Making a decision to start hospice is significant for any family or individual. It is most commonly thought of as care for someone at the end of life, or when treatments are no longer effective. While this is correct, it is so much more than that. Hospice begins as soon as the physician deems it appropriate. sometimes it is as the prognosis of six months is given. However, studies have shown that the average person lives longer on hospice care than without. Here is how A*Med Community Hospice approaches care…
What We Do
Our primary goal is to improve the quality of life for our patients and their loved ones. This includes managing the individual’s symptoms – allowing them to live alert, pain-free, and with dignity – supported by loved ones and our caring staff. Each hospice patient can access nursing services as they have unique end-of-life needs. Our experienced medical staff work hand-in-hand with the patient and their loved ones to develop a personalized care plan.
This collaborative effort helps determine the best care and will provide essential physical comfort as well as emotional and spiritual support for their journey.
What does hospice care consist of?
Hospice focuses on caring — not curing — the terminal illness, in the patient’s home or wherever it is they call home. Hospice care also is provided in hospitals, nursing homes and other long-term care facilities. Hospice services are available to patients of any age, religion, race, or illness. Hospice care is covered under Medicare, Medicaid, VA benefits, many private insurance plans and other managed care organizations.
However, Hospice care is recommended for cases where the aim or priority is to provide comfort and manage symptoms. In instances where recovery is possible, the medical professionals advise Home Health Care, where the main aim is healing the disease rather than managing symptoms.
How does it work?
Typically, there is a family member who serves as the primary caregiver and, when appropriate, they help make decisions for the individual. The hospice team makes regular visits to assess the patient and provide additional care or other services. Our hospice team is available 24 hours a day, seven days a week.
Our physician certifies the patient’s terminal illness and oversees medical care. They work closely with nursing staff and the clinical team to ensure the quality of care.
The doctors have excellent communication skills to help patients, families and staff deal with difficult issues and decisions that can arise. They are well-versed in current principles of hospice care in addition to being great educators on many specialties in their background.
Our registered nurses (RN) are specifically trained in evaluation of care for terminally ill patients. They work closely with the hospice physician to treat symptoms with a goal to provide comfort.
Nurses are the heart of the hospice team. They coordinate with other members of the hospice team to provide the best quality of care for the patient and their loved ones.
Our Home Health Aides are trained to assist patients with their activities of daily living such as eating, bathing and grooming. They are given an individualized care plan from the registered nurse, so they can meet the specific needs of your loved one. They also provide comfort measures and emotional support.
The Hospice Social Worker is a certified medical social worker (MSW) who has had specific training in end-of-life care. They are concerned with enhancing the quality of life and promoting the well-being of patients and family/caregivers.
Some examples of their services may include, contacting local agencies, assistance with benefits, and resource planning or advanced directives.
Chaplains provide spiritual guidance and counseling to hospice patients and their loved ones in the comfort of home. The role of a hospice chaplain is incredibly important, as many people turn toward spirituality for comfort at the end of life. The goal of the chaplain is to promote peace, regardless of religion or spiritual affilitation.
Our hospice bereavement program helps families better understand grief. It can also assist in providing resources to support the grief process.
Grief is a normal and expected reaction to loss. The grieving process is unique to the individual and there is no right or wrong way to grieve. The first year of bereavement is the most difficult as the bereaved experiences the ‘year of firsts’ — such as first birthdays and holidays without their loved one — and then the anniversary of the loss.
Medical Supplies, Equipment and Medications
Medical supplies, equipment and medications related to the patient’s terminal illness are covered. Trained staff will assess the need(s) for these items and will coordinate delivery. We provide items such as wound care supplies, incontinence supplies, hospital beds, oxygen concentrators, wheelchairs and more. At A*Med, we have our own medical equipment division, so rest assured we will be delivering our own items with proper instruction and training on usage and care.
Volunteers provide support for patients and families at a time when they need it most. Services may include providing companionship, an enjoyable activity, assisting with errands, or just providing a much-deserved break for the caregiver.
The level of personal connection and support that volunteers provide allows for a greater level of comfort and care for the patient and families. The volunteers also enjoy feeling immensely rewarded for giving their time and skills in support of others.
When is someone ready for hospice?
- Increased ER visits or hospitalizations
- Increased falls; decreased mobility
- Uninterested in regular activities
- Decrease in weight (~10% over months)
- Sleeping more than usual (metabolism slowing down)
- Missing doctor appointments (too much effort/energy)
- Patient/family no longer wish to seek aggressive treatment
- In PCP’s judgment, life expectance would be 6 months or less
- More than 3 infections within last year (UTIs, pneumonia, bronchitis, etc.)
- Unhealed wounds (due to poor nutrition status, decreased mobility, decreased circulation related to disease process)
- Decreased appetite; difficulty swallowing (stomach stops making enzymes to break down fats, protein, and carbohydrates)
- Increased agitation, confusion, disorientation (brain not getting enough oxygen, lungs not exchanging gases properly, shortness of breath may occur)
Levels of Care
Routine Home Care
Routine Home Care
Routine Home Care is care provided to a patient in the home (or nursing home). Visits are made by the hospice staff in the patient’s own environment.
Continuous Care is an intensive, or “crisis” level of care provided to hospice patients at the routine home level of care. Continuous care is provided on a short-term basis (usually one to two days) to maintain the patient in their home or long-term care facility during an acute symptomatic crisis. Nursing care is primarily provided from 8 to 24 hours in a day to achieve palliation or management of the acute medical symptoms.
General Inpatient Care
General Inpatient Care
General Inpatient Care is short-term inpatient care is available for pain control and symptom management. This is provided for short-term care of pain or symptom control and usually is no more than one to three days. Once the symptoms are resolved and the plan of care is unchanged for 24 hours, the patient is discharged home or nursing home.
Respite Care is 5 days of care in an inpatient or nursing home setting per Medicare benefit period. It is short-term care provided to the individual if necessary to relieve the family members or other persons caring for the individual to give them respite.
Hospice Care vs. Palliative Care
Palliative care focuses on relief from physical suffering when the individual may or may not be terminally ill. These patients may suffer from chronic illnesses and undergoing treatment.
Hospice patients are individuals with a prognosis of six months or less that are not seeking additional treatment.
Both will address the physical, mental, social, and spiritual well-being. The difference is, palliative care is appropriate for patients in all disease stages, and accompanies the patient from diagnosis to cure with life-prolonging medications; hospice patients are provided both comfort and medications and pain management.
Hospice and palliative care both utilize a multi-disciplinary approach using highly trained professionals.
One can choose between home hospice, hospice facilities, and even care provided by hospitals. Palliative care is usually offered where the patient first sought treatment.
A*Med Community Hospice specializes in different services that make up our Inter-Disciplinary Team.
Our physicians certify the terminal illness and oversee the medical care.
They may also serve as a resource to other members of the palliative care team and as a liaison with other doctors involved in the care.
Our nurses make home visits to assess your loved one’s condition.
They provide pain management.
Nurses are available around the clock.
Home Health Aides
Our home health aides assist with personal hygiene.
They can provide light housekeeping and may also assist with light meal preparation.
We offer the home health aide 5 days a week, Monday through Friday.
Our social workers provide counseling for the client and their family.
They are the liaison between the patient and community agencies.
Social workers also provide assistance with legal and financial issues.
Our chaplains care for the spiritual needs of the patients and the family.
Their goal is to promote peace, regardless of religion or spiritual affiliation.
Chaplains can also connect with faith communities to have religious requests met.
Our volunteers can provide companionship or emotional support.
They can perform light housework duties and run errands.
Volunteers can offer music therapy or many other forms of comforting activities for your loved one.
We can provide physical, occupational and speech therapy.
Therapists are utilized if their work contributes to the quality of life for your loved one.
Patient & Family
The patient and/or their family are considered the “head” of our Team
As a member of the Team your input and communication is vital.
Working together with the members of our Team will help you feel confident in the care you are receiving.
Frequently Asked Questions
Hospice care is a service dedicated to providing terminal patients medical, psychological, social, and physiological relief in their final days. It is generally provided by a team of trained professionals who have experience in providing end-of-life care. They ensure high quality of life along with a sense of warmth and a lot of dignity.
Hospice care services fulfill many purposes:
- Gives caretakers as well as patients a sense of community
- Offers hospice bereavement services to manage and cope with grief
- More informed decisions and caregiving from professionals with experience
- Expert medical professionals who are better equipped to deal with pain and other symptoms of the disease
Medicare covers the expenses incurred due to hospice care, whether it is at home, in a hospital, or a facility. You qualify for hospice under the Medicare benefit if the following conditions are fulfilled:
- Your hospice care provider is medicare-certified
- Your prognosis determines you are terminal and have less than 6 months to live
Medicare also tends to cover other expenses such as pain management drugs, medical equipment, and grief and bereavement services.
Most physicians advise hospice care when the prognosis suggests the patient’s life expectancy is less than 6 months. However, it is advised for any patient whose terminal illness has progressed to a point where treatments are burdensome and ineffective.
Hospice care is comprised of a team of interdisciplinary medical professionals, including social workers, grief counselors along with skilled nurses. This ensures that:
- Your loved one has help dealing with the physical and physiological symptoms of their terminal illness
- You and your loved one have a strong support system – people to talk to, run errands, and give the primary caretaker a break
- You and your loved one have emotional anchors to help you deal with your feelings and process grief
- You can rely on trained nurses to meet any special needs with great experience and kindness
It is completely understandable to feel a sense of guilt when seeking hospice care. However, there is absolutely nothing selfish about making this difficult decision. Hospice care is bound to meet the patient’s medical and overall needs much better than just with care at home or in a facility. Patients who rely on hospice care generally live longer and better lives than the ones who don’t.
It is also important to remember that it takes a village to look after the sick. Stressing yourself to meet every requirement of a terminally ill patient will affect your health as well as the quality of their healthcare. Hospice care isn’t an easy choice to make! It is, however, the most fruitful and rewarding.