Clarity on hospice care aids decisions

As hospice and palliative Care are increasingly in the news, it is important to clarify several points. First, hospice is not a place; it is a comprehensive approach to care during the advanced stages of an illness. Hospice care is the choice for patients whose medical condition is no longer responding to treatment or for patients who choose no further aggressive care.

Contrary to what many people think, hospice is not intended to be the last resort when there seem to be only a few days left. Hospice care can be the best option for people to live fully, maintain their dignity and keep control over their lives.

At Our Hospice of South Central Indiana, our goal is to surround the patient and family with support and help as we work together to manage symptoms, and identify what is important for patients to accomplish as they approach the last part of their life.

A person is eligible for hospice care when a physician establishes that there may be about six months left, if the condition was left untreated. However, patients can stay on hospice care much longer than six months if they continue to meet eligibility criteria as the illness progresses.

The best time for hospice care is when patients have the capability to make choices and decide how they want to live the rest of their lives. Our team takes immediate action to coordinate services, medications and supplies to give the patient and family the confidence to start making every day more comfortable and help patients meet their goals. We often hear families say they wished they had chosen hospice care much earlier.

When patients choose hospice care, they receive medical and nursing care to relieve symptoms and promote well being. The hospice model also includes the support of social work and spiritual care professionals, assistance from home-health aides and volunteers for companionship. It is thanks to this interdisciplinary approach that patients receiving hospice care have a higher quality of life and live longer compared to patients who do not have this benefit. A 2007 study published in the “Journal of Pain and Symptom Management” demonstrated that patients who chose hospice care lived 29 days longer than similar patients who did not choose hospice care.

The hospice model, as developed in this country in the 1980s, implies that patients stay at home and family members are the primary caregivers, with the assistance of the hospice team. We go to where our patients are to provide care. When there is no available caregiver in the home, families choose the option of using a residential facility, therefore, “home” can be the patient’s residence, a nursing home or another facility.

The Hospice Center in Columbus, which includes 14 patient rooms, is not a residential option. Rather, it is where patients come temporarily when symptoms cannot be controlled at home and there is need for intensive medication management or if their caregiver needs respite time for a few days. We are very fortunate to have an inpatient facility at Our Hospice, a special benefit for patients and families.

Our Hospice of South Central Indiana is the only free-standing, not-for-profit hospice in the 15-county area we serve. There are several for-profit hospices that serve this area since reimbursement for hospice care became available through Medicare/Medicaid in the late 1990s. There are also a few hospitals in our surrounding counties that include hospice care. It is important when choosing a hospice provider that you ask questions and understand first which hospice you are selecting, and second, the quality, comprehensiveness and frequency of services you will be receiving.

While the care and nearly all the medications, equipment and supplies needed to care for the specific terminal illness are covered by Medicare/Medicaid and employer insurance, there are out-of-pocket expenses which include deductibles and co-pays, and room and board fees when patients are admitted to our facility for care other than the intensive management of symptoms or to provide respite for caregivers. As a not-for-profit organization, Our Hospice services provided to patients who are not covered by public or private insurance are funded by the donations we receive from our generous communities.

The hospice philosophy dictates that we will not hasten nor postpone the death of any patient; therefore at Our Hospice we do everything we can to improve how a patient lives every day spent in our care. We believe that every day is a gift, and we spend much of our time talking with patients and families about their choices.

Laura Hurt is president of Our Hospice of South Central Indiana, which has offices in Columbus, North Vernon and Greensburg and serves 15 counties. Please send comments to johannesen@therepublic.com.