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Does My Loved One Need Hospice Care? Or Palliative Care?

Hospice and Palliative Care May be Hard to Talk About, But the Benefits are Tremendous.

Does my loved one need hospice care or palliative care? That’s a common question. November is National Hospice and Palliative Care month – a good time to learn more about the benefits of each service, which will help you make an informed decision when the time comes for yourself or a loved one.

Hospice Care Can Make End of Life Easier and More Comfortable

For many, the word hospice brings up negative thoughts of very sick people spending their last days and weeks in a depressing hospice facility. However, that is outdated thinking that should not stop you from using hospice services. Hospice care provides comfort care that can make the end of life easier to bear.

What is hospice care?

Hospice care is a philosophy of treatment – to help patients get the best quality of life in the time remaining. Hospice staff are trained to care for any type of physical and emotional symptoms that cause pain, discomfort and distress.

Some important things to know about hospice care:

  • Hospice care can take place at home, in a long-term care facility or in a hospice facility.
  • The patient can still receive medical care.
  • Medicare and most private insurance plans cover hospice care, paying most or all of the costs.
  • If you start hospice, you can quit whenever you want.

older man feeding his wife soup: hospice and palliative careIf the patient is at home or in a long-term care facility:

  • Hospices will arrange for the delivery of all the needed equipment and supplies, including a hospital bed, bedside commode, medications, etc.
  • Hospice will send a variety of qualified staff to make the patient more comfortable. Staff can include a registered nurse, social worker, home health aides, and a chaplain.
  • A trained hospice volunteer is usually available to provide non-medical support to patients and families, including running errands, staying with the patient to give family members a break, preparing light meals, and lending emotional support.
  • Hospice care is available 24/7. If you need a nurse after normal business hours, most hospices have registered nurses who can respond to a call for help within minutes.

Who should receive hospice care?

In order to qualify for hospice care, two doctors must certify that the patient has a life-altering condition with a life expectancy of less than 6 months. However, it’s important to understand that this expectation is a guess – there is no scientific way to know for certain how much time a person will live with a given set of medical conditions.

Many patients who could benefit from hospice don’t receive it at all, or sign up for it at the very end of their life, missing out on the benefits. Although end-of-life discussions are difficult, it’s worth the time and effort to make sure the patient is as comfortable as possible until the end.

Is hospice care covered by insurance?

Medicare, Medicaid, most private insurance plans, HMOs, and other managed care organizations cover hospice care. Check with your provider to learn the details of your coverage.

What are the potential issues with hospice care?

Hospice care is a rapidly growing industry with over 4,000 hospices in the US. Unfortunately, just like with any other business, some providers are great, while others are subpar. An analysis by Kaiser Health News of 20,000 government inspection records found that “missed visits and neglect are common for patients dying at home”. Families and caregivers have filed over 3,200 complaints with state officials in the past five years. Subsequently, government inspectors found problems in 759 hospices; more than half were cited for missing visits or other services they had promised to provide.

How to choose a hospice?

If you are considering using a hospice, do your research. Ask your doctor, friends and family for referrals. Use the helpful worksheet provided by the National Hospice and Palliative Care Organization to help you evaluate the hospices available in your area.

For more information, visit the National Hospice and Palliative Care Organization (www.nhpco.org)

Palliative Care Can Ease Symptoms and Suffering

What is palliative care?

male patient with respirator: hospice and palliative carePalliative care is specialized medical care for people with serious illness. The goal is to improve the quality of life for the patient and their family. Palliative care focuses on the relief of side effects, symptoms and other stresses associated with serious illness. A palliative care program may treat pain, depression, fatigue, shortness of breath, nausea, anxiety and many other symptoms.

Palliative care is appropriate for patients in active treatment or at the end of life.

Who can benefit from palliative care?

It is appropriate for patients of any age and during any stage of an illness. Services can be provided to a patient at home, in a long-term care facility or in the hospital.

Palliative care helps in many ways.

A 3 year study of lung cancer patients at Massachusetts General Hospital found that those patients who received oncology treatment along with palliative care (such as pain relief measures) starting soon after diagnosis fared better than those who only received traditional oncology treatments. Interestingly, the patients receiving palliative care “reported less depression and happier lives as measured on scales for pain, nausea, mobility, worry and other problems”. In addition, even though fewer of them opted for aggressive chemotherapy as their illnesses progressed, this group typically lived 3 months longer than the group getting standard care.

Who is on a palliative care team?

Typically, a palliative care team consists of doctors, nurses, social workers and other professionals. The team works with the patient, family and the treating doctor(s) to develop and administer a program.

The palliative care team can improve communication among the entire medical team.

A palliative care team works with the patient and family to learn the patient’s personal goals and desires. The team can help you understand treatment options. Furthermore, the team will make sure every member of your medical team treats the patient according to his/her desires.

How can patients get palliative care?

Ask your doctor for a palliative care referral, for a patient in the hospital, at home or in a long-term care facility. Call your insurance company and ask what services are covered, length of coverage, and expected co-payments.

For more information, visit www.getpalliativecare.org.

NOTE: I updated this post on 6-20-18

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