At any time during a life-limiting illness it is appropriate to discuss all of a patient’s care options, including hospice care. By law the decision belongs to the patient. Understandably, many people are uncomfortable with the idea of stopping aggressive efforts toward curing their disease. Hospice of the Shoals staff members are very sensitive to these concerns and always available to discuss them with the patient and family.
The patient and family should feel free to discuss the concept of hospice care at any time with their physician, other health care professionals, clergy, or friends.
Most physicians are well acquainted with hospice care in general and Hospice of the Shoals specifically. If you find that is not the case feel free to encourage your physician to contact Hospice of the Shoals at 256-767-6699 and one of our staff members will be happy to provide him with all the information he needs. Other information sources include, the National Council of Hospice Professionals Physician Section, the National Hospice Helpline (800-658-8898), the American Cancer Society, AARP, and the Social Security Administration.
Certainly. If the patient’s condition improves and the disease seems to be in remission, patients can be discharged from hospice and return to aggressive therapy or go on about their daily life. If the discharged patient should later need to return to hospice care, Medicare and most private insurance will allow additional coverage for this purpose.
First an admitting nurse will contact the patient’s physician (if, of course, the physician is not the one making the initial contact) to make sure they agree that hospice care is appropriate for the patient at this time. Following this, an evaluation assessment will be completed. The patient will then be asked to sign consent and insurance forms similar to those they would sign when being admitted to a hospital.
The clinical staff at Hospice of the Shoals will assess your needs, recommend any equipment, and help make arrangements to obtain all necessary equipment. They will also assist in making the home as convenient and safe as possible.
It varies. A “Plan of Care” specific to the individual patient will be prepared by staff members along with the patient and their family upon admission. This plan will address, among other things, the amount of caregiving needed by the patient. Members of the nursing staff will visit regularly and are always available to answer questions, provide support, and educate caregivers. Home-health aides, volunteers, and a chaplain are available as needed according to the family’s preference.
In the early stages, usually not. However, one of many patient’s most common fears is dying alone. Therefore, we generally recommend that someone be there continuously. While family and friends most often provide the bulk of the care, we do have volunteers available to assist with errands and provide a break for a primary caregiver to have some time away.
At Hospice of the Shoals patients are cared for by a team of physicians, registered nurses, social workers, home health aides, a full-time chaplain, and a team of volunteers each providing assistance based on their own area of expertise. Medications, supplies, equipment, and hospital services related to the terminal illness are also provided.
No! We are simply available, when a patient decides to cease with aggressive curative treatments, go home, and be in their own comfortable environment, to help make them comfortable in that environment. We focus on quality-of-life instead of quantity-of-life.
No. Although 90% of hospice patient time is spent in a personal residence, some patients live in nursing homes or assisted living facilities.
At Hospice of the Shoals, our clinical staff is completely up to date on the latest medications, devices, and procedures designed to aid in pain and symptom relief. Our success rate in battling pain is very high. Most patients are able to attain a level of comfort that is acceptable to them and their loved ones. We also pride ourselves in treating the person as a whole. If ordered by a physician, physical and occupational therapists are available to help patients be as mobile and self suffcient as they are able and music therapy as well as nutritional and spiritual counseling are also available dependent upon patient preference.
No. We are an independent not-for-profit agency. We are, however, spiritually-based. Thus, we believe that physical death is not so much an end as it is a transition. Our goal is to help terminally-ill patients make that transition in as comfortable a manner as possible. We certainly do not require that our patients adhere to any particular set of beliefs.
Hospice coverage is provided nationwide by Medicare, by Medicaid in Alabama, and by most insurance providers.
Medicare and Medicaid cover all services and supplies related to a patient’s temminal illness. Some hospice care providers will require a patient to pay a co-payment for medications and respite care. Hospice of the Shoals never requires such payments.
Hospice of the Shoals is able to provide care for terminally-ill patients regardless of their ability to pay using money raised through community efforts as well as memorial gifts.
Bereavement counseling is available to family members for thirteen months after the patient’s life is completed if desired. Hospice of the Shoals also memorializes our patients twice annually with a “Service of Remembrance” ceremony to which all family members and friends are invited.
Hospice is a special way of caring for people who are terminally ill.
- The goal of hospice care is to provide care for people who are terminally ill by managing their pain and other symptoms.
- People of all ages who are terminally ill can receive hospice care during the final months of life. Such care includes not only medical care, but also psychological, soci al, spiritual, and bereavement services.
- In addition, the family of a hospice patient benefits from the education they receive regarding caregiving as well as counseling services designed to help them with their spiritual and social needs. At the same time, the provision of medical equipment and medicines helps ease the family’s financial burden.
A patient is eligible for hospice care if they meet the following conditions:
- Their doctor and the hospice medical director certify that they are terminally ill and have six months or less to live if the illness runs its normal course.
- They sign a statement choosing hospice care instead of other Medicare-covered benefits to treat the terminal illness.
Medicare, Medicaid, and private insurance will still pa y for covered benefits for any health problems that aren’t related to the terminal illness.
Once it is determined that a patient qualifies for hospice care, a specially trained medical team and support staff is
available to help them and their family cope with the terminal illness.
The patient’s doctor and the hospice medical team work together with the patient and their family to set up a pl
an of care that meets the patient’s specific needs. “Comfort care” measures are employed to help make the patient’s last months of life more peaceful. Comfort care focuses on symptom control and pain relief with the goal of increasing the quality of life for the patient and the family.
Nursing care, home health aide services, equipment, and supplies are all provided to make the patient as comforta
ble and pain free as possible. Social and spiritual counseling are also part of the hospice plan of care.
- The Primary Physician….most often the patient’s family doctor. It could also be the medical director of the hospice organization or the patient’s oncologist, cardiologist, or other specialist. In the case of a nursing home resident, it might be the medical director of the nursing home.
- The Hospice Medical Director…. a physician who works under contract with the hospice agency to oversee medical operations. This person may also manage individual cases at the patient’s or primary physician’s request.
- Nurses…. work within the hospice agency. There will usually be a particular nurse assigned to an individual patient who will visit the patient in their place of residence 2 to 5 times a week as is needed. In addition there are “on-call’ nurses available to the patient 24 hours a day/7 days a week.
- Home Health Aides….also referred to as Certified Nursing Assistants (CNA’s). Their job is to provide for the physical and hygenic needs of the patient including baths, linen changes, etc….They also normally visit the patient 2 to 5 times a week as is needed.
- Chaplain…. available to discuss and resolve spiritual matters according to individual needs and desires. The Chaplain is also normally involved in tending to the bereavement needs of the family after the completion of the patient’s life.
- Social Workers….accessible to the patient and family to help them cope with the emotional and psychosocial matters that are so often magnified during a loved one’s illness. A social worker might also aid in directing families to other agencies and institutions that would be of benefit to their particular needs.
- Therapists….normally work under contract with the hospice ageny. Physical, speech, and occupational therapies are all available as required by an individual patient’s needs.
- Volunteers….able to help with such things as running small errands, preparing meals, or providing short sitting services for the patient and family.
Hospice benefits provide these hospice services for a patient’s terminal illness and related conditions:
- Physician services
- Nursing care
- Medical equipment (such as wheelchairs or walkers)
- Medical supplies (such as bandages and catheters)
- Drugs for symptom control and pain relief
- Home health aide services
- Physical and occupational therapy
- Speech therapy
- Social worker services
- Dietary counseling
- Bereavement counseling for the patient and their family
- Short-term inpatient care
- Short-term respite care
- Any other covered services needed to manage pain and control symptoms, as recommended by the hospice team.
- When hospice care is chosen, the following items are normally no longer covered:
- Treatment intended to cure the terminal illness – A patient should consult with their doctor if they are considering getting treatment to cure their illness. Any hospice patient always has the right to stop getting hospice care at any time and receive the coverage they had before they began receiving hospice care.
- Prescription drugs intended to cure the terminal illness – Only the drugs used to provide symptom control and pain relief are covered. If a patient is enrolled in prescription drug coverage, however, drugs unrelated to the terminal
illness normally remain covered.
- Room and board – Room and board aren’t covered if the patient is receiving hospice care in a nursing home unless the nursing home stay is related to short-term inpatient or respite services that the hospice medical team determines are needed.
- Other – The following services are not covered unless they have been arranged in advance by the hospice medical team:
- Emergency room care
- Care in an inpatient facility
- Ambulance transportation
A patient can continue to use their benefit plan to receive care for any health problems that aren’t related to their te
rminal illness. They can also still use their own doctor for this care.
A patient can benefit from hospice care as long as their doctor and the hospice medical director certify that they are terminally ill and probably have six months or less to live if the disease runs its normal course. Even if they live longer than six months, they can still receive hospice care, as long as the hospice medical director recertifies that they are still terminally ill.
If a patient’s health improves or if their illness goes into remission, they may no longer need hospice care. Also, any patient always has the right to stop getting hospice care for any reason. If a patient decides to stop their hospice care, they normally may return to the type of coverage that they had before they chose a hospice program. If they are eligible, they can begin receiving hospice care again at any time.
While in hospice care, a patient may have one person who takes care of them every day, such as a family member. Sometimes this person needs someone to take care of the patient for a short time when he or she needs a break from
caregiving. Respite care is care given to a hospice patient by another caregiver such as a nursing home or other inpatient facility so that the primary caregiver(s) can rest.