Hospice: An In-Depth Look, Part 2

April 17, 2018

In our previous post, we discussed the history and background of hospice. But what does hospice care look like today?

Medicare brochureHospice is covered by Medicare Part A, Medicaid, and most private insurance. You must qualify for hospice, which is done by a doctor’s evaluation. Medicare stipulates that you must have a terminal diagnosis within 6 months. 6 months is a period of time you’ll hear often in hospice care, but it is important to note that hospice care will NOT be taken away if the patient does not pass inside that window. It is simply a benchmark Medicare uses to manage the process. Once you have been qualified by a physician, there is no charge to the family, with few exceptions. And in those cases, private insurance will typically cover hospice.

It is also important to note, hospice care can absolutely be administered at the community level. You do not have to move your loved one to a hospice facility. The goal is comfort and quality of life, so keeping them where they feel most at home is ideal.

Once you are on hospice care, everything related to that terminal diagnosis is covered. This includes medications, durable medical equipment such as hospital beds, walkers, wheelchairs, chair and bed alarms, to name a few. In addition, you can expect a marked increase in care for your loved one. Medicare requires an RN visit every 14 days, but most providers we spoke with visit much more frequently (often twice a week).

Hospice Nurse visiting an elderly male patientIn addition to nurse visits, hospice also provides a physician for the resident, although they are welcome to continue seeing their own physician as well. They will also have a hospice aide who visits 3-5 times a week. The aide is trained to look for any signs or symptoms that may signal a change in health and will work diligently to keep the resident clean and wound-free (in addition to dressing wounds) to head off any risk of infection. With dementia, not only can changes be subtle, but the person cannot always articulate pain or recognize symptoms, so it is important to closely monitor the individual and be aware of any issues so that they may be promptly treated. Because the aide is with the resident so often and is sometimes the first to notice when something is off, they are truly vital to the care plan.

Whether it be a wound, a UTI, intestinal blockage or other treatable condition, the faster treatment is administered, the better. As Kerri and Marlene reiterated, the goal is to improve quality of life, not hasten death. This is why many people with dementia who are on hospice care can often live longer than expected. Not only are they still receiving care from their assisted living staff, but now have another group of people who are complementing that care. The hospice aides also work diligently to give their patients comfort and preserve their dignity. They can bathe the resident and help out with hygiene, among other activities of daily living. This increase in daily care offers family members and in-house care staff much relief and peace of mind. It frees everyone up to just be with that person. A win-win for everyone on this journey.

In our next post, we’ll cover the many ways hospice can offer comfort beyond the physical care of your loved one. Click to continue reading –>

————
To read this entire series, follow the links below:

Part 1 – History of hospice
Part 2 – Hospice today
Part 3 – Treating body and soul
Part 4 – When is it time to call hospice
Part 5 – Choosing a hospice provider