The long-term survival of hospice in America depends on a public that is fully aware of the benefits of hospice and palliative care services. According to a survey conducted by the National Hospice Foundation, 75% of Americans do not know that hospice care can be provided in the home, and 90% did not realize that hospice care can be fully covered through Medicare. However this survey also showed that Americans want the kind of end-of-life services offered by hospice.
To learn more about hospice, begin with the following questions and answers...
What is palliative care?
NHPCO's Standards of Practice for Hospice Programs describes palliative care as: Treatment that enhances comfort and improves the quality of an individual's life during the last phase of life. No specific therapy is excluded from consideration. The test of palliative care lies in the agreement between the individual, physician(s), primary caregiver, and the hospice team that the expected outcome is relief from distressing symptoms, the easing of pain, and/or enhancing the quality of life.
The decision to intervene with active palliative care is based on an ability to meet stated goals rather than affect the underlying disease. An individual's needs must continue to be assessed and all treatment options explored and evaluated in the context of the individual's values and symptoms. The individual's choices and decisions regarding care are paramount and must be followed.
What are some questions that you should ask when looking for a hospice program?
Hospice care is a philosophy of care that accepts dying as a natural part of life. When death is inevitable, hospice seeks neither to hasten nor postpone it. Below is a list of questions you should consider when looking for a hospice program...
- What services are provided?
- What kind of support is available to the family/caregiver?
- What roles do the attending physician and hospice play?
- What does the hospice volunteer do?
- How does hospice work to keep the patient comfortable?
- How are services provided after hours?
- How and where does hospice provide short-term inpatient care?
- Can hospice be brought into a nursing home or long-term care facility?
How can you afford hospice care?
Eighty percent of people who use hospice care are over the age of 65, and are thus entitled to the services offered by the Medicare Hospice Benefit. This benefit covers virtually all aspects of hospice care with little out-of-pocket expense to the patient or family. As a result, the financial burdens usually associated with caring for a terminally ill patient are virtually nonexistent. In addition, most private health plans and Medicaid in 45 states and the District of Columbia cover hospice services.
Where does hospice care take place?
The majority of hospice patients are cared for in their own homes or the homes of a loved one. "Home" may also be broadly construed to include services provided in nursing homes, hospitals and prisons. Both cancer and non-cancer illnesses are eligible to receive hospice care. All hospices consider the patient and family together as the unit of care.
How does hospice serve patients and families?
Hospice care is a family-centered approach that includes, at a minimum, a team of doctors, nurses, social workers, counselors, and trained volunteers. They work collaboratively focusing on the dying patient's needs, be they physical, psychological, or spiritual. The goal is to help keep the patient as pain-free and lucid as possible, with the loved ones nearby until death.
Below is a list of services available to Medicare hospice recipients...
- Physician services for the medical direction of the patient's care.
- Regular home visits by registered nurses and licensed practical nurses.
- Home health aides and homemakers for services such as dressing and bathing.
- Social work and counseling.
- Medical equipment such as hospital beds.
- Medical supplies such as bandages and catheters.
- Drugs for symptom control and pain relief.
- Volunteer support to assist patients and loved ones.
- Physical therapy, speech therapy, occupational therapy and dietary counseling.
What role do volunteers play in hospice care?
Because round-the-clock, hands-on care is the hallmark of the hospice experience, hospice provides trained volunteers to aid the family and patients. Most hospice volunteers are trained to relieve the primary caregivers, do household chores and help bathe the patients. Perhaps the most important task, however, is their ability to be "good listeners."
Who qualifies for hospice care?