Hospice is probably the most underused benefit in this country. The National Hospice and Palliative Care Organization estimates that two-thirds of all eligible patients do not receive the hospice benefit and, of those who do, more than 36 percent receive care for less than a week, unaware that the benefit covers the last six months of life. The Medicare deductions that are paid throughout our working lives cover the cost. There is no out-of pocket expense for patients. Medical equipment, medications, and other supplies are covered. Most Medicaid and some commercial insurance plans cover the benefit as well. VistaCare, a leading national provider of hospice care, has 58 sites in 14 states. They are the largest hospice provider in New Mexico with offices in Albuquerque, Clovis, Roswell, Hobbs, and Carlsbad, serving 12 New Mexico counties. Their most recent acquisition is Lovelace-Sandia’s Hospice, Albuquerque Regional Medical Center. As part of this acquisition, 45 employees from Lovelace Sandia will join VistaCare’s staff of almost 3,000, which includes 111 medical directors and more than 800 nurses. Their mission is “the passionate pursuit of excellence in nurturing the physical, spiritual, and emotional well-being of our patients and their families, while being responsible stewards of human and financial resources.” VistaCare’s “open access” philosophy provides care for “all eligible adult patients and their families, regardless of the complexity of their medical needs or other patient and family issues.” The care offered includes, but is not limited to, managing patient’s pain and symptoms, assisting with the emotional and psychological aspects of dying (for both patient and family), coaching the family on care, offering spiritual care, searching out community resources, and providing bereavement care and counseling to surviving family and friends. Most often, hospice is thought of in connection with cancer patients but many other conditions are treated as well. Heart disease, dementia, Alzheimer’s, kidney, liver, and lung diseases are common areas of care. VistaCare offers unique benefits through their VistaCare Hospice Foundation. Classes for the medical profession and the general public on pain management, medical ethics, and emotional and spiritual support of families are offered. Expenses that might fall through the cracks are taken care of so “patients can concentrate on living in peace with the love of family and friends.”
“The Foundation gives us the ability to say ‘yes’ to enhance their quality of life,” Jessica Hood, RN, Area Vice President says. According to Wilda Martinez, Volunteer Coordinator, “Volunteers are always needed.” Executive Director Bruce Kemper adds, “Whatever you have to offer, Wilda will find a place for it.” Many volunteers give office time or use their craft skills to make lap blankets or toys. Volunteers work with patients as well, but training is required. VistaCare’s most valuable asset is their staff and they know it. Caregivers are protected from burnout. When their day is over, they can go home and know that they will be disturbed only in cases of dire emergency. On-call staff, fully briefed on the patients and their needs, covers the off hours. The staff receives a comprehensive benefits package with 30 days paid time off each year, extensive training, ongoing educational support, and tuition reimbursement. In interviewing several staff members, the overall impression was of dedication, compassion, and passion for the work they do. DIANE SANSONETTI, M.D., Dr. Sansonetti has been with VistaCare for three years coming from a 20-year career as a cardiothoracic surgeon, requiring intense one-on-one contact between surgeon and patient. Always interested in medical ethics, a transition to end-of-life work seemed a logical progression. “I wanted to be involved in significant moments with patients and families. The majority of families and patients we accompany on their end-of-life journey travel smoothly. They expect us to treat their physical distress adeptly, to touch their soul and psyche with compassion, and offer practical help in the process of dying. All of these are sources of satisfaction. However, in a minority of cases, team members find themselves meeting families with crises and long-term conflicts, and patients overwhelmed with anger or fear. These are the situations when I am ‘wowed’ at the passion for caring exhibited by the hospice team.” CHANTAL SHEPPARD, RN ANGELINA “ANGEL” ESPINOZA, CNA
As a psychiatric nurse and consultant for 20 years, Libby was well prepared to deal with the psychological aspects of dying when she came to VistaCare five years ago. She sees part of her role as managing pain, physical and psychological. “Sometimes that means stopping to get the patient a milkshake or sitting with them for a while. Sometimes it’s the littlest things. One patient loved her dog and when she came home for her last days, I put the dog on the bed with her. She reached up to pet him and sighed with contentment. It was the last time she reacted to anything. Another patient had Parkinson’s disease. She had lovely hands and kept her nails polished until the tremors kept her from it. I did her nails on her last day so she could have beautiful nails at her viewing. I get so much more back from these patients than I give. That’s what keeps me going.” JESSICA HOOD, RN, Jessica was an ICU nurse prior to joining VistaCare as an on-call nurse in 1998. She is now Area Vice-President and her role is mostly office oriented. She notes that in “meeting people where they are” they must provide for the spiritual and emotional needs of patients along with the physical needs. This is especially important when they are providing help in naturally sensitive areas. When working with Native Americans, VistaCare respects tribal customs and works with the Pueblos and medicine men to make sure that everything is done correctly. There is a great concern among the people I met at VistaCare that there has to be a way to let more people know this benefit is available for those who need it. Take the time to check out their website, educate yourself and others, and take the time to make some decisions and make your family aware of them. VistaCare hopes you never need them but wants you to remember that they are there for you if you do. VistaCare has a series of handouts available on the web or in hardcopy by request. If you are wondering if hospice is right for you or your loved ones, there is a questionnaire on VistaCare’s website, “Is Hospice The Answer for You?” For a speaker for your group or organization contact: To volunteer contact: For more information: A personal note: I dabble at crafts and card making. One of the needs is for cards to send to family members and patients. I urge you to take the time to make a few blank cards. Give them each a stamped envelope and send them to VistaCare or any hospice organization.
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The Foundation provides the extraordinary as well. From replacing a worn-out air conditioner for a patient who was worried his family would suffer after his death to plane fares for distant family members to make a final visit, the Foundation helps with all aspects of patient need. Sometimes they grant a last wish as with a former mariachi band member. Because of his illness, he’d not heard a mariachi band for a long time. His wish was granted as they arranged for a mariachi band to visit his bedside. Another patient wanted to see his son one last time but the son was in prison. The Foundation and Albuquerque’s sister offices made the complicated medical transport possible to reunite father and son. 
Coming from a job as coordinator of a long-term care program, Chantal has been with VistaCare for three years. “Death and dying are not new to me. I have more time now with patients and the ability to make independent decisions, as part of the team.” Of Native American and Spanish heritage, she especially enjoys working with those ethnic groups that are often overlooked. “One of my most satisfying cases was helping a Spanish-speaking woman learn how to care for her husband properly. No one had taken the time to help her understand what was happening, what to expect, or what to do. When he passed on, the family was comfortable with his last days.” 
Angel came to VistaCare two years ago from a local nursing home. “I love my job. Making a difference in someone’s life makes you feel better. Everyone is different and has different reactions to you but most look forward to your visits. I had a male patient who used to wait for me and he’d make me food and get me to eat. We had a strong bond and he was like my grandfather. Another patient, a woman, used to wait for me to help her shower. She liked how I washed her hair. It’s hard when you lose someone you’ve bonded with. It’s like losing a family member but you go on and see who needs your help next.” 
Sandra Brown Steinsiek is the author of the prize-winning Taylor Morgan Trilogy available at the New Mexico Book Co-op Books and More Store at Cottonwood Mall in November and December or from the Coop web store at