems in place, or appear to be completely alone. She takes a history, listening for verbal clues about emotional issues that may be important.

As part of a home care team, she may arrange for an air conditioner to be installed or schedule Meals on Wheels. She’ll call the team’s caseworker if more extensive financial support, like applying for Medicaid, is necessary. And she works closely with the team chaplain, who offers spiritual support when the patient comes onto hospice care. "Hospice is holistic," she says. "It encompasses the whole person."

She meets families who are unhappy that Mom is on hospice, who see it as giving up on the patient or hurrying her demise. Unresolved family issues often surface when the siblings are together at a parent’s bedside. It’s Adams-Hove’s job to de-escalate emotions and gently redirect the focus to why the family is together.

Because she’s good at what she does, Adams-Hove makes connections during this time of crisis, teaching families healthy ways to express what they’re feeling. It serves them well at the bedside and again later, after the death.

The Medicare Hospice Benefit requires at least 12 months of bereavement services. Adams-Hove sometimes uses that time—and more. She cites the example of a patient who died this spring and left three young sons to grieve. Adams-Hove had established a strong relationship with them before and even during the death of their parent, and continues to see them today. "I hope to get them to a place where they have integrated the death into their life," she says. "Sometimes there is anger at the deceased, or at God. I validate that and try to channel it into acceptance. And I assure them that we all have questions and none of us have answers, but that there are other humans in the same place they are."

For another family, supplying the location of a local bereavement group may be all the assistance necessary. Adams-Hove also works with her own teammates, who, despite being professional hospice caregivers dealing exclusively with the terminally ill, still may take the death of a patient particularly hard. It is her support that allows them to keep working, attending their other patients with the necessary mix of energy and compassion.

For Adams-Hove, the work itself "keeps me fresh." She was a student intern at VITAS seven years ago and enjoyed it so much she never looked elsewhere. "It’s a great job," she says. "It’s a privilege for me to work with people at this extraordinary time in their lives. Every day, I go home a better person."

Ann Adams-Hove can be reached at (954) 336-7615.

Maureen Knips, Associate General Manager, VITAS Innovative Hospice Care® of Broward, can be reached at (954) 486-4085.

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