To help patients live peacefully and at ease during one of life’s most vulnerable moments, Center for Hospice Care (CHC) welcomes all with open arms to its HeartWize program. Through the program, the CHC staff develops individualized plans with each patient and their loved ones to help them manage heart failure and other heart diseases, allowing patients to receive quality care in the comfort of their own homes without the worry of a hospital visit.
“When their symptoms are not managed promptly, it gets to the point that patients can't breathe. When a patient can't breathe, the very first thing they're going to want to do is go to the hospital,” said Director of Nursing Chrissy Madlem. “It's important that we teach them the techniques to manage these end-of-life care symptoms that they're dealing with so they can stay home and be comfortable with their families.”
Heart diseases can have a crippling effect on the body and often brings about symptoms such as weight gain, chest pains, and shortness of breath. With such sensitive and versatile symptoms, CHC understands that no two treatment journeys are ever the same. While one patient may be set on monitoring his or her weight, for example, another may just want to be able to breathe with ease.
Each treatment plan takes these needs into account and from there sets a course of action. This may include education on different types of medications or mindfulness activities for both the patient and his or her loved ones. Weight is also monitored closely, as an increase in weight can mean an influx of fluid in the body, one of the key indicators of heart failure or other related diseases. By having such a detailed plan in place, the CHC team can always keep an eye on the patient’s status and take immediate action should an instance ever arise.
“We see the patient pretty frequently – visit schedules are like a fluid document. It's based on the needs of the patient and can change when needed,” Madlem said. “They establish the patient’s base weight and then manage their care based on that. Heart failure patients have one of the highest frequencies of rebounding back to the hospital because they have trouble breathing very easily and could have chest pain. We want to monitor their symptoms and teach them ways to manage their symptoms at home to prevent rehospitalization. We also have a 24-hour triage, seven days a week. Our patients have access to care, so we monitor them closely, get out to them quickly, and prevent them from being rehospitalized.”
No matter how the plan is designed, however, the patient is always in charge and will always have final say at every point in time.
“It is all about the patient,” Madlem said. “The patient is in the center, and we are around the patient. I always tell our nurses, ‘The patient is in the driver's seat, the family is in the front seat, and we're in the back seat.’ We're not going to be backseat drivers. We're just along for the ride, and we're going to go where the patient and the family want to go to manage their care.”
To make sure all staff can provide quality cardiac treatment to each patient, the CHC team undergoes extensive training. The treatment is not limited to the nursing staff, either – establishing this quality care is a group effort and comes with the help of CHC’s spiritual services, care services, social work services, countless volunteers, and many others to make it all happen.
“It is a two-day cardiac boot camp,” Madlem said. “It’s 16 hours in total of additional cardiac and COPD training. It covers all the pulmonary types of diagnosis along with cardiac diagnosis. Nurses were brought in, and we had a very lofty goal after we completed the education to have every nurse at CHC screened in this program within the first quarter of the year. We did accomplish that goal, and every nurse under our roof has been trained.”
Being able to offer a program that allows patients to receive such personalized care in the comfort of their own homes means a lot to the CHC team. It holds a special place in Madlem’s heart particularly, as she was a nurse on the team years ago when the program was first established, and she was also a big proponent in the program’s recent revisions. To watch it grow over the years has been a wonderful feeling. It means the world to Madlem that such special care is readily available for all patients right in the heart of the Mishawaka area.
“I have worked here for 18 years this year, and I was a nurse when we first created this program – I was one of the first nurses in the program,” she said. “I had a cardiac background before coming to CHC, and I worked as a cardiac nurse. This program has always been dear to my heart, so when I became the director of nursing a year ago, I had a great passion to have this program be resurrected, so we definitely worked hard to get it done. We have an amazing team.”
For more information on Center for Hospice Care, visit cfhcare.org.
