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Hospice is a holistic and coordinated program of care. It honors the unique physical, social, emotional and spiritual needs of each child, adult and family who receives care. The emphasis is on providing the highest quality of care so that patients and their families may enjoy their remaining time together. A primary component of this care involves helping patients remain in their homes with the people they love. Medicare, Medicaid and private health insurance cover hospice care costs for most patients who meet specified criteria.
While caring for a loved one at home can be challenging, Providence offers extensive practical and emotional support to families and caregivers. A hospice nurse is available 24 hours a day to provide phone consultations, and to visit the patient when appropriate. We also offer trained volunteers who can provide respite care and companionship to patients and families.
Despite the challenges of providing care for a loved one who is ill, many families say that they are grateful for the opportunities for closeness that spending this time with their loved one has given them. It can be a deeply rewarding experience for everyone involved.
Hospice care raises a lot of questions in people's minds. Below are some of the most frequently asked questions we hear with answers that we hope will help you and your family
Hospice care is for people who have a limited life expectancy (6 months or less) and have decided to shift the focus of their care from cure to comfort. Hospice emphasizes the quality of remaining life, allowing people to stay in familiar surroundings with their loved ones while receiving the health care and support services they need (including pain and symptom management). The hospice team consists of medical directors, nurses, hospice aides, social workers, chaplains, volunteers, bereavement counselors and others who support the physical, emotional, social and spiritual needs of patients and their families.
You and your family should feel free to discuss hospice care with your physician or health care provider any time you think it may be appropriate or desirable during the course of a life-limiting disease. It is important at such times to discuss all care options, including hospice. Most physicians know about hospice. If your physician wants more information about hospice, it is available from Providence as well as the Academy of Hospice Physicians, medical societies and state hospice associations (in Washington State, it is the Washington State Hospice Association). Good web-sites to explain hospice care include The National Hospice and Palliative Care Organization and The Hospice Foundation of America.
By law, the decision whether to elect hospice services belongs to the patient (assuming he or she has a qualifying diagnosis). Understandably, most people are uncomfortable with the idea of stopping all efforts to "cure" a disease. Hospice staff members are highly sensitive to these concerns and are available to discuss them with you and your family. The ultimate decision is always up to you.
How does hospice "manage" pain?
Hospice staff members believe that emotional and spiritual pain are as real and as in need of attention as is physical pain. Thus, we address all facets of pain. Hospice nurses and physicians are up-to-date on the latest pain medications and procedures. In addition, counseling and spiritual support are available to help patients and their loved ones deal with emotional and spiritual pain.
What success rate does hospice have in helping patients manage their pain?
Very high. Most people receiving hospice care feel comfortable and enjoy a good quality of life. To achieve this, hospice staff use a variety of combinations of medications, counseling and therapies.
Will medications prevent me from being able to talk or know what is happening?
Not usually. We work very hard to help people in our care remain pain free, but alert. By working closely with you and your family, we are usually very successful in reaching this goal.
Does hospice pay for medications for everyone? Are all medications covered?
Your insurance coverage determines whether hospice pays for medications. For instance, the Medicare and Medicaid Hospice benefit covers medications used to treat pain and other symptoms. Our staff can help you and your family understand your insurance benefits.
People do sometimes "outlive" their prognoses, which is often reason for celebration, especially if they are receiving good care and enjoying an enhanced quality of life. What happens at that point depends upon the unique circumstances of each situation. Sometimes people outlive their prognoses but their disease processes continue, so it is appropriate for them to continue on hospice service. Sometimes, however, people improve after receiving hospice care. In these cases, it may be appropriate for them to discontinue hospice care to enjoy the months or years of life they have remaining.
It is not unusual for people to feel better after coming on hospice care. In some situations the disease process seems to halt and may even reverse course. Hospice staff will share their observations with you and review your care options with you should this occur.
Patients have the right to stop receiving hospice care at any time, for any reason. In addition, sometimes their health improves or their illnesses go into remission while receiving hospice care. When patients' conditions become stable to the point that they can no longer be certified as terminally ill (having a life expectancy of six months or less), they are no longer eligible for the hospice benefit. However, they can always return to hospice care in the future should their conditions change and they once again meet eligibility criteria.
Can hospice help me die?
Hospice does nothing to either speed up or slow down the dying process. Just as doctors and midwives lend support and expertise during the time of childbirth, hospice provides its presence and specialized knowledge during the dying process. Hospice care focuses on comfort and palliative care. We work hard to ensure that people have the best quality of life with their loved ones for whatever amount of time they have granted to them. That said, it is often difficult for patients and their families when patients linger for months, ready to die. If this happens, hospice staff work hard to help patients continue the highest quality of life possible. Many times, this involves helping patients resolve "unfinished business," such as personal or family issues, seeing loved ones or saying good-byes. We continue our care and our service for as long as patients continue to meet hospice eligibility guidelines.