MORGANTOWN, W.Va. – When Kevin Knopf, 43 of Morgantown, became paralyzed from his mid-torso down due to a spinal cord infection in 2019, he knew his life would change drastically. He would have to find new ways to navigate not only the world, but his health.
“I spent five months in and out of the hospital and rehabilitation facilities,” Knopf said. “I had a wound VAC, and that’s when I started working with Home Health.” (A wound VAC – vacuum-assisted closure – is a type of therapy used to help wounds heal.)
WVU Medicine Home Health and Hospice provides care to patients of all ages in their homes following a surgery or illness with the goal of reducing the need for hospital readmissions and helps patients and their families with end-of-life-care.
For Knopf, Home Health helped restore his independence, allowing him to go back to remote work. He said he initially viewed the fact that he needed home health services as a negative, but his opinion has changed. Now, he believes he might not be alive today without the services they provide.
“The nurses who come really know what they’re doing in regard to wound care and using a wound VAC. They know how to prevent issues because there are many things that can happen that inhibit wound healing. They’ve been proactive, and since I started with WVU Medicine Home Health, I haven’t had any infections or problems with the wound VAC that they didn’t foresee. I wouldn’t be where I am today without their help. I still have a way to go, but they have definitely gotten me on the right path,” Knopf said.
“If someone has a question about whether their condition or situation can be handled from home, I encourage them to at least talk to someone from Home Health. They are honest and confident in what they can do. They know when you need to go to the doctor, the emergency department, or urgent care, or if it’s something that can wait until their next visit. You don’t have to play that guessing game. They’re there to keep you out of the hospital or a skilled nursing facility. They help you take care of things from home and not have to worry about handling the medical side of things on your own.”
WVU Medicine Home Health and Hospice helps patients manage their illnesses not only through treatment, such as wound care and medications, but also through education, such as how to adapt to diet changes after a cardiac or diabetes diagnosis. Providers can see the patient’s inpatient records and care plan through EPIC, the electronic medical record system used by WVU Medicine. This helps provide a seamless transition of care from the hospital to Home Health for patients in the WVU Medicine system.
“I think, too, that it’s really important to remember that oftentimes these patients are either diagnosed with a new problem or they are dealing with an exacerbation of a problem. In the hospital environment, you're trying to learn about taking care of yourself and trying to learn about your new medicines or a lifestyle change, but your care team is doing that for you. A dietitian decides what you should eat for lunch, and it’s delivered to your room. Or, your medications are delivered when and how you need to take them by nursing staff. Home Health staff helps people transition from the hospital to home and teaches them how to implement their new healthcare plan,” Linda Carte, R.N., WVU Medicine Home Health and Hospice vice president, said.
“Studies have shown that if you can keep a patient out of the hospital for three weeks, you are more likely to be successful in preventing rehospitalization. We try to maximize our services during that time to make sure the patient is receiving the care they need and that we are identifying and addressing any barriers to care.”
Social workers from WVU Medicine Home Health and Hospice work to connect patients to resources in their communities to ensure they are in a safe environment and have their needs met, such as assistance paying utility bills and having enough to eat or making their home safe and accessible. They also work with Veterans Affairs to ensure that qualified veterans have access to the resources they provide.
For patients who have a life-limiting illness but are not ready to transition to hospice care, the WVU Medicine Home Health and Hospice Bridge Program helps maintain their quality of life. This includes meetings with hospice care providers to determine what the patient’s goals are and how to meet them, whether it is spending as much time with their family as they can or preventing hospital readmissions.
“When a provider consents for a patient to participate in the Bridge program, we make sure that their symptoms are controlled, they have a life filled with quality, and when the time comes either from a physical standpoint or a psychological standpoint, that they can easily and more comfortably transition over into their hospice benefit,” Carte said. “I think that’s the biggest thing that sets us apart from other providers.”
When patients and their providers determine it is time to transition to hospice care, WVU Medicine Home Health and Hospice provides not only for the needs of the patient, but their family.
When Albert Munson, then 84 of Morgantown, received a sudden metastatic colorectal cancer diagnosis in 2018, he was given an estimate of three-to-six months to live. His physicians had been monitoring an aortic aneurysm when routine scans discovered metastasis on his liver.
“He was asymptomatic, but had a strong family history of colon cancer,” Jean Meade, Albert Munson’s wife, said. “He had just gone through this with his brother who passed away during the time that Albert was diagnosed. He saw his brother go through standard chemotherapy and be ill the entire time, and he just didn’t want to go through that. He decided that he wanted to go on hospice fairly early and just enjoy the time he had left.”
At the request of his daughters, Munson sought a second opinion and was offered oral chemotherapy, which he decided to try, knowing he could stop at any time. After six months, he began to fail the protocol and was given other options but chose to go on hospice with an organization outside of WVU Medicine.
“Albert was a retired immunotoxicologist,” Meade said. “When researchers reached out to him about a possible immunotherapy treatment, he agreed to undergo another biopsy to determine his eligibility. He went through three immunotherapy protocols, which extended his life by about three years. When he failed the last one, he realized the only other offering available to him was standard chemotherapy, which he still didn’t want to do.”
Even though he didn’t have immediate support needs at the time, Munson decided to reenroll in hospice so he would have resources available when he needed them. WVU Medicine had begun offering hospice by this time, and he was able to enroll with the program.
Hospice tailors its support to the patient’s needs and works with insurance and Medicare to cover the cost of durable medical equipment, including hospital beds and bedside toilets. Even though Munson did not require a great deal of support in his final days, Hospice was able to provide medications to ensure his comfort and deliver oxygen and suction that he only needed for a short time. When he developed ascites, a buildup of fluid in the abdomen, Hospice arranged appointments with interventional radiology to have the fluid drained and then helped manage an in-dwelling drain.
“Because I’m a retired physician, I felt like I could manage things. Hospice allowed me to access the medication, equipment, and supplies we needed. I think that even if I hadn’t had that background, I think I would have been able to handle things with training from Hospice. It was about the ability to handle the end of life as you chose to do it. I could see how some people wouldn’t want to be responsible for that level of care and want the Hospice nurses and aides to do those things,” Meade said.
“It was good to know that for someone who wanted the privacy and intimacy of that time, that if you got in over your head, emotionally got too much, or if the needs were greater, that help was just a phone call away. You knew you were never alone.”
The family also received visits from a chaplain and a social worker to make sure their spiritual, physical, and psychological needs were being met.
The most important thing for both Munson and Meade was the ability for friends and family to be able to have time to say goodbye to Munson outside of a medical setting.
“I think that the common misconception is that hospice care is giving up, but it’s about embracing the life more fully instead of fighting to the very end,” Meade said. “It gives the person the time to be at home, where they can privately say goodbye instead of having other people around in a hospital setting. It’s important for people to know that hospice doesn’t mean that you just receive pain relief at the end, but that you can still receive treatment to ensure you are able to embrace the time you have left. He was able to have his children and grandchildren around him in an environment that wasn’t intimidating to them. It was just a time that made it so much easier to say goodbye. For our family, it was a way for us to say that we didn’t have regrets because he was able to pass the way he wanted.”
Family members can access therapists and bereavement services through the hospice benefit, which can help them cope with the loss of their loved one.
“We follow the families of our hospice patients for a year after they pass to make sure they are OK because these deaths can often be traumatic. It might be that the patient was diagnosed just a month before they passed, and the family never expected it. This has been especially common during COVID because those patients passed so quickly. It is important for people to know that they can access professional care a time when they need it the most. We wouldn’t think about letting a child come into this world without being surrounded by professionals who can help, and people who leave this world deserve the same benefit of professional care and services,” Carte said.
“We want people to know about these services so that they always have what they need, whether they are inside the walls of a WVU Medicine facility or in their home.”
For more information on WVU Medicine Home Health and Hospice, visit WVUMedicine.org/Home-Health-Hospice.