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By Dr. Colleen Morley, DNP, RN, CCM, CMAC, CMCN, ACM-RN, FCM

November, among other recognitions, is National Home Care and Hospice Month. It is also the 2nd anniversary of my mother’s passing. I would like to take this opportunity to publicly thank the Home Care and Hospice specialties for the work they do every day and in particular, for the care extended to my mother.

Many of you know this story; so bear with me one last time. My mother was a nurse, ICU, CCU, ED, for 38 years. She lived healthcare and was fairly conscientious about her health, having several chronic conditions. When she retired, she stayed engaged in healthcare by managing her and her husband’s health issues, always reading up on the latest and greatest information.

She saw her PCP monthly, along with other specialists; sadly, no one caught the signs and symptoms that led to a surprise diagnosis of stage 3 Parkinson’s disease with onset of dementia at age 69. She passed on less than two years after that day. During those two years, we engaged home care to support her after her hospitalizations. She adored her home care teams; they would chit-chat about her brief stint as a home care nurse and the adventures in home care, as Mom called it.  She would always try to go above and beyond for her home PT and OT teams.

We would talk about hospice; even as a nurse, she wanted to postpone using hospice services as long as possible. I would pull out my case manager hat and quote statistics, go over services offered but she always stated that “she wasn’t ready to call it quits”.  My replies of “it’s not quits” fell on deaf ears.  I am sure every case manager reading this has had this experience.

After yet another hospitalization, she was too weak to come home and needed to go to rehab (again). Her previous experience in rehab ended in a recommendation of needing long-term care (she declined). I negotiated with the rehab facility to give her a week’s trial. If she did not progress, we would move to other options. They agreed. I brought this to Mom. She was happy that she was going to rehab as it “gave her hope” but said that if she wasn’t able to handle it, she would consider going home on hospice care.

Well, she couldn’t handle rehab and was discharged home to hospice care (a provider with a Parkinson’s specific program). They met her every need. There was someone from the hospice team to see every day (“my visitors”) and she was able to stay in her home, comfortable, until the very end. As luck would have it, her fabulous hospice nurse was at her side when she left us.

One of the last conversations I had with her revolved around her reluctance to get hospice involved earlier than she did. She said, “as a nurse, I know what hospice is and what they do; as a patient, I wasn’t ready to hear it.”  Mom transitioned to hospice care in May 2020 and passed on November 9, 2020.

Thank you to Home Care and Hospice practitioners, team members and providers for giving us this phenomenal option for our patients to meet life and death on their terms, in their preferred environment and respecting their goals. And thank you to all for the opportunity do what Mom told me;  “tell my story, teach others”; a nurse to the very end.

Bio: Dr. Colleen Morley, DNP, RN, CCM, CMAC, CMCN, ACM-RN, FCM, is the Associate Chief Clinical Operations Officer, Care Continuum for University of Illinois Health System and the current President of the Case Management Society of America National Board of Directors.  She has held positions in acute care as Director of Case Management at several acute care facilities and managed care entities in Illinois, overseeing Utilization Review, Case Management and Social Services for over 14 years; piloting quality improvement initiatives focused on readmission reduction, care coordination through better communication and population health management.

Her current passion is in the area of improving health literacy. She is the recipient of the CMSA Foundation Practice Improvement Award (2020) and ANA Illinois Practice Improvement Award (2020) for her work in this area. Dr. Morley also received the AAMCN Managed Care Nurse Leader of the Year in 2010 and the CMSA Fellow of Case Management designation in 2022. Her 1st book, “A Practical Guide to Acute Care Case Management”, published by Blue Bayou Press was released in February 2022.

Dr. Morley has over 20 years of nursing experience. Her clinical specialties include Med/Surg, Oncology and Pediatric Nursing.  She received her ADN at South Suburban College in South Holland, IL; BSN at Jacksonville University in Jacksonville, FL, MSN from Norwich University in Northfield, VT and her DNP at Chamberlain College of Nursing.

 

To learn the difference between palliative care and hospice care, watch the 1-hour CE course "Respecting Choices: A Guide to Advanced Care Planning": https://www.pathlms.com/cmsa/courses/40415
This presentation will help the viewer to develop a toolkit for advanced care planning with patients and their families.