It was after Ed Blumenthal’s sudden drop in motor function that his wife, Fay, knew she would have to make the decision she had been hesitant to make.
The 83-year-old Beachwood resident had dedicated the past 10 years tending to her 84-year-old husband who had been diagnosed with progressive dementia, but she knew deep down that what she referred to as Ed’s “bad day” in December 2018 – where he suddenly went limp and injured himself and an aide was a sign that Ed needed more personalized and intense care his current hospice doctor couldn’t provide just through home visits.
And so, instead of Blumenthal being transported to the hospital following his fall, he went to the place where he could receive specific medical care and therapy for the remaining months of his life until his death in July 2019 – Montefiore’s Maltz Hospice House in Beachwood, where he had already been receiving Montefiore’s Vinney Hospice and Palliative Care through home visits. November is National Hospice and Palliative Care Month.
“Ed had been getting medical service at home through Cleveland Clinic, and the nurses and doctors came out from Cleveland Clinic and said, ‘You know, he’s hospice level. You should consider getting hospice services,’” Fay Blumenthal said. “I had the choice of using Cleveland Clinic or a number of facilities, and after doing some interviews, I made the choice to use Montefiore. It proved to be a good choice.”
Montefiore, an assisted living, hospice, long term and post-hospital home care, health care services and memory care facility with locations in Beachwood and Bainbridge Township, offers a hospice program that prioritizes individualized treatment and care above all else with its Vinney Hospice and Palliative Care program. Vinney Hospice patients are assigned a team of a hospice physician, nurse, nursing assistants, medically oriented social worker and chaplain to meet every need they might have.
The six-bed Maltz Hospice House is for hospice patients in need of intense, symptom-calming care to eventually return home or patients close to end of life. While the house is made comfortable for patients with suite-style rooms with full bathrooms and individual patios, families who visit or stay over have access to pullout couches, a kitchen, two living rooms, a kid’s playroom, a meditation room, outdoor gardens and other amenities.
Dr. Barbara Messinger-Rapport, medical director of Vinney Hospice and Palliative Care of Montefiore, is responsible for all medical oversight of the hospice program and the Maltz Hospice House. She was named medical director in early 2019, but has worked with Vinney Hospice since 2010 in various positions. She’s held a number of geriatric medicine positions with Cleveland Clinic, including director of geriatric medicine, where she completed her geriatric medicine fellowship and geriatric medicine and hospice and palliative care medicine certification, and the VA Northeast Ohio Healthcare System.
“What drew me to Vinney Hospice was the opportunity to help patients and their families make choices at the end of life that would improve the quality of their care and help facilitate the caregivers’ ability to take care of their loved ones and themselves, because many caregivers of those at end of life are elderly themselves,” Messinger-Rapport said.
One of the many things that makes Vinney Hospice special in Messinger-Rapport’s eyes is that she only sees about 70 patients, giving her the opportunity to personally get to know her patients and their families on a much more intimate level.
“For that period of time, weeks or months, I’m the physician that tends to know the patients and their needs the best because even if I’m not the primary care physician and I’m just a consultant, I’m often dropping by,” she said. “If I can’t do that, I’m checking with the hospice team who go into the home to take care of them. I form very close relationships with families because toward the end when patients are no longer able to express themselves, it’s the families that have to advocate and make sure that patients’ wishes are honored. I try to make myself available to them all the time to make sure that they know that they’re able to request the things for their loved ones that would help their quality of life.”
Messinger-Rapport, a resident of Highland Heights and who attends Temple Emanu El in Orange, visits patients receiving her care even if they live at home in the Beachwood area or other parts of Northeast Ohio – often on her bicycle, giving her the nickname “bicycle doctor” by her patients – and Geagua County where The Weils, another campus of Montefiore, is located.
Vinney Hospice patients also have access to a list of integrative therapies, including Reiki treatments, massage, music and art therapies. The therapies can help patients cope with their illnesses, but they can also provide an opportunity for patients to connect with their family.
“Many patients toward the end of life are aware that their time is short and they want to leave a legacy behind,” Messinger-Rapport said. “We have one patient who is working with her art therapist to write holiday cards for her grandchildren. She might not live to Chanukah, but the grandchildren will have cards from her that she will dictate and the therapist will help her draw pictures and help write a message for her.”
A part of the clinical team of nurses and social workers assigned to patients, they also have a chaplain who helps address any spiritual concerns they or their family might have.
“Just like the nurse writes an assessment about the heart rate and the blood pressure and weight, we have to assess when a person comes to us, like how much fear and anxiety they have, how much purpose they have, how faithful they are to what’s happening, do they believe in God,” said Rabbi Akiva Feinstein, Vinney Hospice chaplain and director of spiritual care.
“We try to assess and evaluate, and we share the results with the other people on the hospice team. And in that kind of sharing, we help each other out with the process.”
Even if a patient isn’t particularly religious, Feinstein works with patients with whatever concerns they might have to make sure they’re able to pass on unafraid and content with the lives they lived.
“It’s basically a way of serving the deeper human needs that sometimes can be hard to define,” he said. “The people that we serve, they’re thinking about many things. They’re thinking about leaving this world, they’re thinking about closure or things that they didn’t do right. They’re thinking about what the next world is going to be like. Spiritual care is helping them and guiding them with those questions without making them come to a religious approach. It’s just utilizing what’s in them, utilizing their thinking and the feelings, heart and soul of a person.”
Feinstein, a resident of Cleveland Heights, greatly helped Fay Blumenthal during her husband's time in the Maltz Hospice House, as he was always there for the both of them whether it was for Ed Blumenthal’s love of attending Shabbat services in Montefiore or making sure Fay was OK throughout the process.
“Rabbi Feinstein, he went out of his way,” Fay said. “On the Friday before Ed died, we would have gone to the service, but we didn’t go cause he was in bad shape. Rabbi Feinstein brought Ed’s cousin to see him, and that was so thoughtful. Then Ed died on Sunday, and we were sitting there after they prepared his body. Rabbi Feinstein sat with us for over an hour and he read psalms. It was just beautiful. You don’t expect someone to do that, to have someone just sit with you for over an hour.”
While Fay Blumenthal had to go through the painful process of losing her husband of 61 years in July 2019, she was thankful for Montefiore, the staff and the care Ed received to allow him to pass painlessly and calmly.
“It had become too hard to care for him at home, and I needed the help,” Fay said. “I’m glad I made the decision when I did. I think it turned out to be a good choice.”