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A: At any time during a life-limiting illness, it's appropriate to discuss all of a patient's care options, including hospice. By law the decision belongs to the patient. Understandably, most people are uncomfortable with the idea of stopping aggressive efforts to "beat" the disease. Hospice staff members are highly sensitive to these concerns and always available to discuss them with the patient and family. Under Medicare guidelines, hospice care is available to those patients that the doctor believes, if the patient continues to follow the natural disease progression, have a prognosis of 6 months or less.
A: Hospice coverage is widely available. It is provided by Medicare nationwide, by Medi-Cal and by most private insurance providers. To be sure of coverage, families should, of course, check with their employer or health insurance provider.
Medicare covers all services and supplies for the hospice patient related to the terminal illness. In some hospices, the patient may be required to pay a 5% or $5 "co-payment" on medication and a 5% co-payment for respite care. You should find out about any co-payment when selecting a hospice. Butte Hospice does not currently charge such a co-payment.
A: The patient and family should feel free to discuss hospice care at any time with their physician, other health care professionals, clergy or friends.
A: Most physicians know about hospice. If your physician wants more information about hospice, it is available from the National Council of Hospice Professionals Physician Section, medical societies, state hospice organizations, or the National Hospice Helpline, 1-800-658-8898. In addition, they can arrange a consultation by calling our office.
A: Certainly. If the patient's condition improves and the disease seems to be in remission, patients can be discharged from hospice and return to aggressive therapy or go on about their daily lives.
If the discharged patient should later need to return to hospice care, Medicare and most private insurance will allow additional coverage for this purpose.
A: Your hospice provider will assess your needs, recommend any equipment, and help make arrangements to obtain any necessary equipment. Often the need for equipment is minimal at first and increases as the disease progresses. In general, hospice will assist in any way it can to make home care as convenient, clean and safe as possible.
A: There's no set number. One of the first things a hospice team will do is to prepare an individualized care plan that will, among other things, address the amount of caregiving needed by the patient. Hospice staff visits regularly and is always accessible to answer medical questions, provide support and teach caregivers. Our nurses are available 24/7 to assist with patient care needs.
A: In the early weeks of care, it's usually not necessary for someone to be with the patient all the time. Later, however, based upon the changing needs of the patient and since one of the most common Fears of patients is the fear of dying alone, hospice generally recommends someone be there continuously.
A: It's never easy and sometimes can be quite hard. At the end of a long, progressive illness, nights especially can be very long, lonely and scary. So, hospices have staff available around the clock to consult by phone with the family and make night visits if appropriate. "Respite care" can be arranged to give family members a break. Arrangements can also be made for inpatient, nursing home or assisted living placement, should the need arise.
A: Hospice patients are cared for by a team of physicians, nurses, social workers, counselors, hospice aides, clergy, therapists and volunteers. Each provides assistance based on his or her own area of expertise. In addition, hospices provide medications, supplies, equipment, and hospital services, related to the terminal illness and additional helpers in the home, if and when needed.
A: Hospice neither hastens nor postpones dying. Just as doctors and midwives lend support and expertise during the time of child birth, hospice provides its presence and specialized knowledge during the dying process.
A: Hospice believes that emotional and spiritual pain are just as real and in need of attention as physical pain, so it can address each. Hospice nurses and doctors are up to date on the latest medications and devices for pain and symptom relief. In addition, physical and occupational therapists can assist patients to be as mobile and self sufficient as possible, and they are often joined by specialists schooled in music therapy, art therapy, massage and diet counseling. Finally, various counselors, including clergy, are available to assist family members as well as patients.
A: Very high. Using various combinations of medications, counseling and therapies, most patients can attain a level of comfort that is acceptable to them.
A: Usually not. It is the goal of hospice to have the patient as pain free and alert as possible. By constantly consulting with the patient, hospices have been very successful in reaching this goal.
A: No. While some churches and religious groups have started hospices (sometimes in connection with their hospitals), these hospices serve a broad community and do not require patients to adhere to any particular set of beliefs.
A: Hospice provides continuing contact and support for caregivers for at least a year following the death of a loved one. Most hospices also sponsor bereavement groups and support for anyone in the community who has experienced a death of a family member, a friend or similar losses.