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Hospice care is a continuum of supportive services provided to individuals and their families who are facing life-limiting illness. It is comprehensive in nature and is delivered by a team of trained healthcare professionals during the last six months of an individual's life.
It is aimed at optimizing quality of life by anticipating, preventing, and managing physical, psychosocial, and spiritual symptoms associated with end-stage disease. Simultaneously, education and support are given to families and caregivers.
Patients are eligible to receive hospice services when they have been diagnosed with, or treated for, an illness that provides them with a life-expectancy of six months or less. When hospice services are elected, comfort care and symptom management become the primary focus of treatment, and curative therapy is no longer a patient’s choice or option.
Hospice care is delivered at the location that best meets the needs of patients and their families. This may include a private home, nursing home, assisted living facility, group home, or our inpatient hospice facility, Maltz Hospice House.
Medicare, Medicaid and most private insurances cover the cost of hospice care. This includes visits by hospice staff, 24/7 on-call services, oxygen and medications related to the terminal illness, and equipment deemed necessary to assist patients with their function and well-being. Of note, insurance providers do not pay for both hospice care and skilled care or aggressive care simultaneously.
The last six months of life often require specialized care beyond the comfort of a primary care physician. Also, you may find it more difficult to get back and forth to your doctor’s office now or over time. After you are referred to hospice, your physician will let you know if he/she will continue to follow you.
The hospice physician and nurse practitioner are certified in hospice and palliative care. They are always available to be your attending physician and to make house calls. If you decide to continue with your current primary care physician, the hospice physician or nurse practitioner are still available to make in-person or virtual visits to check you.
If you choose a hospice attending physician, that person will handle all your medical needs including medications not part of the terminal diagnosis. If you continue with your current primary care physician, he/she is in charge of your medical care. The hospice physician or nurse practitioner will make recommendations and the final decision is by the primary care physician.
No. The hospice team provides intermittent visits from a nurse, social worker, and spiritual care coordinator to assess, monitor, and treat physical, emotional and spiritual symptoms associated with illness, as well as to teach families and caregivers the skills they need to assist with patient care. In addition, the hospice team provides 24/7 on-call services that can be accessed whenever necessary.
Yes. However, part of the admission evaluation and the ongoing care process involves planning and preparing for a future time when 24-hour/day care may be necessary. Similarly, a person does not need to be home-bound to receive hospice services. Patients are encouraged to participate in activities they enjoy for as long as they are able.
Yes. Receiving hospice care is always a choice. If a person revokes these services and later chooses to return to hospice care, most insurance providers permit re-activation of their hospice benefit.
No. Hospice care is about living! Hospice care is not provided to help people to die but to help people to live fully until they die. The focus is on hope for the promotion of remaining health, the management of symptoms, the alleviation of physical, emotional and spiritual suffering, and the accomplishment of patient and family goals for as a long a time as possible!
Although many persons think of hospice as “giving up” and possibly causing the person receiving hospice services to die sooner, evidence does not support that assumption. Persons receiving hospice services for certain advanced cancers (such as lung, pancreas, or melanoma) actually live longer compared with those matched for age and comorbidities who did not receive hospice services.
The data for non-cancer diagnoses, such as dementia, is not as clear. However, all persons receiving hospice services receive a personalized evaluation of their condition and medications. Some medications may be added; some medications which may be burdensome may be discontinued.
Although it is not necessary to discontinue medications in hospice, often people think more clearly when they are on fewer medications. When death approaches and the person is “actively dying,” the hospice team ensures patient comfort and family support so that peace and dignity are maintained.
From the time a patient enrolls in hospice services, support is provided to all involved for anticipatory loss. Thereafter, bereavement services are provided for an entire year following a patient’s death. These may include personal visits or telephone check-ins, education regarding the grief process, and periodic opportunities for group support. Information about, and referral to, other area resources may also be given when needed.
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