I’ve served on the Board for Pathways Home Health and Hospice Foundation here in Northern California for many years and have come to know the hospice movement from both a personal and professional perspective. They provide specialized care for people whose doctors believe they probably have six months or less to live.
Caring for an elderly or terminally ill loved one can take a tremendous toll on family members –physically, emotionally and financially. Hospice care is a doctor-prescribed support system that can give relief to family members while ensuring that their loved one’s physical comfort and emotional well-being are attended to. In most cases it is covered by Medicare. But how does it work and who qualifies?
Hospice is a team-approach to care for someone who is terminally ill. It focuses on providing comfort for people with advanced illnesses such as heart or lung disease, stroke, liver disease, kidney disease, ALS,
multiple sclerosis, AIDS and Alzheimer’s disease. One of the benefits of hospice care is that it comes to the patient, whether that’s at their private residence, or at an assisted living community, nursing home or inpatient facility. While most hospice patients are over 65, hospice care is available at any time of life.
The typical professional hospice care team includes a nurse, hospice aide, social worker, physician, chaplain, volunteers and others as needed. The team works in conjunction with the patient’s personal physician to address their medical, physical, social, emotional and spiritual needs. The hospice team also provides support to the patient’s family or caregiver. In addition to making regular visits to the patient, the hospice team is on-call 24/7 to answer questions or to manage any medical or other issues for the patient.
Hospice care is typically initiated by the patient’s physician, but family members can also initiate it as long as eligibility requirements are met. The Hospice Foundation of America provides step-by-step instructions on how to initiate the process.
Before providing care, the hospice team does an evaluation to determine the patient’s eligibility and the appropriate care. They then develop a care plan that meets the patient’s individual needs for pain management and symptom control. The focus is on comfort versus cure. Hospice provides any medical equipment and supplies needed, such as hospital beds, shower chairs, incontinence supplies, etc. This can be a huge help for the family and improve the quality of life for the patient. Hospice also provides any medications needed to alleviate symptoms and provide the most comfort. Medicare, Medicaid/Medi-Cal, and most private insurance plans cover hospice care at 100%. This includes visits to the patient, equipment, supplies and medications related to the terminal diagnosis. In addition to the comfort and care provided the patient, hospice provides peace of mind to families.
Here’s an example. A friend of mine’s elderly mother was in assisted living and began falling at least once a week. Each time she fell, the facility would send her to ER, which they were obligated to do. This meant an ambulance ride to the hospital and back, and several hours on a gurney, in X-ray, etc. My friend would either leave work to be with her Mom or, if unable to, make worried calls to the hospital and facility to check her Mom’s status. Although her Mom was usually just checked out and sent home, each trip took a physical toll on her. Once hospice was involved, if she fell, the hospice nurse came to her to determine whether a trip to ER was necessary. They also provided an occupational therapist to work with her on moving around safely and provided additional equipment to help prevent her falling.
When her Mom died (at nearly 97!) the hospice team was there to provide my friend with both logistical and emotional support.