Horizon Hospice focuses on holistic care
By Marijke Fakasiieiki
Since Horizon Hospice started 25 years ago, the program has grown to 100 staff who provide personalized care for 170 patients, said CEO Chris McFaul.
Their focus is on holistic self-directed care of mind, body and spirit, he pointed out.
The care is also adjusted to help people live life to the fullest while they navigate the final chapter of life, he added.
"We understand the importance of the last days of life because everything then changes and becomes more difficult for the patient, and more exhausting and emotional for the family," Chris said. "We are dedicated to making sure no one dies alone, in pain or outside their home."
Horizon Hospice continues to figure out how to make a positive difference for patients.
Chris came out of a business and medical science background, working as a leader in a pharmaceutical company, knowing little about hospice.
In 2008, his mother-in-law, Sue, called with news that she was diagnosed with terminal liver cancer.
About the same time, Loren Guske, who founded Horizon Hospice with Barbara Morgan and his wife Beth, invited Chris to join him to run Horizon Hospice.
"In terms of providence, God's timing is interesting," Chris observed. "I just couldn't imagine doing it, but in walking through the last several months of my mother-in-law's life, while she was receiving hospice care, I saw the impact it made, not only for her, but more so for my wife, her sisters and our entire family."
His newly married niece, who lived a few hundred miles away with a new job and new house, had not been in touch with Grandma Sue for several months and didn't see her gradual decline. When she came to visit, she saw visibly the decline that was taking place and how much had changed in that short period.
She talked to family members and eased her way into seeing Grandma Sue, who was sitting on the edge of her bed and engaging in the key conversations of 'I love you' and 'Goodbye.'
"The value of Hospice showed. If we were in a hospital, not in her home, it would have been difficult," Chris said. "At that moment, I knew this was something I could pour my life into that would be more than a job and paycheck. It would be a mission, a calling for my life.
"What I see with Hospice was that this is a critical juncture, where people don't know how difficult the end-of-life journey is. It is a pathway strewn with landmines we are not aware of. We are emotionally fragile. Medically, our loved one is very fragile," he said.
To have a guide can make a positive difference if it's done well, he added.
Chris said care providers, aides, nurses, social workers and chaplains are to be personable, so care is personalized, prioritizing listening and connection.
He described what that looked like for one patient, a cowboy, who grew up riding a horse under the big sky on the range, away from the city. He was in hospice care in an apartment, looking out the window to a parking lot.
"You can imagine that person would feel cooped up in hospice care," he said.
One care team member learned from his wife that he loved horses and the outdoors. One Sunday morning while he was sitting in his wheelchair he rolled his chair to the window and saw the caregiver bringing a horse to visit him, Chris said.
His wife was in tears. He said, "That's a red roan." His wife said the horse looked like the last horse he had owned.
They took pictures of him feeding and petting the horse as he sat in his wheelchair, celebrating his life with his whole family.
"Our vision at Horizon is to help people live life to the fullest, one day at a time," Chris said.
Another caregiver learned a patient and his wife had their first date 40 years before at the movie, "The Electric Horseman." With a few phone calls, they arranged for the family to recreate the first date and have a private viewing of "The Electric Horseman" in the Garland Theatre.
"When I meet on the first day with a new employee, I talk with them about these stories. When I tell these stories and see tears in their eyes and emotional connection, I say, 'This is a good hire.' They understand the reason we exist, catch the vision and will take good care of our patients."
Hospice is unique because Medicare requires patients to address medical, psychological and social elements of care, as well as spiritual care.
"We are grateful for that requirement because it is important to address the questions, What's next? Does my life have significance? and Will I see God face to face? We support them in pursuing their spiritual meaning," said Chris.
"Faith is important as we focus on patient and family autonomy in self-directed care. Patients determine what their care looks like. If they are not able to do this, their healthcare durable power of attorney determines what care looks like," he said. "Whatever faith system a patient wants support for, that's what we connect them to. Each describes that and our team makes connections to put that support in place.
Chris believes everyone lives by a faith system. Being a follower of Jesus Christ, he said, informs him to be a servant leader and empowers the Horizon team to meet a patient's spiritual needs through self-directed care.
On intake, Hospice staff ask the patient, "Do you have a faith system that you want supported?" Knowing that, the care team can help them connect with their spirituality as they face their mortality and end.
Communication is critical to keep people connected.
"My perception of my title CEO is as a Custodial Equipment Operator. My job is to get the broom out and sweep any obstacle out of the way, anything that is impeding our care team from giving the patient quality care, support and ability to process with the least restrictions and encumbrances."
Because the staff care so deeply for the patients, they need to process their emotions, frustrations and loss as part of their work. They do that with teammates, a social worker, chaplain, nurse or someone else.
"That way we are all recharging their batteries so they are able to give their best," Chris said.
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