Wednesday, May 8, 2013

The Benefits of Hospice Care.

This subject has been coming up a lot lately in my counseling and the forums I'm a part of, so I thought I'd address it here. It's about hospice care.

 Unfortunately, people still don't know much about hospice care and the benefits it can provide a family dealing with a terminal illness.  Some still think it is connected in some way to euthanasia or 'mercy killing', which couldn't be further from the truth, or that families and doctors are giving up on the patient.  In fact, the truth is that people more often come too late to hospice, rather than too early.  Unfortunately, most people believe hospice is for the last few days of life, which doesn't allow the hospice team to really stabilize a patient.  Hospice care is designed to support the physical, emotional, and spiritual needs of both a patient and their family, promoting self-determination and awareness of what course an illness will take and what options are available.  It allows a patient to decide how they want to spend the end of their life and emphasizes dying at home with the involvement of friends and family.

Hospice care is not designed for those people who are still undertaking aggressive treatment or care for their illness, nor is it for people who can expect to live with their chronic illness for years.  Traditionally, hospice is recommended for those who have six months or less to live, and have decided not to pursue any further treatment options.  Hospice care is designed around palliative care, which focuses on making a patient as comfortable as possible through pain management, help with constipation and nausea, assistance with toileting and physical adjustment to prevent sores.  It is also designed around a family member or friend taking the main caregiver role, with hospice nurses and aides as support.  In general, families accepted to hospice agree to sign a Do Not Recussitate Order, refusing drastic life support measure such as CPR and artificial breathing. Although hospice is aimed at care in the home, many hospice programs are beginning to bring the hospice model and spirit of hospice care into nursing and other facilities.  Many cities also have residential hospice facilities.

The benefit of hospice care is that it can provide a patient and family essential care and support that they may otherwise not be able afford or receive.  The patient's primary physician must make the recommendation but anyone can initiate the discussion by calling the hospice organizations in their area or discussing it with the physicians.  When a patient is accepted into hospice care, an entire team of professionals begins to manage their care. The primary physician oversees the care; a social worker is available for help with benefits, dealing with creditors, and making legal and funeral arrangements; trained nurses and home health aides manage medications, toileting, and bathing; a chaplain is available for spiritual care; and volunteers are available for light chores, respite for family members, and companioning the patient.  The other benefit is that most hospice care is covered by Medicare and Medicaid.

Hospice care is truly all about supporting and caring for the patient and their family. It focuses on helping a patient die with dignity and in comfort, spending any remaining time as they desire, possibly by improving family relationships and dealing with any remaining wishes and regrets.  Don't hesitate to initiate the discussion about hospice care with your loved ones. It's all about the best end of life possible.

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