Visiting Nurse Association of Texas

When is the right time for hospice care?

The Visiting Nurse Association of Texas (VNA) serves patients along the continuum of healthcare as they face serious illness or the end of life. A patient doesn’t have to be imminently dying to be appropriate for hospice care. Many people wait until it’s too late to fully benefit from the range of services hospice offers. The median length of stay on hospice is somewhere around 16 days, when patients could feasibly utilize hospice care for six months or more, if the disease progression warrants end-of-life care. We can better serve patients in our care for a longer period, giving them more time to get to know the team and plan how they want to spend their end of life.

What are some things VNA can help with before a crisis occurs?

We can help guide those discussions about end-of-life decisions. Ideally, advanced directive discussions should occur before a family is facing a crisis when their loved one is no longer able to make decisions for him/herself about things like a living will, different powers of attorney, out of hospital DNR — things that are hard for a family to decide on behalf of their loved one. It would be better if patients make their wishes known before a crisis.

What is supportive palliative care?

This is serious illness care that patients can access before the point where they may need hospice. They may be experiencing changes in a disease process or their health is declining in some way, and they prefer to spend more time at home and less time in the hospital. A team of nurses, social workers, chaplains, and doctors make the same kinds of in-home visits that we do in hospice, but the patient can still pursue treatment with a team of physicians whereas hospice care takes over the primary management of your healthcare. With supportive palliative care, the patient can maintain all treatment options and access some supportive care at home.

Does VNA provide other services?

VNA also provides Meals on Wheels, providing 5,000 hot, home-delivered meals and social interaction every weekday to seniors in Dallas County. While our hospice care services 16 counties in North Texas, our Meals on Wheels serves Dallas County specifically. We are a social service agency and a healthcare agency rolled into one. Importantly, we’re able to help some of our Meals on Wheels clients with their clinical needs and help our hospice and palliative patients with meals service if appropriate.

What about those who don’t have access to healthcare?

VNA is trying to make an impact in health equity issues. Depending on where patients live, they may not have equal access to appropriate healthcare of any kind, much less end-of-life services or serious illness care. We can help provide access to appropriate primary care, vaccinations, and transportation through our Community Health Workers, who are responsible for visiting our Meals on Wheels clients and doing screenings to determine their healthcare needs and connect them with the appropriate providers.