Hospice & Palliative Care

Hospice and Palliative Care

 Hospice

Hospice is a very special way of caring for individuals with limited life expectancy.  Hospices recognize dying as a normal part of life and provide service to comfort when a cure is no longer possible.  These programs neither hasten or postpone death.  Hospice care involves a team of skilled professionals and volunteers who provide comprehensive medical, psychological, and spiritual care for the terminally ill and support for the care recipient and their families.  Hospice care includes medications, medical supplies, and equipment.  Most hospices are Medicare-certified and licensed according to state requirements.

 Palliative Care

Like hospice palliative care, sometimes called comfort care, considers dying a natural part of life.  Palliative care focuses on preserving the best quality of life possible by relieving pain, controlling symptoms, and supporting the patients continuing involvement with life.

The psychological, emotional, and spiritual work involved in the dying process requires energy that can be eroded by severe pain, persistent nausea, or unrelated shortness of breath.  Aggressive management of those symptoms offers patients the opportunity to deal with anxieties about death, put affairs in order, and attend to the principal relationships that sustain them.

The information above is reprinted from Working with Seniors: Health, Financial and Social Issues with permission from Society of Certified Senior Advisors® . Copyright © 2009. All rights reserved. www.csa.us

Misconceptions Regarding Hospice

Myth:     Hospice is where you go when there is “nothing else to be done.”

Reality:   Hospice is “something more” that can be done for the patient and the family when the illness cannot be cured.  It is a concept based on comfort-oriented care.  Referral into hospice is a movement into another mode of therapy, which may be more appropriate for terminal care.  

 Myth:     Families should be isolated from a dying patient.

Reality:   Hospice staff believe that when family members (including children) experience the dying process in a caring environment, it helps counteract the fear of their own mortality and mortality of their loved one.

Myth:     Hospice care is more expensive.

Reality:   Studies have shown hospice care to be no more costly.  Frequently it is less expensive than conventional care during the last six months of life. Less high-cost technology is used and family, friends, and volunteers provide 90% of the day to day patient care at home.  Additionally, patients eligible for Medicare or Medicaid will pay few out of pocket expenses related to their hospice care.  Most private insurers also cover many hospice related expenses.

Myth:     You can’t keep your own doctor if you enter hospice.      

Reality:   Hospice physicians work closely with your doctor of choice to determine a plan of care.

Another misconception about Hospice is that it is one large organization; however, there are many hospice programs. Many communities have more than one hospice. Some are national companies while others are locally owned.  Medicare requires certified hospices provide a basic level of care but the quantity and quality of all services can vary significantly from one hospice to another. 

HOSPICE:  LIFE vs DEATH

Many people misunderstand hospice.  At the center of hospice is the belief that each of us has the right to die pain-free and with dignity.    However, the concept of hospice is more about living than dying.  Each person admitted to hospice care is viewed as a unique individual and a team of compassionate and caring professionals are available to assist them with expert medical care, pain management and emotional and spiritual support.  In other words, the focus is on caring for the patient and not on curing.  Support is also provided to the caregivers and loved ones of the patients.

 

  • Hospice care is provided in the patient’s home or nursing homes, or other long term care facilities. 
  • Hospice staff is on-call 24 hours a day, seven days a week.
  • Hospice services are available to patients of any age, religion, race or illness.
  • Hospice care is covered under Medicare, Medicaid, most private insurance plans, HMOs and other managed care organizations.

The hospice team consists of:

  • The patient’s personal physician
  • Hospice physician (or medical director)
  • Nurses
  • Home health aides
  • Social workers
  • Clergy or other counselors
  • Trained volunteers
  • Speech, physical , and occupational therapist, if needed

 

There are many companies providing hospice care, however, Community Loving Care Hospice of Wentzville, Missouri is a small company with a big heart.  The corporate headquarters located in Wentzville allows for better response and service to the patients. There are a high number of volunteers considering the size of the hospice, which means better continued care for the patients and their family members.  CLC Hospice has recently expanded to also serve Audrain, Marion, Montgomery, Pike, Gasconade and Ralls Counties as well as Franklin, Lincoln, Warren, St. Charles and St. Louis counties.  If you have ever wondered what hospice is or wanted to volunteer please call 1-800-252-3649.

Dinah Sutton, Chaplain

Community Loving Care Hospice

http://www.clchospice.com/

Hospice - Not What You Think 

Recently, a wife of a patient suggested that her mother-in-law consider hospice for her husband. Without hesitation the mother-in-law replied “No, we’re not doing that, that means it’s over”. I am reminded of a commercial from a few years ago that went something like; ‘It’s not your daddy’s Oldsmobile’; implying that only an older person would drive an Oldsmobile, but increasing numbers of younger people were purchasing Oldsmobiles until production ceased a few years ago. The point is, times have changed.

The image of Hospice is much the same.  Years ago, the perception was if a person was on hospice they had only days or possibly only hours to live and there are those who still think hospice is only for those final hours.  The reason for this is that someone thinks if hospice care is used the family, the physician or the patient has given up. Not true!  Hospice emphasizes palliative care or “comfort care” which also means pain management. This is achieved by a team which consists of a physician, nurse, nurse’s aide, social worker, chaplain, and volunteers.  The ultimate goal of hospice care is to make the patient’s last days the best they can be by offering comfort and dignity.  The care one receives does not accelerate death nor put off death to a later date; it simply provides comfort and dignity to the patient and encouragement, information and support to the patient’s family.

When a patient is terminally ill (typically a life expectancy of six months or less and referred by a physician), all of his health care options should be discussed, including hospice care.  Patients have actually improved while on hospice so they are discharged from the program to go about their daily lives.  Some patients have lived a year or more while on hospice.  

Hospice is not just for cancer patients; it is for anyone who has a life threatening illness.

Children and young adults are on hospice. Hospice is not a place; it is a concept. Hospice care can be given in the patient’s home, a nursing home or assisted living facility. Again, the concept of hospice is to affirm the patient’s life and help the patient and the family view death as a normal process. According to the American Hospice Foundation, only 10% of deaths are sudden, the overwhelming majority of people die from a long-term illness. Why not choose hospice for you or your loved one?

Hospice care is not more expensive to the patient or family.  These services are covered by private insurance, Medicare, or Medicaid in 47 states.  Again, not having to worry about paying for medical care can be comforting and will allow patient and family to spend more time together which is another example of palliative care. 

In early times “hospice” was a place where weary or sick travelers could find shelter returning from religious pilgrimages.  It stems from the Latin word “hospitium” meaning a guesthouse.  Life’s journey is going to end for everyone, will that journey take you to the “hospice”?

Dinah Sutton, Chaplain

Community Loving Care Hospice

http://www.clchospice.com/

Volunteers and Hospice

In the American culture the word “volunteer” may be a foreign one, however according the Hospice Foundation of America there are 400,000 plus volunteers across the United States donating time to hospice care.  These volunteers range in age from teenagers to senior citizens contributing more than 18 million hours a year to hospice care.  Every hospice relies on volunteer support to provide excellent end of life care to each patient and family.

 Hospice volunteers can do just about anything they want to do.  They will never be asked to do anything that makes them feel uncomfortable. A hospice volunteer is given choices as to how much and what types of things they want to do.  Some of the typical volunteer duties are:

  • Running errands or doing light housekeeping for the patient and family
  • Help with administrative work in the office, such as copying, filing or answering phones
  • Altering a patient’s clothing
  • Moving furniture or building a ramp
  • Running errands or doing light housekeeping for the patient and family
  • Listening to patient’s concerns
  • Being a comforting and supportive presence
  • Engaging in the patient’s hobbies, for example playing a board game or discussing current events
  • Transporting the patient to physician’s visits or shopping
  • Providing relief to the patient’s caregiver, by giving them a respite break
  • Read to patients, listen, and be there for patients who need companionship

Although volunteers come from many professions, a person who wishes to volunteer simply needs to have the desire to serve.  Volunteers make a difference in the lives of the hospice patient and their family providing care, companionship, and utilizing their unique abilities.

A volunteer coordinator is responsible for recruiting and training and scheduling volunteers.  The volunteer coordinator places notices in newspapers, radio and T.V. in newsletters, church bulletins and on bulletin boards.  Referrals also come from friends, neighbors and relatives who want to volunteer.  Hospices provide orientation and training for each volunteer to equip them with as much information as possible before they begin.  State regulations require that a volunteer complete an eight-hour orientation if they are going to work directly with the patients.  A three-hour orientation is required if they are not working with patients.  A mandatory training session on dementia is also required yearly and there are three optional in-services offered to volunteers. 

 Medicare in the state of Missouri requires the use of volunteers equal 5% of the patient care hours. If you want to make a difference in someone’s life and in your community, hospices are always looking for volunteers. 

Dinah Sutton, Chaplain

Community Loving Care Hospice

http://www.clchospice.com/