Health Watch by Sherry Mullenix

The North Jefferson News



When you hear someone is under hospice care, most people think the worst and say, “I’m Sorry,” or offer some similar sentiment.

In reality, hospice can be a God-send for a lot of individuals. Hospice care provides medical services, emotional support and spiritual resources for people who are in the last stages of a terminal illness. A local hospice program defines terminal illness as an illness that follows its natural course.

These illnesses include not just cancer, congestive heart failure and Chronic Obstructive Pulmonary Disease, but also Parkinson’s, Adult Failure to Thrive and HIV. The goal of hospice is to keep the ill individuals comfortable and improve their quality of life.

The philosophy of hospice is a shift from the traditional medical environment in which medical professionals strive to cure the disease. Hospice services are not intended to speed up or prolong the dying process, but focuses instead on relief of pain and other symptoms. The hospice caregivers are concerned with enhancing the quality of the remaining life by treating and keeping the sick as comfortable as possible in a familiar environment with family and friends.

Hospice programs offer services 24 hours a day, seven days a week, in the patient’s home or a hospice center. The services normally provided by a hospice program include:

• Basic medical care with a focus on pain and symptom control

• Medical supplies and equipment as needed to improve the quality of life

• Counseling and social support to help the family with the psychological, emotional and spiritual issues of the dying process

• Guidance with the difficult, but normal issues of life completion and closure

• A break (respite care) for caregivers, family and others responsible for the individual’s care

• Volunteer services for things such meal preparations and errand running

• Counseling and support for loved ones if/when the patient dies

A trained healthcare professional is usually scheduled to visit on a daily or weekly basis as the need demands and is always on call for an on-need basis 24 hours a day, seven days a week. The hospice team usually includes a doctor, nurse, social worker, nursing assistant and trained volunteers. It may also include a pharmacist, respiratory therapist, psychologist, psychiatrist, occupational therapist and clergy.

Eligibility for hospice is based on two criteria:

• There is a terminable illness

• The doctor has indicated that the life expectancy is six months or less

While it can be hard for the physician to determine an individual’s life expectancy, it is part of the application process. If the patient lives longer than six months, he can continue hospice. However, if the condition improves, he may be required to stop receiving hospice care. The patient can also decide to opt out of the hospice program at any time.

Payment for hospice services is covered through Medicare and most Medicaid programs. Some private insurance programs will also provide for a hospice benefit.

If you decide to pursue hospice care you will need to do the following:

• Talk to the primary care physician. Discuss the patient’s condition, medication regime and home situation. The doctor and his/her office staff will take care of the arrangements if the patient qualifies.

• Talk to the case manager if the patient is in a hospital setting.

• Complete some documents, including a power of attorney and living will

• Legal documents related to finances, property and other matters

• Decide what kind of hospice services are needed: Each hospice program has its own guidelines and admission rules, and type of services offered. For example, if they don’t provide a service you need, will they work with another provider who does. All hospice programs should provide a written document that describes their services including who will provide the services. This documentation should include eligibility, cost and payment processes, and liability information. Ask for this information and read it carefully.

• Identify hospice programs in your area. Those who can help you find hospice programs include:

• Your physician or hospital

• Medical social worker, or nursing home

• State or local agency on aging

• State health department

• Your insurance provider

• Phone book, look under hospice

• Your state hospice organization

After you have begun the hospice program, you will want to:

• Choose one person in the family to be the coordinator of services, to make others aware of support group meetings, bereavement counseling opportunities and other important meetings, needs or services

• Get all billing arrangements in writing, including cost and payment arrangements; keep a copy.

• Be sure that your family knows what services you are receiving and the schedule of services.

• Be sure everyone in the family knows names and phone number of hospice contact individuals. Post these numbers near the phone.

Hospice can make the last weeks or months of life a time of comfort and ease for the ill individual. However, more than that, it allows family and friends to focus on comforting the sick individual without the stress and concern of being the primary caregiver.

It allows family and friends time to savor memories and celebrate the life the individual had and has remaining. I’ve not found anyone who has had the experience of hospice in their family regret it or not appreciate the services.

Sherry Mullenix (J.D., R.N.) co-owns The Pharmacy in Mount Olive with her husband, Steve Mullenix (R.Ph). They can be reached at 631-1201.