Anthony Wayne Walkup had a close relationship with his father, William Dave Walkup.

“We fished on vacations before he got sick, went to visit family and friends,” the Bowling Green man said. “He was a farmer and my mom, Esther, sewed at Turner Industries. He was a dairy farmer. He milked cows for as long as I can remember.”

When it came time for his father to die, Anthony Wayne Walkup and his siblings – Carolyn Mathews, Betty Phelps and David Walkup – turned to Hospice of Southern Kentucky. William Dave Walkup died May 12, 2015.

“Going home was his last wish. He was at home. (Hospice) set up his bed. They brought him oxygen,” he said. “When my dad passed, they was there. Our family and friends was all there.”

Report: Millions received care 

According to a report by the National Hospice and Palliative Care Organization, an estimated 1.6 million to 1.7 million patients received services from a hospice provider in 2014. The estimate included patients who died while receiving hospice care, patients who received care in 2013 and who continued to receive care in 2014 – who are known as “carryovers” – and patients who left hospice care alive in 2014 for various reasons including extended prognosis, desire for curative treatment and other reasons, known as “live discharges.”

The report says that the majority of patient care is provided in the place the patient calls home. That includes nursing homes and residential facilities as well as private residences. In 2014, 58.9 percent of patients received care at home. The percentage of hospice patients receiving care in a hospice inpatient facility increased from 26.4 percent to 31.8 percent.

Hospice care is often paid by a Medicare hospice benefit, managed care or private insurance, Medicaid hospice benefit, uncompensated or charity care, self pay or other payment sources, the report says.

Southcentral Kentucky has two hospice services – Hospice of Southern Kentucky and Hosparus-Barren River. Hospice of Southern Kentucky does in-home services wherever the patient calls home and runs Hospice House, and Hosparus provides services at wherever the patient calls home.

‘Comfort and caring is the main goal’

Hosparus serves 33 counties in Kentucky and southern Indiana, said Hosparus Manager of Communications Nedra Morrell.

“Last year we served a little more than 6,300 patients in our service area,” she said.

Hosparus, which doesn’t have a residential-style facility in Bowling Green, tries to keep people home if possible, said Hosparus-Barren River Associate Medical Director Dr. Douglas Thomson.

“We want to be a support to families,” he said. “Comfort and caring is the main goal.”

People struggle with the term “hospice,” said Hosparus-Barren River Community Director Melainie Plumb.

“What we’re trying to do is education in this area. We can be in the home and be effective,” she said. “If we can get people in earlier and take away that fear of hospice care, we can help. Some people graduate out of hospice care.”

Thomson agreed that patients should start thinking about hospice care early and learn how it works.

“We can stay in contact knowing they know. People sign up for six months and think that’s the end,” he said. “If they last more than six months they can be recertified. We have a few people who have been under hospice care for two years.”

Different kind of care

Treating hospice patients is “quite a bit different than a typical medical practice,” Thomson said.

“You’re done with a lot of intensive testing and treatment,” he said. “You try to make the remaining days of that person as comfortable as possible. Studies have shown that patients live longer when on a hospice program.”

The Hosparus team consists of a doctor, nurse practitioner, certified nursing assistant, volunteer chaplain, social worker, grief counselor and registered nurse, Plumb said.

“It’s a team approach with the services of hospice care,” she said. “We review the patient’s plan of care to see if we need to help the family in any sort of way.”

The nursing assistants are quite busy, Thomson said.

“We may know about some of the disease process, but it’s the nursing assistants who are going in and giving the care,” he said.

Team nurses are ready to go at any time, Plumb said.

“There are two nurses every day on call to see anybody who needs to be seen,” she said.

They go out and see people at night, Thomson said.

“Anyone who dies they go out and see them pronounced,” he said.

Some of the medical personnel deal with medicines, many of which have side effects, so the benefits with the burden of medicine are weighed, Thomson said.

“If someone is 90 years old and dying of cancer, they may not need a cholesterol medicine anymore,” he said.

If someone has to go to the hospital while they are in hospice care they are allowed to do so, Thomson said.

“If somebody has terminal lung cancer and breaks a hip, they can go to the hospital and get that fixed and then go back home and get hospice care again,” he said. “It doesn’t mean we’re just going to give them pain medicine and that’s it. We look at the patient’s comfort, spiritual and physical.”

The patient care teams of Hosparus-Barren River visit many types of places in the 10-county area it serves, Plumb said.

“A lot of roads don’t have lines or phone services. We ride ferries,” she said. “We get creative.”

Anyone can call the office at anytime and Hosparus-Barren River will send a nurse to explain the services it has to offer, Plumb said.

“If they’re not ready, we can follow them. It’s a misconception that you have to be homebound,” she said. 

Hosparus offers a variety of services. One is helping families get respite services, Plumb said.

“We work with them to provide respite service with local nursing facilities for five days at a time,” she said. “Hosparus covers this.”

“The families don’t usually get a bill from Hosparus,” Thomson said.

Hosparus-Barren River has a veterans program.

“We have several vets in our care,” she said. “It’s a nice program.”

Grief counseling services are also available, Morrell said.

“Families learn how to deal with the emotions they’re going through. The service is available up to 13 months after the patient dies,” she said. “It covers a real wide range of people and availability. Chaplain services can be whatever you want them to be. They can guide you spiritually. They can discuss things like hobbies, arts, fishing.

“Sometimes they don’t discuss religion at all,” Thomson said. “It’s not just for the patient, but for the family as well.”

Death is a stressful time, and chaplains are there to help, Plumb said.

“I think they’re very valuable in that process,” she said.

Hospice also offers grief services.

“Sometimes these classes can consist of something we take for granted, like balancing a checkbook,” Arnett said. “Sometimes there’s an elderly person and they’ve always relied on their spouse for certain things and never thought about it.”

‘It’s not a job to us, it’s a calling’

Greg Wilson, chaplain at Hospice of South Central Kentucky, said he enjoys working with patients and families, regardless of their background.

“We’ve going to serve them in the ways I have mentioned,” he said. “We’ll help them get in touch with the cleric in their time of need. We want to make sure they have a representative of their faith.”

Wilson has also worked with chaplains in the penal system to arrange special calls with the patients and their loved ones.

“It’s a real joy to those patients when we can work that out,” he said.

Families need a friend as they go through the process of losing a loved one, Wilson said.

“It’s not a job to us. It’s a calling,” he said. “There’s nothing in the world I would change for that. Hospice gives me the opportunity to do this.”

Shawn Arnett, a registered nurse at Hospice of Southern Kentucky also enjoys his job at Hospice. He keeps electronic medical records maintained and trains and supports the staff. He has been working there for a little more than 15 years.

“It’s more like a family atmosphere than a corporate structure. Everybody wants to help each other out,” he said. “Patient care has been very rewarding, too. So many families thank you for the support you provided for them while you were caring for their loved one.”

Hospice offers in-home services, social work for financial and emotional support, CNAs to do personal care and visits from medical director Dr. Brian Humble.

“For him to make those home visits is another layer of support,” he said.

There is also Hospice House, which is a “huge benefit,” Arnett said.

“If someone is having trouble at home, we can bring them in and have that added support,” he said. “It helps them get more comfortable. Some of the families said they get wrapped up in care. Here, they can step back in their role and love on their loved one while the staff takes care of their needs.”

Help wanted

People can volunteer, Arnett said.

They can do everything from being in the home with families to providing respite care or socialization,” he said. “They can help with errands, groceries, pharmacy, help with fundraisers, answering the phone, filing.”

Arnett’s favorite thing about working at Hospice is spending time with families.

“I worked at The Medical Center prior to being at Hospice. Everything happened so quickly. The patients you’re taking care of had to move quickly,” he said. “Here, you’re taking time to sit down with the families and answer their questions. You celebrate special days – birthdays, anniversaries, births of babies. You have experiences with the families when you see them day to day and week to week.”

Arnett remembers taking care of a man with Alzheimer’s disease. He also spent time with his wife.

“When we visited, it was beneficial with the social time she received. She would also invite me to have something to eat with her or something to drink,” he said. “It was something more than just the care he received, it was something she needed as well. Those are the things they come back and thank us for, for helping them through those tough times.”

Anthony Wayne Walkup doesn’t think he would’ve been able to make it through that difficult time of his father’s death if it hadn’t been for his family, his fiancee, Polly Frogge, and Hospice.

“Barely a day goes by that I don’t think about him,” he said.

Hospice was there when he needed them.

“They were friendly, loving people,” he said.

— Follow features reporter Alyssa Harvey on Twitter @bgdnfeatures or visit bgdailynews.com.