Most of us assume we will always have a bit more time with our aging grandparents or parents. Even when our family members are in the late phase of a severe illness, medical treatments might offer hope for longer life. However, medicine is only able to take you so far.
8 Indications That it Might be Time for Hospice Care
- The decision to concentrate on the quality of life rather than aggressive treatments
- The incapability of performing daily living tasks, like walking, eating, going to the bathroom, getting dressed, or personal cleaning
- A reduction in alertness, withdrawal, mental confusion, or increased sleeping
- Nausea or vomiting, shortness of breath, or uncontrolled pain
- The fast decline in health over the last 6 months, even with aggressive treatments
- A decrease in a desire to eat, which leads to changes in body composition and substantial weight loss
- Reoccurring or frequent infections
- Frequent trips to the emergency room or hospitalizations
The choice to start care is very personal, yet know that family members or patients have the option to end hospice care, as well as restart curative care at any point. In addition, patients have the choice to transfer over to a new hospice.
Where to Start
Speak with your doctor, your family, and other people you trust. Families frequently tell us that they regret not getting into hospice care earlier.
Families and patients handling a severe illness may be overwhelmed with tasks, treatments, and schedules. If this illness becomes life-threatening, discussing the following steps may be challenging. We have gathered information to assist you in having informed and honest conversations regarding options for comfort care.
When and how does hospice begin?
Anyone may inquire about hospice services. For example, you or your family might contact a local hospice and ask about benefits. The hospice team will then contact your doctor to determine if a referral to hospice is suitable. One other method of inquiring about hospice includes talking to your doctor, and they may make a hospice care referral.
Typically, care is prepared to start within one or two days of the referral. But, under urgent circumstances, service might start sooner.
When’s the proper time to ask about hospice care?
Now’s the best time to hear more about hospice care and inquire about what you should expect. Even though end-of-life care might be hard to talk about, it’s better for family members and loved ones to share their wishes before becoming concerned. It may vastly decrease stress once the point of hospice becomes apparent. In having those discussions ahead of time, uncomfortable circumstances may be avoided. Instead, informed decisions may be made, including family members’ input and advice.
Hospice is all about improving the quality of life of the one who is suffering. Patients obtain physical therapy, intensive pain management, and the appropriate medical equipment. In addition, patients and their loved ones have the choice to connect with social workers who will assist in navigating the medical system, as well as chaplains for religious care.
Overview of Medicare Eligibility
Hospice is for those with a terminal diagnosis and life expectancy of 6 months or less, which was determined by a patient’s physician and hospice medical director. The family or the patient must be aware of the prognosis and determine comfort care instead of curative treatment for their terminal condition.
It might be challenging to determine a prognosis of 6 months or less. However, declining awareness requires understanding the patient’s condition over time. That is the reason why primary care physicians are critical for determining eligibility for a hospice.
The next step for eligibility for hospice typically involves an evaluation by a nurse who has specialized hospice training or a hospice medical director.
Hospice pre-election consults are free to family and patients and without any obligation.
Medicare permits and reimburses for a single-time visitation by a doctor who either is the employee of or the medical director of a hospice facility.
- Assess the necessity for symptom and pain management
- Counsel the person concerning hospice and additional options of care
- Advise the person concerning advanced care planning
- Hospice Information on Pre-Election Evaluation & Counseling – CMS-R386CP.pdf
Staff at our hospice location are readily available for no-obligation consults.
Eligibility Concerning the Hospice Decision
For many families and patients, Hospice care in Sugar Land provides provides peace and an opportunity to concentrate on what is essential. However, if the patient is qualified for hospice, we understand that deciding to select hospice can be difficult.
Open communication is critical. Our staff encourages families and patients to begin conversations with one another and with a patient’s physician. In addition, advance care planning may clarify the patient’s end-of-life objectives and help families and doctors become familiar with the patient’s wishes.
Families and patients need to know that anybody may make a hospice referral. Research shows that patients receiving early care substantially benefit more than the ones who go into hospice during the final hours or days of life.
Hospice-appropriate patients might suffer from the following:
- Specific condition decline
- Recurrent infections
- Deteriorating mental capabilities
- Progressive loss of weight
- Frequent hospitalizations
Hospice is an entirely covered Medicare benefit.
Coverage will include nurses, additional caregivers, supplies, medicines, support, and equipment without out-of-pocket costs for a hospice diagnosis.
Medicare Advantage Plans and Hospice
Hospice care is always covered for every Medicare beneficiary via Medicare Part A, including beneficiaries enrolled in the Medicare Advantage plan.
If you currently have the Medicare Advantage plan, occasionally referred to as Medicare Part C, and select hospice care for a terminal diagnosis, you’re qualified to obtain hospice care coverage via Medicare Part A. However, that doesn’t mean you must drop the Medicare Advantage plan.
The Medicare Advantage plan continuously provides supplemental health services, like dental or vision, and the prescription drug benefit (Medicare Part D) that aren’t associated with the terminal illness. Original Medicare (Part A & B) also is available to cover all additional services not related to the terminal illness care offered by the hospice. Part A will cover mainly inpatient care, whereas Part B will cover especially outpatient care.
Real World Example
A patient with the Medicare Advantage plan is getting chemotherapy for end-stage cancer. During a specific point, with a prognosis of 6 months or less, he opts to quit getting curative treatment and then transitions to hospice.
Medicare Part A will cover his hospice services, including medical equipment, nursing care, family support and spiritual care, professional pain management, and advance care planning.
His health care for a pre-existing diagnosis unassociated with his terminal illness, like diabetes, might be covered by original Medicare. In contrast, his Medicare Advantage plan continuously offers his dental, vision, and additional supplemental services.
That patient might opt to disenroll from the Medicare Advantage plan when he transitions to hospice. Still, he’d lose the supplemental coverage provided by his Medicare Advantage plan that might involve options for reduced co-pays, vision, dental, and drug coverage.
The Future of Medicare Advantage Hospice Coverage
Medicare, in 2021, might provide the choice to obtain hospice benefits through the Medicare Advantage plan within a couple of counties. More details about this pilot project, occasionally referred to as the Medicare Advantage carve-in, were available in 2020.
Medicare Advantage plans, frequently called Medicare Part C, include Medicare coverage options provided by private insurance companies, which are approved by the United States CMS (Centers for Medicare and Medicaid Services). Medicare Advantage involves PPO, HMO, and fee-for-service plans covering the services of Original Medicare, except for hospice, and frequently adds extra coverage for dental, drug, and vision care.
Discovering the Proper Care
Making informed medical decisions within times of immediate need may be very stressful. A significant first step includes having honest discussions regarding what matters most to you and your loved ones. When you gain a better understanding of your priorities and needs, you can be bold about sharing these with hospice providers.
Questions you should ask your physician regarding hospice care
You’re the best advocate for your well-being. However, a period of severe illness isn’t the time to be coy about asking honest and challenging questions.
The majority of health care providers are trained to encourage the asking of questions. Even if they do not ask, be brave and speak up. If it is an emergency and you forget a question, most providers have forms online for sending concerns or questions.
Use a note app on your cell phone or notebook to jot down questions that arise before the visit.
Having a loved one with you during portions of the visit will help.
Here are 7 recommendations for honest discussions with your physician:
- What are the expenses to me or my loved ones?
- Will you still be there even when I am ill and close to the end of life?
- If I get to a point where I’m too sick to talk for myself, how will you make choices regarding my care?
- Will you assist us in finding professionals who have specialized training when we need them? For instance, surgical, medical, and palliative care experts, social workers, or faith leaders.
- What will you do if I experience pain or additional uncomfortable symptoms?
- Please speak candidly and openly with my loved ones and me.
- What are my care options and the possible results for these options?
How to find the proper hospice provider
If you are handling immediate medical concerns, you might be tempted to hurry through decisions for hospice care. However, locating the proper care at the appropriate time will require asking critical questions before choosing a provider.
Find time for honest discussions regarding what matters the most to you and your loved ones.
Once you know your priorities and goals, conversations with hospice providers and doctors will be much more productive. Some patients under hospice care value awareness much more than eliminating their pain. Ask a lot of questions and allow your voice to be heard.
Create a list of questions for prospective hospice providers. Keep in mind that emotional and medical needs are going to change within end-of-life care. Ask the medical staff how the care program adapts to your specific needs.
Questions you should ask about hospice care
Critical decisions include the medical and personal priorities of a hospice patient. Some questions to ask regarding hospice care have:
- How will you manage pain and additional symptoms to the desired level?
- What personal supplies and medical equipment are used?
- What are the expenses related to any medications or services?
- What if the symptoms require emergency care or become uncontrollable?
- How rapidly will the hospice team respond to emergency needs?
- What type of family support services will be offered?
- Is the team experienced with your family member’s specific life-limiting sickness?
- Do they provide support services for vets?
- What staff training or qualifications do you require? Volunteers, Aides, RNs?
- What if we aren’t satisfied with the nurses or additional staff members?
Options for Palliative Care
Palliative care is one option for the ones who want to decrease the anxiety, side effects, and symptoms of a severe illness. Patients aren’t required to forego treatments to cure the disease. Instead, they obtain care to decrease pain, additional symptoms, and occasional debilitating medical treatment side effects.
Often, palliative care includes goals of advance care planning and care conversations to offer a roadmap for future healthcare decision-making, which may decrease stress on family members and patients.
For more information on our assisted living, respite care, disability care, short-term memory loss care, or hospice care services, please feel free to contact Optimum Personal Care in Missouri City, TX immediately at 281.565.4144.