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In Wyoming, End Of Life Care Often Means Leaving Home

Miles Bryan

If you receive hospice end of life care in the United States it probably comes to you. Nationally about 60% of hospice care is administered at the patient’s home, or in a nursing home. Only about 7% receive care in a facility designed specifically for hospice patients. But in Wyoming, that number is closer to 30%--and its growing.

Pat Hague and her daughter Dawn Shupik both moved their families back here to Casper 10 years ago to care for a member of their family who had developed Alzheimer's. Her name was June, and she was Pat’s mom, and Dawn’s grandma, Previously, all the caretaking duties had fallen on Pat’s dad, grampa Gardner.

“We’re still getting used to not having to rush over and help grandpa,” they told me. “Because he was caring for her, all day every day.”

Credit Miles Bryan
Pat Hague, left, and Dawn Shupik.

For centuries this is how end of life care worked in America--when grandma or grandpa gets sick their kids or grandkids come back to take care of them. But Pat was working full time at a machine shop, and Dawn had her hands full raising two kids, so the family eventually did what most families do these days for end of life care: they hired a hospice nurse to come to their home. Dawn says it helped, but it wasn’t enough.

“We had one instance where mom was real bad where we had a snow storm,” she said. “[The hospice nurse] wasn’t working that day. So I went on my lunch hour and got her dressed and got her out of bed. So at least she would be clean and she would be able to get up.”

Grandpa Gardner is a fiercely independent guy and the family kept June  at home as long as possible per his wishes. But finally the family decided they had no choice but to move her to a facility. Pat and Dawn says the idea of a hospice facility freaked them out--at least until they visited. “Wonderful!” Is how they described it in unison. “If we hadn’t put grandma there,” Dawn said, “grandpa would now be in hospice care.”

Marilyn Connor is the Director of Central Wyoming hospice in Casper, where Grandma June spent her last few weeks. Nationally there is only one facility like this for about every  500,000 people--but in Wyoming there’s 1 for every 100,000. Laramie’s building a hospice facility, and Rock Springs is trying to. Connor says part of the reason for that is Wyoming’s chronic shortage of medical professionals. “Just finding good staff to come into existing [hospice] facilities is a challenge,” she said. “You add to that the need to provide resources one on one in a patient’s home? It simply isn’t there.”

Credit Miles Bryan
Central Wyoming Hospice Director Marilyn Connor.

That shortage has plagued Wyoming for decades, but twenty years ago Central Wyoming hospice was the only hospice facility  in the state. Connor says back then it was much more common for family members, especially women, to give up other responsibilities to care for a loved one. But now more people want, or need, to stay working.

An old western plays on the television at the hospice patient’s facility. It feels less like sterile nursing home than a 1970s lounge : there’s wood paneling, a fireplace, and a big open kitchen where staff members mingle with patients. those patients pay 75 to 250 dollars a day to stay here, depending on their assets. It’s on top of what’s covered by most insurance, though Wyoming is one of only four states that covers that charge in its Medicare program. That’s been great for Lynette Bernardis, whose mom has medicare benefits. Bernardis said she expected her to live for only a few more weeks when she arrived at the facility. That was in August.

That kind of long stay can actually be a problem for people living out their days at a hospice facility. Hospice is meant to cover only your last six months of life--insurance doesn’t want to pay for more time than that. Nationally the average length of hospice care at home is sixty days, at a facility like this, its one hundred and thirty. Nurse Helen Osterman says one reason people live longer here is there’s a lot to live for. They’ve had everything from parties to birthdays to even a wedding, she said.

In Wyoming, it's not easy for most people to take care of their loved one at home during the end of their life, but the nice thing about hospice facilities like this one is they can come pretty close.

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