From The Enterprise - Upper Cape Cod News and Information
Waquoit Couple Changing Way People Look At Hospice
By MICHAEL C. BAILEY
May 1, 2008 - 11:33:56 AM
Say the word “hospice” to most people and they envision a place where people go to die.
Say it to David W. Rehm of Waquoit, the new president and CEO of Hospice & Palliative Care of Cape Cod (H&PCCC), and he will tell you otherwise. To him, it is a place where people go to live their remaining days to their fullest.
“There’s something about the word ‘hospice’ that frightens people…people think hospice is for the very end, when there’s no hope,” he said, “but that simply is not true.”
“We’re trying to actually change their understanding of what hospice is,” Mr. Rehm said, and to that end, he has a very able partner in his wife of two years, Lise M. Lambert, who has joined H&PCCC as the nonprofit’s vice-president of business development and philanthropy.
“We asked ourselves, ‘Would a married couple fly?’ ” said Melissa R. Weidman, director of communications and community outreach, but the couple’s enthusiasm for the organization’s work and their natural synergy quickly proved a winning combination. “We get way more out of them working together.”
The couple met by chance while both were working for VistaCare in Arizona, Mr. Rehm as senior vice president of business development for the hospice care service, Ms. Lambert as senior vice president of strategic planning and marketing.
“It’s safe to say David came in through the front door” of the industry, Ms. Lambert said, whereas she “came in through the side door.”
Ms. Lambert’s career began as an educator for deaf children, which she described as “very soulful work.” During her time with the Phoenix State School for the Deaf/Phoenix Day School for the Deaf, she designed and implemented a music and theater program for deaf students, and developed curricula for deaf students in voice, drama, band, and instrumental instruction.
Financial demands “pretty much forced me to look for other pursuits,” Ms. Lambert said, and she wound up working in the technology industry, serving as senior management for several firms before co-founding one company and founding a second.
“I loved the work from an intellectual standpoint,” she said, but it wasn’t until she joined VistaCare as its IT department manager that she realized what was lacking: “I was missing the human connection.”
The VistaCare staff gave Ms. Lambert a crash course in the hospice industry, “and within five days I was totally smitten…I knew I had landed again. I had one of those ‘a-ha’ moments.”
Mr. Rehm had a similar epiphany almost two decades ago when he entered the hospice industry, which felt very familiar due to his childhood; his family owned a funeral home in a small, close-knit community, and he often saw his mother working with bereaved neighbors sometimes for months after their loss.
“I like to say my mom created the first bereavement program in the country,” he said.
Mr. Rehm’s formal entry into the hospice industry followed a 10-year run as associate director of the Kent County Mental Health Center in Warwick, Rhode Island. He joined VistaCare in 1998.
The couple first met and bonded as colleagues while working together as part of a management group tasked with exploring expanding opportunities for the organization.
“We had a mutual respect for each other,” Ms. Lambert said. “We were getting to know each other as friends.”
A deeper bond began to form one night when the group went out to dinner together “and we got to talking about our own experiences” with the loss of a loved one, Mr. Rehm said; two years earlier, he had lost his first wife to cancer, while Ms. Lambert’s mother was dealing with a life-threatening illness and was eligible for hospice services.
“We had that kind of sharing experience,” Ms. Lambert said. “We both teared up.”
They married in August 2006, less than a year after they moved back to the East Coast “because we both had parents here and we wanted to be closer to them,” Mr. Rehm explained. They lived in Maryland until the opportunity to work together in Massachusetts presented itself.
“We thought of working together down the road,” Mr. Rehm said, but when Mr. Rehm was offered his current position with H&PCCC, “I initially said I wasn’t interested” out of consideration for his wife, who was in the process of founding a new company, “but they asked if we would consider joining as a team.”
“It was a no-brainer,” Ms. Lambert said.
‘Third Act Of Life’
Hospice & Palliative Care of Cape Cod was founded in 1981 by a group of citizens led by Mary McCarthy, then a nurse at Falmouth Hospital. The hospice movement itself, Mr. Rehm said, was not much older and existed only as scattered hospice services across the country.
“It was an effort to change the way people were cared for at the end of their lives,” he said, noting that until the hospice revolution, there was a lack of a comprehensive medical, emotional, and spiritual support system for people “in the third act of their lives” and their families.
Hospice has since grown into a $10 billion-a-year industry, and Mr. Rehm called H&PCCC “one of the country’s flagship hospice programs…this is the organization that brought the whole concept of end-of-life care to this community.”
H&PCCC has a main office in Hyannis, satellite offices in Falmouth and Wellfleet, and runs the Mary McCarthy Hospice House residential program in Sandwich. The organization boasts “a really vibrant volunteer core” of more than 200 people, Mr. Rehm said, and a paid staff of 130 ranging from counselors to nurses to chaplains.
Many staff members have been with the organization for more than 20 years, Mr. Rehm noted. “It’s an opportunity for really meaningful work,” he said, adding that hospice industry workers generally have a much higher level of job satisfaction than employees in other health care sectors.
All hospice organizations share the same general philosophy and strive to make people dealing with terminal illness as comfortable as possible, but how different organizations go about this can vary significantly.
“Our philosophy is something broader than what’s provided by some hospices,” Ms. Lambert said.
At H&PCCC, “anyone is eligible to benefit from hospice care” if they have been given six months or less to live due to terminal illness as diagnosed by their doctor, and request hospice care, Ms. Lambert said. “We won’t turn down any patient.”
According to Mr. Rehm, the scope of services is much broader than many think, and can begin immediately after a terminal diagnosis. In fact, he said that many families who receive hospice services later are unaware that they could have sought out those services much earlier.
“The most common statement I hear is, ‘If we only knew, we would have called you much earlier,’ ” he said.
About half of the people eligible for hospice care do not seek it out, Mr. Rehm said, “far short of what it should be.”
He added that even healthcare providers are often unaware of the potential extent of a partnership with H&PCCC, stating that doctors often think of hospice as a handing-off of their patient “rather than a partnership…we want a handshake, rather than a hand-off.”
Once a family comes to H&PCCC, they can immediately benefit from services “that take the medical, financial, and emotional burden off their shoulders…families often feel they’re on their own after that doctor’s phone call,” Mr. Rehm said. “We manage everything.”
Mr. Rehm further detailed the financial benefits of entering hospice care, noting that early entry can save an average $2,300 in Medicare expenses.
H&PCCC accepts Medicare and other health insurance plans, but also covers expenses through independent fundraising, which nets $1.5 million a year. Ms. Lambert said H&PCCC “has enjoyed a great legacy of support” due to its history and reputation, “and we’ve come to depend on the generosity of Cape residents.”
Services can be delivered in a variety of settings, whatever the patient regards as their home, Ms. Lambert said, whether that is their house, an assisted living facility, or a hospital room. “That’s not true of all hospices,” she said.
“People think patients need to be bed-bound,” Mr. Rehm said, “but that certainly is not what hospice is anymore.”
The Mary McCarthy House provides short-term services for those patients who are bed-bound, or at least cannot receive services in their own home. The 10-bed facility provides patients with private rooms and is continually staffed by physicians, nurses, social workers, and volunteers.
In general, hospice care is designed to optimize the patient’s comfort and care rather than focusing on a cure, but Mr. Rehm said it is not unheard of for people to leave hospice care alive and in good health; he estimated 20 percent of H&PCCC clients “are discharged alive.”
For the other patients, Ms. Weidman said they typically live 30 days longer than expected under hospice care.
For a patient’s family, H&PCCC offers a grief support center, which is available for up to 13 months after the patient’s passing, and a child-oriented program, “Kids Grieve Too!” That latter program utilizes a unique volunteer: Murphy, a specially trained Austrian sheepdog mix that works with children in individual and group settings.
Finding New Partners
Ms. Lambert said part of her job with H&PCCC is to better educate the public as to what hospice is and what the organization does, a crucial element of her strategy for finding new individuals, businesses, and organizations—both within and outside the healthcare field—to support H&PCCC’s mission.
“People are very responsive to us,” she said. “They’re motivated by our compassion and leadership.”
“And we will be asking the community, which really owns us, to become partners with us again,” Mr. Rehm said.
Ms. Lambert said she will be identifying organizations across the Cape that H&PCCC already works with to find ways to improve their relationship, and organizations and businesses with which it can forge new partnerships.
“We’ve developed valuable relationships in the community, but we want to strengthen them,” she said.
This support will help the Mary McCarthy House evolve to become only the third licensed “hospice intensive care unit” in-patient care facility in Massachusetts, which will provide patients with a more intensive and sophisticated medical monitoring.
“That’s good for patients and families, but benefits hospitals as well” as they can discharge terminal patients to free up much-needed hospital beds, but without the patient losing top-quality medical care,” Ms. Lambert said.
“We’re focused on the short-term now,” Mr. Rehm said, “but we will assess our service gaps, then create creative solutions to close those gaps.”
For more information about Hospice & Palliative Care of Cape Cod, visit the organization’s official website at www.hospicecapecod.org.