Kentucky Derby Celebration

Hospice of St. Mary’s wishes to thank all of our generous guests, donors and sponsors who made the 2015 Kentucky Derby Celebration a great success! To view photos from the event, please visit: www.HOSMDerby2015.shutterfly.com.

We’d like to thank the following for helping us raise over $12,000 towards funding our continuing mission of serving the terminally ill and their families here in St. Mary’s County. We could not do this important work without your support!

WIN SPONSORS

Old Line Bank
Ms. Christine Wray and Mr. John Felicitas

PLACE SPONSORS

Rick and Paula Tepel
Tom and Katie Watts

SHOW SPONSORS

Askey, Askey & Associates, CPA
Baldwin & Briscoe, P.C.
CTSi, Incorporated
Marrick Homes
Taylor Gas Company, Inc.
The Law Office of Joann M. Wood, LLC
Jan and Tom Barnes
Barry and Kelly Friedman/Primary Residential Mortgage, Inc.
Todd Morgan and Family
Steve and Michelle Wall

GIFT IN KIND DONORS

Bailey Rentals
Best Buy
Chesapeake Swing Band
Charlie Bennett
Expressions of St. Mary’s
Guy Distributing
Heritage Chocolates Humphry’s Flag Company
Sotterley Plantation
The Fabric Store
Tidewater Dental
Vintage Source
Wentworth Nursery
Traditions of Loveville

Hospice Board of Directors

The Board of Directors of Hospice of St. Mary's serves as the fundraising arm of Hospice. The financial support that the Board generates ensures that no one is ever denied care for lack of ability to pay. Fundraising continues to be a critical requirement for the operation of both in-home hospice services as well as at the Hospice House.

The Board is comprised of community volunteers who recognize the positive impact of philanthropy on hospice care. In addition to the Board members, a large group of "ambassadors" and an even larger list of volunteers are consistently planning and supporting many fundraising events throughout the year.

Hospice of St. Mary's Board Members

  • Mary Ann Stamm, President
  • Cindy Beakes, Vice President
  • Beth Morse, CNO, MedStar St. Mary's Hospital
  • Christine R. Wray, President, MedStar St. Mary's Hospital 
  • Karen Raley
  • Gabrielle Forte
  • Jan Barnes
  • Nancy Glockner
  • Jennifer Overstreet
  • John Scheffler

Payment and Insurance

Hospice Payments & Insurance Options

Hospice is covered by Medicare, Medicaid and most private insurance policies. Insurance covers all hospice services and supplies related to the patient's illness. Hospice of St. Mary's provides care regardless of a patient's ability to pay. The Hospice Board of Directors ensures ongoing support through fundraising, which helps offset the cost of care for those who are not insured. The hospice staff will assist families in finding out whether the patient is eligible for any coverage that he or she may not be aware of.

Hospice FAQs

The following are questions we all may have at some time in our lives. They may be in response to our personal experiences or those of our loved ones. The most important thing to remember is that there are options available.

1. Isn't hospice 'giving up?'

Did you know that some of the latest studies show that people actually live longer on hospice care than when undergoing aggressive curative treatment? Although many see choosing hospice services as not having any other options, hospice is actually an active treatment option. The Hospice of St. Mary's team is aggressive in managing pain and symptoms so patients can get out and enjoy those things that are most important to them. The team ensures that the patient and family's goals, hopes and wishes are always the primary concern.

2. When should a decision about entering a hospice program be made and who should make it?

It's appropriate to discuss all care options, including hospice, at any time during a life-limiting illness. By law, the decision belongs to the patient. Though some people view hospice as giving up, most hospice families say that being in hospice gave them precious quality time with their loved ones.

Because it can take some time for hospice professionals to tailor palliative care and pain management to each person, it is best to begin some level of professional care before a crisis exists. Families often feel it is "too soon" to begin hospice care and wait until death is very near. Bringing hospice professionals in at the last minute potentially limits their effectiveness. A better approach is to arrange introductory home meetings or hospice visits well in advance of need and obtain counseling from a hospice professional who can provide helpful suggestions on care arrangements. Put the support network in place before you need it.

3. Who should raise the possibility of hospice care - a doctor, the family or the patient?

Many physicians hesitate to broach the subject of hospice because they don't want to destroy your hope. Frequently, they will continue to pursue treatment because they assume that's what you want. In other cases, such as congestive heart failure or COPD, it is difficult for them to predict the rate of a patient's decline. When a doctor does mention hospice, even casually, you should discuss it immediately. In fact, he or she may actually be relieved if you bring up the subject. It is important that you understand the benefits of curative versus comfort care, and that you and your doctor share the same goals for maintaining quality of life. You and your family should feel free to discuss hospice care at any time with your physician, other healthcare professionals, hospice staff, clergy or friends.

4. What if our doctor doesn't know about hospice?

Most physicians know about hospice. It is the patient and the family's right and privilege to request information on Hospice at any time. If your physician wants more information about hospice, it is available 24 hours a day from Hospice of St. Mary's at 301-994-3023; or the Hospice Network of Maryland at 410-729-4571; or the National Hospice Helpline at 1-800-658-8898.

5. Can a hospice patient ever return to a curative medical treatment?

Certainly. Patients can be discharged from Hospice and return to aggressive therapy or go on about his or her daily lives. A patient may relinquish their Hospice benefit at any time and return to aggressive treatment. If a patient's condition improves, the hospice team may recommend discharge. If a discharged patient should later need to return to hospice care, hospice will be available at that time.

6. What does the hospice admission process involve?

Hospice will first contact the patient's physician to make sure he or she agrees that hospice care is appropriate for this patient at this time. A hospice nurse or social worker will then visit the patient and family.

The patient will be asked to sign consent and insurance forms. These are similar to the forms patients sign when they enter a hospital. The Hospice Informed Consent Form states that the patient understands that care is palliative, which means it is aimed at pain relief and symptom control, rather than curative. Services available will be described. The Medicare election form explains how electing the Medicare Hospice benefit impacts other Medicare coverage for terminal illness.

7. Are there any special changes or equipment needs that I have to make in my house before hospice care begins?

The hospice staff will assess your needs, make recommendations and help make arrangements to obtain any necessary equipment. The need for equipment may be minimal at first, but may increase over time. The hospice staff will provide ongoing assistance to continue to make home care as convenient, comfortable and safe as possible.

8. How many family members or friends does it take to care for a patient at home?

There's no set number. An individualized care plan will be developed that will address, among other things, the amount of care needed in your situation. Hospice staff members visit regularly and are accessible 24 hours a day, seven days a week to answer questions and provide support.

9. Must someone be with the patient at all times?

This will depend upon how ill the patient is when he or she is admitted to hospice. Generally, if a patient cannot get out of bed without help then they should not be left alone.

10. How difficult is caring for a dying loved one at home?

It's never easy emotionally and sometimes can also be physically and mentally draining to care for a terminally ill loved one. Nights can be very long, lonely and scary near the end of a lengthy, progressive illness. Hospice provides uniquely qualified nursing staff, home health aides and volunteers available around the clock, seven days a week, to consult with the patient and family. This support may allow a potentially scary time to be especially rewarding to the patient and family.

11. What specific assistance does Hospice provide home-based patients?

Hospice provides a team of nurses, social workers, counselors, home health aides, clergy, therapists and volunteers to care for each patient/family. Each team member provides assistance based on his or her area of expertise. In addition, hospice helps provide medications, supplies, equipment, hospital services and additional helpers in the home, if needed.

While most direct patient care is provided by family and friends, hospice volunteers are available to assist with errands and to provide a break and time away for caregivers.

12. Does hospice do anything to make death come sooner?

Hospice does not speed up or slow down the dying process. The hospice team is there to ensure comfort and to allow a natural death. Hospice provides its presence and specialized knowledge during the dying process.

13. Is caring for the patient at home the only place hospice care can be delivered?

No. Although the majority of hospice patients are cared for at home, care may also be provided for patients living in retirement communities, assisted living facilities and nursing homes. Many times, however, it is the patient's wish to remain at home where he or she feels comfortable and safe. Our six-bed Hospice House offers the comfort of a home, with care that may not be available at home.

14. Can a person who lives in a nursing home have hospice services?

Yes. Hospice care can provide an extra layer of care for a person in a long-term care or assisted-living facility. The hospice interdisciplinary team supports the patient/family unit as if the patient is in a regular home setting. The nurses collaborate with the nursing home staff to ensure pain and symptom control. The hospice principles of care and comfort can help enhance the care to a very deserving but underserved population.

15. How does hospice manage pain?

Hospice nurses and doctors are uniquely trained in the latest approach to medications and devices for pain and symptom relief. In addition, physical and occupational therapists are available to assist patients to remain as mobile and self-sufficient as possible. Hospice believes that emotional and spiritual pain are just as real and in need of attention as physical pain, so it addresses each. Trained counselors and members of the clergy may be available to assist family members as well as patients.

16. What is hospice's success rate in battling pain?

Very high. Using some combination of medications, counseling and therapies, most patients can have their pain managed at an acceptable level. Will medication prevent the patient from being able to talk or know what's happening? Usually not. It is the goal of hospice to allow the patient to be free of pain but also alert. By constantly consulting with the patient, hospice has been generally successful in reaching this goal.

17. Does the nurse stay at the house?

No, but the hospice nurse is only a phone call away 24 hours a day, seven days a week and any time a visit is needed. If there is a crisis, the nurse will stay with the family until the crisis is resolved.

18. Is hospice care covered by insurance?

Hospice is covered by Medicare, Medicaid and most private insurance policies. Hospice staff will gladly assist you by contacting your insurance company to assess benefits. No patient is ever turned away because of the inability to pay for care.

19. Are there any additional expenses the patient/family has to pay?

Medicare and private insurances cover all services and supplies for the patient related to his or her terminal diagnosis.

20. If the patient is not covered by Medicare or any other health insurance, will hospice still provide care?

Hospice of St. Mary's provides care regardless of a patient's ability to pay. We support ongoing fundraising events to offset the cost of those who are uninsured, or to provide comfort items that may not be covered by insurance. The hospice staff will assist families in finding out whether the patient is eligible for any coverage he or she may not be aware of. Care will always be provided.

21. What happens after the patient dies?

Hospice provides continuing contact and support for family and friends for a minimum of 13 months following the death of a loved one. Hospice of St. Mary's also sponsors bereavement groups and individual support for community members who are grieving the death of a loved one.

Eligibility

Hospice Eligibility

Patients determined to be at the end stages of illness (doctor prognosis of six months or less to live) are entitled to care by Hospice of St. Mary's. Please understand that the six-month prognosis is merely a guideline. Hospice re-evaluates patients every 60 days and, as long as their conditions continue to decline, they are re-certified for hospice coverage for as long as they live.

A Hospice of St. Mary's nurse is available 24 hours a day, seven days a week at 301-994-3023 if you ever need to discuss a patient's eligibility for hospice services.

Common Terminal Diagnoses

Hospice of St. Mary's is Available
24 Hours a Day, Seven Days a Week

Call 301-994-3023 if you ever need to discuss a patient's eligibility for hospice services.

A patient does not need to meet all of the listed conditions in order to be considered appropriate for services by Hospice of St. Mary's. This information should be used ONLY as a guideline and not as a final determining factor.

Amyotrophic Lateral Sclerosis (ALS)

  • Rapid progression in last 12 months
  • Impaired breathing at rest
  • Insufficient nutrition and hydration
  • Recurrent aspiration pneumonia
  • Upper urinary tract infection
  • Sepsis
  • Recurrent fever
  • Decubitus ulcers

Dementia

  • Inability to walk
  • Incontinence
  • Fewer than seven intelligible words
  • Albumin less than 2.5 or decrease PO intake
  • Frequent emergency department visits

Failure to Thrive

  • Frequent emergency department visits
  • Albumin less than 2.5
  • Unintentional weight loss
  • Decubitus ulcers
  • Homebound/bed confined

Heart Disease

  • Congestive Heart Failure
  • (CHF) symptoms at rest
  • Ejection Fraction (EF) of less than 20%
  • New dysrhythmia
  • Cardiac arrest, syncope or cerebrovascular accident (CVA)
  • Frequent emergency department visits for symptoms

Liver Disease

  • Prothrombin time (PT) greater than 5 seconds
  • Albumin less than 2.5
  • Refractory ascites
  • Spontaneous bacterial peritonitis
  • Jaundice
  • Malnutrition and muscle wasting

Lung Cancer

  • Advanced disease stage
  • Albumin less than 2.5
  • Calcium greater than or equal to 12.0
  • Metastasis to brain, bone
  • Decreasing functional status

Pulmonary Disease

  • Dyspnea at rest
  • Signs or symptoms of right heart failure
  • Oxygen (O2) sat on O2 of less than 88%
  • Partial pressure of carbon dioxide (P CO2) greater than 50
  • Unintentional weight loss

Renal Disease

  • Not a candidate for dialysis
  • Creatinine clearance of less than 15 ml per minute
  • Serum creatine greater than 6.0

Stroke-Acute

  • Secondary coma greater than 3 days
  • Dysphagia

Stroke-Chronic

  • Post-stroke dementia
  • Poor functional status
  • Unintentional weight loss
  • Serum albumin less than 2.5

Other Diseases with Short Prognosis

  • Esophageal cancer
  • Pancreatic cancer
  • Glioblastoma
  • Liver cancer
  • Gall bladder cancer
  • Any cancer with generalized metastases; metastasis to brain, liver, bone; or unresectable

How to Talk to Your Patients about Hospice

Setting the Stage

  • Choose a private environment that is conducive to open discussion. Try to provide seating for everyone that will be present for the discussion. This will allow the patient to feel as though they are not being rushed. Have tissues available.
  • With the patient's permission, invite the patient's family/friends/decision makers to be part of the discussion.
  • Allot plenty of time in your schedule, at least 20 to 30 minutes, in order to thoroughly discuss the patient's prognosis and whatever options may be available to the patient.
  • Turn beepers and cell phones to vibrate; do not allow any interruption and give the patient your undivided attention.
  • Introduce yourself to everyone in the room and sit in a position on the patient's level, where you can maintain eye contact.

Having the Conversation

Identify who the decision makers are; it may not always be the patient.

► Ask questions like:

"Who do you rely on to help you make important decisions?"

Assess the patient's understanding of his or her prognosis and fill in any gaps.

► Ask questions like: 

"What do you understand about your condition?"

"Do you think you will get better, worse or stay the same over the next few months?"

► Provide general estimates for how long the patient will survive and details on how the condition will progress.

Identify the patient's/family's goals for care.

► Ask questions like: 

"What do you hope for most over the next few months?" 

"Is there anything you are afraid of?" 

"Is there anything you need or want?"

► Admit limitations: 

"I wish we could guarantee....but unfortunately we can't." 

"Perhaps we can....instead."

Identify needs for care.

► Ask questions like:

"It can be difficult to care for a family member at home; no one can do it alone. Have you thought about what kind of help you might need?"

"Would it help if we could send a nurse to your home to check on you?"

"Are there any financial, emotional and/or spiritual issues you would like help with?"

Summarize the patient's/family's goals.

► Make statements like:

"It sounds like your main goal is to stay at home and be with your family and remain in control of your care."

"I can tell you want to be as independent as possible and not be a burden to your family. Having a nurse visit at home and having some help around the house might make that possible."

Introduce Hospice as a way to achieve the patient's/family's goals. 

► Make statements like:

"One of the best ways to give you the help you will need to stay at home with your family is Hospice. Hospice can also provide care in nursing homes and assisted-living residences. Have you heard of Hospice?"

"Hospice is able to provide more services and support at home than most other home-care programs. The Hospice team has a lot of experience caring for terminally ill patients at home."

"Hospice helps people die comfortably in their own time and helps people live as well as they can for as long as they can."

Respond, reaffirm and recommend hospice.

► Make statements like:

"I can see it's not easy for you to talk about this. Tell me what's upsetting you the most."

"I usually recommend that Hospice get involved for patients at this stage of their illness."

"I will continue to be your physician while you are with Hospice and will work with the Hospice team to ensure you remain pain-free and comfortable."

"I think Hospice would be your best choice right now, but, of course, the final decision is yours. Think this over for a couple of days."

"You know I will continue to care for you whatever decision you make."

"If you want, I can arrange for a Hospice nurse or social worker to visit you so that you can decide for yourself whether Hospice is right for you."

Guidelines For Physicians

Communicating with patients and their loved ones about end-of-life care options is a daunting task for physicians. At Hospice of St. Mary's, we want to help guide you in your discussions. We have included the following references to make your discussions easier.

For more information, please call the clinical coordinator at 301-994-3074.

Directions

Hospice of St. Mary's

44724 Hospice Lane
Callaway, Maryland 20620          
301-994-3023

Mailing Address:

P.O. Box 625
Leonardtown, MD 20650

Directions: View Map

  • From Route 5 in Callaway, turn onto Camp Cosoma Road (follow signs for St. Mary's River State Park)
  • Turn right onto Redbud (this is the first right-hand turn)
  • Go to the end and bear right onto Montgomery Lane (this is a small paved road - the speed limit is 10 mph and the road has speed bumps)
  • The Hospice House driveway is your first turn on the right