|
Hospice Frequently asked questions
When should a decision about entering a
hospice program be made and who should make it?
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 aggressive efforts to “beat” the
disease. Hospice staff members are highly sensitive to these concerns and
always available to discuss them with the patient and family.
Should I wait for our physician to raise the
possibility of hospice, or should I raise it first?
The patient and family should feel free to discuss
hospice care at any time with their physician, other health care
professionals, clergy or friends.
What if our physician doesn’t know about
hospice?
Most physicians know about hospice. If your physician
wants more information about hospice, it is available from the National
Council of Hospice Professionals Physician Section, medical societies, state
hospice organizations, 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.
Can a hospice patient who shows signs of
recovery be returned to regular medical treatment?
Certainly. If the patient’s condition improves and the
disease seems to be in remission, patients can be discharged from hospice
and return to aggressive therapy or go on about their daily life. If the
discharged patient should later need to return to hospice care, Medicare and
most private insurance will allow additional coverage for this purpose.
What does the hospice admission process
involve?
One of the first things the hospice program 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. (Most hospices have
medical staff available to help patients who have no physician.) The patient
will 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.
Is there any special equipment or changes I
have to make in my home before hospice care begins?
Your hospice provider will assess your needs, recommend
any equipment, and help make arrangements to obtain any necessary equipment.
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.
How many family members or friends does it
take to care for a patient at home?
There’s no set number. One of the first things a
hospice team will do is to prepare an individualized care plan that will,
among other things, address the amount of caregiving needed by the patient.
Hospice staff visit regularly and are always accessible to answer medical
questions, provide support, and teach caregivers.
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. 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
do deliver most of the care, hospices provide volunteers to assist with
errands and to provide a break and time away for primary caregivers.
How difficult is caring for a dying loved one
at home?
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 by phone with the family and make night visits if appropriate. To
repeat: Hospice can also provide trained volunteers to provide “respite
care,” to give family members a break and/or provide companionship to the
patient.
What specific assistance does hospice provide
home-based patients?
Hospice patients are cared for by a team of physicians,
nurses, social workers, counselors, hospice certified nursing assistants,
clergy, therapists, and volunteers - and each provides assistance based on
his or her own area of expertise. In addition, hospices provide medications,
supplies, equipment, and hospital services, related to the terminal illness.
and additional helpers in the home, if and when needed.
Does hospice do anything to make death come
sooner?
Hospice neither hastens nor postpones dying. Just as
doctors and midwives lend support and expertise during the time of child
birth, hospice provides its presence and specialized knowledge during the
dying process.
Is caring for the patient at home the only
place hospice care can be delivered?
No. Although most patients receive
care in their homes, hospice patients who live in assisted living centers,
skilled nursing facilities or are patients in acute hospitals also may
qualify for care.
How does hospice “manage pain”?
Hospice believes that emotional and spiritual pain are
just as real and in need of attention as physical pain, so it can address
each. 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 can assist patients to be as mobile and self
sufficient as they wish, and they are often joined by specialists schooled
in music therapy, art therapy, massage and diet counseling. Finally, various
counselors, including clergy, are available to assist family members as well
as patients.
What is hospice’s success rate in battling
pain?
Very high. Using some combination of medications,
counseling and therapies, most patients can attain a level of comfort that
is acceptable to them. Mercy hospice consistently scores well in pain
management as benchmarked at the national level.
Will medications prevent the patient from
being able to talk or know what’s happening?
Usually not. It is the goal of hospice to have the
patient as pain free and alert as possible. By constantly consulting with
the patient, hospices have been very successful in reaching this goal.
Is hospice affiliated with any religious
organization?
Mercy hospice is rooted in the
ministry of the Sisters of Mercy. However Mercy Hospice serves a broad
community and respects each patients beliefs and faith tradition.
Is hospice care covered by insurance?
Hospice coverage is widely
available. It is provided by Medicare nationwide and by most private
insurance providers. To be sure of coverage, families should check with
their employer or health insurance provider. Oklahoma currently does not
have a Medicaid hospice benefit. Legislative has been proposed.
If the patient is eligible for Medicare, will
there be any additional expense to be paid?
Medicare covers all services and supplies for the
hospice patient related to the terminal illness. 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 selecting a hospice.
If the patient is not covered by Medicare or
any other health insurance, will hospice still provide care?
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. Check with the hospice and their policy.
Mercy Hospice is one of only two non-profits of more than 70 hospices in the
Oklahoma City metro area.
Does hospice provide any help to the family
after the patient dies?
Hospice provides continuing contact and support for
caregivers for at least a year following the death of a loved one. Most
hospices also sponsor bereavement groups and support for anyone in the
community who has experienced a death of a family member, a friend, or
similar losses.
Source: The National Hospice and
Palliative Care Organization
|
