Monday, January 27, 2014

Hospice and Palliative Care

In the last 30 years, hospice and palliative care organizations across the country have made an incredible difference in the lives and the last days of millions of people and their families. Simply put, palliative care is focused on the relief of a patient’s pain, rather than curing the underlying illness. It is not an attempt to prolong life or to bring about death. Palliative care can be provided along with curative procedures, or in the case of hospice, without those efforts for a person with a life-limiting condition and a prognosis of only months to live.
In this moving video below, a man provides his personal perspective on the value of hospice care and how helping his mother-in-law move from the hospital to hospice care at her home made a positive, and life-affirming difference for her and her family, even as she approached death.

 Hospice began as a way of treating terminally ill cancer patients, but soon grew to encompass palliative care for patients suffering from any life-limiting condition. Before the hospice and palliative care movement took root in this country, the dominant focus of treatment for the terminally ill was the preservation and prolongation of life at any cost. Many people who had little hope of living more than weeks or months were subjected to extraordinary and intrusive procedures in an attempt to keep them alive for even a little bit longer. An unintended consequence of this focus on treatment was a loss in the quality of life for many patients who died in pain or unconscious in hospitals, rather than in a coherent and pain-free state in the presence of their families.

Options for Care

Throughout the ages, most people have been able to die in the comfort and familiarity of their own homes. In the mid to late 20th century, this changed as treatment focused on prolonging life at all costs. More and more people ended up dying, often against their own wishes, in the cold and institutional environments of hospitals. One of the most significant ways that the hospice movement has helped patients and their families, is advocating for the right of patients to choose where they spent their last days, allowing the terminally ill to once again have the option of dying at home.
Although this option remains a priority for hospice organizations, care is available in a variety of settings. In addition to in-home skilled nursing care, hospice care is available in nursing homes, hospitals, and inpatient hospice care facilities. Some organizations supplement in-home care with periods of facility-based care to provide respite for caregivers. This service allows for caregivers to recharge and enables them to continue to care for the patient at home for a longer time. Generally, the services provided to hospice patients includes nursing care, physician care, 24 hour on-call assistance, medical social services, spiritual support, trained volunteers, and bereavement services for patients in any treatment setting, as well as home care aids, and limited 24 hour continuous care for patients at home.

Who pays for hospice care?

Many see in-home care to be a far preferable experience for the patient, and it is less expensive to deliver as well. Insurance coverage for hospice care is available through Medicaid, Medicare, and many private insurers. In fact, Hospice care saves these programs and taxpayers money, as compared to costs associated with traditional treatment.

Who is eligible for hospice care?

Typically, patients with a physician’s diagnosis of a terminal illness and a prognosis of living for only another six months are eligible for hospice care. Hospice care is available to the terminally ill no matter what their age. If you or your loved one fits this description, discuss your options with your physician.

When to call

Many patients and their family members remark that they wish they had contacted their hospice care provider earlier, and providers encourage people to call as soon as they are diagnosed with a life-limiting condition. Often, the quality of life experienced by the patient and the family can be meaningfully improved, and their ability to maintain care at home prolonged because of an early call to hospice.
Patients with life-limiting conditions have more options today than ever before, including the opportunity to spend their last days in a lucid, pain managed and comforted environment. The ability to spend these precious days interacting with their families and friends in a meaningful way has had a wonderful effect on their experience and that of those close to them. If you or someone you love has been diagnosed with a terminal illness, talk with your physician about all the options for your care, including hospice.

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