The Enid News and Eagle, Enid, OK

November 16, 2013

Making every day count: Hospice Circle of Love celebrates 30 years

By Jeff Mullin, Senior Writer
Enid News and Eagle

ENID, Okla. — The sign in front of Hospice Circle of Love’s offices sums up the organization’s mission statement — “Make every day count.”

In November, Enid’s only not-for-profit hospice is celebrating its 30th anniversary, as well as National Hospice and Palliative Care Month.

Hospice cares for terminally ill patients and their families, so death is a natural part of the process.

But hospice care is not about death, said Chad Caldwell, Hospice Circle of Love director.

“Hospice still has the perception that it means you’re giving up, that we’re here to help you die,” Caldwell said. “That’s not what hospice is. Whatever those final days are, we want to make sure that they are the best that they can be. We are not so much focused on the quantity of days, but the quality of days. It’s not about the dying process, it’s about the living process. It’s about making every day count.

“If we can make sure that our patients are comfortable, that they are at the place they want to be and they are surrounded by the people they want to be surrounded by, that’s what hospice is.”

“Hospice is not about dying,” said Hospice Circle of Love social worker Lynn Curl. “Hospice is about living. That’s what people don’t understand, and I think that’s why they are afraid of it.”

In the past 30 years, Hospice Circle of Love has served some 5,000 patients and their families within a 60-mile radius of Enid. In that time, not one family has been charged for any of Hospice Circle of Love’s services, and no patients have been turned away. Medicare and private insurance are Hospice Circle of Love’s primary sources of income, but if a patient is too young for Medicare and lacks private insurance that covers hospice, they are cared for regardless. In its 30 years of existence, it is estimated Hospice Circle of Love has provided more than $2.5 million in free care.

“Hospice Circle of Love exists for one reason, and that’s taking care of folks,” Caldwell said. “That’s it. The rest of the stuff doesn’t really matter. We’ve got to pay our bills just like anybody else, but we always focus on patient care.

“We have never turned down someone because they don’t have a pay source. We might not be able to admit someone because they don’t qualify medically, but if someone doesn’t have a pay source, not only do we take them and treat them, but we care for them the exact same way as someone who has Medicare or the best private insurance.”

That’s one reason Curl is Hospice Circle of Love’s longest-tenured employee. She is a 17-year veteran with Hospice Circle of Love.

“Over the years there have been a lot of changes with our hospice, but the one thing that has never changed is our goals,” Curl said. “Our goal is to provide good care so our patients and families can hopefully make a successful transition to what’s ahead of them.”

Hospice Circle of Love depends on fundraisers, memorials and contributions to help defray the costs for patients that have no other pay source. Oklahoma is one of three states in the country to not have a Medicaid hospice benefit.

To qualify for hospice care, a patient must be diagnosed with a terminal illness and must choose not to pursue aggressive treatment. Once a patient is admitted by Hospice Circle of Love, a team goes into action to meet the needs of the patient and their family, whether at home, in a nursing home or a residential facility. The team includes nurses, aides, social worker, counselor, music therapist, dietitian, physical and occupational therapist, speech therapist, spiritual care team, pet therapist and volunteers.

Naoma Snow has been a volunteer with Hospice Circle of Love for the organization’s entire existence. In fact, she helped care for the organization’s first patient in 1983.

When she filled out a questionnaire listing her qualifications as a Hospice Circle of Love volunteer, she said she “Couldn’t think why I was qualified, except I could be there. And that’s all I wrote down.”

Snow, 81, has been there for Hospice Circle of Love patients ever since, providing a friendly face, a sympathetic ear and anything else patients or their families needed.

One patient stands out, a lady in a nursing home whom the staff warned Snow never spoke. Snow went to visit the woman and did all the talking, telling the patient all about herself and her family. Before she left, Snow touched the patient’s arm and said she would come back and see her within the week. As it turned out, she didn’t make it back for two weeks.

“When I went up to say hello to her, she said, ‘I thought you’d never come back,’” said Snow. “That just melts you.”

In 2009, Snow was named Virginia Staples Volunteer of the Year by the Oklahoma Hospice and Palliative Care Association.

As a social worker, Curl is among the first Hospice Circle of Love staff members to meet with patients and their families.

“I try to connect our patients and family members with community resources that they need,” she said. “I sometimes become a mediator, an advocate. I’m not a counselor, but you spend some of your time doing some counseling. I try to educate them for that road that they are getting ready to go on.”

In 2011, Curl was named Oklahoma Hospice and Palliative Care Association social worker of the year. She has seen hospice care from both sides, as both her parents were Hospice Circle of Love patients.

“It gives you a whole different outlook as to what you’re really doing out there with these families,” she said.

The greatest satisfaction she receives from her work with Hospice Circle of Love is “Touching people’s lives. If somebody has a peaceful death and the family has been able to work through the grieving process, you’ve done what you can do.”

Hospice Circle of Love helps patients through the grieving process for up to a year after their loved one’s death, Curl said.

In the past 30 years, hospice care has exploded nationally. In 2012, an estimated 1.5 million patients received hospice care in this country, according to the National Hospice and Palliative Care Organization website. In 1974 there was just one hospice in the United States. Today there are some 5,500.

“Hospice is much more readily accepted,” said Caldwell. “I think in 1983, when this got started, it was an unknown commodity, it was very much on the fringe of health care.”

Caldwell said education remains an important piece of Hospice Circle of Love’s mission, informing the public about the benefits of hospice care, both to patients and their families.

“One thing our society does not do very well is discuss death and dying,” he said.

When Hospice Circle of Love got started, it was one of the few hospices in the state. No longer. Oklahoma now has more hospices per capita than any state in the nation.

“There is a lot more competition, and it has changed a lot,” said Caldwell.

Not-for-profit hospices like Circle of Love used to be the rule, now they are the exception.

“Today, I think there are less than 20 not-for-profit hospices in the entire state,” Caldwell said, “out of 130- or 140-some agencies.” Nationwide it is estimated that 32 percent of hospices today are not-for-profit.

In the weeks after a patient’s death, their families are asked to evaluate the level of care they received from Hospice Circle of Love.

“The thank you’s and the stories we get from families, go on and on about our staff and the care and the love they provide,” Caldwell said. “The one word that gets used most often to describe them, especially our nurses and our aides, is angels. I do think that is a pretty apt description.”

Working with a hospice, Caldwell said, cannot simply be a job.

“There are lots of jobs out there,” he said. “You have to love being with hospice. I do think it has to be a calling to be in this business.”

Hospice Circle of Love’s staff gets close to patients and their families, but not too close.

“Our staff experiences 200-plus deaths every single year,” said Caldwell. “You can’t not care about the people you are taking care of, but you can’t become so attached to them. No one can lose their best friend 200-plus times a year. I think our staff is great at finding that balance.”

Each quarter the Hospice Circle of Love staff holds a memorial service. During the service the staff gets the opportunity to talk about all their patients that have passed away in the past three months. The sessions are marked by laughter as well as tears, said Caldwell.

“Not only do I hope our staff made an impression on the family, but one thing there is no doubt, those patients and those families made an indelible impression on our staff,” he said.