Heading Upstream – Expanding Our Services and Changing Our Name

Charlene Thurston, R.N., A.N.P.

We have come to a crossroad in the evolution of our program and have had to make a decision about whether to become a “Medicare-certified” hospice or to continue to move upstream in the patient’s disease progression to offer more services to patients who are not terminally ill. For many reasons, we have never felt that becoming a Medicare hospice was in the best interest of the program or of the people of the island, and we have consistently tried to offer services beyond the confines of such a program and prided ourselves in being different from other hospice programs. Our goal, since we first developed our program, has been to consistently broaden our reach to serve patients from the time of diagnosis onward, not just at end of life.

However, as much as we’ve tried to encourage patients to use our services early in their disease, many, many patients who could benefit have not accessed them because of the “terminal illness” connotation of the name hospice. In light of all these reasons, we’ve decided to change our name and to continue to expand in directions we feel will better serve our community, rather than becoming a “Medicare-certified” hospice and restricting our services to the terminally ill – a move that we feel would be going backwards.

While this has been a difficult decision, when we really looked at what we were offering and what organizational structure we’ve felt was best for our program, we realized that offering palliative and supportive care is what we’ve always been striving for. We’ve never wanted to restrict ourselves to end of life care, because we’ve always recognized that the same services that were available at end of life (defined by Medicare as the last six months of life) should be available to patients and families from the moment a patient is diagnosed with a life threatening illness. Moreover, we’ve been trying to develop services to help patients get well again in their efforts towards cure, a program component that no other hospice I’m aware of offers.

After much consideration, the new name of our program will be Palliative and Supportive Care of Nantucket. While this is quite long, we wanted to be sure that our name would be inclusive of all we plan to offer, and not be restricted again as regulations change over the years. We feel that this name will accurately reflect our program of services and our overall goals, and we’re hopeful that it will also pose less of a barrier for patients who fear the “end of life” connotation of hospice.

It’s important to realize that all of our present services will continue just as they are. We will continue to offer excellent end of life care, in exactly the same way as we always have, but, in addition, we will expand our reach to offer more services to patients in earlier stages of illness. We’re very hopeful and excited to try to promote this aspect of our program. Most importantly, all of our services will continue to be offered free of charge.

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