Hospice is a philosophy of compassionate and comprehensive care for dying persons and their families that addresses the medical, psychosocial, spiritual and practical needs of the individual and the related needs of the family and loved ones throughout the periods of illness and bereavement. Hospice is a good choice when curative treatment is no longer effective or no longer wanted and when life expectancy is measured in months or weeks.
Palliative care focuses on comfort, but prolonging life may be part of the goal. It’s provided by hospice and palliative care teams of doctors, nurses, social workers, and other counselors. Palliative care is provided most often in hospitals but moving into homes, nursing homes, and other settings.
Hospice services can be provided to a terminally ill person wherever they live. While home is the most common and the preferred place for many patients, it is not always possible or even desirable for all hospice patients. Individual patient, family and caregiver needs determine the location for delivery of hospice care. Patients can receive the services of the hospice team at home, in a nursing facility, an inpatient residential hospice, a long-term care or other residential facility.
Hospice works with the patient’s physician providing care under a plan of treatment designed by the team in conjunction with the patient and the family. Services include:
Hospice care is covered by Medicare, the Oregon Health Plan and private insurance. Through Medicare and most insurance plans, the hospice program manages the total care and costs of treating the terminal illness. Medical services, outpatient drugs and biologicals, counseling and bereavement and attending physician or Nurse Practitioner services are paid for by the hospice provider.
Patients may be asked to meet co-pay or other uncovered costs. However, no one will ever be turned down for financial reasons.
There is no limit under Medicare, and the physician and hospice program medical director will periodically re-certify that patient has a life expectancy of six months or less, if disease follows its normal course.
Sometimes patients get better while on hospice care, or they wish to resume curative measures in their care. Hospice patients also have a “right” to stop anytime and resume their regular Medicare benefit.
Most patients admitted to a hospice program are referred by their physicians. Others come themselves or are referred by the hospital, a community agency, or by a friend or relative. Family members may request counseling even if the patient does not wish to be admitted to the program.
Sometimes doctors wait for their patients to bring up the subject of hospice care, while patients assume their doctor will tell them when they need hospice care. Doctors are afraid to talk about dying, too! Also, some patients demand more treatment, not realizing treatment options may no longer be effective.
Patients are more likely to have futile treatment and more likely to have unrelieved pain. Patients and their families are likely to suffer unnecessary crisis.
Post Office Box 592 • Marylhurst, Oregon 97036 • Telephone 503.228.2104
Made in Portland, Oregon for Oregon Hospice Association, Inc. © 2016
Created by Common Good Communication