What do you know about hospice?

Posted: April 8, 2019, 11:59AM

Hospice is the care that people can receive when they have a life-limiting illness with a prognosis of six months or less. Hospice care involves a team-oriented approach that includes medical care, pain management, emotional support, and spiritual support. The family of the patient receives support as well. Bereavement support is offered for several months after the person dies.

Hospice focuses on caring not curing. Hospice care can be provided in the person's home, in a free-standing hospice care center, in hospitals and in long term care facilities. Hospice services are available to patients of any age, religion, race or with many illnesses that are diagnosed as life-limiting (ALS, cancer, COPD, CHF, dementia and many others). Hospice care is covered under Medicare, Medicaid, most private insurances, HMOs, and other managed care insurance. Many hospices also have patient funds for those who have no insurance.

The belief of hospice and palliative care is that each of us has the right to die pain-free and with dignity, and that our families will receive the support and education to allow us to do so. The care team works with the patient and the family developing a plan of care that meets the individual's needs for pain management and symptom control. The team usually consists of the patient's personal physician, the hospice physician (or medical director), nurses, home health aids, social workers, clergy, volunteers and physical/speech/respiratory therapists (as needed).

Among the responsibilities of the interdisciplinary hospice team:

pain and symptom management,
assistance with the emotional, psychosocial and spiritual aspects of dying,
provides medications, medical supplies and equipment related to the hospice diagnosis,
coaching the family on how to care for the patient,
delivering therapy services when needed,
makes short-term inpatient care available when pain or symptoms become too difficult to manage at home, or the caregiver needs respite time,
provides bereavement counseling and care to surviving family and friends.

A referral is made for hospice care (often from the attending physician), and an assessment is completed. The care plan is developed, and services are offered based on the assessed needs. There is someone available 24 / 7. If help is needed at 2:00am, you can call and get help. (This may be information, education and/or a staff person coming to the patient.) If there is a health crisis, nurses are available for bedside care for a limited period of time. Unforturnately, we often wait to seek hospice assistance which means our loved ones and families miss out on so much potential good from the hospice care team.

If someone leaves hospice care, they can be discharged and return to their original insurance. Someone may determine that they no longer want hospice care or they may want to seek curative treatment. Someone may be discharged because they have stabilized and no longer meet hospice criteria. If this changes and they need and qualify for hospice care in the future, they can contact the hospice agency for reassessment and readmission.

Don't wait to contact the hospice agency of your choice or talk to your doctor about hospice care for you or your loved one. Have the conversation. What do you / does your loved one want at end-of-life? Talk about what type of care you want or don't want. Talk about what quality of life means to you. Complete your medical power of attorney and living will so your loved ones have arrangements in place. Talking about end-of-life care is difficult but do it before those difficult decisions need to be made. It's a great gift to give your family.

There are several hospice options for those facing life-limiting illnesses. Each of these organizations offers several aspects of care for those who are facing life-limiting illnesses. Call them. Talk about your needs. They will be happy to discuss their services and how hospice can benefit you.