Angie's LIST Guide to
Hospice

If your loved one is faced with a terminal illness, he or she may qualify to receive hospice care. This type of comfort-measures only type of care helps patients cope with their illness surrounded by a team of professionals in the surroundings of their own home.
 

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Maricela Rodriquez of Hospice of the Comforter visits terminally ill patients in their homes. (Photo courtesy of Hospice of the Comforter)
Maricela Rodriquez of Hospice of the Comforter visits terminally ill patients in their homes. (Photo courtesy of Hospice of the Comforter)
 
 

What is hospice?

When a doctor or medical care provider determines that a patient has an imminent terminal illness, he or she may institute hospice care. Hospice provides a positive alternative to hospitalization or any lack of care received by a patient after release from a hospital or nursing home.

The main goal of a hospice care team is to keep your loved one comfortable, allowing the patient to pass away with with dignity in his or her own surroundings. The care team often includes a registered nurse case manager, a registered nurse who specializes in palliative care, a home health aide or certified nurse's aide and in some cases a wound care specialist or physical therapist. Other care team members include a licensed social worker, a spiritual care advisor,a  volunteer coordinator and a bereavement counselor. A medical doctor manages the entire care team in conjunction with a medical director. Monthly—and in some cases, weekly—interdisciplinary care team meetings ensure your loved one's needs are being met as his or her condition changes.

Who qualifies for hospice?

A patient mainly qualifies for this type of medical care when the terminal illness or disease is expected to result in death in six months or less. Examples of terminal illnesses include end-stage cancer, end-stage renal disease, end-stage Alzheimer's Disease and end-stage COPD. If your loved one's medical condition changes or improves, they may become ineligible and will have to requalify at a later date.

Most insurance plans cover hospice care and home health care. Your loved one should sign up for hospice care as soon as the doctor diagnoses a need for it, even if the patient is asymptomatic and still self-sufficient. The team then provides the patient with volunteer services, routine health checkups, prescription pickups and medical equipment to help him or her feel comfortable in the advance of disease progression. Discuss this with their doctor and social worker to see if they qualify and meet the specific criteria.

Consult Angie's List for qualified hospice teams in your area and see member reviews of hospice care professionals.

If there is any chance the patient can survive the illness or condition, your doctor may recommend palliative care, which provides specializes medical care at home to patients with a serious illness, such as cancer. Palliative care is intended to give the patient relief from any pain, stress or other symptoms of the disease and treatment.

What to expect from hospice care

Being told your loved one has a terminal illness can be very frightening, and you may not know what to expect from hospice. The average length of hospice care is approximately 19.7 days.

The hospice care team will make sure the the patient has durable medical equipment set up in the home to make that person as comfortable as possible. This type of equipment may include a hospital bed, an egg-crate mattress, an over-the-bed table, a shower chair and portable oxygen tanks. According to the National Hospice and Palliative Care Organization, the interdisciplinary team will create a care plan for each patient based on his or her individual health needs and concerns.

A nurse or social worker will meet with you and your loved one to fill out paperwork. Part of the paperwork required will include both your and the patient's signatures or the durable power of attorney's (DPOA) signature for signing on to services, insurance information, HIPAA information, emergency and family contact information and a do not resuscitate (DNR) order. All of these documents are legally binding, so make sure you discuss them carefully with your loved one, DPOA and the care team.

A social worker will visit with the you and your loved one to discuss any needs that may arise, including emotional or financial concerns. The social worker will help make resources available, such as how to seek financial assistance, how to prepay or set up funeral arrangements and how to obtain the correct documents and signatures for the Family and Medical Leave Act (FMLA).

A clinical care team will keep track of your loved one's illness, let you know what to expect as the end draws near and tell you what symptoms to look for. High fever, mottling (the appearance of uneaven blemishes) and feeling cold to the touch are signs that the body may be shutting down. Changes in breathing, loss of consciousness and a coma-like state are common within the last 24 hours of life.

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