Hospice Care

Posted by Donna Mae Scheib on October 31, 2017

Hospice Care

It has been a l-o-n-g summer, not because of the hot, humid days here in Wisconsin, but because my mother was hospitalized on five separate and lengthy occasions from various falls. Despite being confined to a wheelchair since the second fall, her last fall was the worst.

Her heart rate was over 230 and she was rushed to the neighboring hospital from her memory care facility. Over the duration of the next six days, she was diagnosed with another UTI, pneumonia, and sepsis. This was the weakest I had ever seen my mother; I had to spoon-feed her and she had lost most of her muscle strength in her legs. It took 2-3 nurses to get her up out of her bed and into the bathroom. I was afraid to leave her hospital room.

When I contacted the nurse at my mother’s facility to notify them of my mother’s prognosis, she asked if it was okay to have Mom evaluated for hospice. Then after Mom’s recovery and return to the care facility, the nurse said that we would have a meeting and go over a new individualized care plan. If Mom qualified for hospice, that service could be added.

I was not familiar with the changes in hospice care so I asked many questions. Then before my mother was dismissed from the hospital, and after being told my mother qualified for hospice, I met with the hospice staff to discuss their services, etc.

This particular hospice works with the facility my mother resides at so I thought I should find out more about them. I was going to acquire a bed with rails and alarms and had worried about subsequent falls for my ninety-year-old mother when she got stronger enough to return to her care facility. But these fears and worries were put aside as I was reassured about the medical care provided through hospice to complement the care she was receiving from the memory care facility.

This article highlights what hospice is and how it might help your loved one, too.

Hospice offers medical care to help maintain or improve the quality of life for those whose illness, disease or condition is unlikely to get better. The care plan that the facility had developed now embedded the added services that hospice would provide regarding my mother’s physical, emotional, and spiritual needs. The hospice intake worker also explained how they would provide practical support to the staff at the center and to me (her POA for health/daughter), and subsequently offer grief support upon death.

There are thousands of hospices in the U.S., but if they participate with Medicare, they must provide certain services to the patient and documentation to the government.

These are the services provided:

• Dietary counseling
• Grief and loss counseling
• Medical equipment (walkers, wheelchairs, beds with rails, alarms for wheelchairs/beds, catheters, bandages, oxygen, etc.)
• Medication for pain relief or symptom control
• Physical and occupational therapy
• Short-term inpatient care for symptom/pain management
• Short-term respite care to help the caregiver
• Speech and language pathology
• Visits to the patient’s residence by the hospice staff (physician/nurse/home-health aide/medical social worker, and chaplain/spiritual adviser
• And other services covered by Medicare and recommended by the hospice team to help with symptom/pain management

Typically these services are not covered through hospice (payable by the Medicare Hospice Benefit):

• Ambulance transportation or hospital emergency room care unless it is arranged by the hospice team or it is unrelated to the patient’s terminal illness
• Room and board in a nursing or care facility
• Treatments or prescription medication to “cure” the patient’s illness or that which is unrelated to that illness

What are some of the changes in the hospice program over the course of the past 40+ years?

When hospice was first introduced in the U.S. in the mid-70’s, most hospice patients had cancer and they were near-death. Today, more than half of the patients accessing hospice services in the U.S. have other illnesses (late-stage heart, lung or kidney disease; advanced Alzheimer’s disease or dementia, etc.).

Another main change is that hospice is not just for adults; many hospice programs today serve people of all ages: infants, children and young adults in addition to adults.

Yet another change is that the care comes to the patient in the setting they live in (whether that be a private residence, nursing home, assisted living center, hospital, etc.).

Furthermore, hospice is reaching out to individuals earlier than in the past. To receive services, a hospice physician and another physician (usually the attending physician or specialist of the patient) attests that the patient meets specific medical eligibility criteria: generally, the patient is expected to live 6 months or less if the illness, disease or condition continues at the same rate. However, if the patient lives longer than this, and the illness, disease or condition is still declining, then they can be recertified. You can also leave a hospice program at any time for any reason without penalty and re-enroll again when meeting the eligibility criteria.

Hospice provides peace of mind and comfort to my loved one

I was mostly fearful and exhausted, so when I learned about hospice and how the program could help my mother, it was a wonderful relief.

Hospice professionals can explain to you the program’s services and assess if it right for your loved one. You can initiate a discussion with your loved one’s doctor or healthcare provider at any time. If they agree, they can recommend a hospice provider or you can talk to others you may know who have used a hospice provider. In my case, a specific hospice provider works with the facility so I went with that one. The intake worker met with me for about two hours and patiently and professionally explained all of the services.

It has not even been a week since my mother was enrolled in hospice, but I have an added peace of mind that my mother is getting the best care possible and that she is as safe as she can be given her condition.

I was grateful for the assisted living facility to set up a clinical assessment and to initiate a discussion about hospice. It happened at a time when Mom needed more services and I needed more support. With my siblings all living far away, most of the responsibility has fallen on me and I was feeling all alone and was very, very exhausted in dealing with my mother’s care.

After I met with the hospice representatives and signed the necessary paperwork, I picked up my mother at the hospital and brought her back to the assisted living facility she has been living in for almost three years.

Her medication was updated, she regained much of her strength and appetite, and I was reassured that the necessary medical equipment was set up in her room. Sure enough, we were greeted by the hospice nurse, a new wheelchair with an alarm, and a room set up with a bed with rails and alarms, a floor mat, a moveable table, etc.

As my mother finished her brownie she saved from the hospital dinner, the nurse took my mother to her room to get her vitals. The next day, a social worker called me to get more data about my mother and there was a care plan meeting with the assisted living and hospital staff to discuss responsibilities and patient needs.

I am forever grateful to hospice. It might be worthwhile for you to check out, too.