When should you call hospice?
While only those with a life expectancy of six months or less is eligible, the best time to call is soon after a terminal diagnosis is made by the patient’s private physician or specialist. Hospice staff can answer questions and help you to understand what lies ahead and when you would be eligible for hospice as well as offering other options for care that you may not have considered. At all times the patient and family wishes and choices are taken into consideration.
Hospice staff can answer questions and bring patients and families peace of mind. While it is never too early to contact us, all too often people wait until it is too late for us to make a real difference – hospice is there to help patients to LIVE through their final months, so the sooner you contact us the better for the patient and their loved ones and caregivers. A common statement that we receive on our Patient Satisfaction Surveys from family following the death of a loved one is, “We wish we had called sooner.”
A patient with a prognosis of 6 months or less is eligible for hospice services, though care may continue beyond that time. There is no “magic” figure but a timely admission allows hospice to work with the patient and family for several months before death. This normally results in more successful pain management, greater conflict resolution and preparation for death, and a higher level of long term well being for survivors.
Eligibility varies by individual, the illness they are living with and many other factors. In general, if treatment no longer works or is no longer desired, or significant decline in status has occurred, then you should call the hospice office nearest you to discuss the options available to you.
Hospice is specialized care that meets the needs and desires of people living with terminal illness and those who care for them.
Hospice provides the information, expertise and added care needed to have the highest quality of life possible. It is meant to allow someone to live as fully and comfortably as possible every day. Hospice care focuses not only on the person who is living with the illness but also on their family – however they define it – and provides support that continues through the illness and after. Hospice is not about dying, it’s about how you live – in comfort and with dignity.
Patients are asked to articulate their desires and needs and to participate in choices about their care giving them back control. With the hospice emphasis on pain control management patients are given comfort so they may enjoy the time they have with those they love. Whenever possible, care is given in the location where the patient feels most comfortable, most often in the familiar surroundings of their home. Hospice staff provides the medical, spiritual, emotional and practical support to allow the patient to live their lives to the fullest.
Hospice care includes visits, assessment, planning and teaching by nurses, social workers, chaplains, aides, support volunteers and others. It also provides needed medications, equipment, supplies and materials related to the hospice illness and needed to address or prevent symptoms or discomfort.
Hospice is community based, compassionate end-of-life care which is a gift to those on their final journey.
Choosing hospice does not mean a death sentence. What hospice does mean is a total change of focus. It means the person is in control: making choices about what is most important in his or her life. Hospice philosophy emphasizes the creative and positive outcomes to be realized by defining and achieving personal goals and by living life as fully as possible.
It is not uncommon for people entering hospice care to experience an improved sense of well being and comfort. This sometimes happens because pain management and symptom control issues are openly discussed and effectively resolved. Sometimes, this sense of well-being is a reflection of the person’s sense of control gained from defining her/his goals and from active participation in developing the plan of care.
Living with end-stage disease and dying well takes work. Hospice workers handle that job very well and help people in hospice and their families to have some of the most memorable moments of their lives.
Every hospice experience is unique, but one key thing families tell us about hospice is that “we wish we had known about hospice sooner”. Hospice team members also know that having more time to work with a person and family means better quality of life. Because the goal of hospice is to achieve the highest quality of life possible, some people may actually live longer than expected without the burden of symptoms and aggressive care.
People on hospice care and their families receive care for an unlimited amount of time, depending upon the course of the illness. There is no fixed limit on the amount of time a person may continue to receive hospice services.
Hospice isn’t really about dying. Hospice is about living as well as one can every day we have. It is about adding life, quality of life, to someone’s final days, weeks or months. Hospice is a program of services available to the person and her/his loved ones where ever they may be. Most hospice care takes place where the person already lives: in their own home or a family member’s, a nursing home, or an assisted living facility.
Hospice is care designed for people living with a life-limiting illness. There is so much more that can be done to assist individuals and families in living their lives fully, completely, and without pain until the end of their lives.
More than 50% of people on hospice are diagnosed with conditions other than cancer or AIDS. Anyone with a life-limiting illness can receive hospice care. Heart disease, kidney disease, COPD and dementia are a few of the illnesses that can benefit from hospice services.
This is an individual/family choice. A person can certainly choose to be resuscitated. The hospice will generally not provide this type of care, but will explain what you need to do to access such services. The hospice team will provide information that might be useful in making such decisions.
In the past, some hospices required a primary care giver because the hospice cannot provide 24 hour care except in crisis situations. Most hospices do not require this any longer. The hospice will ask you to make a plan for what will happen when you need round the clock care.
Family members and friends are encouraged, supported, and trained by hospice professionals to care for their loved ones. Hospice staff is on call to the individual and their families 24 hours a day, 7 days a week, to help family and friends care for their loved ones.
QUESTIONS OR EMERGENCIES – AFTER HOURS CARE – HOW TO REACH US
Always call High Peaks Hospice & Palliative Care first if you have a concern. An on-call nurse is available 24 hours a day, 7 days a week, to answer your questions and to visit if necessary. The nurse is skilled in handling many situations so that hospitalization may not be a necessary.
Remember, calling an ambulance or going to an emergency room might result in unnecessary procedures on the patient. Decisions about possible hospitalization and its’ goal should be made in conjunction with the patient and family, hospice nurses and physicians.
The same number you call during regular office hours will put you in contact with the answering service after hours.
Palliative care can be defined simply as “comfort” care – the relieving and preventing of suffering. This is what hospice is about. Hospice staff members receive advanced training in identifying, controlling, alleviating and preventing symptoms as much as possible. Not everything can be prevented, but hospice staff members have years of training and experience that helps people become, and stay, comfortable and as active as possible. Registered Nurses and physicians reassess the patients pain on a regular basis – and make adjustments as needed to assure the greatest level of comfort as the disease progresses.
Hospice team members will recommend options for symptom management in consultation with your physician. The individual, family and caregivers are strongly encouraged to be involved in examining options and participating in creating a plan that addresses their needs.
View the NHDD “Speak Up” video here
Advance care planning is making decisions about the healthcare you would want to receive if you happen to become unable to speak for yourself. These are your decisions to make, regardless of what you choose for your care, and the decisions are based on your personal values, preferences, and discussions with your loved ones.
Advance care planning includes:
- Getting information on the types of life-sustaining treatments that are available.
- Deciding what types of treatment you would or would not want should you be diagnosed with a life-limiting illness.
- Sharing your personal values with your loved ones.
- Completing advance directives to put into writing what types of treatment you would or would not want- and who you choose to speak for you- should you be unable to speak for yourself
Advance directives are legal documents that ensure your wishes are followed if you cannot make decisions for yourself.
- New York State Combined Living Will and Health Care Proxy New_York_Combined.pdf
- Five Wishes- learn more. Call for your free copy! 518.891.9631 x107 or email: firstname.lastname@example.org
Advance directives are not just for the elderly! Anyone over the age of 18 should have an advance directive.
There are times when people- even young, healthy people- can’t make their own decisions about medical care.
- You could be injured in an accident and arrive at the hospital unconscious.
- You might be under general anesthesia for routine surgery when something unexpected happens.
- You could have an illness that leaves you unable to speak, or you are comotose.
Let’s get started!
Are you ready to start planning your health care in advance? Download this comprehensive, easy to follow guide to completing an advance directive Planning_Your_Health_Care_in_Advance.pdf
For more information about advance directives or to schedule an educational event contact a location nearest you.
To alleviate the stress and burden on patients and their families, one of the services provided by hospice agencies is all billing. Once a patient is admitted the High Peaks Hospice and Palliative Care, the Billing Coordinator and Business Manager deal with with Medicare, Medicaid, private health care carriers, pharmaceutical vendors, durable medical equipment, oxygen and any other needs associates with the terminal diagnosis. While they may need to confer with families regarding specific questions and issues, hospice staff work with the health care providers directly so families do not have to.
Hospice is considered skilled health services and is covered by Medicare, Medicaid, and most private health insurance plans. Provided all eligibility requirements are met, Medicare and Medicaid will pay for all home visits, medications, supplies, and equipment related to end of life care. Some private insurance plans require a co-pay or deductible. Contact your insurance company to determine if hospice services are covered under your plan.
If insurance coverage is not available, hospice care can be provided for a set daily fee, regardless of the amount of visits, medications, or equipment required in the home environment. Individuals and families who cannot afford the cost of services can complete an application for financial assistance. Inability to pay or lack of insurance is never a barrier to receiving care.
The emotional toll of caring for and living with lonesome with an advanced illness is an ongoing process and the effect on families and caregivers does not end when a loved one dies. The hospice bereavement team provides support for family, caregivers and friends involved in caring for the individual. This support starts during care and continues after through our bereavement program
The Bereavement Program supports hospice families and friends after the death of a loved one. Support is also available to community members who have experienced the loss of a loved one – even if they did not use hospice services. Support is provided by phone and mail contact, phone or in person counseling, printed resources and networking. Workshops and support groups are provided by each office according to need.
Griever’s Bill of Rights
- You have the right to experience your own unique grief
- You have the right to talk about your grief
- You have the right to feel a multitude of emotions
- You have the right to be tolerant of your physical and emotional limits
- You have the right to experience “griefbursts”
- You have the right to make use of ritual
- You have the right to embrace your spirituality
- You have the right to search for meaning
- You have the right to treasure your memories
- You have the right to move forward your grief and heal
Most people, when asked where they would like to spend the end of their lives respond without hesitation,” At home.” At home they are surrounded by the familiar – their pets, their loved ones, their memories. For this reason hospice care is most often provided in their home. But whether home is a private residence, an apartment, a group home, or a nursing facility – Hospice is where the home is.
Hospice staff and volunteers provide services in your “home” – wherever that is.
Short inpatient care is available for control of symptoms that cannot be addressed at home. It is also available for respite for caregivers on a short-term basis.
Please note that High Peaks Hospice and Palliative Care is willing to arrange care in almost any setting that wishes to collaborate with hospice staff in
enhancing the quality of life of the patient.