|what's a hospice?
|Hospice care involves a core interdisciplinary team of professionals and volunteers who provide medical, psychological, and spiritual support for the terminally ill and assistance to their families. Focused on pain management and symptom control, the care is primarily based in the home, enabling families to remain together in peace, comfort, and dignity.
What are the advantages of hospice?
Hospice treats the person, instead of the disease; focuses on the family, instead of just the individual; and emphasizes the quality of life, instead of its duration. Hospice care allows terminally ill patients and their families to experience the end of life together, in the comfort and security of home or a home-like setting. Hospice uses the combined knowledge and skills of an interdisciplinary team of professionals, including physicians nurses, home care aides, social workers, spiritual caregivers, counselors, and volunteers. Hospice care is a cost-effective alternative to services provided in hospitals, nursing homes, and other institutional settings. Hospice is the preferred choice of health care delivery for the terminally ill and their families.
What services are provided?
Medicare-certified hospices are required to provide nursing care; social services; physician services; counseling services (including spiritual and dietary); home care aide and homemaker services; bereavement services; physical and occupational therapies; and speech-language pathology service. Short-term, in-patient (for respite, pain control, and symptom management), continuous care in the home, and medical equipment and supplies (including drugs and biologicals) are also available. Additional services can be offered. Therefore, the range of hospice services may vary from program to program. Care is structured to keep families together in the least restrictive environment possible.
Who is eligible?
A person is eligible for hospice under the Medicare Hospice Benefit once he or she is certified by a physician as having a terminal illness with a life expectancy of six months or less. Hospice is available to all terminally ill individuals and their families regardless of their age, gender, race, nationality, creed, sexual orientation, physical condition, availability of primary caregiver, or ability to pay. Although nearly 59% of the patients who were admitted to hospice agencies in 1994 had conditions related to cancer, other frequent admission diagnoses include heart and lung disease, AIDS, and neurological disorders.
Who pays for hospice care?
Hospice services are covered by Medicare, the Medicaid programs of 41 states and the District of Columbia, and most private insurance and managed care plans. In addition, military personnel and their dependents can receive hospice under the Civilian Health and Medical Program of the Uniformed Services (CHAMPUS). Hospices heavily rely on grants and community support to fund services for patients with little or no insurance.
The patient's care team consists of visiting team members who provide care to the patient and family. The patient is considered to be the center of the team, and there is always a doctor who oversees the medical aspects of care. The other visiting team members are the nurses, a home health aide, a social worker, a spiritual care provider and volunteers.
Primary caregiver refers to someone who will be available for the patient. This may be family, friends, or a paid caregiver. The caregiver is a part of the team. He/she will receive support services according to needs. He/she may also be included in discussions related to the patient's care.
Primary Care Physician
The primary care physician is the first person we call with any medical concerns. The doctor may visit in the home or refer to other community resources for help with care. The Hospice Home Care medical director can also visit the patient and family and is available for consultation with the primary care physician. The role of the Hospice Medial Director is as follows:
- Oversees all Hospice Home Care medical services
- Certifies patient medical eligibility for hospice care
- Assists in developing the Plan of Care
- Serves as a liaison with the primary care physician
- Provides direct medical care as needed to patients in their homes, nursing homes, and hospitals
- Authorizes inpatient care for Hospice Home Care patients
- Is available for medical education of physicians and nurses in pain and symptom management
- Is on call 24 hours a day for medical consultations
Primary Care Nurses
The primary care nurse will coordinate care in the home. This nurse may give nursing care, teach patient care and health, request other services, arrange supplies and home aides, and provide support to the patient and family. Nursing services include:
- Problem-based treatment using Palliation Protocols
- Primary liaison with attending physician
- Pain management
- Regularly scheduled visits
- 24-hour on-call availability
- Arranging for medical equipment and supplies
- Patient and family education
- Extended hours of care in the home during acute crisis
- Support and preparation for death
Home Health Aides
The home health aide is the person who helps in the home with specific tasks determined by the primary care nurse. These tasks include:
- Regularly scheduled visits
- Personal hygiene assistance
- Light housekeeping
- Meal preparation
- Respite for family
The social worker can assist with concerns or problems that are not medical in nature. Some of the ways in which a social worker may help include addressing family problems, resolving unfinished business, planning options or care, preparation for death, communicating with other care team members, and estate planning.
Spiritual care is coordinated in each office area by chaplains who are available upon request to support and encourage both patients and families as they deal with issues around life and death. The chaplains work with patients of all faiths, including those with no religious affiliation. In addition, chaplains are ready to serve as resource and liaisons to patients' choice of a particular faith community.
Volunteers are an important part of the hospice team. They are caring people, from all walks of life, who bring special talents and skills to their volunteer work. All are trained for the tasks and roles they assume within Hospice Home Care.
In each office area, HHC chaplains coordinate bereavement support for families after the death of a loved one. These bereavement services are offered to each family for thirteen months. Bereavement support includes assisting with funerals or funeral arrangements; grief cards; packet of grief educational materials; phone calls of support; individual grief counseling if so desired; grief group support; and scheduled memorial services. All of our efforts are to provide a friendly environment for extra support during the grieving and healing process.
|what can i do to help?
Volunteers are used for patient companionship. Sometimes this will be visiting, reading, or just sharing radio and television time. Sometimes our volunteers spend time with patients to give their caregivers a much-needed break, or time that they need for errands such as grocery-shopping or medicine pick-ups.
Volunteer time is not limited to direct patient care. There are some volunteers who work in the Hospice office and some who just work for special events and activities. Our memorial services are held one to two times a year, usually in the spring and at Christmas, for the families who have recently lost loved ones. Volunteers also help with phone calls, set-up and clean up for these events, besides participating in them. Some volunteers are active participants in our grief support groups, designed to help families and caregivers deal with the loss of a loved one.
Our volunteers are given ongoing training and supervision to help them in doing their jobs. They are given interviews and background checks before they are assigned to patients. An annual tuberculosis skin test is required of our volunteers, also. This requirement is mandated by the state of Arkansas.
There are many ways to help Hospice Home Care patients and caregivers. We would love to put you to work wherever you feel most comfortable. The extras that our volunteers can provide just by being there really do make a difference to our patients and caregivers.
For more information on how you can help, contact the volunteer coordinator at: