Hospice And Palliative Care To Empower Your Loved One

Chris DiMaso | July 28, 2021

“Praise be to the God and Father of our Lord Jesus Christ, the Father of compassion and the God of all comfort” 2 Cor 1:3

Hospice and palliative care are unique services available to help empower you and your loved one during end-of-life. This article is to help you make a decision on what services you need and provide you with resources to move forward.

What is hospice?
Hospice is a unique service that focuses on patients and their caregivers who are facing advanced end-of-life illness. Hospice provides compassionate care for people in their final phase of life so they can live in peace and comfort. The guiding philosophy of hospice is to regard death as the final stage of life. It respects life without trying to postpone death. Hospice focuses on the needs of the person and alleviating the symptoms afflicting them, related to their disease process instead of aggressively trying to cure the disease. Hospice works as a holistic team to manage symptoms, so the patient’s final time is met with quality and dignity. Hospice care is family-focused and includes the patient and their loved ones when making decisions.

What does hospice do?
When a care provider deems hospice is the right course of action, the patient will choose a hospice agency that suites their needs. Often the hospital or nursing facility can help provide options if the family doesn’t already have a choice in mind. The patient will be visited by a hospice nurse for an evaluation. Two doctors must agree that the patient’s prognosis is 6 months or less to qualify for services. If a patient qualifies, they are admitted and services begin. An interdisciplinary team is assigned to the patient/family that includes: an RN Case Manager, Social Worker, Home Health Aide, bereavement coordinator and a Chaplain and volunteers if they wish. Often hospice agencies also have complementary therapies such as music therapy, massage therapy, aromatherapy, and beautician services. This team approach is overseen by a hospice medical director who will collaborate with the primary physician of the patient. A patient can choose to have the hospice medical director as their primary physician if they prefer.

Services offered in hospice care include, but are not limited to:

• Symptom and medication management from a nurse.
• Coordinating resources with a social worker.
• Personal care and assistance with bathing needs from a home health aide.
• Spiritual support from a chaplain.
• Companionship from volunteers.
• Bereavement support for 13 months after their loved one passes away.
• Supplies/delivers medications that relate to the course of treatment, medical equipment that the patient needs in their home such as a hospital bed/wheelchair/shower chair etc.
• Supplies personal care protection such as bathing supplies and dignity items.
• On-call nursing support 24/7. Outside of business hours, there will be a nurse available to make visits for emergent needs at all times. Hospice wants to be the new “911” for their patient.

Who needs hospice?
Hospice is considered when you or a loved one has been diagnosed with an illness that will limit the length and quality of life. Speak with your care provider about all options, including hospice. Frequent reasons to consider hospice include but are not limited to late-stage dementia and Alzheimer’s, cancer, heart disease, AIDS, ALS, COPD and others. Patients can become eligible for hospice care services when their provider deems that the natural course of illness has a life expectancy of six months or less. It is important that comfort and care of symptom management becomes the priority, and continuing treatment of the illness is no longer beneficial. Hospice care provides a level of support that is unrivaled. An interdisciplinary team of clinicians, social workers, spiritual and grief counselors, and volunteers rally around you or your loved one to meet their needs. This can range from medical treatment and cessation of pain, to coordination of services, or making peace with family and a higher power.

“At the end of our lives, what do we most wish for? For many, it’s simply comfort, respect, love.” -BJ Miller

What are the options in hospice?
End-of-life care is personal and should be tailored to meet the needs and desires of the individual. This can include everything from the level of care needed to directives of where someone wishes to pass.

Hospice vs palliative care
Hospice and palliative care address many of the same issues, but can look very different on a case-by-case basis. Hospice is intended for individuals will a life expectancy of fewer than six months, where palliative care isn’t limited to this time period. Your loved one could benefit from advanced care even if their illness is not life-limiting in the near future. End-of-life goals and symptom management are crucial in both scenarios, and it is important to meet with your healthcare provider to discuss which is appropriate for you or your loved one.

Home-based care
Depending on the resources needed, some patients choose to remain in the home at the end of their journey. This decision is closely linked to the goals of the patient, their condition, and the amount and quality of support available. It is important to note, that the hospice benefit does not include private duty care/or around the clock nursing services.

Long-term care facilities
Facilities like Villa St. Francis offer higher levels of support and can address needs on a case-by-case basis. We offer tranquil settings both in private and semi-private rooms. Our team works closely with Hospice services to ensure pain and symptom management is addressed 24 hours a day, and our nurses and CNAs are available to take care of the patient around the clock and coordinate care plans with hospice professionals who supply supplementary care. We have social workers and spiritual care on-site. Working with Villa St. Francis and a hospice service offers a comprehensive level of care.

General inpatient care
The highest level of care under hospice is called GIP- general inpatient. A patient can qualify for this if their symptoms are unmanageable in their home. GIP is considered “the ICU” of hospice. This can occur in the hospital, but most patients prefer not to return to or remain in the hospital at end of life. Villa St. Francis has a dedicated wing, called The Hospice Suites, with private rooms that can accommodate GIP level of care, with 24 hour RN support.

Who pays for hospice?
The majority of patients requiring hospice services will be eligible for Medicare Hospice Benefit, which covers up to 100% of services. You should not defer hospice due to concerns about payment or financial concerns. Medicare covers hospice as an inclusive benefit and all services related to a life limiting illness are included up to 100% by Medicare Part A. Services unrelated to the illness are covered by Parts A and B where normal rules apply.

Little known facts about hospice

• Hospice isn’t giving up; it is speaking up. Working with a hospice service ensures you or your loved one’s needs will be heard and addressed.
• People can live longer with hospice. It is not unusual for someone to live longer when the quality of their life increases. Pain management and peace of mind are contributing factors to someone’s life expectancy.
• Hospice isn’t a place; it is a philosophy of care. Most hospice patients receive care in their home, but even when it is it elsewhere it remains about the treatment.
• Hospice gives you control, not take it away. Death, just like life is very personal. Hospice professionals work diligently to ensure that the wishes of the patient and their family are upheld.
• Hospice isn’t about giving up medical care, it merely changes the goal. Rather than focusing on length of life, you focus on quality of life.
• Through medical treatments and therapies, you or your loved one can enjoy the rest of their life.
• Hospice is for the entire family, not just the patient. End of life is a stressful time, not just for the patient but also the family. Hospice can relieve some of the burden by offering care and respite to the family.
• Working with social workers and bereavement counselors can help in planning.

What to look for in a hospice provider.
Talk to the professionals. Your doctor, nurses, and social workers are great resources when it comes to choosing a hospice provider. Also, speak with friends and neighbors for advice, it is likely they have had the experience you can draw from in making your decision. You are encouraged to interview hospice agencies to choose the one that is best for you and your family.

Consider asking some of the following questions of the hospice agencies before making a decision:

• Are you Medicare-certified?
• Who is on the hospice care team and how often do they make visits?
• Are you non-profit or for-profit?
• Do you have a dedicated pharmacy for medicine and do they deliver medications?
• How are pain and other symptoms managed?
• What services are offered in your program?
• What complementary therapies do you provide?
• What services do you offer the family?

Companies we regularly work with at Villa St. Francis, but not limited to:
Catholic Community Hospice
Kindred Hospice
Kansas City Hospice and Palliative Care
Good Shepherd Hospice
Vitas Hospice

Read more about what Villa St. Francis has to offer you and your loved one during this time. Read more…