In Memoriam: Judy Fulwell . We honor her memory and are grateful she shared her story.
"I have so much to take care of," says Judy Fuwell when she reflects on life after her cancer diagnosis. Judy, a devoted mother and grandmother, was diagnosed with cancer in her appendix in 2012. Her appendix was removed, but the cancer spread. Five years after her first surgery, she had mucinous adenocarcinoma—cancerous tumors lining her gastrointestinal tract.
Judy’s care team at the time told her she was going to need hospice. Judy disagreed. She went to Huntsman Cancer Institute (HCI) for a second opinion. Shortly thereafter, she had chemotherapy again, this time for the tumors around her stomach. Now, a team from Huntsman at Home™, HCI’s at-home cancer care service, goes to Judy’s house regularly to give her the fluids and medicines she needs.
"It’s also reassuring that they take my vital signs," Judy says. "I feel like I’m doing well, but then they confirm I am."
Huntsman at Home helps Judy, and patients like her, stay out of the hospital and avoid emergency department visits. "They make it so I don’t get severe enough to go to the hospital," Judy says. When patients avoid emergency hospital visits because of Huntsman at Home, it not only saves money, but it also ensures their care will be cancer-specific. The program serves only HCI patients, unlike other at-home care options. It’s a continuation of HCI’s nationally recognized oncology care.
Huntsman at Home launched in 2018 and typically serves between 75 to 80 patients. For a hospital like HCI that has 100 inpatient beds, this number is significant. "Huntsman at Home allows me to help patients navigate their symptoms," says Kim Dumas, DNP, FNP-BC, clinical lead for Huntsman at Home. "We’re advocates who know what they need and can stay with them throughout the trajectory of their care or life."
Judy’s current trajectory consists of palliative, not hospice, care. "All care is palliative," Kim explains. "Palliative simply means we focus on improving their quality of life. It can run the spectrum from supporting patients and family during treatment to acute medical care to hospice. Hospice is specific to the end of someone’s life."
In her previous roles, Kim worked in palliative care, but she had to pass off patients if they moved into hospice. "That was difficult for me," she says. "I wanted to continue to be with them throughout their lives." The vast majority of Huntsman at Home patients are not receiving end-of-life care. The program often discharges patients after helping them through medical challenges. For one recent HCI patient with cancer, that meant recovering from hip repair. For others, it’s helping manage symptoms right after surgery. And for the few dozen individuals who are in hospice, they are largely able to have the same continuous teams caring for them.
In July 2020, HCI announced a major expansion of Huntsman at Home, made possible by a $4.5 million gift from the Huntsman family. The funds will expand services from the immediate Salt Lake City area to rural Utah, adding patients in Carbon, Emery, and Grand counties. This expansion comes on the heels of new research that demonstrates the effectiveness of Huntsman at Home.
"I’m excited for the fact that rural patients will have the option for somebody who is focused on their cancer, who is within the HCI system, and who is in their area to provide them with care," says Kim. "It’ll give them an extra layer of support and hopefully improve their quality of life."
As for Judy?
"Huntsman at Home allowed me to keep fighting," she says. "I’m not ready to go yet."