What is Palliative Care and How is it Different from Hospice?

In this episode, we dive in deep with Mindy Rice from Hospice & Palliative Care of Iredell County to demystify the often misunderstood concepts of hospice and palliative care. Mindy explains that palliative care is a specialty focused on pain and symptom management for those suffering from serious illnesses, while also differentiating it from hospice care, which is geared towards providing comfort during the final stages of life. She shares personal anecdotes, including her own father's experience with esophageal cancer, to illustrate the profound impact of these services.

We also learn about the significant roles that team members like doctors, nurse practitioners, social workers, and caregivers play in both hospice and palliative care settings. Mindy highlights the importance of advocating for a loved one's care and the available resources to support families during these challenging times. Tune in to discover invaluable insights and practical advice that can enhance the quality of life for patients and bring peace of mind to their families.

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Transcript

Darleen Mahoney [00:00:01]:

Today we are super excited and lucky to have Mindy Rice in the podcast studio today. She is the director of development and marketing for Hospice and Palliative Care of Iredell county, which is in North Carolina, correct?

Mindy Rice [00:00:16]:

It is, yeah.

Darleen Mahoney [00:00:17]:

Okay. She is a proud graduate of Appalachian State University. She has been with Hospice of Iredell for 20 years. That's a long time. She has a passion for helping people learn more about hospice and pall care so she can help patients and their families navigate what is definitely a very difficult time. Hospice and Palliative Care of Iredell county has been serving patients for more than 40 years and is a five star Medicare rated Hospice and Hospice Honors elite recipient. That's pretty nice.

Mindy Rice [00:00:53]:

It is. Very proud of that.

Darleen Mahoney [00:00:54]:

Yeah, absolutely. You should be. For sure. So I'm excited to dive in and talk about hospice and palliative care. And I'll be straight up. I really don't know much about palliative care, so I'm really excited to learn today. And I'll probably have a lot of questions because that's usually how it rolls. So tell me, what is palliative care?

Mindy Rice [00:01:16]:

Sure. Well, first of all, thank you so much for having me and just this platform to be able to share more about hospice and palliative care, which really can be so beneficial to patients and families during what is always a difficult time. So we appreciate your support in that. Palliative care is a specialty similar to your cardiologist, your podiatrist, whatever it might be. So if you think about when you have been dealing with some sort of a serious illness and you want to go to the specialist in pain and symptom management, and that's basically what they do. So palliative care is a specialty service for patients who are suffering with a terminal illness and experiencing pain and symptom management. And it allows our doctors and nurse practitioners to be able to go in and help a patient with their pain and symptoms, whether it be that you are receiving chemo treatments for cancer or you're just, you know, you're not quite ready for hospice, but you need that pain and symptom management.

Darleen Mahoney [00:02:31]:

That makes perfect sense. And I had never really thought that that was something that was an option. And I do know that you are clearly at certain times, especially with, like cancer and other illnesses, you're not. You can still be somewhat independent, but the pain is really what you have to power through.

Mindy Rice [00:02:50]:

Exactly. And that's really the main difference that I know. We'll get into exactly what hospice is, but the main Difference between the two is with palliative care, you're still here. You're still in that curative treatment time. You're receiving curative treatment. Your hope is that, you know, you're going to be able to treat this diagnosis, this disease, whatever it is that you're dealing with. And, you know, then we discharge you, and that's pretty much like a specialty. You only go to a specialist when you need them.

Mindy Rice [00:03:22]:

So that is a little different as well. So you're only going to have a visit or a phone call from a doctor or nurse practitioner when you need it. So it might look like you only see the palliative care doctor once every six months or once every two months or whatever it is that that's needed at that time. And along with that, they're the experts in navigating that end of life and serious illness so they can help with end of life planning and just maybe getting ready for when it might be time for hospice.

Darleen Mahoney [00:03:54]:

Okay, so are there times I'm suspecting, that you might go through palliative care and then have a full recovery? So hospice isn't always the next step, but it can be. It can be something that is. That carries on over after the palliative, Is that correct?

Mindy Rice [00:04:12]:

Absolutely. Yeah. And depending on where you live and what that program looks like in Iredell county, with hospice and palliative care of Iredell county, we do focus on palliative care patients who have serious illnesses. But there are places across this country that are offering palliative care as part of their treatment plan for a knee replacement or a serious surgery, because that physician knows how to treat that pain. Well, my best example of that I always use with my own experience with my father. My father had esophageal cancer. And although his physician, his oncologist were great, they knew how to treat this disease, but they were not good at treating his pain. And so my mother was driving 45 minutes back and forth for this liquid hydrocodone that he was taking, and he was watching the clock because if you can imagine, you receive radiation to your throat, the inside of your throat, it's very painful because it's really burned, basically.

Mindy Rice [00:05:22]:

And so he's looking at the clock every four hours, just waiting to take his dose because he's in so much pain. And then it's hard for her. She's 45 minutes back and forth to get a paper prescription, and it just was not working well. And so I finally called, and I'm in North Carolina there in Florida and even then, the misconception. I called and I said, listen, I want my dad to have palliative care. And the nurse practitioner at the oncology office says, well, he can't because he's getting chemo. That is not true. You can receive palliative care services alongside curative treatment like chemo.

Mindy Rice [00:05:59]:

And so once we got that referral sent over, his pain was managed in so much of a better way. They were able to call in the scripts, the nurse practitioner could come to the home. He didn't have to go out. So it just, all in all, it was exactly what he needed at that time.

Darleen Mahoney [00:06:22]:

I will tell you, as someone that has been in the hospital or seen family members that you love and care for, experience pain that is so stressful when you can't fix it. And for your mom, I know that she's driving, she's trying to get that done, and, you know, traffic and all these different things, you know, are a stressor, an additional stressor that she does not need in her life to properly take care of your dad. Because it is. It's hard to watch someone in pain. I mean, for me, it is. I know that. It's just. It causes me anxiety because I can't fix it.

Darleen Mahoney [00:06:58]:

I'm a fixer. And so, yeah, I think that is something that's really cool. And then something you mentioned, the palliative care, they come to your home.

Mindy Rice [00:07:07]:

They do, they do. And that looks very different as well. Across the country, we have some young palliative patients that they don't want anybody coming to their home so they can come into a clinic, clinical setting. But majority of our palliative care patients are in their home, which is just such a benefit for maybe, you know, many of our patients, they're not getting up and around anymore, or maybe their caregiver is elderly and it's just hard for them to get out of the house. So it really helps to be able to simplify things a little more, get the care that they need, get the pain and symptom management they need. And then every palliative care doctor works very closely along with, with the patient's primary doctor or other specialists, whether it be an oncologist or a cardiologist. So everybody works together as a network.

Darleen Mahoney [00:07:58]:

Yeah, they're talking. I like that. Because we don't always get that in medical care. When everybody is seeing different types of specialists, they don't always talk. So that's something that has to be facilitated. One of the things that you were mentioning, as far as getting out of the house. I always think just getting in and out of a car can be adding to that additional pain. Going up and down stairs to leave a home and even walking through a medical facility.

Darleen Mahoney [00:08:25]:

I mean, that can be a lot of work if you don't have access to a wheelchair or a different type of device.

Mindy Rice [00:08:31]:

Yeah, absolutely. And having a palliative care doctor. And I can only speak for our organization, but when our patients are in crisis or they have a question, they can call us. So we can. I mean, we're avoiding hospitalizations, which keeps people healthier and keeps people at home. Spend more time with your family. All of those things that are just so important.

Darleen Mahoney [00:08:58]:

Yeah. I think with palliative care, if you're not at that point of needing hospice or having that conversation about hospice at that point, and there is some expectation of recovery or maybe going into remission for long periods of time, the pain can alter your entire. It can alter your life as far as just the general things you would want to get out of life. So if you're treating a disease and you're not able to decrease or eliminate the pain, your quality of life is clearly affected more significantly than just with the treatments and the diagnoses and the disease itself.

Mindy Rice [00:09:40]:

Right. 100%. And it's just unnecessary to live with pain like that. And I know, you know, so many of our patients, when they come on, they have lived with it for so long to the point where they've just adjusted to it, and once we get it under control, we're like, wow, I really can have a good quality of life, even though I'm dealing with this illness.

Darleen Mahoney [00:10:00]:

Yeah, no, I think that's so important. It's so super important. So as far as what is. What's the difference in similarity? I got it out. Between hospice and palliative care. Is there like a defining line. I know that you mentioned that palliative will help into that process of hospice, if that is the next step.

Mindy Rice [00:10:27]:

Right. And there is a defining line, and it's. Nobody has a crystal ball and knows for sure what's going to happen. But hospice care is typically for patients who are going to likely pass away within six months if their disease follows their natural course. Where palliative care, there's no timeline for that. You can be receiving curative treatment. Your focus is still on curing. Where hospice.

Mindy Rice [00:10:55]:

Your focus is on comfort. So you're looking at palliative care. You can have any time. Hospice care, you have to have that prognosis or six months or less. And really, the Big, big thing is that you can still combine it palliative care with your curative treatment. And again, as you mentioned, if you can have your symptoms and your pain under control while you're receiving treatment, a lot of times you can have more successful treatment because you're not in all that pain.

Darleen Mahoney [00:11:25]:

Yeah, yeah. I mean, I will tell you, pain will cause anxiety and stress and loss of sleep and it's just not healthy. I mean, you can't be in a place when you're dealing with that on a daily basis.

Mindy Rice [00:11:36]:

Right, exactly.

Darleen Mahoney [00:11:37]:

It's not even just the joy you get from everyday living. It really can take a toll on you physically as well as mentally, for sure. So what are the roles within the care plan? I mean, do they. The hospice and palliative. So they're working together on a care plan and that could include like the primary or the oncologist or whatever the case may be. And it's in its all together put together program kind of thing or.

Mindy Rice [00:12:06]:

Well, you have. And that's another one of the main differences between palliative care and hospice care. With palliative care, your, your team really consists of the physician, the nurse practitioner, and then some organizations like ours do offer a social worker. On the hospice side, as you can imagine, if you're shifting just to comfort care, you need more services. So at that point, you have the nurse that makes at least weekly visits, if not more. You have the nursing assistant who can come out and help with baths and maybe some light housework. You have a social worker that is following your case all the way through the journey and helping your family with any needs that they have, whether it be just comfort and care and education or helping with end of life planning and then the patient as well, helping them to maybe talk through some things that they need. And then we have volunteers that can help and chaplain services as well.

Mindy Rice [00:13:06]:

So because when you're on that hospice trajectory, your disease is declining, you have more services and more people that are part of your care plan. But, but either way, it's tailored to the patient's needs, whether it's hospice or palliative care. And everybody works together, including the patient and the family.

Darleen Mahoney [00:13:30]:

Yeah. So what are some resources for the families? Because I know that that's something that if you're not familiar with is you need to educate yourself and you don't necessarily want to go to Google to get the information. But if you're working, are they included in the care plan? Are they part of the conversation and decision making?

Mindy Rice [00:13:52]:

Absolutely. The family is a Member of what we call our interdisciplinary team. So our staff meet every other week to discuss every single patient with every single discipline in our care team, and that includes patients, family. They're invited to come to that. We discuss and explain everything that is happening with their loved ones, educate them on how to change. Change the bed sheets, you know, in a way that the patient can still remain comfortable. Everything from something like that to why and how to, you know, administer a medication.

Darleen Mahoney [00:14:34]:

Right, right. I do remember on the hospice side with my mom who was in hospice, my mom was very. She. She died at a very young age. She was in her late 60s. She has. She had ovarian cancer, but she was still, like, completely intact as far as she knew what was going on. And she'd always been a very prideful woman and lady.

Darleen Mahoney [00:14:58]:

And when it came to the point where she wasn't able to get out of bed to go to the bathroom and she was. We had not switched her over into the adult diaper on the hospice side yet. But just having help on how to as a family, as her daughters, to help her to get on the little potty, it was so important that I think that we knew how to work with her on that because that was one of the hardest things, you know, for my mom with cancer, losing her hair was almost worse than the chemo. She just stressed about it, but that she just really had a hard time letting go of her. I don't want to say pride, but of kind of her what was her. What she had control over. And now my sister and I are really helping her just barely get out of the bed. And having that help, help to be able to know how to do that is so super important because it's those little things that can keep that dignity intact for your loved ones as well.

Mindy Rice [00:16:00]:

Yeah, that's exactly the word that you were looking for.

Darleen Mahoney [00:16:03]:

That was. The word I was looking for is dignity.

Mindy Rice [00:16:05]:

And, you know, that's our patients. They're the boss until they can no longer speak for themselves for sure. So we meet patients where they are. We want to honor their wishes and do everything we can to honor exactly what it is that they want. You know, what do you want your end of life journey to look like? And most want to be home with family and free of pain and kept clean and comfortable. And that's. That's what we aim to do.

Darleen Mahoney [00:16:35]:

No, that's perfect. Absolutely. I know that one of the things when my mom was in hospice is her dog slept in the bed with her the whole time.

Mindy Rice [00:16:42]:

Oh, yeah, yeah. And we, you know, there's different, there's different kinds of hospice care, levels of care we call them, and home hospice care. And then there's inpatient units, which we're very fortunate in our community to have two hospice houses here. And that point for us, patients are typically about three weeks. And that's for patients who just have pain and symptoms that are out of control. They need 24 hour care, or maybe they don't have a caregiver or young children in the home, but in that situation, the services are the same. They're just there 24, seven for them. But we always encourage whatever it is that brings a patient comfort, bring your pet in, bring your own pillowcase, whatever it might be, encourage family to stay alongside their loved one.

Mindy Rice [00:17:39]:

And at that point that, at that point we're there for that patient and family 24, seven. And a lot of times it's also used for what we call respite care. So when you need that five days where, you know, the caregiver just needs a rest so they can come into a hospice house or an inpatient setting of their choice and have hospice care 24 7. And it just allows that either a family to travel or maybe they just want to sit next to the bedside and not have to actually care for their loved one. They just want to be there.

Darleen Mahoney [00:18:15]:

Yeah. You know, we don't ever talk about respite. And I know that I'm out, you know, in the community talking to people, you know, just even in my personal life, and they, they need respite for even something as simple as my mom has dementia, she lives with me, and I would like to take a vacation. They don't even know that it exists.

Mindy Rice [00:18:33]:

Right.

Darleen Mahoney [00:18:34]:

So I think it's so important to share that this is such a fabulous option for people that do need that you can only be as good of a caregiver as you are a healthy person. If you go down that road and you're just not getting sleep, you're exhausted, you're not eating, you're emotionally distressed, you're not gonna be the best caregiver for that person.

Mindy Rice [00:18:56]:

Exactly. It's so important to care for the caregiver and to not get that compassion fatigue. And so, yeah, not only is respite an option, it's a Medicare benefit. It's one that, you know, we've all worked our whole lives to have that benefit that is there for us and it can be used basically, I believe, don't quote me, but I believe it's once every 30 days. Or something like that. And it's for five full days, and it's. I really encourage people to take advantage of that. Your loved one will be cared for and you'll get the care that you need whether you take a vacation or not.

Mindy Rice [00:19:35]:

You just get five days where maybe you just go home and you rest.

Darleen Mahoney [00:19:40]:

Yeah, exactly, exactly. Maybe scooching a spa day, even, that would be, you know, just throwing some ideas out there while we're on it. So. So are resources provided to families post hospice? Is that something? Because once you lose a loved one and you've been through that emotional journey, especially if you've done the palliative care, gone into the hospice care, that could be a good chunk of time. And then once someone passes away those resources, because at that point you're exhausted, you're broken, you're heartbroken, and it's just a whole different thing. Is that something you provide as well? Is that something that's typical?

Mindy Rice [00:20:19]:

Yes. So it is part of Medicare requirement, the conditions of participation that a hospice organization offers bereavement care for the primary caregiver, and that is for 11 months after the patient has passed away. Our organization, just like many across the country, offer grief and bereavement support not just to our hospice families, but to the community, as in general, we have caregiver support groups and grief and bereavement support groups as well. So. And our. Our bereavement staff follow up with all of our families on anniversaries, whether it be a birthday or a death anniversary or. Or the holidays is a big one as well. Kind of getting through the holidays, especially.

Darleen Mahoney [00:21:08]:

Those first holidays, I think absolutely. Probably the toughest to power through the first birthday, the first Mother's Day, the first. Everything just, you know, just tips and.

Mindy Rice [00:21:17]:

Tricks on how to navigate that first holiday. And sometimes people just need to know it's okay. If you just want to say, I'm not. I'm just going to stay home, that's okay. There's no, you know, rule to that, but, yeah, we're definitely there. Always encourage our families to call us if they need anything at all.

Darleen Mahoney [00:21:34]:

Yeah, yeah. So how do you refer a loved one to hospice or palliative care? I mean, is that something you wait for your primary to do, or is that something you need to be more conscientious of?

Mindy Rice [00:21:45]:

Well, there's a couple things I always look for, and I always try to explain to people when you think it might be time. And I say this because you can advocate for your loved one, you can advocate for yourself. You don't have to have a doctor say it's time for hospice. You can call and say, hey, I think it might be time. You can call your doctor and say that, or you can call your local hospice and say that, and they will help navigate that. But we look for, regardless of a diagnosis, if a patient is starting to have multiple falls, if they've had, you know, one or more hospitalizations within a short period of time, maybe they're not eating as much, maybe they're not getting up and getting around quite as much, maybe they're having frequent UTIs. Those are all kind of the key things to say, oh, this person might be starting to decline and they may qualify for hospice. And at that point, you can call your local hospice, or you can call, you know, the physician and ask for that referral.

Mindy Rice [00:22:49]:

It does take, although anybody can refer, it does take a written hospice order. A physician has to say that they feel this patient is ready for hospice services. But anybody can call at any time, and most especially community based hospices are going to be very open to even home visits to say, I'll just come out and explain to you what this looks like so that you're comfortable.

Darleen Mahoney [00:23:14]:

Right, right. So on the palliative care side, is that something you would have to talk to your primary physician about to advocate for yourself if it's not something that he's already or she's already recommended? Is that something you want to kind of keep in the back of your mind if you think that the pain is just getting to be too much?

Mindy Rice [00:23:34]:

Yes, yes, for sure. It is becoming very much more common. Years ago, it was, you know, very. I mean, this for us, for our organization. This has been the first year that our palliative care referrals have surpassed our hospice referrals. So we're getting much more palliative referrals. Some of that is, you know, it's a lot easier for a doctor to say, I'm not going to, you know, you're not ready for hospice. But I think you could really benefit from palliative care knowing that probably very soon the patient may transition.

Mindy Rice [00:24:13]:

So that makes it a little easier. But it's still fairly new. So I always encourage people to advocate for their loved one. And palliative care is a great way to start. If you're not ready to talk about hospice care or just, you know, maybe you're not sure that that's quite the direction you need to go, you can always call about palliative care and they'll ask the Right. Questions to get the right care for you.

Darleen Mahoney [00:24:38]:

Right, right. No, I love the fact that the palliative care is there, and it is. It does seem new because I really don't remember the conversation on palliative care years ago, but I'm somewhat new to, you know, senior living in general just in the last six or seven years. And it's been. Been a whirlwind of information because it is senior housing, senior living, senior health, all these things, they're just so complex. The older you get, the harder, the more complex, you know, all of the things get to be. Which is so disheartening. It's supposed to get easier, but it doesn't.

Darleen Mahoney [00:25:14]:

So.

Mindy Rice [00:25:15]:

Oh, no, it's, it's. And. And, you know, I. We always say we can't imagine families going through this alone. And years ago, before palliative care was. Was so much more common, you know, as a hospice organization, we would be frustrated. You'd have a patient come in that didn't qualify for hospice services. They weren't quite at that six months or less.

Mindy Rice [00:25:35]:

But, man, we could see so many ways that we could help them and make their lives easier and their quality of life better. But we were, we were. Our hands were tied. So once palliative care came to be, it just opened up this whole new side of care that we can provide for families that aren't ready for hospice but still need that pain and symptom management.

Darleen Mahoney [00:25:57]:

Right. And I almost feel like the palliative care would be super beneficial. Even more so, to be honest with you, someone that doesn't have a consistent caregiver or a family member that's living alone or that type of thing, because they don't have someone typically advocating on their behalf, but also making their quality of life while they are trying to navigate their own home or whatever the case may be to, you know, just doing dishes or, you know, simple things like that. If they don't have someone there that's able to assist.

Mindy Rice [00:26:28]:

Yeah, palliative care. Now, palliative care does not have like the certified nursing assistants that help with the lighthouse work and all things like that, because it's really just for pain and symptoms. But having that social worker aspect, they're going to go in and identify these needs and they're going to be able to connect this patient with resources in the community that can help them with these needs. And it's just like you said, it's an advocate. It's somebody that's going to work to keep the patient at home if that's what they want or whatever their wants are for that time in their journey.

Darleen Mahoney [00:27:06]:

Yeah, absolutely. And advocating for yourself is really the best way. But education, if you don't know what you need, you don't know what's available, then you don't know how to advocate in your best interest because you just don't know what's there.

Mindy Rice [00:27:18]:

And it's so hard. It really is hard. Even when you've worked in it for so many years, when that happens to your own family, you're just kind of at a loss. So oftentimes when we see that and patients and families that have been dealing with illnesses for years and years, just the relief that they feel when they just have a phone number to call when they have a crisis situation and that somebody can come out to the house any time of the day or night rather than going to the emergency room. It's just. The relief is tremendous.

Darleen Mahoney [00:27:52]:

Yeah, I absolutely agree with that. So how do you pay for palliative care and hospice care? I mean, I know that, you know, I think Medicaid pays for some things. Medicare, I mean, correct me on each of those. But what, what, what is the expectation? Because clearly medical costs, especially if you've been dealing with cancer or long term illness, you know, that piggy bank may be drained.

Mindy Rice [00:28:16]:

Oh, absolutely. So palliative care is billed the exact same as any specialist. So if you have a car, you know, your cardiologist, you have a, a copay, you would have a copay. For hospice care, it is Medicare and all Medicaid and all most major insurance companies will cover hospice care. Of course, our organization, not all, but many, are nonprofit. So in that case, there's never a barrier to care, whether somebody can't cover their copay, whether they don't have any insurance at all. I will say that most palliative care programs that are associated with hospice programs are nonprofit organizations because palliative care is very expensive and insurance just doesn't reimburse enough. So we do it because people need it in our community and hopefully it gets these patients connected to hospice services sooner so they can get that whole array of services that they need.

Darleen Mahoney [00:29:20]:

No, I love that you shared that, because I would have never thought to specifically, you know, no matter where you're located, look for nonprofit palliative care or a hospice that has and offers the palliative care and see if that's something that can be included with a care plan at that. What is it? Is it a reduced rate or if it's something that's covered under Medicare or exactly how does that work?

Mindy Rice [00:29:43]:

Well, it's, we, it just depends on the service. Like in the hospice house, it might be a sliding fee scale, but regardless, we're always going to be working with families. We never want that to be a barrier to care. We do always. And I, you know, even in my personal life, friends that don't that live outside of my service area always recommend that people visit hospice Compare and it's a hospice.gov website and you can search by your zip code and find hospice organizations in your area and compare them by quality scores.

Darleen Mahoney [00:30:24]:

Oh my gosh, that is amazing.

Mindy Rice [00:30:26]:

So that just like your hospitals have been doing for some time, a couple years ago they started that and that's where our five stars comes from. It's rated on one to five stars. So that's where you can really look to see the quality of the program in your area. Become educated on the programs that are around you and help you choose which one. And we're proud of that. And the reason why I really, really encourage that is because those ratings are coming straight from the patients, the families of the patients that we've cared from. And it's 24 questions that are, that are looked at and it's everything from was your loved one's pain managed to, you know, was your weekend and on call staff effective? So it's all those important questions coming straight from the families of the patients that have been cared for. And it allow you to really choose a quality program in your area, whether it be for profit or nonprofit.

Mindy Rice [00:31:27]:

I will say there are some, some great for profit organizations out there. So just the quality really is what we like to focus on.

Darleen Mahoney [00:31:36]:

No, absolutely. And we're going to share that link. Hospice.gov correct? Is that what you said? So we'll add that link into the description as well. So if you're listening, you can just click on that within the description of the podcast. That is great. I'm really appreciate that you shared that. So do you have some key takeaways that we may have missed?

Mindy Rice [00:32:01]:

You know, really the. I don't know that we missed anything. We covered a lot. But really we just want people to remember when you're, when you're told that there's nothing more that can be done, there is something more and that's hospice and palliative care. There's always something more. You're just moving from curative treatment to comfort. And we just want to be there for patient and families and do all that we can to help them through this difficult time.

Darleen Mahoney [00:32:34]:

Yeah, no, I definitely appreciate that. So one of the things that I think is important and we haven't really covered this, but I'd like to kind of wrap it up with talking to your family and talking to those that might need these services in a very productive, loving way and understanding way. How important is that?

Mindy Rice [00:32:56]:

Absolutely. And there's some great resources out there. National Hospice and Palliative Care Organization has some wonderful resources that can help families talk through that end of life journey as a nonprofit organization. We have lots of information here, and you can call any nonprofit organization and ask for some resources for that. There's one particular booklet called Isn't It Time Talk.

Darleen Mahoney [00:33:29]:

Okay.

Mindy Rice [00:33:30]:

And it's, it's great. It just, it just walks you through that hard conversation.

Darleen Mahoney [00:33:34]:

Okay. Now I like that as well. So I definitely want to look that.

Mindy Rice [00:33:37]:

It'S called Isn't It Time We Talk?

Darleen Mahoney [00:33:39]:

Isn't It Time We Talk? Because that is really the hardest conversation I think it is.

Mindy Rice [00:33:44]:

And that booklet is wonderful because it starts very early on. Like hospice is in the back of it, but it starts very early on. And we always, of course, advocates for advanced healthcare directives to get those in place. Too many hospices help with that for free. So that's another benefit to having an organization in your community as well.

Darleen Mahoney [00:34:07]:

Okay, perfect. So tell us a little bit before we sign off a little bit about your hospice and what they specialize in. And then we're going to include, if anyone's listening and they're living in that area, this might be an incredible option if needing either one of these services. So a little bit about what makes you proud of some of the things that you do there and what's so great about your facility.

Mindy Rice [00:34:33]:

Yeah. So we, as you mentioned in the beginning, hospice and palliative care of Iredell county has been serving patients for 40 years. We serve patients all throughout Iredell county and any county that touches Iredell County. We have two hospice inpatient units in Statesville and in Mooresville, North Carolina. And we also have a very large pediatric grief and bereavement program called Rainbow Kids. We're very proud of last year we served 769 children through that program. We give back more than a million dollars a year to the community and programs such as Rainbow Kids. So we're just, we're very proud.

Mindy Rice [00:35:14]:

And, you know, I've been here 20 years. I tell people I started when I was 12, but in 20 years, I.

Darleen Mahoney [00:35:21]:

Would believe that looking at you. So you're good, you're good.

Mindy Rice [00:35:24]:

But in 20 years. I can honestly say that regardless of who's been the captain of the ship, it's our commitment to quality care and our mission has never wavered. And I think that's what has helped us to stand out above the rest and become a five star and a hospice honors elite, which means that we are rated above the national average on every single indicator. And that's about 5% of hospices in the country. So we're very, very, very proud of that.

Darleen Mahoney [00:35:56]:

And you absolutely should be. That is fabulous. Yes. I'm really glad to hear that. And I love the passion that you have, and I think it's sometimes working in this industry, working in senior living and Medicare and Medicaid and insurance and all the different things that are helpful for seniors. If you've experienced it in your own life and you see the need, I think that just makes you so much more passionate about helping seniors, helping their families and giving them the right resources. And that support is just such a game changer.

Mindy Rice [00:36:25]:

It really is. And it's very frustrating to watch somebody go through that alone when they don't have to. And you know, the early referral, you know, we preach that over and over again, how it calls sooner rather than later. There's nobody that's ever said they called hospice too soon. They all say they wish they would have called sooner. So that's a message that we like to try to get across as well.

Darleen Mahoney [00:36:49]:

Yeah, no, I love it. I think, you know, education is number one and providing those resources where they can get more information and get those services are definitely key to happier, healthier people, seniors and their families for sure. So perfect. Well, thank you, Mindy, so much for joining me on this podcast. This was such an informative podcast and I hope our listeners were able to take some nuggets to better improve their lives, their family lives and their loved ones. Yeah, absolutely. Thank you so much. And if you enjoy this podcast, we can be found to listen to anywhere.

Darleen Mahoney [00:37:23]:

You listen to podcasts such as Spotify, Apple podcasts, good pods, all kinds of different places, anywhere you enjoy music. Thanks for listening.