Perhaps it’s time to consider hospice, holistic care that is designed for support and comfort in the final stages of life. There are many considerations:
- Is your condition terminal with a prognosis of less than six months?
- Do you want the care given at home or in a medical facility?
- Are you willing to forego any curative options and have only supportive care?
- Have you confidence that the hospice respects the sanctity and dignity of life?
Additional Hospice Considerations
Your own needs and wants at this critical time should take precedence. A good hospice will provide for you, and also provide supportive care for your family in a manner that is holistic and addresses any spiritual, psychological, and medical care needed.
It is important, however, to understand that cure is not a goal of hospice, and the types of care you can receive are limited.
Hospice patients should choose to have their care remain under the direction of a trusted physician who is not associated with the hospice provider. It is better to have an attending physician whose concern rests entirely with the patient than one who is also concerned with the provider’s bottom line.1
Comfort and pain control are indispensable requirements to maintain a good quality of life. If at any time an emergency arises, a nurse should be on call 24/7. Remember that with very few exceptions, it is never justified to withhold feeding and hydration from a dying patient.
Sometimes the care being given in a hospice is unacceptable, and if so, every effort should be made to remedy the situation. If all else fails, according to the Hospice Patients Alliance, you always have the right to change hospices at least once within a hospice “certification period.”
Guide to Interviewing a Hospice
In order to ensure full understanding, patients and families must do their homework by asking questions and getting a copy of the answers in writing (any marketing or sales expert will tell a family what they want to hear). We’re listing some questions to ask when interviewing a hospice agency2
- What is the “mission” or “business statement” of the hospice?
- Is the hospice non-profit or for profit?
- Is the hospice pro-life? If yes, is this evidenced on the website, in brochures, mission, etc.
- Is the hospice licensed by the state?
- Is the hospice Medicare certified?
- Has the hospice ever committed insurance fraud? Google the name of the hospice and Medicare fraud.
- How many counties does the hospice serve?
- Can I meet or speak by phone with the hospice administrator prior to hospice admission?
- Can I meet the staff who will be providing care prior to admission?
- What types of services are provided? How often will each of these services be provided to me (or my loved one)? Get these important details in writing.
- Will services be provided by the same individuals throughout the course of my care?
- What kinds of support are available to my family/caregivers?
- How are services provided after hours? How long may it take for an on-call nurse to respond to my call? How long may it take for an on-call nurse to get to my home?
- What do hospice volunteers do? Am I eligible for volunteer services?
- Can the hospice provide care in a nursing home or personal care home/assisted living?
- Must someone be with me at all times?
- Must I commit to a DNR (Do Not Resuscitate) status?
- Can I receive IV fluids and tube feedings?
- What is the hospice’s position regarding Terminal Sedation (also mistakenly called Palliative Sedation)?
- Will I receive a bill for expenses not covered by insurance?
- What should I do first if I am having a problem with the care my hospice is providing?
- What should I do if I feel the hospice hasn’t addressed my concerns adequately.
2.adapted from the Hospice Patients Alliance.
3.Most hospices caught for Insurance fraud are for-profits. Additionally, many for-profits are governed by shareholders concerned about returns on their investments. As a result, monies are often allocated away from the bedside and into their pockets. However, many non-profits also follow a business model resulting in the same problems. Therefore, asking about a hospice agency’s business status is as important as asking about profit status. If the hospice employs marketers, this is often an indication that they are more interested in keeping money in the bank than in providing services to patients. Any hospice that keeps saying “We don’t provide that” is not nhancing life and is most likely cutting costs at the bedside in order to enrich investors and pay executives’ salaries.
4.Hospice agencies often serve many counties from a single office. The on-call nurse may have difficulty
reaching you quickly in an emergency as he/she may be several hours away. Your values should
come first and must never be compromised.