Never far away

A patient uses the Angela’s Virtual Assist device to speak with a nurse at the Angela Hospice call center.
Dan Melow | The Michigan Catholic

Livonia — It’s 2 a.m., and something’s wrong with a patient’s breathing apparatus. A loved one is trying to get it to work, panic-stricken; not knowing what to do.

So they pick up the Angela’s Virtual Assist device, calling the 24/7 call center at Angela Hospice in Livonia, where calmly, a nurse instructs the caregiver what to do.

Peace is restored.

Angela’s Virtual Assist (AVA) is a new program from the Felician-run Angela Hospice, where hospice patients and caregivers have the ability to teleconference with a nurse at the Livonia facility, who can hear — and see — how a patient is doing.

“We want to give our patients and families the comfort of knowing we’re always there for them,” said Margot Parr, Angela Hospice president and CEO. “Sometimes, it’s hard to translate over the phone what’s going on. We use this device as a telecommunication device, so that families can show us, and we can hear and see what’s going on.”

Angela Hospice has 75 devices, with 25 more ordered, and has distributed them to an estimated 200 patients for uses varying from answering questions with equipment malfunctions to asking when it’s OK to take certain medications or even emotional support for caregivers.

“Any tool we give our patients to help them more efficiently is a positive,” said Karen Gugala, coordinator of Angela Hospice’s AVA program. “I was just on a call, where unfortunately we weren’t able to solve the problem with a pain pump, but we were able to determine what the problem was and quickly get a nurse out with the right type of equipment to fix the problem.”

Angela’s Virtual Assist has a simple layout, with patients and caregivers using a four-digit passcode to access the program, which has three buttons: place a call, schedule a call later and cancel a call.

When a call is placed, the triage nurse at the center will call back, connecting with the patient or caregiver via a face-to-face conversation on the screen.

Parr said the device helps empower caregivers to be better equipped to care for their loved ones, knowing they have access to a nurse who can answer questions 24/7.

“The AVA device gives them confidence to care for their loved ones,” Parr said. “It’s what they want to do, their loved ones want to be at home, and they want to care for them. But sometimes caregivers can be uncertain whether they can give this particular kind of medication, or if this is the proper way to administer a treatment. Through the AVA unit, we give them that confidence.”

Denise Grabowski, RN, and Mary Sutton, RN, staff the 24/7 call center at Angela Hospice in Livonia, answering calls from caregivers and patients using the Angela’s Virtual Assist program.

The AVA device can be programmed to remind patients and caregivers to take medications or ask if they need more supplies.

“We program the device to ask questions, remind patients and caregivers about medications,” Gugala said. “We know it can be challenging for a caregiver to know everything about a medication schedule, so the reminders help. If you take a certain medication, you might need to take another medication, so the program flags them.”

The AVA unit also is there for emotional support for patients, caregivers and nurses, who recognize the emotional drain that can play a big role in the hospice environment.

“We’ve had patients at night call just to talk to people, because they don’t see people anymore,” Gugala said. “They’re never going to be able to leave their home. For them to see these triage nurses and be able to talk to them, sometimes patients develop a relationship with the nurses that’s very nice.”

Angela’s Virtual Assist doesn’t replace in-home nurses’ visits, but instead offers greater access to support, answers to questions or even simply the comfort of talking to a live person, said Margot Parr, Angela Hospice president and CEO.

While patients might fear the personal touch of hospice care is being replaced with a person on the screen, Parr reiterates the AVA device in no way replaces in-home visits from Angela Hospice nurses.

“AVA never circumvents another visit, it doesn’t replace a visit, it doesn’t keep us from making a visit,” Parr said. “What it does is act as a great supplement to a visit. There are still routine visits scheduled by social workers, spiritual care and home health aides as well. With the device we can know what to look out for during home visits, so we’re more prepared.”

The AVA program was made possible from a $2.1 million grant from the Ralph C. Wilson, Jr. Foundation, which wanted to upgrade the technology associated with Angela Hospices’ services.

“We were thinking, ‘Gee, do technology and hospice go together?’” Parr said. “Typically, hospice is very high touch, low-tech. But we found a way to use it so our nurses are always available, ready to help.”

Karen Gugala shows off the features of Angela’s Virtual Assist, which allows patients and caregivers to virtually connect with a nurse at any hour of the day or night. The new program was launched in June after a $2.1 million grant from the Ralph C. Wilson, Jr. Foundation.

When Gugala and her colleagues go to homes to introduce patients to AVA, there is some trepidation about what this mysterious screen will do. But Gugala loves to see the weight of worry come off people’s shoulders when they explain how this device works.

“I was speaking with a woman, Marie, and her being the caregiver she was, was always hands on,” Gugala said. “I showed how this will allow a nurse to say, ‘Yes, this is what you need to do.’ And you can just see their shoulders relax.”


Gugala and Parr said the AVA unit is just a tool to further extend the quality of care for which Angela Hospice strives.

“There was another man, Norm, he and his wife were nervous at first,” Gugala continued. “But once we got out and showed them how simple it is, they were surprised. I’ve yet to go out and explain it to someone and they said it’s too hard. Instead, there’s relief in the patient’s eyes, the caregiver’s eyes. Knowing we’re always there, we’re always caring, and we’re always here to help.”

Angela Hospice

For more information about the programs and services of Angela Hospice, a Felician-sponsored end-of-life care ministry in Livonia, call (734) 464-7810 or visit