André Lee (left), administrator and co-founder of Heart and Soul Hospice, stands with Keisha Mason, chief nursing officer, in front of their office building in Nashville, Tenn., on December 20, 2021.
Erica Calhoun for NPR
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Erica Calhoun for NPR
André Lee (left), administrator and co-founder of Heart and Soul Hospice, stands with Keisha Mason, chief nursing officer, in front of their office building in Nashville, Tenn., on December 20, 2021.
Erica Calhoun for NPR
This time, it didn’t take much persuasion for Mary Murphy to accept the home hospice. When her mother died of Alzheimer’s in 2020, she was reluctant until she saw how it helped. And so when her husband, Willie, neared the end of his life, she took over the hospice again.
The Murphys’ home in a tree-lined Nashville neighborhood is their happy place – filled with their treasures.
“He’s been good to me – buys me whatever I want,” she said as she pulled a milky white glass vase out of a floor-to-ceiling cabinet with mirrored shelves.
Willie bought Mary a display cabinet so that she could display all the trinkets she picked up while buying and selling real estate.
Down the hall, Willie lay on their bed, now unable to speak. His heart is giving.
“Will you wake up in a minute?” she asked as she held his head. She patted his back while he cleared his throat. “Cough cough.”
Mary is her husband’s primary carer, but she gets help from a new aged care agency in Nashville that is focused on increasing families’ use of end-of-life amenity care. Black skin. Heart and Soul Hospice owned and operated by people from a cultural background with the patients they are trying to serve.
In the family application In order to obtain a Certificate of Need in Tennessee, hospice owners made it clear that they were Black and that they intended to serve all but focused on currently underserved African-Americans. Tennessee data shows that in Nashville, only 19% of delicate patients are Black even though they make up 27% of the population.
Although the area has had many hospice agencies, the governing bodies have licensed them, primarily on the merits of educating an underserved group.
Hospice gave Mary and Willie a bath several times a week, mailed medication, and any medical equipment they needed. And there’s emotional support from a dedicated nurse.
Blake Farmer / WPLN
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Blake Farmer / WPLN
Hospice gave Mary and Willie a bath several times a week, mailed medication, and any medical equipment they needed. And there’s emotional support from a dedicated nurse.
Blake Farmer / WPLN
During Mary Murphy’s first experience with the hospice, her mother suffered from dementia for decades, but when her mother transitioned to hospice, Murphy’s worries grew even more. She felt like she was abandoning her mother.
“My first thought was death,” she said.
National data show that black Medicare patients and their families do not transition into routine care as often as white patients. About 41% of Black Medicare beneficiaries who died in 2019 were enrolled in hospice, compared with white patients, which was 54%, according to the report. data compiled annually by the National Hospice and Palliative Care Foundation.
Murphy’s mother survived nearly three years in the hospice. The benefits are for people in the last six months of life, but predicting when it will end is difficult, especially with dementia. Hospice provides palliative care to the dying and supports caregivers as long as the process lasts.
Murphy did most of the care work – probably overwhelmed – but the hospice helped with a few baths a week, mailed medicine, and any medical equipment they needed.
And most importantly for Murphy is the emotional support, which comes in large part from her healthcare nurse.
“No doctor is coming here, hold my hand, stay here until the funeral home comes for her,” she said of the day her mother died.
This year, on the day after Thanksgiving, Willie Murphy passed away. And the same good health nurse was at Murphy’s house within minutes. She dropped in that morning to check on him and returned shortly after Mary called and told her he wasn’t breathing.
“If you don’t feel like, ‘God, thank God, I have hospice’,” says Keisha Mason, nursing director of Heart and Soul. .
Mason is Black, just like Murphy, and in her view, there is nothing fundamentally stopping Black patients from using hospice except to learn what the service can provide and about the facilities. It’s free for patients – paid for by Medicare, Medicaid and most private health plans.
“I told them, ‘If you see a bill, give us a call, because you shouldn’t,'” she said.
Because Mason helped found this new hospice agency, she started using new language, calling hospice more of a Medicare benefit. She describes it as an entitlement.
“Just like you get unemployment, when you get Social Security, you get the health care worker benefit,” she said.
Investors in Heart and Soul include David Turner, owner of CNS Hospice in Detroit, Mich., Nashville pastor Rev. Sandy McClain and André Lee, who was a hospital administrator on the campus of Meharry Medical College in Nashville, an institution with a history of Black people.
Lee and Turner also started focusing on Black People hospice agency in Michigan, with plans to replicate the model in other states.
Lee says more families need to consider home hospice as an alternative to hospice. Nursing homes are very expensive. And even with Medicare, hospital bills can be very expensive.
“You will go in there and they will eat you alive,” he said. “I hate to say [something] bad about the hospital, but it’s true. “
Family research does not provide a clear reason why there is a gap between welfare use by white and black families. Some speculate it has to do with spiritual beliefs and widespread distrust in the healthcare system due to decades of discrimination.
The national trade group of the forage industry, NHCPO, has released a diversity and inclusion tools and a tutorial how to reach more black patients this year. It recommends connecting with influential DJs and partnering with Black pastors. But also only hire more Black nurses.
Lee says it’s not too complicated.
“Many hospices are not recruiting enough Negroes,” he said. “We all get comfortable when you see someone over there who looks like you.”
Well-established cell care agencies have tried to reduce all barriers to diversity initiative. Michelle Drayton of the Visiting Nurse Service in New York said her large body had been meeting with ministers, who advise families dealing with ill health.
“Many of them don’t fully understand what a hospice is,” she said. “They had many of the same misconceptions.”
Whether it’s an emerging hospice company or one of the oldest in the country, says Drayton, people still have a lot of work to do to close the racial gap. “We’re not just handing out a brochure,” she added.
This story was produced in partnership between Kaiser Health News, NPR and Nashville Public Radio.
