Local program called Transitions offered through Hospice

Roger Swingle and his first wife, Linda, found some solace through Hospice & Palliative Care of Western Colorado’s Transitions program during her last six months battling lung cancer. Transitions gave them access to 24-hour nursing care and enabled them to avoid spending time at a hospital, Swingle said.

When Roger Swingle’s first wife, Linda, was diagnosed with lung cancer in 2000, the two couldn’t have imagined the maze of medical treatments or the gravity of each decision that would follow.

Every two years after her diagnosis and before she died in August 2005, Linda fought the disease with chemotherapy treatments.

But six months before her battle with cancer ended, the couple discovered a little known local program called Transitions offered through Hospice & Palliative Care of Western Colorado, 3090B N. 12th St.

It’s a program that Swingle says helped alleviate much of the mystery surrounding how much medical treatment to pursue and offered him peace of mind as a caregiver.

“It’s safe to say if we hadn’t have been involved in Transitions, we would have been scampering back to the hospital for fear of making the wrong decision of not going in when we should go in,” Swingle said.

Typically, if a patient has problems over a weekend or after business hours, for example, he or she could normally be treated by an on-call doctor unfamiliar with the patient’s health.

Physicians wanting to be certain they’re offering enough care recommend that an emergency room visit be followed by a hospital stay, Swingle said.

Transitions, a decade-old program, is an option for those who are not sick enough to be admitted to a hospital, or Hospice’s Care Center, but who can still receive 24-hour access to health care through a nurse.

At any time of day, the Swingles could call or be visited at home by a nurse familiar with Linda’s condition.

Thanks to the program, Linda was never hospitalized, though she received personalized care, Swingle said.

“Both Linda and I felt like we were in control,” he said.

It’s this kind of care offered in expanded programs through Hospice that can partly take credit for Mesa County’s recent notoriety as a model of health care reform, said Christy Whitney, Hospice’s chief executive officer.

Keeping patients from needless hospital stays or using Hospice’s end of life care instead of the hospital’s, is one cog in keeping health care cost down and quality up, Whitney said.

In 2006, Grand Junction’s Medicare per person reimbursement rates were some of the country’s lowest at $2,664 a year. Those rates soared to more than five times higher in other parts of the country, according to the Dartmouth Atlas of Healthcare.

Hospice was started locally in 1993. In 1994, the program cared for about 60 patients a day. That number increased to 220 patients a day in 2005, Whitney said.

Average end-of-life Hospice care locally is twice as long, or 22 days, compared to the national average of 12 days.

A national average of 30 percent of people die in hospitals, while about 21 percent die in hospitals in Grand Junction, the Dartmouth Atlas reported.

“None of these things by themselves are the silver bullet, but it’s a constellation of things that are keeping costs lower,” Whitney said.

Up to 100 people are receiving care from the Transitions program, which is designed for non-traditional Hospice patients, many of whom were given a diagnosis with a couple of years to live, Whitney said.

“They’re the kind of people who are caught in between the cracks,” she said.

Steve ErkenBrack, president of health insurer Rocky Mountain Health Plans, said end-of-life care is not where you try to save money, but increase quality.

Patients, their families and physicians are making decisions, and that interaction usually results in Hospice being used appropriately, he said.


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