Hospice: What You Need to Know

BY LISA PIPER – focusonthefamily.com

If you ask me what kind of car my brother has, I’d say, “Hmmm…it’s blue.” If you ask my dad, he’d smile with joy and say, “It’s a 1969 Dodge Super Bee with a 440 engine.” What does that have to do with hospice home care? I think that there are a lot of people who would say about hospice, “Hmmm…it has to do with someone passing away.” Yet, if they knew what was under the hood of the hospice care service, they would be amazed at what an incredible comfort and resource the program can be for both the patient and their loved ones.

What Is Hospice Care?

Hospice care is specialized care given to people who are in their last stages of life, whether from advanced illness or life-limiting injury. This type of care is specifically designed to focus on patient quality of life and comfort, rather than recovery or cure. In addition to medical services, hospice care provides patients with emotional and spiritual support. Hospice care also delivers guidance and support to the patient’s loved ones and caregivers during the care process and after their passing.”

How Can Hospice Make a Difference?

The patient no longer has to go to routine medical visits, order their own medicines, wait in lines at the ER, or worry that the pain will be too much to manage. The patient can be comforted knowing their caregiver has support and will have access to resources they may not even know they need yet.

For the caregiver, the support can be life-changing. The needs of not just the patient are considered, but those of the family as well. No longer is the caregiver alone, but a team is ready to educate, offer solutions, and carry the burden of ordering supplies. Some services even offer household help or assist with direct care for the patient. Many organizations offering hospice offer respite care which gives the caregiver time away without compromising the care of their loved one.

Fortunately, when the caregiver has children or other demands on their time, having their loved one at home may be possible through the support of hospice home care.

The Hospice Team

After acquiring hospice services, a plan will be made for how often the patient will be seen and what kinds of services are required to make the patient comfortable. A team of trained professionals is available to the patient and family including nurses, doctors, social workers, home health aides, therapists, counselors, and chaplains.

The home hospice care team members do not stay in the home 24/7 to care for the patient, but there is a nurse on call at all times. An answer to a question, a visit, or help with resources is a phone call away!

The hospice team shares their expertise with tasks such as changing linens while the bed is occupied, administering medication, how to take vital signs, or what medical supplies and equipment will aid in the care of the patient.

Hospice Services

When I mentioned looking under the hood to see what value the hospice program has, it is hard to fathom all of the moving parts that can make the program work as well as it does. Some of the services offered through hospice home care include:

• Medical Equipment (hospital beds, wheelchairs, oxygen equipment, blood pressure monitor, etc.)
• Medical Supplies (mouth swabs, foley catheters, incontinent supplies, adult wet wipes, bandages, disposable gloves, etc.)
• Emotional and spiritual counseling for the patient and the family
• Grief Counseling
• Education
• Medicines to manage pain
• Respite Care
• Laboratory services
• Patient assistance like bathing

Who Pays for Hospice Home Care?

Hospice Foundation of America notes the following about Medicare and Medicaid:

“Most hospice patients are eligible for Medicare, which covers all aspects of hospice care and services. There is no deductible for hospice services although there may be a very small co-payment for prescriptions and for respite care. In most states, Medicaid offers similar coverage.”

Financing for hospice can be provided in one of the following ways:

• Insurance companies
• Medicare
• Medicaid
• Veterans’ Administration
• Charity Care (CHP is a non-profit organization with a patient care fund to help those with coverage deficencies.)
• Self-Pay

How to Get Hospice Care

Qualify Through a Diagnosis

Medicare standards state that only the hospice doctor and your regular doctor (if you have one) can certify that you’re terminally ill and have a life expectancy of 6 months or less. After 6 months, you can continue to get hospice care as long as the hospice medical director or hospice doctor re-certifies (at a face-to-face meeting) that you’re still terminally ill.

Get a Referral/Contact Hospice Provider

Hospice referrals typically come from a physician. Referrals may also come from the patient, family, nurses, friends, hospital discharge planners, or a social worker. A patient may ask their physician to begin hospice services.

Not all hospice providers are the same. It’s important to ask for a local, reputable, nonprofit hospice provider like CHP Home Care & Hospice.

A hospice nurse will schedule an appointment to do an assessment in your home. This is also a good time for the patient or caregivers to ask questions and learn about all the services offered and how to receive them.

Hospice Admission

Once approved, hospice services can begin as soon as the consent form and other documents are completed.

Treatment of Medical Condition to Treatment of Patient

Medical treatments designed to cure the disease or treat the illness are stopped when hospice care is initiated. The focus goes from curing the disease to caring for the patient, controlling symptoms, creating a quality life, and relieving or managing pain.

Misconceptions of Hospice Care

Stigma and false perceptions can feed into fear and misinformation. As a result, those who could benefit from hospice benefits may avoid seeking help. Here are some truth statements to shed light on some misconceptions about hospice home care.

• Agreeing to receive hospice care is not the same thing as giving up. Hospice patients can, and do improve. The key is to seek services earlier than later.
• Hospice care does not speed up death or facilitate the passing of the patient.
• There is no age limit on the service. Patients and families of infants, children, teenagers, and adults may qualify.
• Just because a terminal illness is no longer being treated, that does not mean the patient will not be prescribed medicines for non-related illnesses like pneumonia or wound care.
• Patients do not have to be bedridden or homebound to qualify.
• Hospice services can last longer than 6 months.
• If a patient changes their mind, they can cancel hospice services.

Navigating the Process

For many families, experiencing the end-of-life process is like driving on new terrain. There are curves, potholes, and hills that can be difficult to navigate. Having a team that has navigated its way through all of the ups, downs, and surprises of the end-of-life process can bring peace and comfort to a hurting family. There’s no reason for a patient or a caregiver to go through what can be one of the darkest times in life alone. Hospice Home Care may be the service no one ever wants to employ. However, it is the program that would be everything if a loved one needed it.