What is Hospice Care, and What are Its Purposes?
Patients diagnosed with terminal illnesses often lose their will to live and give up before they have even tried to prolong their life. Still, family members and loved ones can significantly help them live to the fullest, even if their time is running out.
Families usually talk to doctors, trying to find the best solution for their loved one, who’s coming through the most challenging time of his/her life. Doctors may suggest certain treatments, as well as make a referral for hospice care, which is also known as end-of-life care.
Although some people may think of hospice as a pessimistic move, a real picture is a bit different. Hospice care focuses on improving the quality of patients’ last days, making sure they get the best supervision, medical assistance, or just a company.
Hospice programs may include teams of doctors, nurses, volunteers, social workers, counselors, chaplains, and other professionals that would meet your physical, emotional, and spiritual needs.
Bear in mind that hospice care aims not only at patients but also at family members. They can rely on hospice if they need help with cleaning, shopping, or any other house activity they can’t complete due to the situation. Let’s see what else hospice may bring.
What is Hospice?
Hospice care is a type of health care that focuses on helping patients that have been diagnosed with terminal illnesses and have a 6-month prognosis. Such a kind of care aims to mitigate the patient’s pain and fulfill their wishes.
It’s critical to know that the goal of hospice care isn’t to cure the patients’ illness but to support them and improve the quality of their last days.
The hospice philosophy is based upon the fact that every person has their right to prioritize comfort, quality of life, and individual wishes. That said, caregivers tend to address a patient’s emotional, physical, and spiritual needs in order to make their last days better and more fulfilled.
What are the Benefits of Hospice Care?
The greatest benefit of hospice care lies in relieving suffering, promoting dignity, and facilitating closure for families and patients. The good thing is that hospice can be provided for as long as a patient’s doctor and the hospice team confirm that the disease remains life-limiting.
The earlier the patient enrolls in hospice care, the higher the chances to live better, longer, and more fulfilling. Besides, caregivers often decrease the burden on the family, their likelihood of having complicated and long-term grief, and gets them prepared for the death of their beloved ones.
Hospice can help virtually any terminally ill patient, but those that often receive this type of care have cancer, kidney failure, dementia, or pulmonary disease. Such services are convenient for every patient that has less than 6 months to live, that is rapidly declining despite prescribed medical treatment (experiencing weight loss, mental status decline, or inability to perform daily tasks), and is ready to go through other procedures that could prolong life.
Where is Hospice Care Typically Provided?
Hospice care is usually provided at a patient’s home. Still, it can be implemented at hospitals, nursing homes, assisted living facilities, or practically any place that the patient calls home. However, such services must be performed at the hospital if a hospice group can’t manage some of the patient’s symptoms in a home setting.
Generally, hospice offers four levels of care, and two of them are happening at home. They are:
- Routine home care is the most common level of care, and it includes nursing and home aide services.
- Continuous home care refers to the situations where a patient needs ongoing nursing care during a difficult time.
- General inpatient care is a short-term care period when a patient’s pain and other symptoms can’t be managed without proper medical care at the hospital.
- Respite care is another short-term care period in which the patient’s caregiver needs a break.
What Does Hospice Care Provide?
Hospice programs often include more or less similar services, but they do have different approaches. Still, the most common types of care you can expect to receive are:
Palliative care is also known as supportive care, and it’s used for symptom management. That said, it is usually given separately from hospice care, but it can also be a part of it if the patient’s condition is not treated anymore due to its progression. Palliative care does not cure the illness, but it helps reduce the symptoms and relieve pain.
The primary objective of palliative care is to help the patient feel comfortable and allow them to enjoy during their last days. Palliative care may help manage mental, physical, emotional, social, and spiritual issues that may come up as a result of the underlying disease.
Learn more about palliative care and its benefits.
Hospice Care at Home
Most hospice care is done at home, where a designated and trained medical team comes to check on a patient and provide additional care, if necessary. If they see that a patient may need to stay in hospital or another extended-care facility, they will arrange everything and make sure your loved one is getting the best supervision.
You and your caregivers are encouraged to contact your hospice team anytime you need help or any other service. Most hospice providers hire someone on-call, who’s available around-the-clock, and whom you can call to send you out a medical team (doctor, nurse, pharmacist, or someone else) to help you with the ongoing situation.
Most hospice providers schedule regular meetings, in which hospice nurses or social workers keep families informed about their loved one’s condition, telling them what to expect.
These meetings are convenient for encouraging people to express their feelings, talk about their situation, and to learn more about death and the process of dying.
The period of mourning after a loss is called bereavement, and a hospice team will be ready to help families go through the grieving process less painlessly. Support will be provided through visits, phone calls, or meetings with support groups – you will choose the way that fits you the most.
Bereavement services are usually provided for 13 months after the patient’s death.
Hospice Care at Home: What Does It Look Like?
Most hospice programs offer at-home services. Although such services are commonly staffed by doctors, nurses, and other professionals in the field, the primary caregiver is often a family member or a friend that’s responsible for around-the-clock supervision of the patient.
A designated person will be adequately trained to provide the best hands-on care possible. A friend or a family member may be required to supervise a patient 24/7, but hospice staff members will regularly visit to check on the patient and his/her caregiver to make sure everything is under control and to see whether they need additional services.
They will also be able to find volunteers to stay with the patient if a current caregiver is unavailable or needs help. Besides, most hospice centers have an on-call nurse who answers the phone around-the-clock – she can help you during day and night, make home visits, or send you out a team member.
The care process will start right after the patient’s been admitted to the hospice program. It means that a team member will visit him/her at home to learn more about their condition and needs.
A hospice care team typically involves the following professionals:
- Doctor: Each patient will choose a primary doctor who can be either their prior physician or a hospice doctor.
- Home health aides: Such services include extra support for routine care, such as bathing, dressing, and eating.
- Nurses: They are responsible for the coordination of the hospice care team, and they will come to a patient’s home or another facility where the patient is.
- Pharmacists: They are responsible for overseeing the medications and providing suggestions regarding the most efficient ways of relieving the patient’s symptoms.
- Social workers: Such workers often provide counseling and support, as well as referrals to other support systems.
- Spiritual counselors: If a patient wants to fulfill his/her spiritual needs, a hospice center may provide chaplains, priests, lay ministers, or other types of spiritual care and guidance for the entire family.
- Volunteers: A team of trained volunteers will help caregivers with many things, such as transportation, and provide the company and respite.
- Other professionals: Caregivers can rely on the help of speech, physical, and occupational therapists, who will do their best to improve patients’ abilities to speak and perform some daily tasks.
- Bereavement counselors: Bereavement counselors are here to offer support and guidance after the death of a loved one.
Who Pays for Hospice Care at Home? Does Medicare Cover Hospice?
When it comes to enrolling their loved ones in hospice care, families are often concerned about the cost of the service. However, that’s something that shouldn’t worry you – hospice care is 100% covered with Medicare, which means that there aren’t any out-of-pocket expenses for families and caregivers.
Medicare insurance includes everything covered with hospice care – medical equipment, medications, personal care products, oxygen, wound care products, and other necessary supplies.
However, Medicare won’t cover the following parts of your hospice care:
- Treatment aimed at curing terminal illness or related conditions: If you decide to start with any treatment intended to cure your terminal disease, talk to your doctor. Hospice patients are not committed to care services and can stop it at any time.
- Drugs prescribed to cure your condition: Medicare won’t cover any medicines prescribed by your doctor that are used to cure your underlying diseases. Only drugs that control your symptoms and reduce your pain will be considered.
- Care that wasn’t set up by your hospice team: It’s essential to ensure that you’re getting care from the hospice provider that you have chosen. If you receive particular services from different hospice program, you will not be eligible for the coverage, unless you completely change your provider. Still, you can keep seeing your doctor or nurse that you’ve chosen to supervise your hospice care.
- Room and board: Medicare won’t cover board and room if you get hospice care in your home or if you live in a nursing home or a similar facility. Still, if your hospice team determines that you need short-term inpatient care services they arrange, Medicare will cover your stay on the premises. However, you may need to pay a small copayment.
- Emergency room, hospital, or ambulance transportation: Medicare covers neither of these services unless your hospice team arranges them.
Citizens of California can cover the hospice care services with Medi-Cal insurance, which includes all medical equipment and other hospice services. Medi-Cal offers low-cost or free health insurance for children and adults with limited resources and income, people with disabilities, seniors, pregnant women, and children in foster care.
How to Find the Best Hospice Care Program?
You would like to know who is in charge of the health of your family members, which is why you’ll want to research hospice programs in your area. Here are the questions that may help you determine whether the particular program is the right for you:
- Is the program certified and reviewed by the federal government or my state?
- How is the team addressing my loved one’s pain and other symptoms?
- Does the program give caregivers some time to rest?
- Is staff adequately trained for providing care? Do they get screening before they come into our house?
- Does Medicare pay for hospice? Do I need to pay copayments?
- Does the program help us cope with pain and grief after the death of our loved one?