Brain Matters

According to a National Geographic article, the human brain is “more complex than any other known structure in the universe.” It’s Mission Control for everything we do—from voluntary movement to the involuntary operations of our organs…from everyday decision-making to the most complex emotions and thoughts…from holding our memories to making dreams. So when something goes wrong due to disease or injury, the impact can be devastating.

June is Alzheimer’s and Brain Awareness Month, a time when education usually focuses on Alzheimer’s disease as it is the cause of 60 to 80 percent of all dementia cases. Today, nearly 5.8 million Americans live with the disease.

While perhaps the most well-known, Alzheimer’s is only one cause of dementia.

Dementia is actually not a disease, but a term that covers a wide range of symptoms including problems with memory, thinking, and behavior. In addition to Alzheimer’s, dementia can also result from other brain diseases including Parkinson’s, Huntington’s, ALS or Lou Gehrig’s disease, or a vascular disease that causes multiple strokes. Dementia may also occur due to other advanced illnesses such as heart disease and COPD.

Whatever the cause, the progression of dementia differs for each individual—sometimes a person will show little evidence of the disease for years, while others decline rapidly. Nevertheless, nearly every dementia patient will need to transition to end-of-life care at some point. In fact, dementia accounts for nearly one in every five hospice admissions (18 percent), according to the latest data from the National Hospice and Palliative Care Organization.

Capital Caring Health’s (CCH) care and support can make a difference for patients with dementia when the time is right. The goal of palliative and hospice care is to bring the greatest level of comfort to both patients and families, creating the best quality of life possible. Our care team focuses on alleviating pain and emotional distress, while meeting social and spiritual needs with counseling and support.

CCH staff is specially trained to address common problems and symptoms that often occur with dementia, and know how to “read” patients to identify visible signs of pain and discomfort. By also teaching family members and caregivers how to recognize these indicators, we work together to make sure patients are comfortable even when no longer able to verbally express themselves. Care team members also help families understand how to best manage care, what to expect in the late stages of a condition, and how to provide support through the last phase of life.

Once a diagnosis of a degenerative brain condition has been made, certain symptoms may indicate that it’s time to consider palliative or hospice care. Chief among them are when the patient:

  • Can only say a few words
  • Can no longer walk and may be bed-bound
  • Is totally dependent on others for eating, dressing, and grooming
  • Shows signs of severe anxiety

Once palliative or hospice care is selected, Capital Caring Health creates a supportive and comforting care plan for your unique situation addressing medical, emotional, social, and spiritual needs. The care team works with the patient, family members, and caregivers as well as the other medical providers already involved. We are available 24/7 to answer questions, provide support, and help control patient symptoms at home.

As a result of hospice specialized care and attention, dementia patients find the peaceful environment they need and respond positively. Managing symptoms before a situation becomes acute may also help prevent frequent trips to the emergency room and unnecessary hospital admissions. Research shows that Alzheimer’s patients with hospice care have better pain control, are less likely to die in a hospital, and their families have greater satisfaction with end-of-life care.

Philosophers throughout the ages have suggested our brain may hold the essence of who we are. At Capital Caring Health, we lead with both head and heart to help you and your loved one find comfort and peace, making every day the best it can be.

Click on these links to learn more about what symptoms to look for and how hospice can help with Alzheimer’s and other forms of dementia, neurological diseases including Parkinson’s and Huntington’s or about ALS/Lou Gehrig’s Disease and other condition-specific information including heart disease and cancer.

Please call 800-869-2136 or visit for more information or to request an evaluation.

Capital Caring Health Recognized as Volunteer Program of the Year by Volunteer Fairfax

Volunteer Sabre Poimboeuf Recognized for Hours of Service

Each year Volunteer Fairfax recognizes the volunteers, nonprofit organizations and corporate partners who work tirelessly to make Fairfax County a better place.

This year, Volunteer Fairfax is recognizing 143 individual nominees in 16 different award categories. These volunteers have been nominated by community members, local nonprofits and government agencies for their dedication to the community.

Capital Caring Health is the recipient of the 2020 Volunteer Program of the Year one of the top honors recognized each year to an organization that demonstrates a significant contribution to the community.

In addition, Capital Caring Health volunteer Sabre Poimboeuf, an active duty service member in the U. S. Navy, has been chosen for the award for Adult Volunteer 250 Hours and Under for the time she dedicated to meet with veterans.

Katherine Knoble, Manager, Community and Volunteer Engagement, Alexandria/South Eastern Fairfax/Woodbridge Neighborhood, nominated Capital Caring Health and Sabre Poimboeuf for these prestigious awards.

“I’m extremely proud of our more than 1,400 active volunteers and the impact they make on the community every day”, said Capital Caring Health President and CEO Tom Koutsoumpas. “As a leading non-profit provider of advanced illness, home, hospice and elder care, Capital Caring Health is built on the cornerstone of ensuring that all people facing advanced illness receive the care and resources they need regardless of their ability to pay. This award is a reflection on the significant growth and success of our Volunteer Program over the past 43 years,” he stated.

Under the leadership of the Director of Volunteer and Community Engagement, Jenna Cooley, the Capital Caring Volunteer Program has expanded by adding additional Volunteer Managers and support staff

In 2019, Capital Caring Health volunteers performed more than 58,000 hours of service, to the community, performing such functions as patient companions, providing transportation, pet care, coordinating military ceremonies to honor veterans and a variety of services for those in need of support.

Volunteer Sabre Poimboeuf has taken a program of military thanks and elevated it to a program that is now the model for the entire company. She added many enhancements to the military recognition program to include an official flag folding, presenting veterans with challenge coins (a military tradition) and the reading of the poem “The Watch” to all navy veterans.

Staff, volunteers and friends can share their congratulations via clicking on the links below.

Sabre Poimboeuf,  Adult Volunteer 250 Hours and Under

Capital Caring, Volunteer Program

National Alliance on Mental Illness names Capital Caring Health StigmaFree Company Partner

(Falls Church, VA June 19, 2020) -  Even before the Covid-19 pandemic, health care workers were more likely to suffer from mental distress. And now new research shows that healthcare professionals directly engaged in caring for Covid-19 patients may be at an increased risk of psychological distress, according to a study published in the Journal of the American Medical Association.

To address the mental health concerns related to the unprecedented Covid-19 crisis, Capital Caring Health provides a wide-range of wellness and mental health resources at no-cost to its 900-plus employees – from yoga and meditation therapy to phone-based counseling support – and the organization was recently named a StigmaFree Company Partner by the National Alliance on Mental Illness (NAMI)  - one of 52 companies so named nationwide.

“I am very pleased that we have begun work with NAMI to expand our mental health support programs for our employees, their family members and our patients and their caregivers,” said Vivian Hsia-Davis, Chief People Officer, Capital Caring Health.

These are incredibly stressful times and we are taking the necessary actions to help employees reduce stress and enhance their mental health.”  ​​​​​​​​

According to NAMI, nation’s largest grassroots mental health organization, eight in 10 workers say shame and stigma prevent them from seeking treatment for a mental health condition.

NAMI provides resources and educational materials, guidance and expert advice as well assists companies in creating a culture that values employees’ overall health, including emotional well-being and mental health.

Read more about NAMI’s StigmaFree Company initiative here.


About Capital Caring Health

Capital Caring Health is the largest non-profit provider of elder health, advanced illness, hospice, and at-home care services for the Maryland, Virginia, and Washington, D.C. area. We provide quality care where people live, supporting dignified, independent aging. For more information, visit or call our 24-Hour Care Line at 1-800-869-2136.

Amy Shields, Director of Strategic Communications

Capital Caring Health's President & CEO, Tom Koutsoumpas Interviewed by WebMD's Chief Medical Officer

Capital Caring Health’s President and CEO, Tom Koutsoumpas, is interviewed by WebMD’s Chief Medical Officer, Dr. John Whyte

Tom Koutsoumpas and Dr. John Whyte discuss Coronavirus in Context: Home Care in the Setting of Mental Health Disease

One COVID-19 Patient’s Long Journey from Home to the ICU to Home Again

Capital Caring Health Palliative Care Nurse Brings Comfort to a Patient and his Family 

On a recent Friday evening, Ron Kunihiro, of Gainesville, Virginia, played the ukulele and sang, entertaining his wife, daughter, and her family following an outdoor barbeque. There was nothing new about this scene—except for the wearing of face masks and proper distancing in the age of COVID-19. However, the fact that Ron was home at all was something of a miracle: The 78-year-old had survived the novel coronavirus following 50 days in a hospital—mostly in the ICU—and 31 days on a ventilator.

Families of patients with the highly contagious COVID-19 bear a huge emotional toll, as they are unable to be near a loved one who has contracted the virus. For those needing hospitalization, the situation is even more isolating. Family members are not allowed to visit—to hold a hand, to offer reassurance with words and the sound of their voice, or even to see how their loved one looks.

For the large Kunihiro family—three adult children and grandchildren—that’s where Capital Caring Health’s Steve Skobel, a palliative care nurse practitioner, made an enormous difference. As the liaison in the hospital between seriously ill patients and families, Steve became the family’s eyes, ears and even mouth, serving as an important link between the two.

Symptoms Develop, Emergency Room Follows

Ron is a fairly active guy for his age. He works out regularly on his recumbent bike and plays golf. In early March, he developed a fever—but felt fine—until about five days later when he became slightly short of breath after minor exertion. However, as Ron was unable to be tested for possible coronavirus, he quarantined at home in the basement to protect Sue, his wife of 55 years. When he developed a wet cough, his doctor recommended—via a telehealth visit—that Ron stay at home and take a course of antibiotics for bronchitis.

But nearly a week after the fever, Ron felt worse.

In a video call with daughter Cindi Harkes, Ron was coughing and short of breath. They discussed his going to the emergency room, Ron’s doctor agreed and suggested he drive himself to the local hospital which he did the next day. Once there, Ron was intubated, placed on a ventilator and transferred to the ICU at Prince William Medical Center in Manassas, Virginia.

It would be close to four weeks before Ron would actually speak to his family again.

New Knowledge, New Approaches

Ron was, in fact, among the first one or two COVID-19 patients at the Prince William Medical Center. And in those early days of March, doctors everywhere were still trying to understand coronavirus and the most effective treatments. With double pneumonia and not expected to survive, Ron was placed in a medically-induced coma. His family—deeply religious—started making arrangements for last rites.

Instead, as understanding of the coronavirus evolved, so did treatment. On Day 13, Ron was placed in a prone position—on his stomach—and he started to improve a little. A week earlier, Steve Skobel, N.P., entered the picture.

Steve works for Capital Caring Health—one of the country’s largest non-profit providers of hospice, palliative, and elder care—and he cares for patients in hospital inpatient units who need palliative or hospice care. In this role, he serves as the in-hospital liaison for patients with advanced illness and their families, promoting communication and understanding of their loved one’s condition. Palliative care also focuses on providing comfort and managing symptoms such as pain and stress.

Improved Communication   

As Ron’s nurse practitioner, Steve helped establish goals for his patient and saw him every day. Soon he was holding daily conference calls with the family after he had a chance to see Ron and review his chart. Ron’s daughter-in-law Amy Kunihiro—a California-based physician—often spoke or texted Steve before the calls, asking the questions which were on all of their minds.

“When I talk to families, I spend a lot of time listening to their concerns, what their needs are, what they are asking me for,” says Steve. Because he “met” with the family daily, he was able to anticipate what information they wanted and also to build rapport.

“It was so helpful that Steve was able to break down clinical information into understandable, digestible bits for everyone,” Amy says. “As a physician, I also appreciated having a dialogue with another healthcare professional about evolving treatment and recommendations based upon experiences in Italy and New York.”

Knowing they had a dedicated healthcare contact on site brought Ron’s family great relief.

“The daily calls were a ‘lifeline,” Amy continues, “adding important details on how Ron was doing, even when the news was not good. Steve would tell us ’Dad looks good today’ which was detailed description we desperately needed because we couldn’t see or hear him.

He also provided medical updates, forwarded questions and, most importantly for Cindi, “conveyed to dad the things we could not say in person.”

Despite the initial improvement from being repositioned, however, Ron experienced serious setbacks along the way, including dropping oxygen levels.

“The whole healthcare team latched on to Ron,” says Steve. “He was bed-bound for almost two months. There were many times, many days that I didn’t think he would survive to the next morning.”

But thanks to great care, faith, and his own resilience, Ron eventually began to improve. As he was brought out of the medically-induced coma, Ron flashed a thumbs-up sign to Steve and he was moved to an acute-care unit to continue regaining this health.

A Turn for the Better, Then Home  

On Day 42, Ron was finally discharged from the hospital. But there was one more stop before heading home: an inpatient rehab facility. Anyone who has been in an ICU and on a ventilator as long as Ron usually experiences serious consequences. And with the COVID-19 diagnosis, supplemental oxygen is also often on the list. As a result, most patients can expect a long stay in rehab for physical and occupational therapy to help with activities like swallowing, and speech therapy. Not so for Ron—he was discharged after only 8 days.

Now after four weeks of home health care, Ron is walking independently—only using a cane for support—and is back to riding his recumbent bike. “He’s trying to get back to normal” says Cindi. “It’s truly amazing the progress he has made from where he was.”

“It was our good fortune—and Ron’s—that nurse practitioner and our liaison was Steve,” says Amy. “He’s an outstanding nurse practitioner and human being, compassionate and in a class by himself.”

Adds Cindi, “Having a liaison or advocate is invaluable to the well-being of patients and families as communication can be difficult. And as in the best communications, it goes both ways. Don’t be afraid to ask questions.”

Steve, in turn, praises the family for their close involvement in Ron’s care and recovery.

“I chose nursing because I wanted to help people,” Steve concludes “and Ron was a very, very sick man. I’m so grateful I was able to help not only him, but his entire extended family through their shared ordeal. The Kunihiros are truly thoughtful, wonderful people.”

To learn more about palliative care, hospice and elder services, visit Capital Caring Health or call (800) 869-2136.

Drive By Birthday Celebration Planned for 105-Year-Old Army Veteran, Robert Cox

(Prince George’s County, Maryland, June 3, 2020) - The community is invited to join Capital Caring Health to help celebrate the birthday of one of our oldest patients, Mr. Robert Cox, who will turn 105 years old on Thursday, June 4.

Mr. Cox resides at Angel Assisted Living in College Park, Maryland. His team of caregivers have made special plans and invited guests to drive by his home, honk their horns, cheer and wave while Mr. Cox is seated on his patio during the celebration.

Members of the College Park Fire Department, military veterans and other volunteers will be in attendance to mark this special occasion. The Capital Caring Health team will also present Mr. Cox with a special patriotic blanket during the event.

About Robert Cox
Mr. Cox served in the Army during World War II and the Korean War. After 20 years of service, he left the Army in 1962 at the rank of Master Sergeant. He was married for 65 years. Mr. Cox loves jazz music, listening to the news on his radio, and he enjoys when the Bible is read to him.

Event Details:

  • Event – 105th Birthday Celebration for Mr. Robert Cox
  • Date and Time – Thursday, June 4 at noon
  • Location – 3407 Marlbrough Court, College Park, Maryland
  • Please note: Social Distancing will be observed throughout this birthday celebration. Attendees are asked to remain in their cars or stand outside of their car with a mask and ensure 6 feet of distance from other individuals.


About Capital Caring Health

Capital Caring Health is the largest non-profit provider of elder health, advanced illness, hospice, and at-home care services for the Maryland, Virginia, and Washington, D.C. area. We provide quality care where people live, supporting dignified, independent aging. For more information, visit or call our 24-Hour Care Line at 1-800-869-2136.

Media Contact: Amy Shields

America Must Do Better.

The senseless murder of George Floyd, Ahmaud Arbery and Breonna Taylor and others of color throughout America’s past at the hands of those who took an oath to serve and protect all members of their community – leave us outraged and grieving.

America must do better.

We believe everything humanly possible must be done to root out racism.  Capital Caring Health was founded on the premise that we care for every soul in our community, we honor the diversity represented across all communities; and we treat everyone equitably – with respect and compassion.

We do not discriminate against any person on the basis of race, color, national origin, sex, age, disability, sexual orientation, gender identity, gender expression, religion, diagnosis or medical condition, veteran status, ancestry, marital status, occupation, pregnancy, citizenship, or political affiliation.

We stand in solidarity with the Black Community. We pray for peace, safety and healing for our Nation. We thank our Capital Caring Health employees for continuing to live our Core Values: Patients and Families First, Always Do the Right Thing and Respect Everyone.

To fight against racial and social injustice, Capital Caring Health will be making a donation to an organization helping to permanently end these wrongs whenever and wherever they appear.

Dr. Hank Willner Joins Capital Caring Health Medical Staff

Serving patients in Prince George’s and Montgomery counties

Capital Caring Health is pleased welcome back Hank Willner, M.D., to its medical staff.

Dr. Willner is a graduate of Yale University College and Medical School and he completed his residency in Family Practice at the University of Virginia where he was the Chief Resident.

Dr. Willner most recently served as Chief Medical Director and Palliative Care Consultant at Holy Cross Home Care and Hospice in Silver Spring, Maryland.

Prior to joining Holy Cross in 2013, he was Medical Director and a Palliative Care Consultant at Capital Caring Health (formerly known as Hospice of Northern Virginia) from 2001-2013.

Dr. Willner is the Medical Consultant for the Hospice Foundation of America, and he has also served on Maryland's State Advisory Council on Quality Care at the End of Life since 2014.

Dr. Willner is active in teaching medical students and House Staff at medical centers throughout the Washington D.C. Metropolitan area, and he has served as a Clinical Assistant Professor of Family Practice both at Georgetown University Medical School and the Medical College of Virginia.

In 1980, Dr. Willner founded the Virginia Family Practice Associates, PC, in Fairfax, Virginia, where he worked in private family practice for two decades. In 2001, he changed his medical specialty focus to Hospice and Palliative Medicine, and he has practiced as a hospice and palliative care physician since that time.

His special interests include the Doctor-Patient Relationship, Medical Ethics, and the treatment of ALS.

His hobbies include spending time with his family and friends, exercise, reading mystery thrillers, and he is an avid golfer.

Dr. Willner provides care to patients throughout Montgomery and Prince George’s counties in Maryland.

If you or a loved one need help with pain and symptom management associated with cancer, heart disease, stroke, pulmonary disease, Alzheimer’s, ALS, HIV/AIDS, neurological diseases, and other serious and chronic progressive conditions, call Capital Caring Health’s 24-hour care line at (800) 869-2136.

Visit to learn more about the services we provide to individuals with advanced illness and the support we offer to their families.

It's Official: Everyone Loves Nurses!

According to a 2019 Gallup poll, nurses have once again been named “the most trusted profession” in the United States. That’s the 18th year in a row now that Americans have cited nurses for their “honesty” and “ethical standards.”

At Capital Caring Health (CCH), we couldn’t agree more. Our nurses are compassionate, kind, patient, good listeners, and knowledgeable…exactly the kind of people you’d want to take care of you or a loved one during a serious, life-limiting illness.

So while CCH officially observes National Nurses Month throughout May, our nurses are celebrated each and every day for their dedication to patients and families. A nurse may take on a variety of responsibilities at CCH, but their core focus is always on making sure that patients, families, and caregivers have the best care and quality of life possible.

That’s a major reason why Ana Smith, RN, became a nurse in the first place. Her journey began in Colorado where, as a young military wife, she first became interested in hospice care. After relocating to Virginia, Ana joined CCH as a hospice home health aide.

Yet a desire for a stronger role in patient care and for more challenges led Ana to nursing school. After graduation, Ana worked as an ICU/ER nurse and an HIV case manager, but decided to return to the hospice setting. Now in her 10th year at CCH, Ana’s experience demonstrates the many different roles a hospice nurse can fulfill: bedside nurse; clinical supervisor; case manager; liaison between hospital, family and hospice; and care navigation and triage.

“A hospice nurse helps in so many different ways, from managing patient symptoms to training families on how to care for a loved one to coordinating care. We also help patients and families know what to expect at the end of life, providing all the support they need. For me, that means having a direct responsibility in how patients and families are cared for and making sure they feel heard and supported each step of the way.”

That variety and flexibility are part of the appeal of working in hospice, says Ana, now a Triage Coordinator at the CCH Care Navigation Center. She adds, “The triage role allows me to work from home and field calls Thursday through Sunday. That allows me more time to care for my 10-year-old granddaughter while continuing to do the work I love.”

With COVID-19, hospice nurses are among those facing new demands–including a surge in the number of patients referred to hospice. While most patients are cared for at home, care may also be provided in at one of the five CCH general inpatient units at area hospitals.

Successfully dealing with the major challenges of the pandemic recently resulted in Ana and a colleague being named “Heroes of the Hospice” by the Care Navigation Team.  In her role at the Care Navigation Center, Ana helps to keep the operation running over the weekend. She arranges clinical visits, takes triage calls, and troubleshoots.

As a Triage Coordinator, Ana helps handle all calls that come in 24/7 from patients and families. They may be seeking a clinical visit for an urgent problem. Or, as in a recent example, it could be someone seeking reassurance like the mom who called at 1 a.m. because she wanted to talk to someone about medications for her terminally ill son.

Working for the Care Navigation Center can be intense, but rewarding. “Helping someone manage their symptoms and find a positive aspect at the end-of-life is what I’ve always wanted to be part of,” Ana concludes.

Ana recently attended a conference in Hawaii and is pictured above surrounded a flock of parrots.

Capital Caring Health Earns Accreditation from National Institute For Jewish Hospice

May 11, 2020 – Falls Church, Virginia – Capital Caring Health recently earned accreditation from the National Institute For Jewish Hospice (NIJH). The accreditation affirms Capital Caring Health’s commitment to serve Jewish patients and families in a culturally sensitive way.

Capital Caring Health is the only hospice organization in Washington, D.C., to achieve this accreditation, and is among only one other hospice organization to earn this accreditation in both Maryland and Virginia.

“Our organization is committed to meeting the needs of the diverse populations we serve,” said Tom Koutsoumpas, President and CEO, Capital Caring Health.

“We are honored to earn this important accreditation which allows our organization to provide an even greater level of specialized support and end-of-life care for the Jewish terminally ill,” Koutsoumpas added.

Accreditation from the NIJH required that leaders within Capital Caring Health including social workers, nurses, administrators and clergy/chaplains attend a national conference to gain an understanding of Jewish medical ethics in hospice care as well as Jewish aspects of consolation and bereavement. Additionally, NIJH required that CCH provide training on Jewish End-of-Life Caring and medical ethics to its 1,000-plus staff throughout Capital Caring Health.

“The NIJH training and education has provided our staff with an enhanced understanding of Jewish culture and unique aspects of Jewish grief and mourning,” said Altonia Garrett, RN, MBA, Vice President of Public Affairs and Strategic Partnerships, and co-chair of Capital Caring Health’s Inclusion and Diversity Committee.

Garrett added, “We are integrating our understanding of Jewish medical ethics into hospice care in order to provide the best possible care to patients and their families of the Jewish faith.”

NIJH has accredited and reaccredited 225 Jewish hospice programs in the United States. NIJH was established in 1985 and serves as a resource and educational center for hospices, hospitals, family service, medical organizations and all healthcare agencies, educating them to the issues and challenges of serving the Jewish terminally ill.

About Capital Caring Health
Capital Caring Health is one of the leading nonprofit providers of elder health, hospice, and advanced illness care for persons of all ages in the mid-Atlantic region.  A member of a national network of 70 nonprofit hospice providers, our mission is to provide patients and their families with advanced illness care that is second to none.  We also have special hospice teams serving children and veterans.  On an annual basis, we serve over 7,000 hospice patients and provide more than $3 million in charity care to those who are uninsured and have nowhere else to turn.  Almost 90 cents out of every dollar goes to caring for patients and their families. Our website,, is available in English, Spanish, and Korean plus offers 24/7 Live Chat.  Since the beginning of hospice care over 40 years ago, we have served 120,000 patients and their families in Maryland, Virginia, and the District of Columbia.

24 Hour Care Line:  800-869-2136