The old adage that families only get together when there is a wedding or funeral really is accurate. The end of life, sad as it is, tends to unite families and bring them closer through their shared grief.
Recently, I’ve had a lot of contact with hospice through my business as an in-home care provider. As you may know, hospice provides compassionate end-of-life care wherever the person resides. The hospice care staff do an incredible job of providing physical, emotional, and spiritual care and communicate so well with patients and families. Hospice constantly strives to give patients the highest quality of life in their remaining days.
Someone qualifies for hospice when a doctor certifies the person has less than six months to live (if the disease takes its expected course) and meets specific medical criteria. According to the National Hospice and Palliative Care Organization, the most common hospice diagnoses include all types of cancer, cardiac and circulatory disease, dementia, respiratory disease and stroke.
Some Benefits of Hospice
Hospice is a valuable resource for families dealing with a life-limiting illness. Here are seven ways hospice can help patients and families:
- Family-centered plan of care – Unlike traditional medicine, the focus of hospice care is on the patient and the family. The hospice care plan considers the family’s wishes and concerns along with the medical needs of the hospice patient. The family is an integral part of the plan and the delivery of care.
- Pain control and symptom management – Hospice makes patients comfortable by managing their pain and symptoms. The comprehensive plan of care emphasizes caring, rather than curing. The plan often includes medications to relieve pain and anxiety. Medical equipment, such as a wheelchair, may allow the patient to get around despite loss of muscle strength. Other interventions may help maintain quality of life. For instance, having an air mattress on the bed can help prevent skin breakdown.
- Team approach – Hospice has a team of medical professionals who implement a plan of care. Team members include doctors, nurses, social workers, spiritual counselors, home health aides, volunteers and other medical personnel. As part of the care team, family members learn how to care for their loved one. The nurse will teach family caregivers the specific care techniques needed, such as how to do transfers, give oral pain medications or change wound dressings.
- A circle of care – A nurse manages the patient’s medical care, while a social worker helps families cope with practical concerns, funeral plans and caregiver stress. A home health aide provides personal care, such as bathing, based on the treatment plan. The patient and family may receive spiritual support from a chaplain. Hospice care may include volunteer visits for family respite and/or patient companionship. The hospice physician may order speech therapy or other services too. Hospice team members make home visits to the patient and family based on the care plan. Although hospice is on call 24/7 for patient needs, hospice typically does not provide around-the-clock care. It is the family’s responsibility to coordinate daily care and supervision of their loved one.
- Supplies and medications – Hospice provides the patients with supplies and medications related to the terminal illness. This may include items such as pain and anti-anxiety medications, a hospital bed, wound care supplies, gloves or briefs. What hospice covers depend upon the patient’s plan of care.
- Bereavement services – Families are eligible for bereavement services during the 13 months following the death of their loved one. Grief takes many forms, and hospice continues to be there for families through phone calls, in-person visits, educational materials, support groups and/or memorial events.
- Home-based care – Most adults want to continue living at home through the end of life. Hospice care can occur in any place the patient considers home, including a skilled nursing facility or inpatient hospice center. However, most patients receive care in their own homes. With hospice care, families can honor their loved ones’ desire to live at home.
Questions You May Have About Hospice
Who pays for hospice? Most hospice care is paid for by Medicare. However, private insurers and Medicaid may also pay for care, depending upon the age, income level or insurance coverage of the patient.
When someone doesn’t have health insurance, other payment options for hospice are charitable care, reduced rates or private pay. Check with your local hospice provider about financial concerns regarding hospice.
Can someone receive hospice care for more than six months? According to the National Hospice and Palliative Care Association, the average length of hospice care is 69.5 days. Some hospice patients live longer – even more than six months. This is because a patient’s condition can stabilize while receiving care. Their terminal illness may not progress as quickly as expected, or the patient recuperates from an underlying health concern, such as pneumonia.
For a patient to receive hospice care for more than six months, the physician must re-evaluate and certify the patient continues to meet criteria for hospice care. However, sometimes patients are doing so well they are discharged from hospice.
How can I find out more? The Medicare Hospice Benefit is a booklet with helpful explanations about many aspects of hospice care, including who’s eligible for hospice care, what services are included and how to find a hospice provider. You can download a free copy of this publication from https://www.medicare.gov/Pubs/pdf/02154-Medicare-Hospice-Benefits.PDF. To locate nearby hospice providers, go to https://www.nhpco.org/find-hospice.
Lou Sirignano is the owner and operator of ComForCare Home Care, a private care provider serving the Lexington area. Among the many services ComForCare offers is hospice support care for families. ComForCare provides much of the daily/overnight care, allowing families to feel better knowing someone is there with their loved ones.
This blog is adapted and reprinted with permission from an article originally published in the Lexington Colonial Times, April 17, 2017.