While hospice was initially started for patients with cancer, over 50% of all hospice care is now provided to patients with other end-stage diseases, such as lung, heart, renal and liver diseases, dementia, stroke and AIDS.
While a hospital’s goal is to cure, the goal of hospice is to provide palliative (comfort-related) care that enables a patient to live his or her final days as fully as possible, surrounded by care, compassion and dignity.
At any time during a life-limiting illness, it’s appropriate to discuss all of a patient’s care options. Patients and their families should feel free to discuss hospice care at any time with their physician, other health care professionals, clergy or friends. By law, the decision belongs to the patient. Understandably, most people are uncomfortable with the idea of stopping an all-out effort to “beat” their disease. Hospice staff members are highly sensitive to these concerns and are always available to discuss them with the patient, family and physician.
Certainly. If improvement in the condition occurs and the disease seems to be in remission, the patient can be discharged from hospice and return to aggressive therapy or go on about his or her daily life. If a discharged patient should later need to return to hospice care, Medicare and most private insurance will allow additional coverage for this purpose.
Palliative care is care that primarily provides comfort and minimizes symptoms rather instead of providing a cure. Hospice is a type of palliative care, but palliative care may be appropriate for patients who do not require hospice care. Hospice is holistic in nature. In addition to symptom management, hospice addresses the spiritual, mental and emotional challenges of end-of-life and includes the needs of both the patient and the family in the plan of care.
Both Medicare and Virginia hospice regulations state that someone is appropriate for hospice if a physician determines that the patient has approximately six months or less to live if the disease runs its normal course. Determining this six-month timeframe can be very difficult! We would rather ask the question, “Would you be surprised if this person was not here six months from now?” If the answer is, “We would not be surprised,” hospice may be appropriate. Some of our patients do live beyond the six-month timeframe and remain appropriate for hospice as long as they continue to meet hospice appropriateness criteria. Some of our patients improve and “graduate” from hospice. These patients may return to hospice care if they need it at a later date.
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Yes, hospice care is always about comfort. Hospice care does NOT mean “no care.” Many people think that choosing comfort care rather than curative care means someone will not receive any care at all. This could not be more wrong! Hospice care is very aggressive care with the goal of making and keeping someone comfortable.
Hospice care is often confused with traditional “home health” services. In fact, they are quite different.
|For people with terminal illness expected to live 6 months or less.|
|An attending Physician directs care.|
|Part-time or intermittent care that is Physician ordered.|
|Help that only manages the symptoms and pain of a terminal illness so that the patient remains comfortable rather than fighting the disease.|
|Home health aides, medical equipment and supplies are available.|
|Covers other services not covered by Medicare and Medicaid such as grief and spiritual counseling for family members.|
|Skilled nursing visits are given.|
|5 day respite care is available.|
|Continuous care at home is given during periods of medical crisis.|
Hospice is not a place, but a philosophy of care for people with an incurable or life-limiting disease. When a patient enters into hospice care, we come to them to provide services, whether their residence is a home, a nursing facility or a hospital. Hospice care is provided most often in a patient’s home–the place where someone is most comfortable and surrounded by friends, family and familiar objects.