If your loved one is seriously ill, the mention of the word “hospice” can feel very threatening. The concept is, understandably, freighted with associations about death and dying. Some people fear that accepting hospice care means giving up and dying sooner.
But hospice involves much more than simply tending to the terminally ill. It’s a comprehensive approach to end-of-life support that emphasizes care over cure, improving quality of life for whatever time is left.
Although many people enter hospice care within the last few weeks or even days of life, when medical options have been exhausted, it can be beneficial to consider hospice care at an earlier stage, if your loved one meets certain criteria.
Hospice Care May Sometimes Prolong Life
To qualify for hospice care, which is covered under most insurance plans and Medicare and, in 43 states, Medicaid, the patient must have a progressive medical condition that is expected to end her life within six months.
However, none of us has a crystal ball. It’s critical to note that it is both quite possible and well-documented for individuals to stabilize with hospice care and even “graduate.” People with progressive diseases such as Parkinson’s or dementia may cycle in and out of hospice care as their health actually gets better.
A 2012 Duke University study of more than 24,000 hospice enrollees with dementia found that 5 percent were discharged from the service because their health stabilized or improved. Those who outlived their hospice stay were more likely to be women, younger than 85, who had been in hospice care for more than 180 days.
Hospice Offers Comfort, Compassion and a Peaceful Transition to Life’s End
There are many variations of hospice care, which can take place wherever the patient resides—in a nursing home, assisted living, private home or private hospice setting. A specialized team of physicians, nurses, social workers, aides and other healthcare professionals work together with the patient and family to ease pain, care for the individual’s daily needs and provide a comfortable, peaceful environment.
The patient and family agree to focus on comfort measures, rather than seeking any further medical interventions, such as trips to the Emergency Room or CPR.
When Choosing Hospice, Understand Your Options
Hospice benefits include medical supplies and durable equipment such as a hospital bed at home, pain management, specialized services such as physical therapy and nutrition counseling, home visits by registered or licensed practical nurses, home health aides, social work support and counseling, and spiritual counseling.
Coverage depends on the patient’s health insurance and where care is delivered. All services are typically covered; room and board depends on location. For example, if the patient is on Medicaid and lives in a nursing home, room and board for hospice care will be covered. However, if the individual is paying for nursing home care privately, she or her family will continue to be responsible for room and board while she is in hospice.
For those who are privately paying for nursing home care, it’s well worth considering a move to a private hospice setting, because the room and board fees may be less than in the nursing home. Families considering hospice care should check with their insurance company to determine the level of coverage and any restrictions.
Home hospice care can enable family members to play an important role in their loved one’s final stage of life, as well as enable the patient to be comforted by personal surroundings. Others may prefer a private hospice setting to give family members respite from care responsibilities and stress, freeing them to focus on relationships and quality time.
Ultimately, the choice to enroll in hospice care is a very personal one. No one can predict if your loved one’s life will be extended by additional medical treatment for what is ultimately a terminal illness. But many people enjoy a better quality of life in hospice for whatever days and months, and sometimes years, they have left.
President of Deborah Fins Associates, PC, since 1995, Deborah Liss Fins is a licensed independent clinical social worker and certified geriatric care manager. Drawing on more than 30 years of professional experience in geriatric care management, DFA offers comprehensive assessments and planning, guidance in selecting appropriate care, help identifying resources for financial support and professional consulting. Please contact us to set up a complimentary initial telephone consultation.