Hospice of the Valley

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Dr. Jose Urdaneta, Medical Director for Hospice of the Valley, talks about their outreach efforts to raise awareness about hospice care in the Latino community.

Jose Cardenas: Good evening, everyone, and thank you for joining us. When a loved one is facing an illness, family and friends come together to support one another during a difficult time. There's an organization in the Hispanic community doing so. Nadine Arroyo-Rodriguez reports from Hospice of the Valley.

Nadine Arroyo-Rodriguez: Ignacio Soto's children say their father has been a healthy and independent man. The 86-year-old widow has lived in Mexico and would visit his children in the U.S. until recently when the children were told their father had only two weeks to live. While living in Mexico, Soto suffered a stroke. A stroke occurs when there's a rapid loss of brain function due to an interruption in the blood supply. Soto's stroke left him paralyzed on the right side of his body. He was unable to speak, walk and eat. And even worse, he had total memory loss.

Nadine Arroyo-Rodriguez : This is one of his children. She says this is not what she wanted for her father. She moved him to Arizona to care for him and one week after they arrived, he suffered a second stroke. [Speaking Spanish]

Nadine Arroyo-Rodriguez : After two weeks in the hospital, she says the family was told there was nothing else the doctors could do for her father. He would soon die. The family was devastated and not sure what do, so she turned to the Hospice of the Valley. Hospice of the Valley is a nonprofit organization that provides in-home care for terminally ill patients. [Speaking Spanish]

Nadine Arroyo-Rodriguez : She says that not only did her father receive medical care, the agency gave her counseling service to prepare her for the inevitable, a service they provided in Spanish.

Maria Rebozo: We have staff that can speak to them in their language and explain the service to them in the language they understand.

Nadine Arroyo-Rodriguez : Hospice of the Valley says they have made it their mission to not only service the Spanish speaking community but understand their culture to better care and serve them.
Maria Rebozo: Hospice, in a lot of Latin countries, if you translate the word into Spanish, in a lot of countries, the word means a place where you abandon your very sick or very old, where you abandon your handicapped. So I have a tough job trying to let the Hispanic community that that's not what Hospice of the Valley is. It's total opposite. We provide service not only for the patient, but for the entire family. They get a team of doctors, nurses, social workers, home care aides, pastoral counselors and bereavement and volunteers. They get the whole team. But the family is always in control of who they want and when they want them.

Nadine Arroyo-Rodriguez : She says Hospice of the Valley provided service that she never knew existed. Now after several months of care, her father has improved dramatically. Hospice of the Valley continues to care for her family, but this time, for having a chronic illness.

Jose Cardenas: And joining me to talk about outreach efforts in the Hispanic community is Dr. Jose Urdaneta, medical director for Hospice of the Valley. Thank you for joining us.

Dr. Jose Urdaneta : Thank you for having me.

Jose Cardenas: It was talked about, the misconceptions of hospice, and the community as a large would still view it as a place to die. Hospice is more than that.

Dr. Jose Urdaneta : First, hospice is not a place. That's one thing I like to stress to patients and families. It's a service. And a service that's provided probably greater than 90% of the time is provided in the patient's home. Wherever that home may be. And I think Maria talked about the services available, including nursing, physician visits and social services and whatnot. So it's a service, it is not a place. Indeed, it is a service that's provided to people -- to patients and their families, when the patient is facing a life-limiting illness. And so certainly, the -- there is the -- the big word that we often try to avoid, physicians and nurses, is death. And, yes, it's a service provided for patients that may be facing death.

Jose Cardenas: And in terms of the kinds of services the Hospice of the Valley provides, my understanding is they go far beyond what people would normally associate with just making the person, the patient comfortable in the final days of his or her life. Can you describe what it is that Hospice of the Valley offers?

Dr. Jose Urdaneta : It's essentially medical care. It is a bit, I guess you could call it, pragmatic medical care for patients facing life-limiting illnesses. Technically, a physician has to see you as potentially having six months of life or less for whatever illness that may be. And the services that hospice would then come in and provide are really routine medical services. Focusing in on the comfort of the patient, the functional status of the patient, and that patient's interaction or that patient's connections to family and friends.

Jose Cardenas: And how much of these services, what percentage is provided in the home, as opposed to in buildings that hospice may run and operate?

Dr. Jose Urdaneta : It's greater than 90% of the patients on hospice services are at home. And so the majority of patients in hospice are in their own home. Where nurses go and visit. Where the physicians go to see the patient. Where social service staff may go. Nursing assistants, those sorts of services are provided in the home. Some are indeed provided in hospice units or palliative care units and those are units where patients can go when they need a little bit more intensive care than is available to them at home. And in these units, there's 24-hour nursing care, physicians go to make rounds and care for the patients at those units in a similar way to a hospital. Social service staff are available there in those units, so there are those units but the vast majority of hospice patients are in their homes.

Jose Cardenas: In the video package, Maria talked about outreach to the Hispanic community. Is it more than just talk to them in -- to monolingual Spanish speakers? What else do you do to try and explain to Latinos what hospice in this country is?

Dr. Jose Urdaneta : To a certain degree, my role is patient-to-patient and family-to-family. And letting families know that Hospice of the Valley hospice is different from the connotation we may have in mind from our native countries.

Jose Cardenas: In your case, Venezuela.

Dr. Jose Urdaneta : Yes, and I'll use my own experience. Where indeed hospice in Venezuela is particularly a place where people go to die and there's a negative connotation, because the care provided is seen as less than optimal. So I let folks know, I let people of my culture, of what I consider to be my community, know that it's a service. And that the focus really is not on death, but on life. And the fact is that we are all going to leave this earth, and we are all going to die. And at some point, many of us may be facing a life-limiting illness. And at that point, care should not stop. Care should be tailor-made as it is with hospice to focusing in on providing us with comfort and dignity and with as much functional ability so we can enjoy whatever time we have left.

Jose Cardenas: We have about a minute left and I want to touch upon another aspect of your involvement, both in hospice and at St. Joseph's hospital. The subject of palliative care. Tell us what that is and what you're doing.

Dr. Jose Urdaneta : It's a bit of a general term, but to palliate, or to provide palliative care, is care -- it's intended to decrease suffering and there are many different types of things that are palliative. Our primary care doctors and other subspecialized physicians and other healthcare providers do is palliative. It's there to ease suffering but not necessarily there to cure.

Jose Cardenas: And these are services both offered in hospice and broader medical care at St. Joe's.

Dr. Jose Urdaneta : Correct.

Jose Cardenas: It's a fascinating subject. Perhaps we'll have you back to talk on that particular subject. Thank you very much.

Dr. Jose Urdaneta : Thank you.

Dr. Jose Urdaneta:Medical Director, Hospice of the Valley;

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