Uncle fought a battle against cancer and blockage from when he was first diagnosed in November of 2013 with stage IV appendiceal cancer after surgeons at Queen’s Hospital performed a right hemicolectomy.  In the ensuing months, which turned into a year, Uncle was in and out of the hospital for various reasons.

We left Queen’s for the last time under the care of Hospice Hawaii.  This is Aunty’s review.

In the beginning

The initial support and attention as we prepared to leave Queen’s Hospital was top notch.  Dr. Liane Tokushige, the director of Hospice Hawaii, came to meet us and go over what could or could not be provided, with some wiggle room for options.  She is a petite beautiful woman with MD qualifications in various fields.  Very humble, very sweet, very caring.

We left the hospital the day after that with a specialist accompanying us to a waiting transport service, all arranged by Hospice Hawaii.

Any necessities such as a wheel chair, suction compressor, oxygen, walkers, hospital bed, etc. would be provided and set up at home.

Home at last

The first evening home was a big transition, figuring out a new IV system as well as learning about different drugs to provide Uncle comfort.  We had visits from 2 nurses, one who did the “admission” procedure and later another nurse who dropped off more bags of saline for Uncle’s IV drip.

At this point in time, we were not giving up, and we continued with alternative means of getting nutrition into Uncle despite his blockage (which seemed to be clearing) as well as receiving natural treatments for his cancer.

Two days later, nurse Oma, came to check in on Uncle as well as see what else Uncle might be needing.  Oma became Uncle’s case manager.  She had a gentle touch and we were glad to have her on board.

A social worker, Mimi, came by to offer help if needed.  Very soft spoken nice lady, easy to talk with, respectful of our hopeful beliefs.  It was a busy beginning.

On call if needed

Hospice Hawaii has a 24/7 system.  On the 4th night home,  Uncle was in discomfort and having a hard time and we weren’t quite sure what to do.  Send him to the hospital?  Call 911?  We called the Hospice Hawaii main line for advice.

The hospice on call nurse came to our home and told us to dose him with the pain and anxiety meds, which took a little while to kick in, but helped somewhat.  We were informed that going to the ER or hospital would mean giving up all Hospice Hawaii services.  The hospital would do emergency procedures, tests, and constant hustle and bustle versus dosing Uncle with hospice drugs at home to make him comfortable.

His dressing was changed, taking much longer than we were used to.  Although this first on call nurse was very nice, he did not instill confidence in his abilities with us.  We were used to the high professional and quality standards of the nurses at Queen’s Hospital.  The main thing though, was that Uncle was in less pain now.

At the end

With each passing day, Uncle became weaker and weaker, and thankfully in less discomfort as time went on.  His body was shutting down and after a week of being home, Uncle gently passed on, very peacefully, at home.  We called the Hospice Hawaii hotline and a very capable and caring nurse came out to check Uncle’s vitals and call for his final arrangements.

To hospice or not to hospice?

On a prior discharge, Uncle went home on “home care”, which meant that we were still able to see doctors, have tests done, be on IV nutrition, aggressively seek treatment if desired.

When Uncle was discharged on hospice care, test, treatment, doctor visits, etc. were not covered.  The goal and purpose of hospice was to provide comfort, period.

Hospice provided us with on call nurses, a case manager, support staff, and setting up the home with whatever (i.e. bed, walkers, oxygen, etc.) the patient needs.  This was a great service and the biggest difference between hospice and home care was being able to call someone, at any time, for whatever reason.

“Home care”, which is a regular discharge from the hospital, provides the patient with whatever he needs, i.e. nutrition, follow up visits, and treatment for the ailments.  The only option for professional help in Uncle’s case was once a week visits from a traveling nurse who drew blood for lab tests, took vitals, and changed Uncle’s dressings.  It did not cover the costs of a hospital bed and other items of support unless the doctor prescribed them.

The best of both worlds, Supportive Hospice

To have the staff, meds, and equipment needs met by the Hawaii Hospice organization was great.  Being able to also have lab tests, doctor treatments and therapies would be even better.  This is supportive hospice.

Supportive hospice is a brand new program that is now covered by HMSA.  It is not yet covered by the awesome HMAA (our health insurance plan), so we did not have this option.  If we coulda, we woulda.

Aunty hopes you never have to go through the trials and heartache of your loved ones in or out of the hospital.  However, if you do, Hospice Hawaii provides a transition bridge between the hospital and home.  It is a great service.  Mahalo to Hospice Hawaii.