Your family doctor and your neighbor have both suggested you call hospice for your ill loved one but you continue to be reluctant. You fear that accepting hospice is "giving up" and that your loved one will no longer receive state of the art medical care. This article will help you to sort through many of your spoken and unspoken concerns about hospice care.
1. Isn't hospice a place where people go? No, hospice is a service, not a place. Hospice brings care into your own home, be it a private residence, an assisted living facility or a nursing home. Most people want to and can stay at home but if your care becomes too complex to manage at home, hospices also provide short term inpatient care to control symptoms in a hospice unit, a hospital or a skilled nursing facility.
2. What does hospice provide? Hospice provides a lot of professional services. Hospices are mandated to provide both routine and after hours nursing visits. This means that the nurse will visit regularly, assess for changes and arrange for medicines and medical supplies as they are needed. She/he will put emergency medications and oxygen in your home in advance of a crisis. The nurse will spend a great deal of time answering your questions and preparing you for what comes next. Where in the past, you brought your ill loved one to the doctor's office or to the emergency room, now the services will come to you. Should you need help or direction on a Saturday or Sunday, a nurse will visit. You are no longer alone; help is just a phone call away. Other services that the hospice provides include an aide to help with bathing, counselors to help meet emotional needs and volunteers. Some hospices provide physician visits. Some hospices even provide music therapy, massage therapy, aroma therapy, pet therapy and art therapy.
3. When do you qualify for hospice care? Unfortunately most people get hospice care too late, in the final days or weeks of life. They qualify for it as much as six months earlier. Getting hospice care earlier reduces the family's stress, avoids burnout and guarantees an improved quality of life. It keeps the patient well, which allows for special moments and memories to be shared. It affords both you and your loved one the opportunity to say "thank you" and "good bye."
4. Don't most people die at home? While is true that 90% of Americans want to die at home, in actuality, very few do. Currently, 75-80% of Americans die in facilities (hospitals and nursing homes) and less than 25% of them die at home. In contrast, hospice patients almost always get their wish to die at home as their families are well prepared and supported to care for them at home. Hospice patients rarely die in the hospital.
5. Can hospice patients die in a hospital? Of course. If they choose to die in the hospital, the patient will need to be discharged from the hospice, a simple matter of signing a paper.
6. Will entering a hospice make you die sooner? There is a great deal of unfounded concern about the use of medications like Morphine and the fear that its use will shorten life. There are several studies that show that Morphine eases pain but does not shorten life even in the most debilitated and ill patients. Another unfounded fear is that someone will die sooner if they find out that they are terminally ill. Family members sometimes insist that no one mention the word "hospice" to their loved one out of fear that their loved one will give up on life. The reality is, being ill and in failing health is a lonely experience. Most patients know on some level how ill they are. Many want to talk about it and put plans in place. Sometimes they don't bring it up because they see how painful it is for you and they are trying to protect you. This conspiracy of silence robs both parties of opportunities. Many patients want to ask questions about what will happen to them. They look for reassurance that their symptoms will be controlled and that they will remain in control and comfortable. You also may want to ask them questions. Questions about their funeral and how they want issues handled after their death.
7. Do patients admitted to hospice ever improve? Yes, some patients admitted to hospice actually improve and in time, they are discharged from hospice. This makes sense that when you improve someone's pain and ease their loneliness, they will eat and sleep better and regain some health.
8. Will hospice make me give up treatments that are currently benefiting me? You don't have to give up treatments or medications that are benefiting you. The hospice focus is on quality of life. Medications that promote quality of life are usually covered by the hospice. If you find a new treatment that may prolong your life (but not improve your quality of life), you can sign off the hospice benefit and return at a later date.
9. Is hospice care expensive? Hospice care is covered by most insurance. Medicare and most Medicaid insurances cover hospice care at 100%. Many private insurances have modeled themselves after these federal and state programs and also cover hospice care at 100%.
10. Hospice care is a necessary service that many people never receive.
Sometimes it is never offered and other times, the patient or family is reluctant to accept hospice care. Most families who did receive hospice care say that they could have benefited from hospice much earlier. Ask you doctor about hospice care. If your doctor is not sure that you qualify, most hospices will send a nurse to the home to evaluate your appropriateness for hospice. Don't allow your fear to prevent you from getting the help that you need.
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