Hospice care is a benefit every patient that qualifies should take advantage of. Not only is it essentially free, patients of hospice will receive care that’s driven by a person-centered approach. Hospice is designed to provide comfort and support to both patients and their families. Unfortunately, there are many misconceptions surrounding how hospice works. Hospice can sometimes be viewed as a bad or scary thing. Understanding how hospice works is especially important for older adults, who may have to prepare for an end of life situation. That’s why we teamed up with Sarah Young, the Community Liaison with Brookhaven Hospice, to answer some questions about what hospice is and how it can benefit older adults.
What is hospice care?
Hospice care is a specialized form of care that focuses on keeping a person comfortable when they have an advanced illness that is incurable. The goal of hospice care is to palliate the individual. This means keeping them comfortable and ensuring quality of life. The focus of the hospice team is to treat the person and the symptoms they are currently experiencing, rather than try to cure the disease. It’s important to note that hospice care does not hasten nor postpone death.
Hospice care is an entitled benefit that is 100% covered by Medicare part A. Extra clinical care services, durable medical equipment, medical supplies, incontinent supplies, and other services are covered under hospice care.
Who qualifies for hospice?
It’s best to prepare and embrace end of life options early on. Anyone who has a disease or illness that cannot be cured, or does not want to pursue aggressive treatments might qualify for hospice care. Some examples of common incurable diseases include: late stages of Alzheimer’s and dementia, advanced Parkinson’s, advanced cancers (stage 3, 4-where there is notable spread), advanced COPD, end stages of heart failure, and multiple strokes.
If you ever question whether you qualify for hospice, you should reach out to your PCP or nursing staff to ask their opinion. It never hurts to learn more or – at the very least – have an initial screen completed by a hospice agency for qualifying purposes.
When should hospice care start?
A physician may bring up hospice care services, or the patient and family can initiate the conversation. Two physicians need to agree that a patient may have a life expectancy of 6 months or less in order to qualify for these services. A patient would qualify and start services when a disease progresses to the point where treatment is no longer effective. Typically, once hospice care begins a patient will begin their end of life journey, whether that takes a few days, a few months, or years.
There are times patients may revoke services to resume treatment or even improve and “graduate” off of services. In that case, a patient can always re-qualify for hospice in the future.
Where does hospice care take place?
Hospice care can take place in whatever setting the patient considers home. It’s important for a hospice patient to be surrounded by the people and things they love while they receive hospice services. Most often, services take place in their physical place of home, an independent living, assisted living, memory care community, or nursing home. In some circumstances, hospice can take place in an inpatient setting such as a hospital or a hospice house. The whole focus is to keep the patient stress free and prevent hospitalizations.
What happens when hospice care starts?
First, the patient or DPOA (health care proxy) would meet with the hospice team to discuss the hospice philosophy. If the patient or DPOA is on board the next step would be to sign the hospice consents. The hospice Nurse Case Manager would do the admission, assess the patient, and develop a plan of care that the family (and, if applicable, the facility) would follow. Patient and family input is invaluable in the development of this plan. The hospice team will look at the whole person and individualize care. The hospice team keeps the patient and family informed about changes in the plan of care.
The Nurse Case Manager will determine how often they see the patient based on the patient’s symptoms and physical or cognitive abilities. Some patients receive care once or twice a week while others may receive care daily. A Nursing Aid may visit to assist with self care activities such as washing, dressing, bathing, or feeding. Additionally, the plan of care may involve the services of social workers, chaplains, pre-bereavement counselors, or physical therapists.
If the family is not already present for the visit, the different disciplines will update the family. Updates may happen as often as the family would like. You can expect the hospice team to provide emotional, physical, and spiritual support to help make decisions throughout the end of life journey. Hospice teams can help fulfill individual’s end of life wishes such as going to church, going to the beach, or even ordering their favorite food one last time. A successful hospice care program will provide a patient with meaning and joy.
How do I find a hospice care program?
There are several hospices in the state of New Hampshire. It is always an individual’s choice on what agency they would like to use. Do your research and look at Google reviews, ask around the community, and – when in doubt – pick up the phone and interview different agencies! You want to find the best fit for you. Each agency has something different to offer: some agencies may have better staffing and some may offer different programs. A physician may refer you to an agency without consulting with you. Remember, it’s always your choice on who you’d like to use.
Can you tell me what’s unique about Brookhaven hospice?
Brookhaven Hospice focuses on individualizing each patient’s plan of care. We offer several programs including aromatherapy, massage therapy, pet therapy, reiki, bible studies groups, meditation groups, and so much more! Some of these services are done individually while others take place in a group setting. Many patients enjoy these extra services. Hospice encourages individuals to participate in the things they love to do! Hospice care is truly a team effort between the hospice staff, patient, family, and facility. It is a journey we all take together to provide the best care possible before end of life.
You can find more information about Brookhaven Hospice here:
Office #: 603-373-0198
1 New Hampshire Avenue Suite 209 Portsmouth NH, 03801
