iku kiriyama (column)By IKU KIRIYAMA

Postscript to “Death Is a Sure Thing: Are You Prepared? – Long-term Care, Hospice, Caregivers,” held Sept. 20 at Gardena Valley Japanese Cultural Institute.

There wasn’t enough time at the Sept. 20 forum to give a complete personal experience with the hospice that took care of my sister, Aiko. I had such a terrible experience with Vitas, the hospice used by Kaiser in my area, when my husband, George, was assigned. I knew nothing about hospices, what to expect, and what they do.

Hospice Care of the West, Aiko’s hospice, was so wonderful, I wanted to be able to share the experience, so others who haven’t experienced hospice would have a basis for comparison or selection.

Gretchen Schaeffer, executive director of Hospice Care of the West, told the audience that the hospital has to give you three choices from which you select. I was given no choice. Just told a person from hospice would come to enroll George at home. Even if I had been given a choice, I wouldn’t have known whom to select or how to even ask questions regarding care; that’s why I’m sharing this with Rafu readers and those who attended because they had seen the PR in The Rafu.

After Aiko passed away, I wrote a letter of commendation, detailing the hospice caregivers’ services and compared them to what I got from Vitas, which basically was nothing. I also sent that same letter to Kaiser but found it impossible to get a viable address and have not heard back. I told them I want Hospice Care of the West if and when I need hospice and asked them to consider adding them to agencies they use.

Because it is complete and I could not better explain, I am repeating that letter of commendation here.


I am writing to commend the hospice team that took care of my sister, Aiko Shinosaki, who passed away on April 25, 2015. Everyone, from Myra at the Royalwood Care Center to the equipment people, was excellent.

You have my permission to use this letter as a referral for your services with any hospital or institution that uses hospice services.

I am a Kaiser Permanente patient. My husband passed away in 2005. He was assigned hospice care through Vitas. He died in less than seven days, which could have been a factor but his care was non-existent. My sister’s care in the same time period of seven days (she lived 14 days) received excellent care from Hospice Care of the West. To itemize the comparison:

• Intake at Royalwood: Myra spent two days and approximately three hours explaining all the services to expect.

The Vitas person spent 30 minutes.

• Admissions person, Twee (spelling may not be correct), at my home spent around three hours, going over all the care, in addition to providing and bringing the emergency medication kit. She explained in detail about the medications in the kit and the procedure, including calling the 800 number and speaking to a triage nurse before administering. During the time she was at my home, my sister had a bowel movement. Twee not only changed her but also gave suggestions to me. Twee, by the way, arrived just prior to the ambulance with my sister arriving from Royalwood.

Vitas had no such person come. My husband was at home when the first person enrolled him but no one of the caliber of Twee came the following day. Vitas did not give an 800 number or **any** number to call after hours.

• Hospice RN Jean came the second day and spent approximately 30 to 40 minutes with me and the private caregiver I had hired. Jean was thorough and “hands on” with her assistance. She made sure the caregiver (an RN with a Philippines license) understood how to administer medications.

Not only that, Jean came any time the caregiver or I called her, regardless of whether it was her regular day or not. Jean came twice a week.

Also on the first day and the day when my sister’s passing neared, Jean was open and direct in asking if I felt comfortable talking about it.

She also pulled out the signs to expect from the binder of information for me to read. Later, on another visit, when morphine might be advisable, Jean told us an RN would be sent the following day as a 24-hour check.

The Vitas RN spent only about 10 minutes, took vital signs and left. There was no counseling, no conversation about what I should expect. She did not leave any literature, which I found out from a friend who used Trinity said I should have been given. The day my husband died, I asked her about it, and she said, “It’s in my car.”

There was no binder of information, no conversation. She told me the day he died that she knew he was going to die the FIRST time she saw him – the day after enrollment — but said nothing to me. Why didn’t she, like Jean, ask me if I felt comfortable talking about it? Also, unlike Vitas, Hospice Care of the West, sent someone everyday the first three days.

• A home health aide, Carmen, came twice a week to bathe my sister. The private caregiver helped her to make the task more comfortable and speedy. Carmen brought diapers, pads, wipes, ointment.

Vitas sent no one, even though I was told there would be. Vitas provided no supplies.

• I had spoken to Myra about my concern re: the doctor. I told her the Kaiser hospice doctor was scheduled to come – as it happened – on the day he died in the afternoon. She had not called in the morning nor later. Nothing. Later, when the mortuary person went to Kaiser to have her sign the death certificate, she refused because she had not seen him. Whose fault was that?

Fortunately, the hospital doctor on duty during the 10 days my husband was at Kaiser had given me his page number and said to call if any need arose. I told him about the hospice doctor’s refusal, and he said to have the mortuary person see him and he would sign.

Myra told me the doctor does not visit but is the one who authorizes things according to what Jean or other RN reports.

Because of the excellent communication of all concerned, there never was the feeling that I needed a doctor.

• On the day my sister died, an LVN, Chermaine, arrived and took care of everything. She officially pronounced my sister’s death, called the 800 number to report in, called the mortuary, wrapped the medications for disposal, called the equipment people for pick-up.

Vitas: The RN pronounced my husband’s death and left. No such services as described above from Hospice Care of the West. Except the equipment people came.

Iku Kiriyama is a retired educator and a community volunteer. Opinions expressed are not necessarily those of The Rafu Shimpo.

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