Is Hospice the Right Choice?

The decision to stop medications and treatments geared for curing illness is a tough decision to make for patients and families when faced with a terminal illness, but the comprehensive care one receives on hospice is truly beneficial and can be the road to a positive and peaceful end-of-life experience.

Hospice care is provided for people whom a physician certifies as having a terminal illness with a life expectancy of 6 months or less. The philosophy of hospice care is to help patients facilitate a good quality of life that is filled with dignity while dying. The goal of hospice is to manage symptoms associated with terminal illness so that the patient may spend their final days comfortable, in peace, and surrounded by loved ones. In addition, a hospice in a home setting makes it possible for patients and families to have a greater sense of control, which adds to the quality of life and dignity.

Hospice provides services that are coordinated amongst a multidisciplinary team which includes a physician, physician assistant, nurse practitioner, registered nurse, licensed vocational nurse, certified home hospice aide, medical social worker, spiritual counselor, and bereavement counselor. Hospice may also contract with therapies, such as physical or speech, if asked for in the plan of care, to meet the patient’s needs and goals. Some of the services provided by hospice includes (but is not limited to): managing pain and symptoms; providing medications, medical supplies, and equipment; providing emotional, psychosocial, and spiritual support for patients and their loved ones; offering continuous bedside care to manage distress or crisis; facilitating inpatient care or respite care if symptoms become too difficult to manage in a home setting; delivering therapies such as physical therapy or speech therapy if aligned with the goals of the plan of care; providing bereavement care and counseling to families for up to 13 months after their loved one has passed away; and the list goes on.

Once you have chosen to go for hospice care and your doctor has provided a hospice order, a hospice team member (almost always the intake coordinator) will coordinate with you and your family to begin the admission process. A registered nurse will then be assigned and be scheduled for an initial visit to obtain a comprehensive assessment of your medical, psychosocial, and spiritual needs.

During the comprehensive assessment, the registered nurse will do the following:

• Explain the hospice philosophy, present the informed consents/Election of Benefits, and guide you and your family to sign the consents packet. If the person who is being admitted is not able to make their own healthcare decisions, then a health care proxy will need to sign the consent.
• Review your medical history and perform a head-to-toe physical assessment
• Review your current medications. Only medications that are related to your hospice diagnosis are covered by hospice. Any other medications that are being taken that do not pertain to that diagnosis may either be covered by insurance or be paid for privately. A comfort kit will be prescribed which is a box containing standing order medications that are geared towards providing relief for common distressing symptoms, such as pain, anxiety, nausea/vomiting, fever, constipation, etc., and is only to be used AS NEEDED. The registered nurse will review medications with you and provide teaching. Hospice works with pharmacies to provide in-home delivery to make it as easy and convenient as possible for you and your loved ones.
• Determine which durable medical equipment, or DME, is required based on your needs. DME includes, but is not limited to hospital beds, wheelchairs, oxygen, lifts, etc. All of this is covered under the hospice benefit. In addition, if any of these equipment needs to be serviced or replaced, the hospice works with the vendor to dispatch technicians for same-day services, replacements, or deliveries. Equipment will be returned to the DME company following the discharge of the patient.

Once the comprehensive assessment is complete and the information is gathered, the registered nurse will formulate a plan of care and forward a report to an assigned case manager. This case manager will then delegate your needs to the interdisciplinary team based on the plan of care. The case manager is the assigned point-of-contact for you and your loved ones; they will be readily available to talk any time there is a question or concern, or even if you just need someone to talk to.

If you are interested in hospice care but want to get more information, please do not hesitate to call True Care Health Services at (855) 770-8783 to speak with the hospice team member. We are happy to help and want to make this time as easy for you as possible.