Learning About Hospice Care in 7 Steps

by Calyn Ehid
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Hospice care is a support system for terminally ill people and their loved ones, whereby care and comfort is provided to ease the pain and stress of the illness and loss of life. The group of people that are involved in this process usually include a primary care doctor, nurses, home health aides, spiritual counselors, social workers, pharmacists, trained hospice volunteers, and bereavement counselors. The primary care physician and attendant nurses will coordinate all aspects of the patient’s care. Home health aides help patients with personal care and daily maintenance.

 Learning About Hospice Care in 7 Steps

Trained hospice volunteers are available to assist in many areas, from helping caregivers, to transporting patients when needed. Spiritual leaders and social workers counsel patients and loved ones to help them cope with the suffering and prepare them for the future. Bereavement counselors help family and friends deal with the loss of their loved one and moving forward with their lives.

There is no set time or precise method to predict exactly when a patient with a terminal illness will pass away, but doctors can estimate timeframes in certain cases. For example, some types of cancer discovered in the beginning stage can be treated aggressively and cured, but in other cases, the disease progresses to a point where it’s not curable, and a doctor will determine an approximate amount of time, or life, the patient has left.

Hospice is very beneficial to patients and their loved ones, and should be accessed as soon as possible, as it improves patients’ quality of life and is a tremendous resource for them, as well as family and friends. Respite care, which is when the patient receives full time care in a facility for a period of time, is one of the most helpful advantages of hospice. It gives the patient’s caregivers a break, as caring for someone with a terminal illness is very stressful and taxing. Hospice care is usually done at home, but facilities like hospitals and nursing homes provide the service as well.

What Is Hospice Care?

Hospice care is for patients afflicted with a terminal illness, where the determined prognosis is six months or less of life. The length of time in which care is provided isn’t limited to six months, as many patients outlive that amount of time, or sometimes the prognosis is incorrect. The patient’s primary care doctor and hospice team has to attest to the terminal illness in order to continue care. The care team consists of doctors, nurses, clergy, volunteers, and other health care professionals. The focus of this type of care is to make the patient as comfortable as possible during their last days, and to help their family and friends with provision of support and the grieving process.

Some people are unaware of hospice care or its advantages, as their doctor may not suggest or mention it, but it should be considered when all treatments become ineffective, because it will provide much needed help to both the patients and their loved ones. The care team, which is compromised mainly of health care professionals, is responsible for organizing the patients’ care around the clock and they make sure to keep everyone on the team up to date. Respite care is provided by most hospice care, sometimes up to five days, to allow caregivers time to recharge and rest; this takes place in an inpatient setting. Bereavement services are also provided to loved ones for up to a year after the patient passes away. Members of the clergy or mental health professionals will maintain contact to provide support through the grieving process.

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Who Needs Hospice Care?

Hospice care is for people suffering from terminal illnesses and their family and friends. Normally, this type of care starts in the last six months of patients’ lives, but care is provided as long as the patients’ physician certifies it’s necessary. Patients that are at this stage of illness need full time medical attention, pain management, solace, and support in general. Their families need support, as they are caring for their loved one around the clock and preparing for the inevitable conclusion. It’s a very difficult time for all involved, and the support given also includes counseling from clergy and mental health professionals, throughout the process and after the patient passes away. In home hospice care also allows patients to spend their last days in the comfort of their own home, in the presence of their loved ones.

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Where Do You Find Hospice Care

Hospice care can be given at home or in facilities such as a hospital or nursing home. If an in home hospice is not possible, you can check your area hospitals and nursing homes to find out which, if any, has a local hospice program. Hospitals will have a unit set up specifically for hospice care, or they may have a hospice team that visits patients in one of the nursing units. There are nursing homes and independently owned hospices that provide the service as well. Your doctor may be able to help you find a local hospice. Hospices are listed in the phone book and information can be found on the website of the American Cancer Society. State and national resources include your state’s Department of Health or Social Services and The National Hospice and Palliative Care Organization.

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How Much Does Hospice Cost

The price of hospice care can be astronomical, depending on the type of illness, treatment provided, location of treatment, and length of time services are provided. According to MedPac.gov, Medicare paid approximately $672 a day for in-patient care, and the monthly cost of in-patient care could be upwards of $10,000 per month. Routine care at home is much less at an average of $142 per day. But in cases where there’s a crisis or severe symptoms need full time medical attention, the daily price for home care can increase to about $856. In 2009, Medicare paid out approximately $55 billion for doctor and hospital bills incurred during the last two months of patients’ lives.

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Hospice vs. Palliative Care

Hospice and palliative care are very similar, in that they help to treat and improve the quality of life of patients with serious illnesses. In comparison, they both utilize a team of medical professionals to manage all aspects of patients’ care, to make them as comfortable as possible, and communication between the team and the patients, as well as loved ones is very important in both. The difference between the two is that palliative care is for any stage of illness, whereas hospice is typically six months to end of life. Hospice care also has a more holistic approach, with a more diverse team including clergy. This program takes into account the passing of patients and how they, as well as loved ones, are affected during the process, and afterwards; family and friends grieving their loss. Palliative care in comparison to hospice care programs also differ greatly in the location, payment, and eligibility for services.

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Insurance Coverage

Hospice care is covered by Medicare, Medicaid, and the Veteran’s Health Administration. Most patients that are covered by Medicare can have their costs covered by the Medicare Hospice Benefit. Patients that have Medicaid should check with their state to see if they cover hospice care, most do. The Veteran’s Health Administration also provides coverage for care for those eligible for veteran’s benefits. Private insurance also provides some coverage for care, with varying qualifications and benefits. For those persons without insurance, some hospices provide free service or service based on income or other factors. There’s also financial assistance available through donations or grants. You should check within your community for these and other sources.

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How Long Can You Have Hospice Care For?

Hospice care is normally for people with a life expectancy of six months or less, all things considered. Since this is just an approximate time or estimate, patients will sometimes need care for longer periods. This is not an issue as long as the patient’s prognosis of being terminally ill is re-certified by the patient’s hospice doctor. Care will be provided for two 90-day benefit periods, and then an unlimited number of 60-day benefit periods. The hospice doctor or hospice medical director will have to re-certify that the patient is terminally ill at the beginning of each benefit period, in order to continue care.