When considering hospice care for your loved one, you want to be sure it’s the best type of care for them. Several factors will affect your decision. You need to understand the type of care and what benefits your loved one will get under this care. Additionally, you will have to assess your loved one’s finances and find out if they have the means to afford hospice care.
The number of Americans seeking hospice care is rising in proportion to the increase in seniors over 65. A National Hospice and Palliative Care Organization study shows that in 2021, over 1.6 million Americans enrolled for hospice care under Medicare health coverage.
Studies show that most patients are open to the idea of hospice care as they come to terms with their terminal illness and view it as an option for their end-of-life care. When your loved one is under hospice care, the quality of their lives will improve, and they will spend their last days in comfort, reduced pain, and with their family.
History and Evolution of Hospice Services
Hospice care has existed since the 11th century and was linked to the word “hospitality” for the sick, wounded, or dying. This practice continued but got more relevance when Dame Cicely Saunders, a British registered nurse who pursued medical social work as a career in 1957, stressed the need for terminally ill patients to be as pain-free as possible. Saunders also experimented with different pain regimens and visited the United States in 1963.
During her tour, she met Florence Ward, a dean at the School of Nursing at Yale who was interested in Saunder’s work. In 1967, when Saunders opened St. Christopher Hospital in London, Ward visited her and later brought most of Saunder’s principles on hospice care to the U.S.
Ward established the first hospice program in the U.S. in 1971 — Hospice Inc. The hospice movement picked up momentum after this. There are currently over 8,000 hospice care programs in the U.S. only.
Understanding Hospice Care
Hospice provides comprehensive care to both patients and their families. It’s crucial to discuss hospice care with your loved one before consulting with their healthcare provider. Doing this ensures your loved one feels in control of their lives until the last minute.
Seeking hospice care early on is advantageous as it focuses on patients and their families. The hospice care team uses a holistic approach, ensuring that the patient’s physical, emotional, psychological, and spiritual needs are addressed.
When it comes to terminal illness, sometimes a patient may get their diagnosis late; by this time, the disease may have advanced to a stage where curative treatment is no longer an option. At other times, your loved ones’ doctor may give them less than six months to live due to the natural progression of their illness.
With hospice care, you and your loved one will come to terms with the fact that you have limited time together, and you can spend this time ensuring you listen to your loved one, create new memories, and honor their wishes.
Critical Principles of Hospice Care
Hospice care uses a unique approach that mainly focuses on patients’ comfort. The hospice care team will provide comprehensive and compassionate care and support to you and your loved one during this challenging time. Hospice care encourages a different way of thinking that emphasizes your loved one’s overall well-being.
Hospice care addresses all aspects of a patient’s care. It’s like a puzzle, allowing a team of professionally trained individuals to address each of your loved one’s needs during the last stages of their illness.
To better understand hospice care, imagine crafting a quilt that will provide comfort and warmth to your loved ones when they need it. Each stitch in this quilt represents a different type of care, but will provide the care, comfort, and warmth required when you stitch them together.
Principles of hospice care include:
- Patient-focused care
- Symptom management
- Pain relief
- Emotional, mental, and spiritual support
- Bereavement support
- Interdisciplinary team approach
Benefits of Hospice Care for Terminally Ill Patients and Their Families
Some of hospice care benefits include the following:
- Access to medical equipment and supplies
- Skilled nursing care
- Home healthcare aides
- Visits from social workers and chaplain
- Respite care for the family caregiver
- Pain relief medication
Hospice Services and Programs in the U.S.
There comes a point in a patient’s journey when they fail to respond to curative treatments or when they realize that the side effects of these treatment options far outweigh their benefits. When this time comes, your loved one may choose to opt out of these curative treatments and have a hospice care team.
Eligibility Criteria for Hospice Care
Your loved one must meet the following criteria to be eligible for hospice care programs:
- A prognosis from their doctor gives them six or fewer months to live if their illness runs its natural course.
- A certified prognosis from their doctor and signed by a hospice director
- A patient’s or their family’s desire to seek hospice care rather than curative treatment
The Role of Hospice Care Teams
The hospice care team is made up of a multidisciplinary team of healthcare professionals and volunteers. Here’s how they work, and what to expect from each member.
How Does a Hospice Care Team Work?
When your loved one enrolls in a hospice program, they will be cared for by highly trained personnel. These professionals play a crucial role in providing different types of care, including medical, spiritual, emotional, and bereavement support.
The hospice care team usually works collaboratively with you and your loved one. This collaboration ensures your loved one receives the care they need and prefer.
Different Professionals Involved in Hospice Care Teams
When considering hospice care for a loved one, understanding each team member’s role is crucial for success. In most cases, a hospice team consists of the following members:
Physicians
A physician plays a critical role in a patient’s hospice care as they provide you with relevant hospice information and will also explain what to expect when your loved one is under hospice care.
A Hospice Medical Director
A medical director provides oversight and support for the hospice care team. The hospice care director coordinates your loved one’s care, establishes care goals, and creates a care plan to help achieve these goals.
Registered Nurses
A registered nurse on a hospice care team coordinates the hospice care plan with the physician and hospice medical director by providing ongoing assessments and implementing the care plan. You will find a nurse visiting your loved one several times a week or as often as needed.
Social Workers
Social workers provide a psychosocial assessment that targets your loved one’s emotional, spiritual, and social aspects of their lives. A social worker will usually visit your loved one monthly or, in some instances, twice a month. During their visit, they will provide your loved one with emotional support and ensure your loved one’s psychosocial needs are met.
A social worker can also provide relevant resources and information on your loved one’s illness and counsel you and your family during crises.
Chaplain
A chaplain provides spiritual support to you and your loved one. A chaplain might visit once or twice a month, but these visits may increase if you or your loved one request them. A chaplain’s role in a hospice care team is to provide spiritual care.
Bereavement Counselor
A bereavement counselor helps you and your loved one deal with the grief that accompanies the knowledge that they don’t have long to be with you. Knowing and accepting your loved one’s imminent death can take a toll on you. You will need the help of a bereavement counselor to help you deal with anticipatory grief. Your loved one will need to accept their situation, and with this, they may get closure and ensure their loved ones are at peace with their passing. A bereavement counselor will help you and your family deal with your grief up to a year after the death of your loved one.
Home Health Aide
This professional plays a crucial role in a hospice care team. They can help your loved one with light housekeeping and personal care. If you have any questions about hospice care, this is the go-to person, and they will teach you the safe and correct methods of helping your loved one.
Volunteer
A volunteer’s role is to provide companionship to you and your loved one. To join a hospice care team, a volunteer must attend a hospice care volunteer training program.
How Hospice Teams Work Together to Ensure The Best Care for Patients
For a hospice team to work smoothly, the members must promote trust among themselves. Another aspect is collaboration, allowing different members to express their views comfortably. The success of a hospice team hinges on open communication, sharing of insights, expressing different opinions without prejudice, and being able to ask questions.
Regular meetings among the members allow the team to collaborate better and help foster unity and a sense of shared purpose.
Accessing Hospice Care and Payment Options
You don’t have to worry about paying for your loved one’s care, as there are several ways you can pay for end-of-care services.
The following are some of the hospice program payment options. You can choose one that fits your loved one’s specific situation.
Medicare
The federal government usually administers this type of coverage, and the rules are the same throughout the states in the U.S. This makes the coverage available to almost all Americans. It is one of the best ways to pay for hospice care if your loved one has Medicare coverage.
In most cases, Medicare will cover 100% of your loved one’s hospice care when they use a Medicare-approved hospice care provider. Luckily, over 90% of hospice care providers are certified by Medicare, increasing the chances of your loved one being under a Medicare hospice provider.
Benefits of being in a Medicare-approved Hospice Provider
If your loved one qualifies for hospice care, Medicare will ensure they reap the following benefits:
- Pain-relief services
- Symptoms management services
- Nursing and other medical services
- Social care services
- Medical supplies like bandages and catheters
- Healthcare aides services
- Respite care for family caregivers
- Occupational therapy
- Physical and speech therapy
- Short-term inpatient care
- Spiritual care
- Grief counseling for the patient and family
- Additional care
When it comes to Medicare, you need to understand that the coverage doesn’t cover for:
- Curative treatment and prescriptions
- Accommodation (room and board services)
- Services rendered by another hospice care team. Medicare only covers one hospice care team.
- Ambulance services (that are not arranged by a patient’s hospice care team)
- Outpatient and inpatient care that is not related to your loved one’s terminal illness or not arranged by the hospice care team.
Medicaid
Federal and state governments fund this coverage. Medicaid eligibility differs from state to state, significantly affecting your loved one’s eligibility for coverage.
Another thing to consider is that if your loved one decides to move to a different state to be closer to family and friends, they will have to reapply for Medicaid coverage in the new state.
Medicaid is generally ideal for:
- People with low-income
- Seniors
- People living with disabilities
Medicaid Health Coverage Benefits
- Counseling services
- Nursing services
- Pain-relief medications
- Symptom management medications
- Physical, speech, and occupational therapy
- Medical supplies
Contact your state’s Medicaid agency to determine your loved one’s coverage eligibility.
Keep in mind that your loved one can have both Medicare and Medicaid coverage and use the benefits one covers to offset for what the other doesn’t cover.
Private Insurance
If your loved one is not eligible for Medicaid or Medicare; you don’t have to worry, when they have work-based private insurance. You can contact their insurance provider and determine if their insurance plan can cover their hospice care.
Although most private insurance providers have different plans, most will at least cover some hospice care services.
Veterans’ Benefit
If your loved one is a veteran and enrolled in the VA Standard Medical Package, All you have to ensure is that your loved one is eligible for hospice care. The best part about this type of coverage is that your loved one’s age doesn’t matter.
Veterans benefit covers the following hospice services:
- Medical supplies
- Pain relief medication
- Symptom management medications
- Spiritual care
- Volunteers with military experience when needed
- There will be no co-pay for hospice care
- Physical, speech, and occupational therapy
- Grief counseling.
Reduced Rates
If your loved one is uninsured or their available insurance plan doesn’t cover hospice care, you can ask the hospice provider if they offer hospice care at reduced rates.
You can also research hospice facilities that offer reduced rates or free care to patients who can’t cannot afford it.
End-of-Life Care and Support
Seeking end-of-life care is one way to ensure your loved one receives the care and support they require during the last stages of their illness. This type of care enables your loved one to retain their dignity until the end.
Ask your loved one about their wishes and preferences and help them realize them. During this stage, supporting your ailing loved one and letting them express their wishes and desires is essential. Listen to them and honor their wishes if they want to die in the comfort of their home or the hospice care facility.
Conclusion
Deciding to have your loved one in hospice can be one of the hardest decisions you can make as a family. However, hospice care gives you peace of mind, knowing your loved one is as comfortable as possible.
Take this time hospice offers to create new memories with your loved one that will accompany you after they are gone, find closure, and say your goodbyes.
At Amy’s Ede Senior Care, we know and understand your desire to spend every waking moment with your loved one during this time. We provide compassionate end-of-life care that allows address the physical, emotional, and spiritual needs of you and your beloved senior.
If you have any questions regarding our services, do not hesitate to reach out to us to learn more. We can’t wait to be your ally during this time.
