Expanding the boundaries of care

Krisha Arvin and Donna Brooks
Ministers like Krisha Arvin and Donna Brooks provide spiritual care and comfort as part of their training in pastoral care in the inter-faith Emory Center for Pastoral Services, which serves patients, families, and staff in all Emory Healthcare hospitals.


 

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From the Executive VP

Charity care in Emory Healthcare Overview
• Expanding the boundaries of care
• A gift of time
• Fighting with grace and determination

Caring for the elderly

Caring for kids

Care at Grady Hospital

Emory and the Atlanta VA Medical Center

Serving locally and globally

Research

Education

Economic impact

Woodruff Health Sciences Center

In the press of all the legal and medical paperwork—documentation of why the bride could not go to the county office to apply for a marriage license, advance directives about end-of-life care, negotiations as to how medications would be covered once she entered home hospice—no one remembered to get a cake.

Donna Brooks, a chaplain working on the cardiac intensive care unit (ICU), pronounced Katy and Brad husband and wife; friends and care providers cheered; and social worker Sarah Penna dashed to the hospital bakery. The next day, with powerful medicines dripping into her bloodstream, Katy went home to spend her remaining days with her now official husband and their son.

Perfectly healthy two years earlier, Katy developed postpartum cardiomyopathy. She was only 17, with virtually no family. Brad, 18, did what he could. At 19, Katy was airlifted to Emory University Hospital with severe heart failure. 

Emory doctors and nurses stabilized her in the ICU for almost a month, replacing her medicines with more effective—and at $4,000 per month—more expensive ones, drugs Emory provided until Katy’s Medicaid, which had lapsed, could be reinstated. Even these drugs were no match for damage already done to Katy’s heart, however. After several months, she returned to the ICU to be evaluated for transplant. Despite a temporary pump to give her exhausted heart a break, Katy could not withstand a transplant and its demanding aftermath. 

The team that had surrounded her from day 1 now refocused its collective energy to fill Katy’s last wishes: to be married and to die at home. Cardiologists and palliative care nurse practitioner Debbie Gunter kept Katy comfortable. Brooks worked with the couple and their hometown minister on the wedding—and the spiritual aspects of the difficult journey ahead. After many calls, Penna and transition care manager Denise Lowman-Kedzierski found a home care hospice program that could handle Katy’s complex drug regimen and then worked with the hospice and pharmaceutical company on equally complex Medicaid reimbursement requirements. The extra days in the ICU were considered medically unnecessary and were therefore on Emory Healthcare’s ticket. But it was money, time, and effort that made all the difference to the young couple. It was care in its best sense. 

   
   
 
 

A disproportionate number of patients without insurance are sent to Emory because their conditions are so complex or because the specialized care they need is unavailable elsewhere. By the time many arrive, medical catastrophe has already exhausted family resources and any coverage that may once have existed. As the community’s need has grown, so has Emory’s response.

 

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Community Benefits Report Cover 2012