Answers
- At any time during a life-limiting illness, it's appropriate to discuss all of a patient's care options, including
hospice. By law the decision belongs to the patient. Understandably, most people are uncomfortable with the idea of
stopping an all-out effort to "beat" their disease. Hospice staff members are highly sensitive to these concerns and are
always available to discuss them with the patient, family and physician.
Back to the Questions!
- The patient and family should feel free to discuss hospice care at any time with their physician, other healthcare
professionals, clergy or friends.
Back to the Questions!
- Most physicians know about hospice. If your physician wants more information, it is available from the
American Academy of Hospice and Palliative Medicine, medical societies, state hospice organizations, local
hospices, or the National Hospice Helpline, 1-800-658-8898. In addition, physicians and all others
can also obtain information on hospice from the American Cancer Society, the American Association of Retired
Persons, and the Social Security Administration.
Back to the Questions!
- Certainly. If improvement in the condition occurs and
the disease seems to be in remission, the patient can
be
discharged from hospice and return to aggressive
therapy or go on about his or her daily life.
If a discharged patient should later need to return to
hospice care, Medicare and most private insurance
will
allow additional coverage for this purpose.
Back to the Questions!
- One of the first things hospice will do is contact the
patient's physician to make sure he or she agrees that
hospice
care is appropriate for this patient at this
time. (Hospices may have medical staff available to
help patients who
have no physician.) The patient
will also be asked to sign consent and
insurance forms. These are similar to
the
forms patients sign when they
enter a hospital.
The so-called "hospice election form" says that the
patient understands that
the care is palliative (that
is, aimed at
pain relief
and symptom control)
rather than curative. It
also outlines the services
available. The form
Medicare
patients sign
also tells how electing the
Medicare hospice benefit
affects other Medicare
coverage for a terminal illness.
Back to the Questions!
- Your hospice provider will assess your needs, recommend any necessary equipment, and help make arrangements to obtain
it. Often the need for equipment is minimal at first and increases as the disease progresses.
In general, hospice will assist in any way it can to make home care as convenient, clean and safe as possible.
Back to the Questions!
- There's no set number. One of the first things a hospice team will do is prepare an individualized care plan that
will, among other things, address the amount of care-giving a patient needs. Hospice staff visit regularly and are
always accessible to answer questions and provide support.
Back to the Questions!
- In the early weeks of care, it's usually not necessary for someone to be with the patient all the time. Later,
however, since one of the most common fears of patients is the fear of dying alone, hospice generally
recommends someone be there continuously.
While family and friends must be relied on to give most of the care, hospices do provide volunteers to assist
with errands and to provide a break and time away for major caregivers.
Back to the Questions!
- It's never easy and sometimes can be quite hard. At the end of a long, progressive illness, nights especially can
be very long, lonely and scary. So, hospices have staff available around the clock to consult with the family
and to make night visits as appropriate.
Back to the Questions!
- Hospice patients are cared for by a team of doctors, nurses, social workers, counselors, home health aides,
clergy, therapists, and volunteers-and each provides assistance based on his or her area of expertise. In
addition, hospices help provide medications, supplies, equipment, hospital services, and additional helpers in
the home, as appropriate.
Back to the Questions!
- Hospices do nothing either to speed up or to slow down the dying process. Just as doctors and mid wives lend
support and expertise during the time of child birth, so hospice provides its presence and specialized knowledge
during the dying process.
Back to the Questions!
- No. Although most hospice services are delivered in a personal residence, some patients live in nursing homes or
hospice centers.
Back to the Questions!
- Hospice nurses and doctors are up-to-date on the latest medications and devices for pain and
symptom relief. In addition, physical and occupational therapists assist patients to be as mobile and
self-sufficient as possible, and they are often joined by specialists schooled in music therapy, art therapy,
diet counseling, and other therapies.
Hospice believes that emotional and spiritual pain are just as real and in need of attention as physical pain,
so it addresses these, as well. Counselors, including clergy, are available to assist family members as well
as patients.
Back to the Questions!
- Very high. Using some combination of medications, counseling
and therapies, most patients can attain a level of
comfort that is
acceptable to them.
Back to the Questions!
- Usually not. It is the goal of hospice to help patients be as
comfortable and alert as they desire.
By constantly consulting
with the patient, hospices have been very successful in reaching
this goal.
Back to the Questions!
- Hospice care is not an off-shoot of any religion. While some
religious organizations have started hospices
(sometimes in
connection with their hospitals), these hospices serve a broad
community and do not require
patients to adhere to any
particular set of beliefs.
Back to the Questions!
- Hospice coverage is widely available. It is provided by Medicare
nationwide, by Medicaid
in some 42 states, and by most private
health insurance policies. To be sure of coverage, families
should,
of course, check with their employer or health insurance provider.
Back to the Questions!
- The first thing hospice will do is assist families in finding out
whether the patient is eligible
for any coverage they may not be
aware of. Barring this, most hospices will provide care for those
who cannot pay, using money raised from the community or
from memorial or foundation gifts.
Back to the Questions!
- Hospice provides continuing contact and support for family and
friends for at least a year following
the death of a loved one. Most
hospices also sponsor bereavement and support groups for anyone
in the
community who has experienced the death of a family
member, a friend, or a loved one.
Back to the Questions!
- Medicare covers all services and supplies related to the terminal
illness for the hospice patient.
In some hospices, the patient may
be required to pay a 5% or $5 "co-payment" on medication and a
5%
co-payment for respite care. You should find out about any
co-payment when choosing a hospice.
Back to the Questions!
Thanks to the National Hospice Organization for the information above!
|
