Kokua Kalihi Valley  

(Comprehensive Family Services)

End-of-Life Program

COMPREHENSIVE PALLIATIVE MEDICINE SERVICES: AN OVERVIEW

GOALS:

1.	To deliver culturally sensitive care to Kalihi Valley residents that would relieve emotional, spiritual, personal and physical suffering.
2.	To inform patients and families of all reasonable choices and options including hospice care.
3.	Palliative care will be available to terminally ill patients irrespective of ability to pay, to help them die in comfort, with love and dignity.
WHAT SERVICES ARE PROVIDED?
1.	Home based palliative care: Every Monday afternoon physician accompanied by medical assistant and case manager visit clients in their homes. Home blood draws, immunization etc. are provided. Referrals are made to Hospice, home health agencies, and other service providers.
2.	Office based palliative care: Main clinic on School Street. Other satellite centers include Gulick Elder Center (1846 Gulick Ave) and new clinic to soon open at Kuhio Park Terrace public housing.
3.	Palliative Medicine Consultation: (Home/Office) Pain, symptom management and other EOL issues.
4.	Case Management: Through Kupuna Care (>60 years + problem with 2 ADLS) or Public Housing case management (all ages residing in public housing). Physician reviews care plans at monthly interdisciplinary team meetings. Case Managers are multicultural and bilingual. Referrals are made to appropriate community resources like St. Francis bathing services, LMOW, Chaplain, Hospice etc.
5.	Companion: Senior/Respite companion is provided to those enrolled in Kupuna care. They assist clients with personal care, food preparation, social/recreation and home management. Chores program is also available for those enrolled in Medicaid, useful for clients <60 years.
6.	Caregiver support groups: Two groups that meet once a month. Physician in attendance to answer caregiver questions and provide health education.
7.	Respite care: Caregiver respite care also available.
8.	Health Maintenance groups: Exercise followed by congregate dining through partnership with Lanakila Meals on Wheels. Provides socialization needed for terminally ill clients. Three different groups for seniors that meet twice a week from 10am -12noon. New group started for clients <60 years.
9.	Bereavement: assistance with funeral arrangements, condolence visit, follow-up Tel.
10.	Pastoral care: Upon request local community pastors volunteer their time visiting clients at home.
11.	Transportation: Daily van runs to and from the clinic. Assist clients to doctor's appointments, ER, health maintenance and support groups.
12.	Eligibility: Assist clients with applying for insurance, food stamps, welfare & other benefits.
13.	Other: Interpreters (over 17 languages spoken), Emergency food including ensure cans, Nutritionist, behavioral health - supportive psychotherapy etc.
WHO IS ELIGIBLE FOR SERVICES AT KKV?
1.	Residence of Kalihi Valley (from Fort Shafter in the west to Kalihi Street on the east, and from H1 freeway up mauka into the furthest areas of the valley).
2.	We participate with ALL insurance carriers. We welcome those who are uninsured, they will be put on a sliding fee or other programs like IHI. Free medications will be made available through the medicine bank or drug company's patient assistance foundations. Eligibility workers will assist them.
HOW TO GENERATE A REFERRAL?
1.	To schedule physician visits/consultation contact Dr. Ritabelle Fernandes (Board certified Hospice and Palliative Medicine Specialist) pager 852-5571 or via cell phone 478-8474. In-house referrals for case management etc. will be generated by Dr. Fernandes.
2.	If you do not want physician visit and need to refer to Kupuna care, Respite care, health maintenance, caregiver support etc., contact Dr. Valerie Yontz -Elderly services at 848-0977
3.	For <60 years, residing in Public housing referrals for Case management, health maintenance, support groups etc. contact Karen Tyson- Public housing at 847-3038.

Useful End-Of-Life Resources

1.	Growth House (www.growthhouse.org) An international gateway to resources for life-threatening illnesses and end of life care. Growth House, Inc., provides content development and syndication services for organizations working with death and dying issues.
2.	National Hospice and palliative Care (www.nhpco.org) The National Hospice and Palliative Care Organization (NHPCO) is the largest nonprofit membership organization representing hospice and palliative care programs and professionals in the United States. The organization is committed to improving end of life care and expanding access to hospice care with the goal of profoundly enhancing quality of life for people dying in America and their loved ones.
3.	Hospice Foundation of America (www.nationalhospicefoundation.org) This charitable organization seeks to expand America's vision for end-of-life care by engaging and informing the public about the quality end-of-life care that hospice provides. This foundation exists to help those who cope personally with terminal illness, death, and the process of grief and bereavement.
4.	Project of Death in America (www.soros.org/initiatives/pdia) The Project on Death in America seeks to transform the culture of dying by supporting initiatives in research, scholarship, the humanities, and the arts, and by fostering innovation in the provision of care, public and professional education, and public policy.
5.	Bill Moyers (www.pbs.org/wnet/onourownterms/) Bill Moyers PBS series on death and dying issues.
6.	Kokua Mau (www.kokuamau.org) Kokua Mau is a partnership of individuals and organizations working with the general public and with the leaders of healthcare and government to improve how people in Hawaii are cared for at the end of life
7.	Hospice Hawaii (www.hospicehawaii.org) Their mission is to provide a special kind of caring for terminally ill people and their families, to help ensure their quality of life, to help them prepare for death, and to educate our community about the hospice philosophy.

SIGNIFICANCE:

                Traditionally community health centers offer services that include primary and preventive care. We have widened our horizons to include palliative medicine services and improving end-of-life care. KKV is a pioneer in the field and is one of the first community health centers to have an end-of-life policy.

Contact Us: E-O-L Email