The one thing
we all have in common is that everyone faces life's end. The difference
is how. One of the ways we can die with dignity is by making our
own decisions about what kind of treatment we want at the end
of life. To accomplish this, Hospice care which is a special way
of caring for people with terminal illness, may be a choice for
you to consider.
The primary aim of
Hospice care is to help patients die with dignity. The Hospice
focus is on palliative care, not cures. It strives to meet the
entire patient's needs – physical, emotional, social and spiritual
– as well as the needs of the family. Emphasis is on helping the
person make the most of each day of remaining life by providing
comfort and relief from pain. According to the Hospice Association
of America, Hospice recognizes death as the final stage of life
and serves to enable Hospice patients to live their final days
to the fullest in the comfort of home, surrounded by their loved
ones. Many of us believe the Hospice program is for seniors only
but, in reality, there is no age limit for this program. Children
as well as adults may receive the support of a Hospice program.
To be eligible for
Hospice under Medicare a doctor must certify that a beneficiary
is terminally ill (has 6 months or less to live) and the program
must be Medicare-certified. There are hundreds of Hospice programs
in the United States. Although their programs may differ somewhat,
death with dignity is the stated aim of all. One of the ways that
is achieved is by allowing patients, whenever possible, to make
choices about their treatment.
Most Medicare Hospice
programs provide visiting nurses, nurse's aids and homemakers.
They also supply medical appliances and medical supplies. They
also provide trained volunteer visitors who offer respite for
the caregiver. They frequently offer bereavement counseling for
the family and some offer support groups.
Nurses coordinate the
care for the patient under a plan approved by the patient's physician.
The Hospice care team will probably include a social worker that
will provide counseling to the patient and family and help the
family learn how to make use of community resources. If the patient
desires, clergy are available to provide spiritual support. Home
care aids provide personal care and homemakers are sometimes available
to help with light housekeeping. Physical, Occupational and/or
Speech Therapists may help the patient learn new ways to accomplish
activities of daily living such as walking, dressing or feeding
oneself. A Hospice team member should be available 24 hours a
day, seven days a week to give advice by phone or, if necessary,
to make a home visit.
The time to investigate
the Hospice program near you is before you or a loved one is faced
with a terminal illness. Medicare and most Health Maintenance
Organizations for seniors, as well as Medicaid will normally pay
most of the cost of this care. Normally, the only expense to the
patient is limited cost-sharing for outpatient drugs and inpatient
respite. With private insurance, Hospice coverage varies. Some
plans include a benefit similar to Medicare, while others pay
for care similar to home health care. There is no standardized
Hospice benefit in private insurance and the amount of hospice
services a patient can receive may be up to the type of insurance
they subscribe to.
Since there may be
differences between Hospice programs it is important to be sure
you understand exactly what you and your family can expect. The
following are some of the questions you might want to ask when
considering this program:
