Hospice Care How much do people know about hospice care and what is involved in it? We research just about every big decision that affects our lives right now. For example we may research what career is best for us and our family, what kind of car best fits our financial needs, what kind of mortgage can we afford over a long period, and more important how is the neighborhood. Research is even conducted on something as small as what is the latest and greatest phone on the market. We spend hours or some times days researching these decisions, but how much time do we spend looking into the last days of our lives? If the average American is like me, they have not done any research about hospice care. My knowledge of hospice care was very limited by personal experience with both of my grandparents. Several years ago both of my grandparents were suffering from terminal illnesses and were placed in a hospice in Los Angeles with only a few months to live. I recall going to visit both of them and remember how poor the facility was. Just like with almost anything involving medical care, you get what you pay for. Neither one of my grandparents were financially at the top of the health care ladder and were both on Medicare like most Americans in their demographic. Hospice care was first established in the United States in 1970 and has become a growing industry since. (Hospice care in the United States, 2011) By 1995, hospices were a $2.8 billion industry with $1.9 billion from Medicare and Medicaid alone. (Hospice care in the United States, 2011) Hospice care is more than just a billion dollar industry, and it is more than just a place where someone is sent to die. A patient is eligible to enter hospice care if a doctor has determined that they have a terminal illness and death can be expected within six months or less if the illness follows its normal course. However, a patient may stay in hospice care beyond six months if the doctor and hospice team certify that life expectancy is still going to be short. Before providing care, the hospice staff will meet with the patient’s personal physician and discuss patient history, current physical symptoms, and life expectancy. Hospice care is a special concept of care designed to provide comfort, and more important support. The hospice team provides support not only to the patient but also to the families as well when a life limiting illness no longer responds to cure-oriented treatments. A hospice team typically includes a doctor, nurse, social worker, counselor, chaplain, home health aide, and trained volunteers. They work together to meet the patient’s needs and support his or her families physically and emotionally through the dying phase of one’s life. Hospices help meet the emotional, spiritual, and psychological needs of the patients and family members it serves by providing support and therapeutic services, and exploring spiritual concerns and questions. Hospice care addresses the symptoms of a disease with a special emphasis on controlling a patient’s pain and discomfort. Some hospices may even offer a variety of bereavement and counseling services to families before and after a patient’s death for up to one year. Looking further into hospice care one can quickly realize this is more important than a 401K plan. In 2008 1.45 million Americans received services from a hospice, and nearly one million of them died under the care of a hospice. (Hospice Foundation, n.d.) Hospice care is not for everyone, but when hospice care has become an option there are some important facts to consider. Hospice care may extend life compared to patients with a terminal illness and not in hospice care. Hospice care is not designed to meet the needs of only the elderly; it also serves adults under the age of 65, and in many cases children in the end stages of renal diseases. Only 80% of hospice patients in the United States are over the age of 65. (Hospice Foundation, n.d.) Adults and children may enter a hospice for a variety of conditions such as AIDS, cancer, end stage heart and lung disease, stroke, death inducing trauma such as an automobile accident, or any diagnosis considered to be a terminal illness with a life expectancy of six months or less. Today there are more than 4,700 hospice programs in the United States and 80% of them provide care in the patient’s home or in a family member’s home. (Hospice Foundation, n.d.) This service is covered by Medicare or Medicaid and can be helpful for those that wish to die in their own homes and not in a hospital. This information would have been particularly useful for both of my grandparents, as both of them had requested to die in the comfort of their own homes. Care may also be provided in a designated facility such as a nursing home, hospital unit, or a free standing hospice. The level of care a patient receives and the location in which it is administered is based upon frequent evaluations of the patient’s needs. Four levels of care available from hospice are routine home care, continual care, general inpatient, and respite care. (Hospice Foundation, n.d.) The costs of hospice care may be met by health insurance providers including Medicare or Medicaid for eligible Americans. Hospice services are also covered for active duty service members, veterans, and for military families covered by Tricare. Hospice is covered 100% with no co-payment or deductible by Medicare but a co-payment may be required by commercial health insurance providers, depending on individual insurance plans. The research on hospice care has opened my eyes to the reality of hospice care and what I may need to take into consideration if I am ever in need of these types of services. The need for hospice care is something that most American families will need, whether it is for themselves, a spouse, or a parent, as I have discovered recently with my father. My father is in need of a kidney transplant, and without this transplant he will not live much longer and will be in need of hospice care. The information I have discovered has been helpful in bringing to the attention of me and my family members the different hospice services available and what to expect should my father need these services in the near future.
References
Hospice Foundation. (n.d.). What is Hospice. Retrieved from http://www.hospicefoudation.org/pages/page.asp?page_id=47055
Hospice care in the United States. (2011, September 12). Retrieved from http://en.wikipedia.org/wiki/Hospice_care_in_the_United_States