Hospice Services
By John Boden
ElderIssues, LLC
It is the wish of many with terminal illnesses to live their last days with
dignity, comfortably at home among the people and things they love.
And because of hospice, this is possible.
Hospice care is a comprehensive program that focuses on pain control and the
relief of symptoms rather than treatment aimed at a cure. The program
includes supportive and palliative services intended to improve the meaning
and quality of the patient's life. Professional hospice team members and
trained volunteers work with the family or close friends by teaching them
how to manage care for the patient and giving them the emotional support to
do the job.
When Is It Time for Hospice?
Hospice programs care for persons in the last months of life. Persons choose
hospice when they decide to stop curative treatment or there are no further
treatment options. It is important for persons entering hospice to have:
• A family member or close friend willing to be the primary caregiver who provides and manages the care at home.
• An understanding of their prognosis, that they have been diagnosed with a terminal illness, and also an understanding of the types of services hospice does and does not provide.
• The cooperation of their own personal physician who is willing to work with the hospice team to provide care.
All of these components must be in place in order for hospice care to be
effective in the home. It needs to be stressed that although hospice care
offers a desirable alternative to conventional medical treatment for many
people, it is not for everyone. A person who is still looking for a cure or
one who does not want to work with a caregiving team is not a good match for
hospice care.
What Services Does Hospice Offer?
Nursing care: A registered nurse coordinates the care of the patient and is
the link between the patient, family, and physician. The nurse provides
direct care, medications, pain and physical assessment, and educates the
patient and family.
Social services: The social worker provides advice and
counseling to the patient and family, assists the other care team members in
understanding the family dynamics and assists the family in making use of
community resources.
Physician services: The patient's physician approves the
treatment plan and works with the hospice team. The medical director
of the hospice program acts as a consultant and a resource to the patient's
physician, the patient and the other members of the hospice team.
Homecare aide and homemaker services: Aides provide assistance with daily needs such as bathing, feeding, dressing, transferring, and toileting. Homemakers are
available to prepare meals, run errands, and do light
house keeping.
Spiritual support: Members of the clergy are available to visit and provide spiritual support to the terminally ill and their family at
home.
Trained volunteers: Dedicated people who are trained in good listening skills provide compassionate support for both the patient and family. They
offer companionship and help with everyday tasks that are part of the family's routine.
24-hour on-call availability: Nursing care and support of the hospice team is available for patients and primary caregivers on an
on-call basis, 24 hours a day, 7 days a week.
Respite care: Provides family members with relief from caregiving duties by arranging a brief period of in-patient care for the patient.
Bereavement support: The hospice team works with the surviving family members during the first year of the patient's
death. Counselors visit family members, answering questions and providing grief information and referrals when needed.
Who Pays for Hospice?
Coverage for hospice care is available through Medicare, Medicaid, and private insurance.
Medicare Hospice Benefit: Hospice must be provided through a Medicare
approved hospice agency. This benefit pays the hospice organization a
prospective fee for each patient. In order to qualify for the Medicare
Hospice Benefit, the patient's physician must certify that the patient is
expected to live six months or less. The patient and family members
surrender rights to other Medicare payment benefits when receiving the hospice
care benefit. If the patient lives longer than the expected six months or if
for some reason, hospice services cost more that Medicare hospice benefit
provides, hospice organizations are required to still provide care to the patient.
Medicaid: Medicaid is designed to help aid recipients and people whose
incomes are higher than public aid eligibility limits, but who meet other
criteria and cannot pay for medical services. Federal and state governments
jointly fund the program. More than thirty states now offer the hospice
benefit under Medicaid.
Private Insurance: Most private insurance companies include a hospice care
benefit.
Private Pay: If insurance coverage is not available or is insufficient, the
patient and the family can pay for services out of pocket. Most hospices
provide volunteer support without charge.
John Boden
ElderIssues LLC
801 N. Swinton Ave
Delray Beach, FL 33444
(561) 265-0016 (561) 450-5440
jboden@elderissues.com
www.ElderIssues.com
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