Inland Regional Hospice is encouraging longer stays and more interaction with family members. The goal is to make hospice care more than a one or two-week ordeal at the very end of life, but convincing people to take that approach can be difficult.
When he opened Inland Regional Hospice in Corona one year ago, Florin Rominu knew he didn’t want to run a conventional end-of-life facility.
Why, he thought, did a hospice have to be restricted to the last week or two of a person’s life? Why couldn’t hospice treatment be expanded to the last few months of the person’s life, so they could be as comfortable as possible while coping with a life-ending illness?
At the same time, it would be good idea to bring the person’s family into the picture, counsel them and let them have more of a say in the end-of-life treatment. Why not offer them counseling after their loved one is gone? Wouldn’t all of that make it easier for people to deal with the loss when the end finally came?
Inland Regional’s goal would be the same as any hospice: not to speed up or postpone death but to welcome it. The difference would be a less stressful and more drawn out process, not one jammed into one or two weeks, which is closer to the average hospice stay.
“I saw the need for a new business, because it was clear to me that the hospice stay wasn’t doing everything it could for our patients,” said Rominu, who worked in the printing business before he changed careers and opened an assisted living facility in Bloomington in 2003. “The people working in the facility didn’t know the patients, and the patients didn’t know the facility and what was available to them.
“I thought I could improve the industry, which should be about more than dying.”
Rominu now owns two assisted living centers in Redlands along with the Inland Regional Hospice. The hospice employs 16 people and can treat up to 25 patients, and it will extend a stay beyond six months with a doctor’s approval, Rominu said.
A 1990 graduate of Redlands High School, Rominu decided to open an assisted-living facility while he was caring, in-home, for his ailing grandfather. It was while running the Bloomington facility he got the idea to operate a hospice that would encourage longer stays.
“About 99 percent of our assisted-living patients end up in a hospice, either a facility or they get their treatment at home,” said Rominu, who is Inland Regional’s main administrator. “When I talk about longer hospice stays, it’s not about profits. I really believe that’s what’s best for the people we’re caring for and their family.”
Hospice care in the United States is made available to anyone who has been diagnosed with a terminal illness and been given less than six months to live, regardless of their age. An estimated one-third of all U.S. residents who receive such a diagnosis end up using in hospice, a move that is covered by Medicare.
Care is provided either at home or in an approved facility, such as a nursing home, hospital unit or an independent hospice like Inland Regional. The level of treatment is based on the patient’s need, and a person can be remove from a hospice if their condition improves.
Hospice care in the United States emphasizes the patient’s psychological state more so than hospice care in other countries. That might explain why most people are reluctant to seek that treatment until they have no other good options, said Sharon Negreen, executive director of the California Hospice and Palliative Care Association in Sacramento.
Many U.S. hospices have been trying for years to get people to consider longer stays and more counseling for family members, with mixed results, Negreen said.
“Hospice care is about dying, and a lot of people don’t like to admit they’re dying,” Negreen said. “But it’s a quality-of-life issue, because people should be able to get as much as they can with the time they have left. It’s also a fact that hospice facilities in the United States aren’t used nearly
as much as they should be.”
Hospitals will welcome longer hospice stays because it will reduce the amount of end-of-life treatment they must provide, something most hospitals are not set up to handle, Negreen said.
Changing the public perception that hospice care is only for the last days of a person’s life will be difficult and time consuming, Negreen said.
“I think we’re doing better,” Negreen said. “There’s been some stories in the media, some positive coverage about how the hospice industry is trying to change. The Affordable Care Act includes provisions giving people more say in the hospice care they receive, and I think that will help.”
If nothing else, the aging Baby Boomer generation will create a demand for more hospice care. There are currently about 200 hospices in California, and that number could easily double in five years, Negreen said.