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By Betty Berry
Wednesday, March 11, 2009
Q: A family member has been diagnosed with a terminal illness and while hospice services are not needed at this particular time, I am beginning to think about them. 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.
Hospice care differs from other forms of healthcare in a number of ways.
Hospice offers palliative rather than curative treatment. It treats the person, not the disease.
It emphasizes quality of life rather than length of life and it considers the entire family, not just the patient.
When selecting a hospice provider, you should learn all you can about its particular program. Ask exactly 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, on weekends and in case of an emergency.
Payment for services is certainly a concern. Medicare, private insurance and some new long-term-care 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 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 also is 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 his or her family.
Hospice care cannot add days to life, but it can add life to the remaining days.
Happenings
March 25 seminar: The Senior Advocate Services seminar “Do You Know What Is Available?” 1:30 to 3 p.m. at Simi Valley Senior Center, 3900 Avenida Simi, Simi Valley. For information, call 583-6363.
— Betty Berry is a senior advocate for Senior Concerns. The advocates are at the Goebel Senior Adult Center, 1385 E. Janss Road, Thousand Oaks, CA 91362; or call 495-6250.
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