Rehm and Lambert were recruited almost two years ago by Hospice and Palliative Care of Cape Cod, founded in 1981, to help the organization through a critical transition point, in which it needed to reach the community more broadly and effectively. Lambert says, "The board was seeking a culture of growth in the organization. We got excited about the opportunity to be creative and focus on growth."
The number of people admitted to Hospice and Palliative Care doubled in the past year, after remaining relatively stable for the previous 20 years. Lambert explains, "We created a marketing program that was more deliberate about communication, outreach, and a lot of education."
Significantly, the hospice adopted a philosophy of care they term "open-door" admission. This encourages people to enter hospice earlier. Under the Medicare hospice benefit, which most insurers follow, patients are eligible to elect hospice if the normal course of their disease would typically lead to death within six months. Hospices are then responsible for coordinating all care related to the terminal diagnosis.
"We've had to re-educate staff and the community. It's an entirely different approach," says Rehm. Hospice and Palliative Care staff collaborate with physicians and other care providers to work as integrated partners on a patient's care. And while it may be difficult for consumers to acknowledge their mortality, talking to Councils on Aging, senior centers, and clergy helps people understand the physical, emotional, and spiritual benefits of choosing hospice. "We're really seeking to renew quality of life," Lambert says.
Hospice and Palliative Care leaders are involved in a five-year plan that focuses first on maintaining its mission of reaching everyone who's eligible for hospice, and second, exploring what other services could meet the community's needs. One development is the expansion of its service area this year through an alliance with the Hospice of Martha's Vineyard.
The agency's relationship with donors, who contribute approximately $1.5 million annually, allows it to offer services that aren't covered by insurance, such as the Grief Support and Referral Center, and Kids Grieve Too!, a support program with Murphy, the therapy dog, for children experiencing grief and loss. "We'd like to expand that. There's a significant shortage of programs on the Cape especially for children and teens," Rehm says.
Rehm and Lambert also want to ensure their agency can respond to whatever healthcare reform comes out of Washington.
Rehm believes that hospice is a model of fully integrated, coordinated care, which should be available to whoever needs it. For residents of Barnstable County, among the oldest populations in the country, that mission becomes increasingly urgent.