Understand What Hospice Care Is and Isn’t

Hospice care is for people who are terminally ill and for whom there is no cure. One common myth is that a hospice is a specific place, like a nursing home. Instead, hospice is a type of care that can take place in a nursing home, a specialist hospice facility, or the patient’s own home. Most hospice care does happen at home.

Hospice care is about maximizing the quality of life as the end approaches, focusing on compassion, emotional and spiritual support, and pain management. The idea is to keep the patient as comfortable as possible, but not to try and cure them or extend their life. In some rare cases, a patient may recover enough while in hospice care to be able to leave it, but this is not something you should expect to happen.

Hospice is generally recommended when a patient has six months or less to live, although research is being done to combine hospice and curative care and thus expand its availability. It is not 24/7 nursing care, except for specific circumstances, and does not necessarily replace the need for a health aide, adult daycare, etc.

How to Prepare for Hospice Care

The first step is to choose a hospice provider, taking into account budget, geographical location, etc. Most hospice care does take place at home. If your loved one is in an assisted living facility or nursing home they may have a recommended provider. Try to choose a provider that has a board-certified doctor. Once you have made your choice, the hospice will send a representative to meet with you. The initial meeting, which is free of charge and without obligation, should at least include the patient and those members of the family directly involved with care. The representative will help you understand the services and payment options and assess your loved one’s condition.

Your loved one may be admitted at this point. A plan of care will then be developed, which will be discussed with you and your loved one. It’s important at this point to respect their needs and desires over your own; many relatives try to focus on things like extending life that may not be your loved one’s goal.

What Will Hospice Care Entail?

A typical care plan will include:

1. Palliative care and symptom control, which may include pain management and the treatment of other symptoms. Generally, when somebody is in hospice, less care is taken to worry about things like addiction.
2. Respite care. If your loved one is in hospice for an extended period, then the provider may offer respite care. This means that your loved one is moved to a facility such as a nursing home for a brief period so you can get a break from the work of giving care, go on vacation, visit other family members, etc.
3. Spiritual care. If you are religious, the hospice provider may refer you to an appropriate chaplain. Alternatively, your current spiritual advisor may be involved in the plan of care, particularly if you or your loved one belong to a minority religion. Spiritual care is offered not just to the patient but to the family.
4. Family meetings. The hospice care team will meet with you regularly to keep you updated on your loved one’s condition. Daily updates are also given during routine care, but routine meetings can be greatly helpful.
5. Counseling for relatives, including bereavement counseling. A good hospice care plan includes counseling for the family. This counseling may continue for a period of time after your loved one passes. It also includes advice on how to avoid burnout, keep from resenting your loved one, etc. They may also refer you to a support group for people in similar situations. This counseling is generally provided by a trained social worker who can also assist with advanced directives.
6. Occupational, physical or speech therapy. This might include dealing with the effects symptoms are having on speech, providing activities the patient can continue to do with their condition, keeping them moving so they don’t develop bed sores, etc.
7. House calls from the hospice doctor. Most providers do house calls. Alternatively, they may assist with transport to the doctor’s office.
8. Assistance with activities of daily living including bathing and dressing, as needed.
9. Companionship, such as having a nurse or aide stay with your loved one while you run errands.
10. Education on how best to care for your loved one.

Hospice care plans are designed with the needs of both the patient and family in mind. The plan might be quite different, for example, if your loved one is in another state and doesn’t want to leave. Providers take into account the patient’s condition and symptoms, the availability and needs of the family and the patient’s preferences when designing a plan of care.

When Your Loved One Passes On

The most common outcome of hospice care is that the patient passes on. Hospice care includes specific end of life provisions. When your loved one dies, if the hospice nurse is not present you should call them, as they can do the pronunciation of death and the hospice doctor can then sign the death certificate.

If you see signs of approaching death, then you should call the hospice nurse.

Ideally, you should already have made arrangements for the funeral along with your loved one. Prepaying for the funeral and making the arrangements in advance takes a lot of stress off the family.

You will continue to work with the hospice team through the bereavement period. The same counselors will help you deal with your grief and start to move on. You may join a support group. Hospice staff can also sometimes give advice on matters such as putting your relative’s home up for sale and dealing with the estate, simply because they have seen it so many times before.

Hospice care may sound a little bit frightening, but there is a time in life when it is in the best interests of your loved one. Remember that accepting death is not giving up, and be sure to choose a good provider that can help you come through this hard time in your life.

Choosing Hospice is Giving Up

Making the choice to move to hospice care means that rather than focusing energy on curing their disease, patients can focus on rebuilding and enhancing their relationships with friends and family. When a cure is no longer an option, hospice care is a way to redirect the patient’s focus from illness to the things they love and enjoy most, so that they can gain peace and comfort.

Patients Cannot Discontinue Hospice Care Once Started

It is important that patients and their loved ones understand that they are not required to remain in hospice care indefinitely. Patients are free to leave hospice care at any time, and may reapply for entry back into hospice care. As long as they meet the requirements for hospice care upon reapplication, there are no limitations that prevent a patient from returning into hospice care at a later time.

Hospice is Where People go to Die

Contrary to common belief, hospice is not where people go to die. It is where patients who have been exposed to frequent hospital visits, treatments, chemotherapy, dialysis, and any number of other invasive and tiring procedures can go to refocus on their life. The goal of hospice care is to allow the patient to get back in touch with the aspects of life they love. Hospice is a way to reframe the patient’s life in a way that augments their contentment and joy in everything they care about most.

Patients Suffer in Hospice Care

The purpose of hospice care is the opposite of suffering. Hospice care is dedicated to easing the pain and suffering of patients, so that they can enjoy their lives to the fullest extent. With quality pain and symptom management, patients and their families can take pleasure from their time together without discomfort on the part of the patient. The goal of hospice care is to ensure that patients do not have to endure pain or uncomfortable physical symptoms during their time in hospice.

Hospice Must Be Recommended by A Doctor

Although it is good to have the patient’s regular doctor on board, it is not necessary for them to recommend hospice care. The decision to enter into hospice care is that of the patient and their loved ones. Although the doctor may make recommendations, they cannot prevent a patient from choosing to go into hospice care, should they choose to do so.

Patients Can’t See Their Doctor if They Are in Hospice

Along with the misconception that doctors must recommend hospice, there is a myth that once a patient has chosen hospice care, they can no longer continue seeing their regular doctor. On the contrary, hospice care is palliative, which focuses on the comfort of the patient through the assessment and treatment of pain and physical ailments that compromise the patient’s quality of life. Patients are welcome and even encouraged to continue communication with their doctor throughout their time in hospice care.

Hospice Care is Only for Cancer Patients

There is no one parameter that defines patients in hospice care, and that includes illnesses and levels of care. Approximately half of all patients in hospice care are cancer patients. The other half consist of patients with a wide range of conditions, including physical ailments such as kidney disease, liver disease, lung disease, and heart disease, as well as mental illnesses such dementia and Alzheimer’s disease. Hospice care offers a wide range of palliative care for patients with different needs and levels of care, so that patients and their loved ones know that they are receiving the best possible palliative care.

Hospice Care is Expensive

It is widely believed that hospice care is too expensive for patients who are financially challenged. In fact, most patients in hospice care do not have to pay for it. The Medicare Hospice Benefit is widely available to patients who qualify for Medicare, which applies to the majority of patients in hospice care. Alternatively, private insurance companies will often cover the cost of hospice care for individuals with a medical insurance policy. For patients who do not have Medicare or private health coverage, there are numerous charities available to assist with payment for hospice care.

Hospice Care is Only for the Patient

Although hospice care is certainly available to assist a patient with palliative care, the care afforded by hospice providers extends to support loved ones and family members. Transition from active treatment to palliative care can be a confusing and emotional process for patients and their loved ones alike, which is why counselors and chaplains are available for emotional and spiritual support.

All Hospice Care Facilities are the Same

Although all hospice care facilities must meet specific legal requirements and standards in order to operate, each facility operates differently within these parameters. In addition to providing quality palliative care and support, each hospice care facility offers a different cultural and organizational structure. With the large number of hospice care organizations available, there are a wide variety of facilities to meet the needs of every patient. It can take some time for a patient to become comfortable with a hospice care provider, so patients and loved ones should feel comfortable looking at multiple facilities and organizations to find the best one for them.

Choosing the Best Hospice Care Facility

Armed with this information, patients and their family and friends can feel confident that they are choosing the ideal hospice care facility to meet their needs. For information on hospice care facilities in Orange County, California, contact Graceland Hospice Care. We are committed to upholding the highest standards in hospice care, through compassionate medical care, pain management, and customized emotional and spiritual support.

Below we provide a broad overview of each type of care and some scenarios where you might choose one over another. We hope the following information serves as a tool to help you in your decision to care for your loved one.

What Is Hospice Care?

If your loved one has been fighting a chronic illness or disease for some time, he or she might decide they wish to quit receiving treatment. In other cases, doctors might give a grim prognosis and let you and your family know they have done everything they can to cure your loved one’s condition, and his or her body is not responding to the treatment. Choosing hospice care is the choice to forgo all attempts to cure or treat a patient’s illness or disease.

The National Institute of Health recommends medical professionals provide hospice for people who are terminally ill and have six months or less to live without treatment intervention. Some associate hospice to a specific place, but it refers to the type of care your loved one will receive. If you choose hospice care for your loved one, this can occur at home, at a hospital, at a nursing home, or a specialized hospice center.

Hospice care typically includes a team of people committed to providing medical, emotional, and spiritual support to your loved one to make them as comfortable as possible as they prepare to leave. Pain management is often a large part of the medical aspect of hospice care. Hospice team members include nurses, doctors, social workers, trained volunteers, and religious or spiritual members if your loved one chooses. This valuable time provides your loved one the opportunity to come to terms with their mortality and forgo the pain, which can accompany treatments that haven’t worked.

What Is Palliative Care?

Palliative care is another option for those who are battling a chronic illness or disease, such as heart failure, cancer, Parkinson’s disease, and many more. The philosophy behind palliative care is to help your loved one remain comfortable while treating their symptoms and illness as long as possible and hoping for a cure or remission. In many situations, those who are ill or their families choose palliative care before hospice. When your loved one isn’t responding to curative treatments, you can choose to change to a hospice care approach. Also, keep in mind that palliative care specifically refers to providing comfort to a patient, so it is also a part of hospice care.

While hospice care intends to provide end-of-life comfort, palliative care seeks to improve the quality of life for a person who is battling a serious disease or illness without regard to a time frame; Palliative care isn’t appropriate for patients who have been given less than six months to live, unless it is part of hospice care. Patients can receive palliative care at home, at the hospital, in a nursing home, or specialty outpatient clinics. Unlike hospice care, palliative care does not depend on the prognosis of your loved one and can go on indefinitely.

Palliative care also includes a team of people put in place to help you, your family, and your loved one by providing medical treatment and emotional support. In addition to doctors and nurses, a palliative team might also include social workers, nutritionists, and religious advisors. Like hospice care, team members are included based on the needs and wants of the patient and their family.

Which Type of Care Is Right for You?

Many different factors can inform why you would choose one type of care over another. Here are some scenarios which might cause a patient or deciding family members to choose palliative care over hospice care, and vice versa:

• Both types of care are for those with serious illness, but unless a doctor or medical team as giving your loved one a terminal prognosis, you might opt for palliative care. If and when you choose to quit curative treatments, you can always choose to change approaches.
• If you wish for you or your loved one to continue receiving curative treatments, you cannot choose hospice.
• Medicare pays all hospice charges, while coverage for palliative care with curative treatment depends on the patient’s benefits and their treatment plan.
• Your loved one has lived longer than six months in hospice care, which might mean they can lose insurance coverage. In this case, it might be an option to return them to only palliative care for awhile.
• Palliative care can begin at the point of diagnosis and treatment and can help a patient understand their choices for medical care as they battle a severe condition.
• Those whose loved ones have refused treatment of a chronic condition or disease often choose hospice care. Patients might be giving up on surviving their condition because their bodies haven’t responded to the treatments the way doctors hoped, or patients might choose to refuse treatment because they want to spend the short time they have left engaging with friends and family instead of coping with the side effects of chemotherapy, radiation, and other harsh treatments for disease.

Palliative care seeks to increase your loved one’s quality of life while still providing treatment and hoping for a cure for their disease or illness. When treatment is no longer an option, hospice care might be the best choice for your family. Contact Graceland Hospice Care for more information about the differences between palliative and hospice care, and to determine the best path for your loved one’s needs.

That’s where at-home palliative care can help.

What is Palliative Care?

Palliative care is the medical term for pain and symptoms management of a patient who is pursuing curative treatments.  Its focus is on the quality of life for individuals who are diagnosed with a serious or life-changing illness.  The priority of palliative care is the needs of the patient.  A team of healthcare professionals works to manage a patient’s symptoms and pain, regardless of age or stage of illness.  Palliative care services can be provided at different locations such as a retirement facility, a nursing home, or a private residence.

What is a Palliative Care Team?

Palliative care teams are made up of doctors, nurses, social workers, and other health care professionals.  They coordinate with medical professionals involved in a patient’s care to make sure everyone is on the same page.  Care teams are available from the point of diagnosis and treatment and can help patients understand their choices for medical care as they battle a severe condition.

What Does a Palliative Care Team Do?

A palliative care team works with patients to develop a care plan to improve their daily lives.  They can coordinate transitions from a hospital to a nursing facility to home care.  They keep a patient informed on their course of treatment and will speak with patients and their families about what to expect at each point in the illness.  The care team can outline what will happen at various hospital and doctors’ appointments to ease any anxiety or stress.  The following are some of the services an at-home palliative care team can provide.

Manage Symptoms

Individuals suffering from a serious illness often experience illness-related symptoms as well as side effects of treatment.  Palliative care uses a team of medical professionals to find ways to relieve these symptoms.  Symptoms may include, but are not limited to, shortness of breath, fatigue, loss of appetite, difficulty sleeping, and nausea.  The goal is to help people regain their strength so they can enjoy a better quality of life.

Manage Pain

Unfortunately, pain is often a part of a serious illness.  It may or may not be chronic; there may be a sudden onset, and then the pain fades.  Whatever the level of pain, palliative care helps manage the pain.  Uncontrolled pain lowers the quality of life and may interfere with decision-making.  That’s why palliative care works with patients from the very beginning to learn their wishes when it comes to pain management.

Manage Depression, Anxiety or Grief

Feeling depressed, anxious, or sad is not uncommon in individuals with a serious illness, especially immediately following the diagnosis.  If feelings of depression continue beyond a few weeks, the palliative care team needs to know.  Because depression is a serious disease and can impact anyone’s physical well-being, the palliative care team wants to ensure that help is provided.

Patients may experience illness-anxiety as they contemplate their life after a serious or advanced diagnosis.  Some patients may feel anxious about how they will function, especially if they have limitations placed on their usual activities.  They may feel a sense of loss if they can no longer participate in life as they once did.  The care team works with patients and other healthcare providers to help alleviate anxiety and grief.

Suggest Adaptive Strategies

Lifestyle changes usually accompany serious illnesses.  Some changes may be short-term, others of a more permanent nature.  Whether it’s a different way of going upstairs or a simple change in routine, palliative care personnel are experienced in finding strategies to help people adapt to life with a serious illness.  Just having someone available to help you or your loved one through uncharted territory can make the journey less stressful.

Address Social, Financial, Spiritual Concerns

When someone receives a life-changing diagnosis, the world seems to stop.  Unfortunately, it does not.  Coping with day-to-day concerns can seem impossible.  Palliative care personnel can provide suggestions for social and financial matters.  They can also find the right spiritual support if requested.  Their goal is to make living with a serious illness as stress-free as possible.

Speak with Family

Letting those close to you or a loved one know about a serious illness can be stressful.  A care team can reduce stress by speaking with the family about the illness and treatment options.  Sometimes families have questions and concerns that they feel uncomfortable discussing in front of a loved one.  Having a care team available to answer their questions and address their concerns creates a more positive home environment.

How to Get Palliative Care

Palliative care is available at any point in a life-changing illness; however, the earlier in the process, the more beneficial the care.  If you or a loved one is facing a serious illness, you may benefit from palliative care. Contact Graceland Hospice Care for more information on palliative and hospice care and to determine the best path for you or your loved one.