Planning for End-of-Life: Hospice Care
Issues surrounding caregiving are important to us at MedFlight911 Air Ambulance in part because many of the patients who use our air ambulance service require some form of convalescent care or end-of-life care. Last week we wrote about Alzheimer’s disease and the warning signs of the disease. Today I’d like to focus on an underutilized resource for end-of-life care: hospice.
Hospice care is defined as specialized medical care for people with terminal illnesses. It focuses on providing patients with relief from the symptoms, pain, and stress of a serious illness – whatever the diagnosis. The ultimate goal of hospice is to improve the quality of life for both the patient and his or her family.
According to the National Hospice and Palliative Care Organization, an estimated 1.56 million patients received hospice care services in 2010. Yet hospice is often underused or is involved too late in the process. Indeed, many families say they wish they called earlier.
What will hospice do?
Utilizing a team approach, hospice provides expert medical care, pain management, and emotional and spiritual support specifically tailored to the patient’s needs and wishes. Support is often provided to the patient’s family in the form of respite care, support groups, and end-of-life planning. In addition, hospices provide services to the family for 13 months after the patient’s death.
Once the patient’s doctor makes a referral, a hospice professional will evaluate the patient and determine if he or she qualifies for services. The general rule is that to qualify for services an individual must have a life expectancy of 6 months or less. However, people with degenerative illnesses – like multiple sclerosis and Alzheimer’s disease – often qualify for services much earlier.
In most cases, hospice care is provided in the patient’s home – allowing the patient to remain in a comfortable, non-institutional environment until the end of life. Hospice services can also be provided in hospice centers, hospitals, long term care facilities, or assisted living facilities. Hospice care is covered by Medicare, Medicaid and most private health care plans, making the service free to many patients.
Typically, a family member will serve as the primary caregiver with regular visits from hospice staff, who are on call 24 hours a day. An interdisciplinary team involving a physician; nurses; home health aides; social workers; bereavement counselors; spiritual advisors; and speech, physical, and occupational therapists will create a care plan that meets each patient’s individual care needs. Symptom control and pain management are generally the primary focus of the care plan.
End-of-life care can be difficult to discuss; but it is best for loved ones and family members to discuss and share their wishes. Early discussions help avoid uncomfortable situations later. More information about hospice services, including how to find and choose a local hospice, can be found at the National Hospice and Palliative Care Organization website or by calling 1-800-658-8898.