From June 10-13, Volunteer Coordinator Becki Parr represented TRU Community Care (TRU) at the National Hospice and Palliative Care Organization’s (NHPCO) Hospice Action Week in Washington D.C. As a We Honor Veterans Level 5 partner, TRU joined over 100 hospice and palliative care advocates from across the nation to meet with legislators and push for important end-of-life care legislation.

Becki met with staff members from the offices of Colorado Representatives Joe Neguse and Brittany Pettersen, and Senators John Hickenlooper, and Michael Bennet to advocate for two key pieces of legislation:

1. Gerald’s Law Act: This bill would extend full burial and funeral benefits to survivors of veterans who choose to receive hospice care and die outside of a VA facility. Currently, veterans lose these benefits if they choose to spend their final days at home with family. The act aims to ensure veterans can make end-of-life decisions based on comfort, not cost.
2. Hospice Recertification Flexibility Act: This legislation would extend current telehealth flexibilities for face-to-face encounters required for hospice recertification. This change would particularly benefit rural and frontier areas, allowing for more efficient use of staff time and resources.

As part of the Level 5 We Honor Veterans program, Becki also toured various veteran memorials in D.C. She was particularly moved by the American Veterans Disabled for Life Memorial, which honors living veterans who carry both visible and invisible wounds from their service.

“These are the veterans we may have the opportunity to serve at their end-of-life,” Becki reflected. “The people we need to be intentional with, creating safe spaces for their stories to be held, offering veteran-specific care.”

TRU is proud of our commitment to serving veterans and advocating for improved end-of-life care for all. By participating in events like Hospice Action Week, we continue to work towards a future where all individuals can make end-of-life decisions based on comfort and personal wishes, rather than financial concerns.

To learn more about the full range of issues discussed during Hospice Action Week, please visit Hospice Action Network’s online summary and resources page.

Pictured above (from left to right) are Sasha Benner from Intermountain Health Hospice, Don Knox from Home Care & Hospice Association of Colorado, Brian Young of I Street Advocates, and Becki Parr from TRU Community Care.

On Tuesday, April 16th, in honor of National Healthcare Decisions Day, The Conversation Project in Boulder County, a TRU program, hosted an event that featured Cello, a short film about a renowned musician facing a terminal diagnosis and navigating important end-of-life conversations. The film showing was followed by a discussion with a panel that included the film’s producers and others working in end-of-life care. The event, which took place at The Dairy Arts Center’s Boedecker Theatre, sold out quickly, necessitating a second showing and panel discussion that evening.

TRU and The Conversation Project in Boulder County (a program of TRU) hosted this event to encourage people to think about and communicate their end-of-life healthcare values and wishes with those most important to them. We hope the program motivated our guests to consider their choices and start the conversation.

We reached 130 attendees who engaged actively with our carefully selected panel which, in addition to Cello producers, Helen Nightengale and Alex Craven, included:

Jean Abbott, a retired physician, co-founder of The Conversation Project in Boulder County, and member of TRU Community Care’s Ethics Committee.

Kim Mooney, an internationally-recognized thanatologist and educator and co-founder of The Conversation Project in Boulder County.

Claire Riley, RN, MS, a former member of TRU’s Ethics Committee and a coach and advisory board member for The Conversation Project. Claire is also on the governing Board at TRU.

Linda Wallace, who helped start Bristlecone Hospice serving Summit and Eagle counties and shas since served as a hospice volunteer and companion to individuals navigating end-of-life choices.

Susan Wilhoit, MD, a hospice and palliative medicine physician and a death doula and a National Medical Director at Compassion and Choices. This summer, she will launch a full-spectrum end-of-life practice, Rocky Mountain Compassionate Care.

Please see our panelists’ full bios here.

Sometimes it is hard to know where to start when considering your end-of-life choices; you may struggle with identifying a healthcare agent or knowing what advance care planning forms to fill out. The Conversation Project in Boulder County (TCPBC) offers free advance care planning coaching.

Learn more at theconversationprojectinboulder.org or by contacting Becki Parr at beckiparr@truecare.org.

Cello is available to watch on Vimeo for $2.99.

 

 

by Rachel Stackhouse, TRU Clinical Educator

There is only one area of healthcare where governing body regulations require every organization to have volunteers who cover at least 5% of the total clinical care hours; and that one specialty is hospice. TRU Community Care has been blessed with an incredible volunteer services department. From our faithful administrative support volunteers who are in the office every week, to the companion volunteers who travel far and wide to our patients in their homes, and the volunteers who run the TRU Thrift Shop. Altogether TRU is currently bolstered by 365 volunteers, providing 11.7% of the total hours of care given, which is double the required amount. Countless stories could be told of this generous crew, but one is too good to go untold. Often, we tend to think of the impact volunteers have on a patient, but this story is not that. This story is about how one of our patients rocked the volunteer’s world and a salute to the various stories our volunteers carry with them.  

 Meet Drew, a gentle and powerful young woman, who is also currently a nursing student completing her senior practicum here, at TRU Community Care. Drew’s journey with TRU began in the fall of 2020 as a volunteer. Earlier that year Drew had become a trained end-of-life doula. This specialty practices non-medical, holistic death care that assists the dying person and their family in navigating through the physical, emotional, spiritual, and practical aspects of the dying journey.   

 When Drew completed her doula training, she says, the next natural step was volunteering at TRU. She recalls, ” I knew about TRU since I grew up in Boulder, but I didn’t have much familiarity at the time. I just knew that it was our community’s main organization for end-of-life care, and I was excited to get involved.”  

 Drew’s first, and only companion assignment as a TRU volunteer was with a woman that, for the sake of confidentiality, we will call Grace. It was her only companion assignment simply because Grace’s life moved Drew to pursue a degree in nursing. Drew says, ” Nursing was not on my radar at all before this, but as I witnessed her terminal illness, I felt my own limitations and wanted to be able to do more for her. As her illness progressed, sometimes she would jokingly ask me to help with hands-on medical care, and I told her I would pursue a nursing career to gain those skills.“ 

 During the pandemic, Drew began her assignment with Grace strictly over Zoom for about six months, and eventually as regulations allowed in the spring of 2021, was able to visit Grace in person, albeit masked and at a distance. Drew supported Grace by helping her with tasks such as getting water from Natural Grocers, a basic need that Drew was happy to meet. Drew defines this assignment as a “gorgeous friendship that was so life changing.” expressing gratitude for how incredibly lucky she was in this match. Grace became her friend and teacher, and Drew states, “Even though she’s gone, she’s always with me. She has been with me so much through all of nursing school.”  

 During her time with Grace, the two of them wrote out Grace’s last words of wisdom to share with the world. Drew keeps these bits of wisdom at her fingertips, and still treasures them today. Through Grace, Drew connected with others she would not have crossed paths with otherwise. Grace had been involved with an organization called Live By Living, and as Grace attended, Drew got to meet the organization’s director, Stephanie.  Drew and Stephanie are good friends still, and they get together to honor Grace’s memory each year on the anniversary of her death.  

  As I listen to Drew recount these beginnings of her blooming career, I am humbled. What an incredible view into humanity; the beauty of one human life breathing its final breaths of inspiration into a younger life. At times, hospice work feels clinical, technical, and logistical, and we can miss these beautiful moments. When we notice them, they remind us of the power at hand. When one life ends, others can carry that person’s story forward into the world. Like rings rippling out from a drop in a lake, these volunteers ripple the deceased’s impact through the world each day. 

 This week we are honoring the volunteers, past and present, who offer themselves to this work. We recognize that you are the ones who carry these lives in your heart, and we are reminded that this journey is never about us. The patients that we encounter are a powerful invitation to slow down, hear their wisdom, and witness their legacy.  

 This May, Drew will graduate, a BSN, RN fully equipped to provide deeper support to those placed in her care. She will fulfill her word to Grace and meet the calling that usurped her own plans back in 2021. Drew, who is also a TRU nurse extern, has made a profound impact at TRU, and with plans for her to join our New Graduate Nurse Residency, her impact is certain to multiply.  

 I mentioned earlier that Drew treasures Grace’s final words of wisdom. So, let’s end with that – with words that ripple from Grace, through Drew, and now to you. Here are a few of the pieces of wisdom that Grace left with Drew, titled The Things I learned Sometimes Too Late. 

• “Speak like you want to be heard.”
• “You have much more success in finding joy today than tomorrow.”
• “Consider your legacy of love – the greatest gift you leave behind.”

Thank you, Grace, for leaving the gift of your love with Drew, and thank you volunteers who faithfully support our patients and staff daily. This story highlights that you witness sacred moments with those to whom you’ve been assigned, and your commitment to them has the potential to touch more lives than you ever thought possible.  

 

This week is National Volunteer Week (April 21-27), and we’d like to take a moment to celebrate the amazing individuals who give so selflessly of their time and talents to support TRU Community Care’s mission.

Our robust volunteer force of over 360 dedicated volunteers play an invaluable role for TRU. In 2023 alone, these incredible people collectively donated an astounding 30,000 hours of service across our hospice, palliative care, grief services, thrift shop, and other programs.

The impact of our volunteers’ work cannot be overstated. They provide vital personalized support to our hospice patients and families – offering companionship, respite care, specialized therapies, and so much more. Our grief services would not be possible without volunteers facilitating support groups and managing the lending library. And of course, the TRU Thrift Shop simply couldn’t operate without our army of retail volunteers.

Volunteerism is woven into the fabric of who we are as an organization. Medicare actually requires that 5% of all hospice patient care hours come from trained volunteers. But at TRU, we go above and beyond, with volunteers providing double the required number of hours. This speaks to how invaluable they are to delivering the highest quality care.

“Our volunteers are an essential part of our organization. They enable us to provide the best care possible to our patients and their families,” said Jen Thomas, Director of Communications and Volunteer Services. “We could not fulfill our mission of affirming life without their compassionate service.”

From providing a reassuring presence at a patient’s bedside, to carefully sorting donations at the thrift shop, to lending an empathetic ear during grief counseling – our volunteers display unwavering commitment to easing life’s most difficult journeys.

Their selflessness truly makes our community a better, more compassionate place. While National Volunteer Week is a designated time to honor their service, we celebrate our volunteers every single day at TRU Community Care. Thank you, from the bottom of our hearts, for everything you do!

 

 

 

 

 

 

 

On Friday, March 29th, gratitude and recognition filled the air at Carbon Valley Community Center in Firestone, Colorado as we honored those who served in the Vietnam War, yet whose sacrifice often went unrecognized upon their return home.

“As time goes on you want to realize that your sacrifice meant something to somebody,” said Dave Appel, who served in the Marines in Vietnam.

Thanks to the efforts of TRU Community Care, Carbon Valley Community Center, and American Legion Post 1985, along with the community’s support, Friday’s Welcome Home Vietnam Veterans Day event was a resounding success.

The event, which TRU has organized for three years, coincides with Colorado’s establishment of March 30th as Welcome Home Vietnam Veterans Day, a day designed to pay tribute to the service and sacrifice of Vietnam veterans. “Our community failed them almost 50 years ago when they came home, and we are striving to rectify that,” said Becki Parr, TRU Volunteer Coordinator and a key organizer of this event.

A highlight of the day was the Healing Warriors Pop-up, which offered veterans of all eras and their partners the chance to receive acupuncture, craniosacral, and healing touch therapy at no cost. The Healing Warriors Program aims to provide integrative, non-narcotic treatments for a range of issues including PTSD, TBI, chronic pain, and more.

The day culminated with a Welcome Home Vietnam Veterans commemoration that included a presentation and posting of the colors by American Legion Post 1985’s Color Guard, a presentation of handmade quilts by members of Quilts of Valor, and a moving pinning ceremony in which the Vietnam veterans present were individually welcomed home by the community.

Firestone Mayor Drew Peterson was in attendance to offer a heartfelt ‘thank you’ to the veterans for their service and sacrifice, closing out a day of recognition and appreciation that was long overdue.

Thank you to Tone Images for photographing the event.

As the warmth of spring blooms around us, so has TRU Community Care’s latest Spring Newsletter. Learn about TRU’s newest board members, the enduring legacy of Leo Hill, and our unwavering commitment to bridging healthcare disparities in rural communities. Plus, meet TINA: TRU Immediate Nurse Access, the new face of hospice care.

Download the latest issue of TRU Talk here.

The American Academy of Hospice and Palliative Medicine (AAHPM) Annual Assembly, held March 23 – 25 in Phoenix, Arizona, celebrated the presentation of the esteemed AAHPM Presidential Citations of 2024. Among just three recipients was the Hospice Medical Director Certification Board (HMDCB), recognized for its significant contributions to certifying hospice medical directors. Dr. David Wensel, current president of the HMDCB and TRU Community Care medical director, accepted this honor on behalf of the board. AAHPM’s annual Presidential Citations acknowledge individuals or groups who have made significant contributions to the field of hospice and palliative care but do not qualify for consideration in other award categories.

Established in 2012 as an independent, nonprofit certifying body, HMDCB addresses the crucial need for certifying hospice medical directors across the United States, in Puerto Rico, and in Canada. The board’s mission is to ensure a minimum level of knowledge and competency among hospice providers, thereby enhancing standards of care for patients and their families.

Dr. Wensel, in his capacity as president, highlighted the profound impact of receiving the award from AAHPM, emphasizing the collective effort of the board in advancing the field of hospice care. His tenure on the board, which began in 2019 and culminated in being elected president in 2022, underscores his commitment to promoting excellence in hospice care.

“I’ve always felt the importance of this type of certification and this type of community, because many local hospice providers can’t do a fellowship. It’s not realistic for them to stop working their current practice to go do a year-long or two-year fellowship program to get board certification. HMDCB provides them a way to demonstrate this minimum level of knowledge, comprehension, understanding, and expertise as a hospice provider.”

The HMDCB has issued over 1200 certificates to hospice medical directors, setting a benchmark for excellence in hospice care. Dr. Wensel elaborated on the board’s responsibilities, which include overseeing the certification process, fostering a supportive community for hospice medical directors, and facilitating continuing education.

The evolving landscape of certification was also discussed, with Dr. Wensel highlighting HMDCB’s transition this year to a longitudinal approach for continuing certification that ensures ongoing education among certified professionals.

With only three AAHPM presidential citations awarded annually, HMDCB’s recognition reaffirms its pivotal role in advancing the field of hospice care and ensuring compassionate end-of-life care for all. The other two recipients of the AAHPM Presidential Citation were the Carter Family, for raising public awareness by being open about the decision to access hospice care for both President Carter and the late Mrs. Carter, and the International Association of Hospice and Palliative Care (IAHPC) for their outstanding contributions to advancing global hospice and palliative care initiatives.

As an RN at TRU Community Care’s Hospice Inpatient Unit, Justin Raff’s days are filled with opportunities to provide life-changing care, but for Justin, the transformative power of such service extends beyond the workplace. Every year, he volunteers as an operating room nurse with Uplift Internationale, a Colorado nonprofit, on a mission to the Philippines. Their goal? To perform cleft lip and cleft palate surgeries on pediatric patients in need.

Justin’s journey with Uplift Internationale began six years ago, sparked by a former colleague—a Filipino nurse—who introduced him to the organization. Since then, he has dedicated himself to this cause, embarking on his third trip with them this past January. Each trip is entirely self-funded; Justin takes precious time off from work and covers his travel expenses. This year, he created a GoFundMe page to raise funds for his mission.

The impact of Uplift Internationale’s work is impressive. Beginning Sunday morning with patient screenings, the team works 14-hour days performing surgeries that are life-changing for the children and their families. Their roster comprises volunteer nurses, surgeons, doctors, and even non-clinical staff — the youngest of whom this year was 13-years-old. Together, they performed over 100 surgeries during the week.

The organization brings a high degree of service to their patients. Not only are all surgeries provided free of charge, but the organization also covers travel expenses for patients and their families. For those unable to undergo surgery immediately due to illness, Uplift ensures that they receive any necessary medication and arrange for future treatment at their permanent clinic in Manila.

In a society where cleft lips and palates are highly stigmatized, Uplift Internationale offers hope and acceptance. Justin recalls the poignant sight of children arriving at the hospital clutching makeshift coverings – washcloths and children’s blankets – for their condition, only to find these abandoned on the operating room floor after surgery—symbols of newfound confidence and freedom.

When asked if he would continue volunteering each year with Uplift Internationale, Justin replied, “Absolutely. Though I may take next year off to focus on my studies, this work is a

lifelong commitment for me.” Justin, who plans to pursue a doctorate of nursing practice at CU Anschutz this year, embodies the same spirit of service and compassion for patients and families at TRU Community Care. It’s no wonder that his work is also his passion.

But Uplift Internationale’s work doesn’t stop in the operating room. Volunteers like Justin also bring donated clothes, transforming hospital corridors into free shopping malls for patients and their families. Additionally, they distribute hundreds of pairs of donated reading glasses to those in need, further enhancing the impact of their mission.

When asked if he would continue volunteering each year with Uplift Internationale, Justin replied, “Absolutely. Though I may take next year off to focus on my studies, this work is a lifelong commitment for me.” Justin, who plans to pursue a doctorate of nursing practice at CU Anschutz this year, embodies the same spirit of service and compassion for patients and families at TRU Community Care. It’s no wonder that his work is also his passion.

 

by Rachel Stackhouse, TRU Clinical Educator

If you reside in or travel to remote regions of our country, you’re likely aware of the limited access to healthcare. While those of us in the Denver metro area enjoy a plethora of options, our neighbors just an hour east or west often find themselves with little to no healthcare choices. The healthcare industry, already under pressure from reduced reimbursements, has seen numerous hospice providers shutter their operations in recent years. One such instance is the closure of services in the Estes Park area by a local organization. Estes Park Health announced in October its decision to discontinue home health and hospice services due to financial difficulties. As of December 31st, their hospice services ceased, prompting TRU Community Care to step in with innovative solutions to deliver hospice care to the community in mid-January.

Rural areas have long been identified as an area of concern for public health. The CDC reports that 15% of Americans live in a rural area, and those who live rurally have an increased risk for injury-related death, heart disease, cancer, stroke, and other illnesses common to hospice patients. The CDC also highlights that the population in these areas tends to be older and frailer in general.¹ The National Center for Frontier Communities has been advocating for remote areas since 1997.² While there is no clear-cut definition of a “Frontier Community,” as this varies by state, in general, a Frontier Community has fewer than six people per square mile or is greater than 30 minutes or 30 miles to common necessity services. In 2011, each state office determined which of their counties were considered Frontier. When all were totaled, the United States had 46% of its land in Frontier areas, mostly concentrated in the western states. ³ Since these remote communities are at a higher risk for injury and chronic illnesses, there ought to be a way to support them; and indeed, there is.

Supporting remote communities is not new for TRU Community Care. TRU’s Tele-Care program launched in 2019, and when COVID hit in 2020, changing the way healthcare functions, TRU was positioned to provide meaningful care remotely. Since then, telehealth has continued to be a staple for some of our patients, and TRU Tele-Care includes remote patient monitoring, vital signs, symptom questions related to the diagnosis, and immediate access to an RN. When we combine this powerful tool with field staff willing to travel to remote areas, we can effectively support our neighbors who live remotely.

In 2021, TRU partnered with an organization in Kansas to provide telehealth monitoring for an area designated as a Frontier Community. During this effort, TRU nurses were able to detect slight changes in a patient’s condition and alert the Kansas team in advance of further decline. Our ongoing commitment to assisting patients who have lost access to their local hospice provider is exemplified in our current model. Although it’s often the case that individuals in remote areas prefer minimal social interaction, those opting for remote care monitoring can benefit from immediate access to nursing assistance. This support ranges from simple tasks like medication refills to more intricate matters such as wound care education or understanding new symptoms and prognoses with the guidance of our nurses. TRU Tele-Care offers a high level of flexibility tailored to the patient’s preferences, whether they seek minimal contact or daily interaction. With a nurse available at a moment’s notice, the patient and family have control over the level of support they receive.

It may be tempting to perceive these issues as a distant, national concern, but closer examination reveals that many Coloradans are directly impacted by rural health disparities. The Colorado Rural Health Center’s data shows that 73% of our counties are rural, with 23 out of 64 designated as Frontier Communities. Our rural residents are 14% more likely to succumb to coronary heart disease compared to their urban counterparts.⁴  While there are regulatory constraints on how far TRU can extend its in-person care, my tenure of over 7 years at TRU underscores our unwavering dedication to the community. TRU Community Care has earned recognition for catering to all individuals in need of hospice services, irrespective of wealth or geographical proximity. We are committed to continually exploring innovative approaches to serve our remote neighbors to the best of our abilities.

Sources:

1. Centers for Disease Control and Prevention. (2023, November 28). About rural health. Centers for Disease Control and Prevention. https://www.cdc.gov/ruralhealth/about.html
2. National Center for Frontier Communities. National Center For Frontier Communities. (2023, December 13). https://frontierus.org/
3. Healthcare access in rural communities Overview – Rural Health Information Hub. Overview – Rural Health Information Hub. (2022, November 21). https://www.ruralhealthinfo.org/topics/healthcare-access
4. Health disparities in rural Colorado – Coruralhealth.org. Health Disparities in Rural Colorado. (n.d.). https://coruralhealth.org/wp-content/uploads/2014/08/IHI-poster-Colorado-Rural-Health-Center.pdf