Choosing to place your loved one under the care of a hospice team is an extremely emotional decision. It signifies the end of active treatment for the terminal condition and a movement into uncertain territory, for client and family.
In choosing hospice care for my sister who had exhausted treatment options for her cancer, I wrestled with the idea that I was giving up hope and giving up on her. Initially, the anguish associated with this decision was over whelming. My sister's medical team did little to educate our family on the benefits of hospice; which heightened feelings of hopelessness, fear and guilt. Was I doing the right thing for my sister? What if by some miracle her condition improved; could she leave hospice and restart treatment? Would pain medications simply hasten death? Fortunately, I was able to connect with a knowledgeable social worker who answered my questions, offered reassurance, and helped me gain "peace" with the decision. In the end, my sister was extremely well cared for by a team of compassionate professionals who gained control of her physical pain, provided "TLC", education and so much more.
Many patients and families are not familiar with the goals, benefits and limitations of hospice care. Hopefully, this brief outline will assist in summarizing key points associated with hospice services...
Hospice care is a specialized healthcare program designed to meet the needs of terminally ill patients and their loved ones. Its focus is on pain management and comfort. Patients can select hospice care when his/her physician determines that life expectancy for ANY terminal condition is 6 months or less. Under Hospice care, the patient will no longer receive treatment designed to "cure" the terminal health condition. A patient placed under hospice care may very well live beyond the 6 month time frame and is still eligible to receive hospice services, if recertified by their physician.
The decision is not "set in stone". A patient that is placed on hospice care is free to change his mind, leave hospice care and restart standard medical care at any time. Sometimes, hospice care benefits the patient so much that they are able to extend their lives and leave the hospice program.
Also, hospice services can be restarted with physician's certification at a future time. In fact, In order to qualify for hospice care at home, there must be a willing, able and available caregiver in the home. Hospice provides some personal care assistance such as bathing and dressing. However, it does NOT provide full time caregivers. Many families select professional caregivers from Home Care agencies to provide "round the clock" coverage for their loved ones.
Medicare Part A beneficiaries may elect to receive hospice care for two, 90 day periods, followed by an unlimited number of 60 day periods. The patients physician must recertify at the start of each new period.
If dissatisfied, patients can leave one hospice program and enter a new one once each benefit period.
Hospice care can take place in a Medicare approved hospice facility or in the majority of cases, at home (including patients' assisted living or nursing facility). If an in-facility care option is selected, the family should understand that charges for normal "room & board" will be the responsibility of the patient. Investigate out of pocket costs before making selection between in-home vs. in-facility services.
When hospice care is received at home, family members remain as primary caregivers.
The care team will typically consist of a physician, nurse, social worker, counselor, physical/occupational/speech therapists, nursing assistants, and volunteers. The patients regular physician can also be included as part of the team.
The client and family will receive a whole host of services including: physician and nursing services, medical equipment (hospital bed, wheelchair, walker, bedside commode, lift, etc.), drugs for symptom control and pain (small copay may apply), homemaker services, physical/occupational therapy, social worker services, dietary counseling, grief counseling, massage therapy, short term inpatient care if needed for pain and symptom management and short term respite care.
The respite care benefit is an important one for family members. It provides for short term (5 days) care for the patient in a Medicare approved facility to allow family caregivers to rest and "recharge".
Once hospice care has been selected, the following costs will NO LONGER be covered under Medicare: treatments intended to cure the terminal illness, drugs intended to cure the illness, care from any provider that wasn't established by the hospice team, "room & board", care in an emergency room/ ambulance/inpatient facility unless it was arranged by your hospice.
Seeking hospice and palliative care isn't about giving up hope. Its really about finding the appropriate level of care in one's final weeks or months. For many, the comfort of home and spending time with loved ones is desired over the cold, sterile setting of a hospital room. If you have made the decision to transition to hospice care and need information regarding supplemental In-Home care services, contact Easy Living Services, Inc. to discuss your specific needs at 770-442-8664.