2010/03/19 00:00:00
By Nanette Lavoie-Vaughan
My father-in-law passed away recently after a major stroke, preceded by multiple smaller strokes and the ravages of dementia. My husband, Don, and I were his caregivers for the past four years and would not have been able to manage the final year without the help of hospice services.
There is a common misconception that hospice services are only for those who are actively dying or in their last month of life. I want to set the record straight. Hospice services can be initiated any time an individual meets the specific criteria based on his or her medical condition and functional status. The Centers for Medicare & Medicaid Services (CMS) developed eligibility criteria for nine specific conditions —cancer, dementia, failure to thrive, heart disease, liver disease, lung disease, kidney disease, stroke, and functional decline.
My father-in-law needed complete assistance with everything but eating and, because of his dementia, was not always cooperative with my husband and me. Having a nursing assistant provide his bath and personal care was a tremendous relief for us. When he was actively dying, the nurse eased my husband’s anxiety and the burden of handling all the small details that go along with maintaining comfort in someone’s final hours.
Medicare and Medicaid pay for hospice care and provided in an individual’s home, nursing homes, assisted-living facilities, and specially designated hospice units. An entire team of professionals that includes a registered nurse, a home-health aide, a social worker, and a chaplain is available to assist you and your parent.
Services are provided on a weekly schedule based on your parent’s needs, and a registered nurse is available 24 hours a day for urgent concerns. Services include assessment of your parent’s medical condition, bathing, assistance with dressing and grooming, counseling and support for you and your parent, spiritual guidance, and advance planning for the end of life. Hospice also provides all medical equipment and supplies, and a “comfort kit,” containing medications for pain, fever, and excessive saliva, is issued to each patient.
How can you determine if hospice care is appropriate for your parent and whether he or she is eligible? First, talk to your parent’s health care provider about his or her medical condition and plan of treatment. If your parent’s prognosis is less than six months and it is his or her wish to receive supportive and comfort care only, a referral is made to hospice for an evaluation visit. The initial visit is completed by a registered nurse who performs a complete assessment and compares the results to the eligibility criteria for your parent’s primary diagnosis. If your parent meets at least three of the criteria, he or she will be enrolled in services for three months.
Once your parent is receiving hospice services, he or she will be reevaluated every three months, and if he or she still meets the criteria, the services will be extended for another three months. If your parent’s condition improves, he or she might be discharged from hospice but can be reenrolled in the future if his or her condition deteriorates.
Hospice provides much-needed support for caregivers, whether you care for a parent yourself or need the peace of mind that your parent is receiving care and support because you cannot be there to provide assistance. The goals of hospice — maintaining quality of life and comfort — are what we all wish for our parents during their final years. Talk with your parents, and plan ahead for when hospice care might be needed. You will not regret the decision and comfort that comes from knowing you provided the best for your parent at the end of his or her life.
To learn more about hospice services or to find a hospice organization near you, visit www.hospicenet.org.
About the Author: Nanette Lavoie-Vaughan is an adult nurse practitioner and professional consultant. She is a featured speaker at national professional conferences and writes about geriatrics for multiple publications.
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Copyright Nanette Lavoie-Vaughan and Military Officers Association of America. All rights reserved.
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Commander Edwards |
4/8/2010 9:40:03 AM |
This is good information and provides another option for one to consider.
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Colonel Torraca |
4/7/2010 10:40:01 PM |
Good article, but one point...medicare does pay for services, but not daily cost which in Hawaii runs almost $300 per day in a Hospice approved home. This doesn't apply for in-home, but u need someone there 24/7 to take care of your loved one.
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Chief Warrant Officer Stein |
4/7/2010 3:32:50 PM |
Very interesting. My wife is a volunteer hospice facility and you would expect that I would know this information. I did not. Thanks.
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Major Ryan |
4/7/2010 2:19:32 PM |
Enlightening
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Colonel Leisge |
4/7/2010 2:16:53 PM |
Excellent overview.
