Pictured front row, from left, are Vivian Dodge, executive director; Elvis, pet support dog; and Livia LaPradd, clinical manager. Pictured back row, from left, are Kerry Foote, chaplain; Darla Applegarth, registered nurse; Krista Edwards, social worker; Paige Clem, registered nurse; and Monica Pettegrow, registered nurse. Missing from the photo are Dr. Joanne Mahoney and Jennifer Pema, hospice representative. CONTRIBUTED

What do you think of when you hear the word hospice? The Keys Weekly recently sat down with Vivian Dodge, executive director of Chapters Health Hospice for Monroe County, to learn about the history and all the incredible ways hospice can help an end-of-life patient and their family.

There was a former hospice in the Florida Keys for well over 30 years and it folded in early 2018. That not-for-profit license was set idle, and the state of Florida realized that the residents of Monroe were not being served well without a hospice program—it was an unmet need here. So, Chapters Health System contacted the state and applied for that license, and we are honored to have been awarded that license.

We are a community-based not-for-profit hospice. Our parent company is Chapters Health System, one of the largest not-for-profit healthcare organizations in Florida and lower Georgia. The Keys affiliate is one of the newest hospice programs, and we were awarded our license In December of 2020 by the agency for health care administration in the state of Florida. Since then, we’ve been operational and have met with wonderfully warm reception from the residents and other visitors to the Keys about our services.

I have been a registered nurse for nearly 40 years and have been working in the hospice environment for the last 20 years. Chapters Health contacted me to be the executive director and help us get started. Since I love to start new programs and problem solve, having the opportunity to create a brand new hospice from ground zero was very exciting. 

Our team has a lot of experience and all work throughout Monroe County. Our medical director, Dr. Joanne Mahoney, has been in hospice for 32 years and has her own private practice in Key Largo and a clinical manager who has worked in hospice for about eight years. Our chaplain has been working in hospice for almost six years. We also have nurses who’ve been with us a couple of years, a social worker, and a bereavement coordinator. Altogether, it’s a phenomenal team that gives our patients and families stellar quality care.

The care they receive depends on the patient needs and what visit frequency they like. So, it varies depending on the individual patient and what the family puts together. The hospice philosophy is patient-centric for people with a terminal illness and their families and individuals facing the end of life issues. So a focus of hospice is on comfort care, pain management, symptom management and the emotional aspects of one’s disease within the context of maintaining the quality of life for that dying patient and their family.

This model of care where the team provides care is unique to hospice. Patients’ and their families’ wishes are honored with support, guidance and heart-felt concern. We believe there is a lot of living to do in the last chapter of life. But, the end of life is equally as important as the beginning of life.

Many people think that hospice is just for cancer patients or the elderly, but hospice care is for anyone with a life-limiting illness and all ages. There is also ongoing support, such as coping mechanisms, for the family for up to 13 months.

 We provide the personal care and medical management of the disease— pain or symptom management, medical equipment, oxygen, hospital bed, bedtime commode, wheelchair, walker, medical supplies and more. We also help with those difficult conversations about their mortality and funeral arrangements.

A not-for-profit mission and philosophy are to care for individuals who need us regardless of their socio-economic or financial status. In the past year, Chapters Health System as a whole has provided over $5 million in charity care. That’s the distinction about being a not-for-profit; the profit we make goes back into programs and services versus paying out shareholders.

We care for patients wherever they reside—private homes, condos, boats. We help with in-home safety suggestions and can help with various agencies such as Meals on Wheels and provide some extra supplements. We find a way to make it happen.

We also offer a few other special programs. One is a legacy program where my team will work with the hospice individual and ascertain if there is anything they would like to be remembered for in their life and leave a legacy for their family. Another is a valor program in which we honor veterans and first responders who are under our program with a special recognition ceremony. And we also have one of our favorite team members is a basset hound named Elvis, and it’s just amazing to see the bond between animals and humans. Even those individuals who may have Alzheimer’s or severe dementia, when this dog is next to them, you see their eyes light, creating a calming effect.

Our families become part of our circle, so we try to promote and encourage our hospice team to do self-care. Whatever it is they like to do — fishing, boating, running. Whatever resonates with our team members, so they rejuvenate their spirit, and we try to tell the family members as well. You have to take care of yourself.

One of our challenges in hospice is late referrals. Many individuals in our society feel or believe that hospice is just for your last few days of life, and that’s a myth. Hospice is a very rich benefit, and the patient and the family can benefit if they’re on hospice for months. Someone can be admitted to hospice if their physician feels they have a six-month prognosis or less, but patients can live longer and have a better quality of life under hospice.

What’s important to know is that hospice allows the natural progression of the body to happen, so we affirm life and neither postpone nor hasten life. We are another option of healthcare for people with a life-limiting illness. I would love to change the mindset and society’s viewpoint around hospice.

We hear all the time from family members after the fact, “I wish we would have known about hospice sooner; we would have benefited much more if we knew about hospice months ago.”Learn more at and connect on Facebook @ ChaptersHealth.

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Melinda Van Fleet is a sales strategy and success coach/consultant, bestselling author of "Confidence Mastery for Couples and Life & Love Lessons," and speaker. Melinda is the host of two weekly podcasts, "The Good Karma Success Coach" and "Crush It In Sales." You can connect with her more at