Hospice care is for people who are nearing the end of life and is covered by Medicare, Medicaid, and most insurance providers in Indiana. Unlike other medical care, the focus of hospice care isn't to cure the underlying disease. The goal is to support the highest quality of life possible for the patient and family for whatever time remains.
The services are provided by a team of health care professionals who maximize comfort for a person who is terminally ill by reducing pain and addressing physical, psychological, social and spiritual needs. To help families and caregivers, hospice care also provides counseling, respite care, and practical support. Bereavement support is also a central goal. Caregivers and other loved ones need support during and after the hospice process.
Who SHOULD CONSIDER hospice care? Hospice care is for a seriously ill person who is expected to have six months or less to live. Many people who receive hospice care have cancer, while others have heart disease, dementia, kidney disease, stroke, or chronic obstructive pulmonary disease. Hospice care can be provided for as long as the person's doctor and hospice care team certify that the person’s condition remains life-limiting.
How do you know when it's time for hospice care? Enrolling in hospice care early helps patients live better and sometimes live longer. Hospice services decrease the burden on family, decrease the family's likelihood of having complicated grief, and prepare family members for their loved one's death.
Requesting hospice care is a personal decision, but it's important to understand that at a certain point, doing "everything possible" may no longer be helping. Sometimes the burdens of a treatment outweigh the benefits. Hospice care will help you begin and/or continue treatments that are maintaining or improving your quality of life. If your condition improves, you can leave hospice care at any time and return if and when you choose.
Signs that you or a loved one may experience a better quality of life with hospice care:
- The patient has had several trips to the emergency room, and while his/her condition was stabilized, it continues to worsen.
- The patient wishes to remain at home rather than spending time in the hospital.
- The patient is no longer receiving treatments to cure his/her disease.
- The patient has any of the following symptoms:
- Difficulty managing pain;
- Difficulty swallowing and/or a decrease in appetite and/or weight loss;
- Wounds not healing properly and/or recurrent infections.
- Increased edema;
- Increased shortness of breath;
- Increased need for assistance with activities of daily living;
- Decrease in comprehension and/or increased disorientation or confusion;
- Decrease in smiling and communication; withdrawal from family and friends.
I wish we had been referred to hospice sooner. This is a sentiment that is expressed frequently in patient/family surveys returned to hospices each year. Sadly, while experts agree that hospice care is most beneficial when received over several months, the 2020 National Hospice and Palliative Care Organization Facts and Figures Report indicated that nearly 28% of Medicare hospice recipients received services for seven days or less, and forty percent of hospice beneficiaries in 2018 were served 14 days or less. Here are some of the benefits of timely referral to hospice:
- The patient can participate in all planning and decisions. Before the stress of a medical crisis, early discussions about hospice can facilitate open communication and provide clients a choice and sense of control.
- Pain and symptoms are addressed sooner and crises can be avoided.
- Hospice can eliminate unnecessary calls to 911 and trips to the emergency room by giving families the means to care for their loved one at home and the knowledge of what to expect at the end of life.
- Hospitalizations can be reduced or eliminated.
- Advance directives can be prepared to avoid difficult decisions later.
- Patients benefit from sustained relationships with the hospice team. Because hospice is focused on living, not dying, people who utilize hospice services early in the course of a life-limiting illness have more time to develop personal and professional rapport with supportive staff and volunteers, discuss end-of-life goals, and create an optimal plan of care designed around patient and family wishes.
- Hospice can help a patient and family spend peaceful time together. It offers a comforting alternative when a cure is no longer possible.
