Thursday, 25th of May 2017

Questions About Hospice

Anyone who has been diagnosed with a life limiting illness of six months or less can benefit from the comfort of hospice care. As hospice focuses on caring, not curing, our goal is to help patients maintain control of their lives, and live their last days in comfort and with dignity. The sooner hospice care begins, the more the patient and family can benefit from its many services.

 

What is Hospice?

Hospice is a program of compassionate, family-centered care. It allows patients with a terminal illness to remain at home, in greater control of their lives, surrounded by the people and things that give life meaning and comfort. Since the physical, emotional, and spiritual aspects of a terminal disease affect everyone in the home, hospice care serves the entire family, not just the patient, and continues after death with bereavement support. Hospice focuses on helping patients be pain free and comfortable so they can make the most of the time that remains. We believe that quality of life is as important as length of life.

How do I get Hospice care?

A referral to hospice can be made whenever a patient and family are dealing with a life limiting illness. While the referral must be approved by the patient’s physician, the patient may be referred to hospice by family members, friends, clergy or health professionals. The hospice will then coordinate individualized care with the family and primary physician.

What are the different levels of Hospice care?

  • Routine Home Care – This level of care is provided wherever the patient resides, at home, a skilled nursing facility, or an assisted living center.
  • Continuous Care – Hospice nurses and home health aides provide intensive care for short periods of time to manage a crisis situation in the home.
  • In-Patient Care – When the patient is experiencing acute pain or symptoms that cannot be adequately managed in the home, the patient will be admitted to a skilled nursing facility or hospital where short term intensive care is provided
  • Respite Care – Respite care is provided in a hospital or skilled nursing facility to allow the patient’s primary caregiver a rest. Up to five days of respite care are allowed at a time.

Is Hospice covered by insurance?

Hospice coverage is widely available. It is provided by Medicare nationwide, by Medicaid in 42 states–including Utah–and by most private insurance policies. To be sure of coverage, families should check with their employer or health insurance provider. Patients who don’t have insurance can be accepted by Hospice For Utah based on health needs rather than their ability to pay. To provide this care, the Hospice For Utah Foundation relies on charitable donations.

What does Hospice cover?

In general, hospice covers services related to the terminal illness. The coverage includes physician services, nursing care, medical equipment, supplies and drugs for symptom management and pain relief. It also includes short-term inpatient and respite care, home health aide services, physical and other therapies, as well as social work services and bereavement counseling.

If the patient has no insurance will Hospice for Utah still provide care?

First, hospice will assist families in finding out whether the patient is eligible for any coverage they may not be aware of. Patients who don’t have any insurance can be accepted by Hospice For Utah based on health needs rather than their ability to pay. To provide this care, the Hospice For Utah Foundation relies on charitable donations.

What does the Hospice admission process involve?

Hospice will contact the patient’s primary care physician to coordinate care. An appointment will then be set for representatives from Hospice For Utah to visit with the patient, family and/or caregivers to explain in detail what hospice provides and answer any questions. If the patient and/or family feels that all curative measures have been exhausted and that comfort care is the focus, hospice care is started, and a plan of care centered on the specific needs of the patient is developed.

What specific assistance does Hospice provide home-based patients?

Hospice patients are cared for by a team of doctors, nurses, social workers, counselors, certified nursing assistants, clergy, therapists and volunteers. Each provides assistance based on their area of expertise. In addition, hospices help provide medications, supplies, equipment, hospital services and additional helpers in the home as appropriate.

Are there initial steps I can take to make sure I get Hospice care when the time comes?

Ideally, everyone would make their views about end-of-life care known to their families long before any illness strikes. There are two ways to make your wishes known. First, a Living Will is written instructions to make known is wanted. Second, is a Durable Power of Attorney, which authorizes a person of your choosing to make decisions for you if you become unable to do so for yourself. Both of these forms are available through Hospice For Utah.

What is the role of the physician?

The hospice team works under the direction of the patient’s family physician, who continues to provide primary medical services. At Hospice for Utah, our medical director consults with the patient’s primary physician in caring for the patient and visits patients wherever they reside. Please click here to review our medical director’s expertise: http://hospice4utah.com/about/our-staff/ .

Should I wait for our physician to raise the possibility of Hospice?

The patient and family should feel free to discuss hospice care at any time with their physician, other healthcare professionals, clergy or friends.

What if our physician doesn’t know about Hospice?

Most physicians know about hospice. If your physician wants more information, it is available from Hospice For Utah, the American Academy of Hospice and Palliative Medicine, or the National Hospice and Palliative Care Organization Help line, 1-800-658-8898. In addition, information on Hospice is available from the American Cancer Society, The American Association of Retired Persons and the Social Security Administration.

Can a Hospice patient who shows signs of recovery be returned to regular medical treatment?

Certainly. If improvement in condition occurs and the disease is in remission, the patient may return home or to a previous medical care facility.

Does Hospice do anything to make death come sooner?

Hospice does nothing either to hasten or to slow down the dying process. Just as doctors and midwives lend support and expertise during the time of childbirth, so hospice provides specialized knowledge and care during the dying process.

Is the home the only place Hospice care can be delivered?

Hospice care is provided anywhere the patient resides.

How does Hospice manage pain?

Hospice nurses and doctors are trained in the latest medications, equipment and treatment for pain and symptom relief. In addition, physical and occupational therapists assist patients in remaining as mobile and self-sufficient as possible. These caregivers are often joined by specialists schooled in music therapy, art therapy, nutritional counseling and others to aid in palliative care. Hospice care seeks to alleviate all forms of pain—emotional and spiritual pain as well as physical pain. Counselors, including clergy, are available to assist family members as well as patients.

What is hospice’s success rate in battling pain?

With a multi-modal approach that uses emotional and spiritual support as well as appropriate medications, hospice care helps most patients live in comfort. It is the goal of hospice to help the patient be as comfortable and alert as he or she desires. By constantly consulting with the patient, hospice can be very successful in reaching this goal.

Is Hospice affiliated with any religious organization?

Hospice care is not affiliated with any religion. While some religious organizations have started hospices, each serves a broad community and does not require patients to adhere to any particular set of beliefs. Hospice For Utah is not affiliated with any religion and works with all patients regardless of religious affiliation.

Is special equipment required, or do changes need to be made in the home before hospice care begins?

Hospice For Utah will assess patient needs, recommend any necessary equipment and make arrangements to obtain it. Often the need for equipment is minimal at first and increases as the illness progresses. In general, hospice will assist in any way it can to make home care as convenient, clean and safe as possible.

How many family members or friends does it take to care for a patient at home?

There is no set number. Along with the patient and/or family, the hospice team will prepare an individualized care plan that will address the amount of care-giving a patient needs. A hospice nurse is accessible 24 hours/day to answer questions and provide support. In addition, hospice provides durable medical equipment, prescription drugs, and medical supplies related to a patient’s diagnosis.

Must someone be with the patient at all times?

In the early weeks of care, it’s usually not necessary for someone to be with the patient all the time. As the illness progresses, however, hospice generally recommends someone be there continuously as most patients find comfort in company and fear dying alone. While family and friends must be relied upon to give most of the care, hospices do provide volunteers to assist with errands and to provide a break and time away for caregivers.

How difficult is caring for a dying loved one at home?

Difficulty and care varies. At the end of a long progressive illness, nights can be especially long. Hospice For Utah has staff available 24 hours a day to consult with the family and to make night visits as appropriate.

Does Hospice provide any help to the family after the patient dies?

Hospice For Utah provides continuing contact and support for family and friends for at least a year following the death of a loved one. Hospice For Utah also sponsors bereavement and support groups for anyone in the community who has experienced the death of a family member, a friend or a loved one.

 Click Here for a copy of Hospice for Utah’s Privacy Policies.

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