Alive Hospice: Friends for Life in Nashville, Tennessee

Alive Hospice, located in Nashville, Tennessee, was founded in 1975. It provides physical, emotional, social and spiritual support to patients and families coping with life threatening illness in Middle Tennessee countries. Alive Hospice’s mission is “to provide compassionate end-of-life care, grief support and education to our patients, their families and our community”(1).
Alive Hospice is the oldest and largest non-profit hospice in Middle Tennessee(2). It offers a variety of services, including: comfort care and pain management to patients diagnosed with a life expectancy of six months or less; patient care in the home, skilled nursing facility, hospital or The Residence at Alive Hospice; Full-time board certified palliative care physicians; full-time medical staff on duty with 24-hour a day on call access; skilled teams of nurses, social workers, chaplains, and certified nurse technicians assigned to help patients and their families; and bereavement support for anyone experiencing the death of loved ones.

Hospice care is provided through a team of interdisciplinary, medically directed professionals. This team typically includes a physician, a nurse, a home health aide, a social worker, a chaplain and a volunteer. The nurse makes regularly scheduled visits to the patient while providing expert pain management and symptom control techniques. He/She keeps the primary physician informed of the patient’s condition and is available 24 hours a day, seven days a week. Home health aides provide assistance with the personal care of the patient. Social workers provide assistance with practical and financial concerns as well as emotional support, counseling and bereavement follow-up. They also determine the need for volunteers and other support services needed by the family. The chaplains provide spiritual support to patients and families, and often assist with memorial services and funeral arrangements.

During 2004, Alive Hospice served over 2,000 patients and their families, either in their homes or in The Residence at Alive Hospice. The Residence is a beautiful 30-bed, 30,000 square foot, single story residence. As with Alive Hospice’s home care program, The Residence provides care ranging from symptom control and pain management for patients, to bereavement services and education for their families. A full-time medical director is on staff, and physician coverage is available 24 hours a day. Registered nurses with special training in the care of terminally ill patients are on duty around the clock as well as care partners that assist with personal care. Social Workers that are knowledgeable about community resources and that have experience dealing with issues of death, dying and bereavement are also on staff. Chaplains coordinate support for the patient and family and provide additional spiritual support. Trained volunteers provide companionship and assist the hospice clinical staff with patient care.

Each patient is given a clean, comfortable, secure room, as well as linens and meals. Even though each room is furnished, residents are encouraged to bring their personal items in order to “customize” their room. Medicines and medical equipment needed after hospice diagnosis are also provided. There is also a “common area”, which includes a library, music room, sanctuary, sun room, and a patient spa, for residents and their visitors to enjoy.

Alive Hospice offers grief counseling for adults, children, and families coping with death and grief, as well as families facing the life-threatening illness of a loved one. Counseling is free of charge if the loved one was an Alive Hospice patient and $10.00 per session if he/she was a hospice patient outside of Alive Hospice’s service area. If the loved one was not a hospice patient, then counseling costs are on a sliding fee scale.

Grief support groups are also offered several times a year and are appropriate for those who have experienced the death of a loved one in the past two years. These groups include: Spouses Group, General Grief Group, Children’s Group (ages 8,9, and 10), Preteen Group (ages 11,12, and 13), Teen Group (ages 14-18), Bereaved Parents, Camp Evergreen, and Holiday Seminars.

Additional services for Alive Hospice families provided by the grief center include: Bereavement Care Notes, which contain helpful material about the grief process and tips for coping during time of adjustment; Memorial Services, which are held each spring and fall to acknowledge grievances; Volunteers, which offer one-on-one follow-up after the death to the families; and spiritual counseling, which is provided by Alive Hospice’s chaplain as needed.

The Grief Center’s community Services include: Alive Hospice’s “Grief in the Workplace”, which gives employees of businesses in the area an opportunity to approach grief issues that may arise in work environments; and, also, educational presentations, which are offered to faith communities, schools, and civic groups upon request.

In order to be admitted into Alive Hospice, one of the first things they will do is contact the patient’s physician in order to make sure that hospice care is appropriate for this patient at this time. Full-time medical directors are on staff to help those without a physician. The patient will, then, be asked to sign consent and insurance forms that are similar to the forms patients sign when being admitted to a hospital. These forms are signed in order to make sure the patient understands that the care is for pain relief and symptom control, not to cure the patient, and to inform Medicare patients that electing the Medicare hospice benefit affects other Medicare coverage.

In March of 1999, Alive Hospice received accreditation from the Joint Commission on Accreditation of Healthcare Organizations. This non-profit home care agency received accreditation after the commission determined it had demonstrated compliance with its standards for home care organizations.

In 2002, Alive Hospice, Inc. and Vanderbilt Home Care Services, Inc. teamed up to create a new service program for terminally ill patients who do not meet Medicare requirements for hospice care or home care. The “Hospice/Home Care Transitions Program” is a free service that will pair clients with trained volunteers to help meet end-of-life needs. The president and CEO of Alive Hospice, Inc. Jan Jones said, “There are many patients each year who fall through the cracks because they don’t qualify for either hospice or home care, but these people still have needs like anyone else. Our goal is to meet as many of their needs as possible through this program.”

The program was funded by a grant from the Memorial Foundation in it’s first year. It had several clients, then, and was working towards getting future funding to support up to 100 patients. “We’re the first program of our kind in this region and we’re very excited about its potential,” said Jones. “I see it as a wonderful opportunity to fulfill our missions in life.”

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