Jul 5, 2017 5 min read

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Becky Markley was in the hospital once again. The former nurse was used to working in healthcare environments, but was growing weary of always being a patient and knew her health was deteriorating. “I smoked for years and I did finally quit but, by then, I had already done the damage,” admits the 68-year-old Washington resident. She suffered a heart attack years ago, had bypass surgery and was eventually diagnosed with heart disease, lung disease and end stage chronic obstructive pulmonary disease (COPD). During her last hospital stay in December, staff arranged for her to have home care through Concordia Hospice of Washington. Markley had hospice care before through a different agency and was not happy with the experience, but, this time, things were different.

“I’ve been seeing her since December and she was not in too good of shape then,” says Concordia nurse Carl Fleissner. “She pretty much lived in bed and on the couch then. She was severely short of breath.”

Fleissner says the previous agency had not tried any morphine or other medications to attempt to give her relief so that she could do some activities.

“I’ve always been independent and I raised my kids to be independent,” explains Markley. “You don’t realize how much you depend on being able to move around and do things until you can’t do them.”

She used to be in too much pain and too short of breath to be able to take a shower by herself. Fleissner tried some new medications to alleviate those symptoms and it’s given her back that ability and independence.

“Hospice is just not for someone who is dying,” explains Janine Zito, executive director of Concordia Hospice of Washington. “It’s for someone who has a chronic illness and is going in and out of the hospital on a constant basis and they’re tired of going to the hospital. They want to enjoy some quality of life and spend more time with their family.”

Concordia Hospice of Washington, a non-profit that serves Washington and Greene counties, offers home hospice services and a residential facility called Donnell House, which was designed to provide a comfortable, home-like atmosphere for those receiving end-of-life care. Staying at home can vastly improve the quality of life for those who are chronically ill and hospice is an insurance benefit designed to help. Services are covered 100 percent through Medicare and include nursing care, social workers, counselors, aides and nursing assistants.

Hospice redirects hope related to keeping the patient comfortable at home and out of the hospital so they can enjoy life.

“Not everybody can go out, but sometimes there are people who want to go to the casino or their grandchild’s graduation and we’re able to get them to that point,” Zito says. “We’ve had people go on vacation and if they go in another state, we set them up with a hospice agency in that state in case there’s an emergency.”

The program is designed to begin when doctors determine a patient’s condition is not going to improve and there’s no more aggressive treatment available. Hospice focuses on managing and adjusting medications to treat symptoms and improve how patients feel. “Sometimes, we improve people so much with their health and well-being that they’re able to be discharged off of hospice services because we’ve been able to keep them out of the hospital and free of infection,” says Zito. “They get stronger and feel better and are able to go out and do the things they want to do. It’s exhausting to go back and forth to hospitals and doctor’s offices and so we find that when we get them and they come onto our services, we’re able to be the person between the physician and the patient.”

Zito says staff follow patients closely with several weekly visits that often enable nurses to recognize a potential problem before it worsens and allows patients to avoid ending up in the hospital again.

That was Becky Markley’s situation six months ago. “She also has diabetes and neuropathy and was having pain in her legs and wasn’t sleeping well,” Fleissner says. “We increased her medication so that her leg pain went away and she’s able to sleep.”

Now, Markley can get around her apartment more easily and do more activities. What’s noteworthy is that since she started care with Concordia in December, she has not been back to the hospital. “You can really help them a lot if you manage their symptoms,” Fleissner says. “If you can do that, they can live fairly well.”

Markley says the difference is tremendous. “Hospice helps you do that. I don’t want to sit in front of the TV and vegetate. I’m a lot more comfortable than I was. I consider Carl a friend now, and not just a nurse.”

Markley says she also feels relieved that Fleissner and the rest of the staff will be there for her in an emergency. Her goal now is to enjoy as much time as she can with her two children and two grandchildren. “I’m not afraid anymore,” she says. “You want your kids to have independence and I never really wanted to live with them. I just didn’t want to be an albatross around my kids’ necks. My daughter says now she doesn’t have to worry about me so much.” n