Q: A family member has been diagnosed with a terminal illness and while not needed at this particular time I am beginning to think about hospice services. When looking into this type of care what should I consider when selecting a hospice provider?
A: I commend you on preparing for future needs. It is something most of us fail to do and then when faced with the actual problem must act in haste sometimes requiring us to make ill-informed decisions.
Most Americans know very little about hospice care. They aren’t aware that it provides pain relief for the terminally ill, that it is an option for end-of-life care and that Medicare covers most of the cost.
When selecting a hospice provider you should learn all you can about their particular program. Ask exactly what services they have the ability to provide not only to the patient but also what kind of support is available to the primary caregiver and other family members.
Ask what roles the patient’s physician and the hospice physician play in the care plan and day-to-day care. Inquire about the role of hospice volunteers and determine how emotional and spiritual needs are met.
You certainly want to know how the hospice keeps the patient comfortable and how the services are provided after hours, weekends and in case of an emergency. Who do you call and what response time can be expected.
If the patient is receiving hospice services at home but conditions require a move to an assisted-care or long-term facility can this hospice continue its services at the facility of your choice.
Payment for these services is certainly a concern. Medicare, private insurance and some new long-term policies cover most hospice services.
To be eligible for Medicare coverage the patient must have Medicare Part A coverage. The patient’s doctor and the hospice medical director must certify that the patient is terminally ill. The patient must sign a statement choosing hospice care instead of standard Medicare benefits for the terminal illness. The care must be provided by a Medicare-certified hospice provider.
For coverage provided under private insurance and long-term care policies you should check with your insurer to determine eligibility requirements.
Hospice care is provided through a team effort. It supplements the caregiving provided by families and other loved ones. The team consists of a medical director, an attending physician, registered nurse, social worker, chaplain, home health aide and volunteers.
The medical director certifies the attending physician’s prognosis and leads the team in developing a plan of care. The patient’s primary care physician remains as the patient’s attending physician. The registered nurse makes regularly scheduled visits, coordinates the care plan and teaches the family about proper patient care.
The social worker assesses the needs of both patient and family and assists with coping and anxiety. The home health aide provides the direct personal care.
Spiritual support is provided by the chaplain who works with the family’s choice of clergy. He or she is also available to assist with funeral and memorial preparations.
Volunteers provide friendly visits, respite to caregivers and general emotional support.
When the quantity of one’s days is limited hospice emphasizes the quality of life. It is a special way of caring for both the terminally ill patient and their family.
Hospice care cannot add days to life — but it can add life to the remaining days.
