Category Archives: Resources

#SoonerIsBetter – Don’t wait to talk about hospice

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It’s an all too common situation. A family is at the bedside of a loved one who is seriously ill and nearing the end of life. Each member of the family has a different idea of what should be done and what the patient would have wanted.

Far too many people wait until they are in the midst of a health care crisis before thinking about what options are available or what care they or their loved ones would have wanted.

Often, by waiting too long to learn about possible options, like hospice care, people end up spending difficult days in the hospital or the emergency room and opportunities to be with loved ones at home are lost.

When a family is coping with a serious illness and a cure is no longer possible, hospice provides the type of care most people say they want at the end of life: comfort and dignity. Considered to be the model for high-quality, compassionate care for people with a life-limiting illness, hospice care includes expert medical care, pain management, and emotional and spiritual support. Care is provided by an inter-disciplinary team of professionals and trained volunteers. The wishes of the patient and family are always at the center of care.

Most hospice care is provided in the home – where the majority of Americans have said they would want to be at this time. Care is also provided in nursing homes, assisted living facilities, and hospice centers.

Care is paid for by Medicare, Medicaid, and most private insurance plans and HMOs.

The National Hospice and Palliative Care Organization reports that more than 1.5 million people received care from our nation’s hospices last year.

One of the best ways to make sure you and your loved ones benefit fully from hospice, should you ever need this care, is to talk about it before it becomes an issue.

For more information, please call us at 973-383-0115. You will also find information about the moments that hospice makes possible for patients and families at www.MomentsOfLife.org.   

Patient Safety in the Home

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Our goal is to prevent all falls. Although they are not always preventable, with the assistance of your health care professional they can be fewer in number an less in severity.

There are many factors that put you at risk for injury due to falls in your home. This information is meant to increase your understanding of safe movement and transfer techniques. Our professional team will monitor our risk for falls on an ongoing basis and work with your on continued preventions of injury.

Remember

  • Our goal is to keep your comfortable, keep you safe, to keep you free from pain
  • Your safety and well being is our concern
  • Your nurse is available to answer any questions you might have
  • There are many different types of equipment available that can assist you so that you can be safe and injury free.

Canes

There are various canes that can be used, but, remember:

  • The cane should be used on the stronger (unaffected) side of your body: If your right side is weaker, hold the cane in your left hand. Move the cane as you move your right leg. Then move your left leg.
  • Always practice first with someone standing beside you before you do it on your own.

Walkers

Walkers are used when you have generalized weakness and instability. Remember:

  • Place your hands on the handle grips on both sides of the walker with slight flex at the elbows. When you walk mover the walker first then step into it. Only move the walker on step.
  • To rise from a sitting position, use the arms of the chair to push your body to a standing position. Do not pull your body into an upright position using the walker.

Sitting

Proper posture encourages good circulation, comfort, optimal respiratory function, prevents falls and prevents complications related to skin integrity. Remember:

  • Align your head and spine and keep your back straight
  • Support both arms with armrests
  • Keep your legs uncrossed
  • Keep both feet flat on the floor

Wheel chairs

Wheel chairs are often used when poor endurance leads to immobility as well as when you find it difficult to bear weight. Remember:

  • Always make sure the wheels are locked when transferring in or out of the wheel chair.
  • Maintain proper sitting alignment.
  • Have wheel chair maintained in good mechanical condition.
  • Servicing is available through your medical equipment supplier.

Transfers

Transferring from bed to chair and from chair to bed properly is an important part of maintaining your mobility. Remember:

  • Plan your move before taking action and make sure the area is clear of clutter.
  • Always know your limits and call for help if needed.
  • Ask questions, demonstrate what your know to your nurse and follow all instructions.

In the event of a fall

If you should find yourself falling, the following will help to minimize injury, Remember:

  • Protect your head and face and do not try to break the fall.
  • If possible, don’t move until you are checked by another person.
  • If there is no one available, attempt to move very slowly until the extent of injury is know. Notify your nurse or family as soon as possible after the fall (even if you do not think your have any injury).

Who will care for your pets when facing a life-limiting illness?

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When facing a life-limiting illness many patients worry about who will take care of their beloved pets once they are gone.

 

Having a plan in place can help ease some of the worry and anxiety. Some options include: a will provision, a pet trust, a DIY pet protection agreement or an informal agreement with a family member or friend.

 

Every year between five and seven million companion animals enter animal shelters due to the death of their owners, reports the American Human Association. Of these, approximately three to four million are euthanized (60% of dogs and 70% of cats) when adequate homes cannot be found for them. Older pet owners usually have older pets that can be hard to find adoptive homes for.

 

Placing a pet in a shelter who has spent most of its life in a loving home, sharing a bed, sitting on the couch surrounded by its toys and memories can be very stressful to the pet. If no provisions have been made and no family or friends are able to step forward and care for the pet, a “no-kill” pet rescue organization can be an option to help the pet find a new home.

 

If you are caring for a pet whose owner has already died it’s important to evaluate if you have the financial means, space or time to take care of the pet. Also, find out if there are any provisions made for the pet in the owners will. These provisions can be helpful in providing financially for a pet’s care over the long-term.

 

With a “will provision,” you simply include a provision in your will that leaves your pets to a beneficiary. You can also leave money for their care to the same person. A will that includes provisions regarding pets can cost less than creating and administering a traditional pet trust.

 

The problem with a will provision is that the person you leave your pets to does not have to follow any instructions you provide as they are not legally enforceable. Unlike with a pet trust, you cannot distribute money for care over time – it comes as a lump-sum payout – or ensure that the money gets spent as directed on your pets at all. A will must go through the probate process, leaving the care of your pets up in the air during that time.

 

Also, since a will goes into effect only upon your death, it cannot provide care for your pets if you become seriously ill.

 

A pet trust is a legal process that transfers ownership of your pets to a trust, which includes instructions for their care and money to pay for it. You name a caregiver, and you appoint a trustee to oversee that care and any related expenses. If you do not name a caregiver and trustee, the State of New Jersey will do so. Pet trusts are valid in the state of New Jersey.

 

The trust will terminate upon the death of the pet, or, if the trust was created to care for more than one animal, upon the death of the last surviving animal or the death of the last surviving direct offspring of animals in gestation at the time the trust is enacted. With a traditional pet trust the caregiver and trustee are under a legal obligation to follow your instructions.

 

The court may reduce the amount of the property transferred if it determines that the amount substantially exceeds the amount required for the intended use. If the trust is reduced the property will return to the estate. It is important to consider what amount goes into a trust or pet agreement. It need to cover not only regular care, but also unexpected expenses.

 

If you opt for a living pet trust, as opposed to one that kicks in after you die, you provide for your pets if you become unable to care for them because of serious illness.

 

You do need a legal professional to prepare a trust or living trust. If you already have an estate plan in the works, adding a pet is typically very inexpensive.

 

A DIY Pet Protection Agreement like the one available through LegalZoom, is valid in all states. This legal document allows you to specify a caregiver for your pets and leave money for their care. A Pet Protection Agreement is a contract between the pet owner and the pet guardian. The signature of both parties on the agreement makes it legal.

 

 It falls between a traditional pet trust and will provision in terms of the amount of detail you can include. It cost much less than establishing a traditional pet trust or drafting a will.

 

Like a traditional pet trust, it can apply if you are living but unable to care for your pets. Unlike a traditional pet trust, it does not require funding upon creation. A DIY pet agreement is better than doing nothing, but going to a skilled estate planner will ensure that everything gets done correctly. If you plan to leave a substantial amount of money for the care of pets or think your family members may dispute your wishes, then a formal pet trust could be a better option. A Pet Protection Agreement is a simpler, more affordable alternative.

 

You can also set up an informal arrangement with a trusted family member or friend to take your pets when you die. It cost nothing to come to such an arrangement. You should make sure all family members and friends know about the agreement and will not put up a fight for your pets too. With this type of agreement, you have no control over the care of your pets after you die.

 

The information above is just a starting point. A legal professional can best advise you how to move forward.

Grief and the workplace

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Grief & the Workplace

Whether it’s a colleague’s illness, the boss’ death or trying to help a friend through the loss of a spouse, grief and loss can dramatically affect the workplace. Being sensitive and deliberate in our responses can help the entire office cope with a difficult time.

Supporting a colleague

When someone at work experiences a loss, simply offering your sympathy and support is good way to help. Asking how they are doing and genuinely listening to their response without judgment or comment is usually appreciated. It is important to acknowledge their loss; often a simple “I’m sorry” is enough. Sharing stories of your own loss or avoiding the topic because you aren’t sure what to say is often hurtful to the bereaved person.

Participating in the memorial by attending visitations, funerals or sitting Shiva are all good ways to show your support. Flowers and memorials from the office can demonstrate your concern and care. Remember, there is no timeline to grief. A colleague may have an unexpected bad day months after a loss, so continue to be supportive even after the funeral.

When a coworker dies

The loss of a coworker is troubling. Providing a sensitive and compassionate environment will help the workplace cope with the loss. Remember that everyone grieves in their own way; providing a space for open communication and dialogue will allow everyone’s grieving style to be respected. Information about the death as well as the plans and arrangements should be shared in accordance with the family’s wishes. It may be appropriate to arrange something at the workplace to commemorate the loss as well, to allow colleagues to express their grief in their own way.

Getting help for the office

It is important for the office to be a supportive place for employees dealing with grief and loss. When a death occurs, it may be helpful to consider professional intervention by a crisis team. The Joseph T. Quinlan Bereavement Center is a good resource for providing extra help if needed. Diana Sebzda, Director of Bereavement can be reached by calling 973-948-2283 or email at [email protected]

Download Advance Directive Forms

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What are Advance Directives?

Download an advance directive for your state:
New Jersey
Pennsylvania
Other States

Click here for a guide on choosing a health care proxy.

A living will allows you to document your wishes concerning medical treatments at the end of life.

Before your living will can guide medical decision-making two physicians must certify:

You are unable to make medical decisions,
You are in the medical condition specified in the state’s living will law (such as “terminal illness” or “permanent unconsciousness”),
Other requirements also may apply, depending upon the state.
A medical power of attorney (or healthcare proxy) allows you to appoint a person you trust as your healthcare agent (or surrogate decision maker), who is authorized to make medical decisions on your behalf.

Before a medical power of attorney goes into effect a person’s physician must conclude that they are unable to make their own medical decisions. In addition:

If a person regains the ability to make decisions, the agent cannot continue to act on the person’s behalf.
Many states have additional requirements that apply only to decisions about life-sustaining medical treatments.
For example, before your agent can refuse a life-sustaining treatment on your behalf, a second physician may have to confirm your doctor’s assessment that you are incapable of making treatment decisions.
What Else Do I Need to Know?

Advance directives are legally valid throughout the United States. While you do not need a lawyer to fill out an advance directive, your advance directive becomes legally valid as soon as you sign them in front of the required witnesses. The laws governing advance directives vary from state to state, so it is important to complete and sign advance directives that comply with your state’s law. Also, advance directives can have different titles in different states.
Emergency medical technicians cannot honor living wills or medical powers of attorney. Once emergency personnel have been called, they must do what is necessary to stabilize a person for transfer to a hospital, both from accident sites and from a home or other facility. After a physician fully evaluates the person’s condition and determines the underlying conditions, advance directives can be implemented.
One state’s advance directive does not always work in another state. Some states do honor advance directives from another state; others will honor out-of-state advance directives as long as they are similar to the state’s own law; and some states do not have an answer to this question. The best solution is if you spend a significant amount of time in more than one state, you should complete the advance directives for all the states you spend a significant amount of time in.
Advance directives do not expire. An advance directive remains in effect until you change it. If you complete a new advance directive, it invalidates the previous one.
You should review your advance directives periodically to ensure that they still reflect your wishes. If you want to change anything in an advance directive once you have completed it, you should complete a whole new document.

Understanding Hospice Care

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What is hospice care? Hospice focuses on caring, not curing and in most cases care is provided in the patient’s home. Hospice care also is provided in freestanding hospice centers, hospitals, and nursing homes and other long-term care facilities. Hospice services are available to patients of any age, religion, race, or illness. Hospice care is covered under Medicare, Medicaid, most private insurance plans, HMOs, and other managed care organizations.

 

Sorting out hospice care myths

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In the living room, a grandfather laughs and plays video games with his granddaughters. Later, he joins the rest of his family to say grace before enjoying a meal together. Moments like these may seem ordinary to most. Would it surprise you to know that this grandfather, Robert, is dying and on hospice care?

Many people think that being on hospice means lying in a bed, barely conscious. Robert is a patient who proves that is not case. Many of his final moments were anything but ordinary, and they would not have been possible without the help of hospice.

Robert’s experience is not unique. The mission of Karen Ann Quinlan Hospice is to provide specialized care for end-of-life patients and their families. More simply, hospice care supports living one’s life to the fullest with dignity regardless of how much time remains.

When Robert was diagnosed with cancer, he “wondered if there was any chance of getting my quality of life back while I was still alive.” His answer, “I knew at that moment it was time to call hospice.”

Here are some of the common myths of hospice that need to be put to rest:

MYTH: Hospice care means leaving home.
FACT: Hospice services can be provided in a patient’s own home, a nursing home, long-term care facility or a hospice care center.
Hospice is not a place. In fact, hospice services can be provided to a terminally ill patient and his or her family wherever they are most comfortable, or wherever they consider “home.” Robert’s wish was to make sure he was able to stay home at the end of his life. Hospice made it possible for Robert’s son, Eric, and his family to move into Robert’s home and enjoy dinner together four to five times each week.

MYTH: Hospice means forgoing all medical treatment.
FACT: Hospice nurses and physicians are experts in the latest medications and devices for pain and symptom relief.
In every case, a hospice provider will assess the needs of the patient, deciding which medications and equipment are needed for maximum comfort. For example, Robert’s medical staff provided sleep medication to help him through the night. “I am speaking from the heart when I say hospice provides not only superb medical care, but also offers compassion that I would not have gotten anywhere else,” Robert said.

MYTH: Hospice means strangers care for you.
FACT: Hospice provides a dedicated team of specialists to suit the needs of each patient and educate family members to serve as caregivers.
Hospice organizations strive to educate family members to serve as the primary caregivers for an end-of- life patient. In addition, “The doctors, nurses, aides, social workers, therapists and chaplains who make up my hospice team are there whenever I need them,” Robert said, “All I have to do is pick up the phone and someone from hospice is there to help.”

MYTH: Hospice care ends when someone dies.
FACT: Hospice organizations offer bereavement services for all ages.
Hospice counseling services that deal specifically with grief and coping after the loss of a loved one are available at no cost for up to a year after someone dies. Robert’s son, Eric, credits hospice as something that he and his family can always look back and reflect on in a positive way.

MYTH: People on hospice are in bed, waiting to die.
FACT: Hospice enables special moments and memories at the end of a life that would otherwise not happen.

Robert called hospice because he wanted to live happily and with dignity, restoring a quality of life that he would have otherwise lost to invasive treatments and surgeries. In a final letter chronicling his hospice experience, Robert wrote, “If I inspire others to call hospice, I know I’ve made a difference.”

To learn more about how hospice can help you and your family please call Karen Ann Quinlan Hospice at 973-383-0115.

Paying for End-of-Life Care

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How to pay for the rising costs of health care? Concerns over these costs are shared not only by elected officials but by almost every family across the country. Many baby boomers are providing care for their aging parents just as they are facing their own health care issues.

Yet, for almost 30 years, the Medicare Hospice Benefit has provided a model for financing end-of-life care that can bring great relief and support to families during one of life’s most difficult times.

This benefit covers virtually all aspects of hospice care with little out-of-pocket expense to the patient or family. As a result, the financial burdens often associated with caring for a terminally-ill patient are lifted.

Hospice care also offers supports to the loved ones of the patient; this brings an added level of relief to the dying person, knowing their loved ones are being cared for as well.

Hospice is paid for through the Medicare Hospice Benefit, Medicaid Hospice Benefit, and most private insurers. In addition, most private health plans and Medicaid in 47 States and the District of Columbia cover hospice services. If a person does not have coverage through Medicare, Medicaid or a private insurance company, hospices will work with the person and their family to ensure needed services can be provided.

Medicare covers these hospice services and pays nearly all of their costs:

  • Doctor services
  • Nursing care
  • Medical equipment (like wheelchairs or walkers)
  • Medical supplies (like bandages and catheters)
  • Drugs for symptom control and pain relief
  • Short-term care in the hospital, including respite and inpatient for pain and symptom management
  • Home health aide and homemaker services
  • Physical and occupational therapy
  • Speech therapy
  • Social work services
  • Dietary counseling
  • Grief support

Medicare will still pay for covered benefits for any health problems that aren’t related to a terminal illness.

Hospice and palliative care involves a team-oriented approach to expert medical care, pain management, and emotional and spiritual support expressly tailored to the patient’s needs and wishes. Families making end-of-life decisions for a loved one need compassion and support, not financial worries. The Medicare Hospice Benefit helps alleviate these concerns.

How to Choose Hospice Care

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Hospice provides support and comfort for people who need end-of-life care. Opting for hospice care is one of the most compassionate decisions you will ever make. You will find hospice workers in assisted living centers, nursing homes, hospitals and residential facilities. Some patients may even receive care in their own homes or the homes of friends and family,

According to the Hospice Foundation of America, a third of all Americans choose hospice care when they are dying. But hospice isn’t only for the dying. Loved ones also benefit from hospice care, as workers will support them through some of the most difficult moments in life.

And while all hospice centers are regulated by the government, each facility has meaningful differences in personnel, policies and facilities.

LOCATION

Hospice specializes in making the patient feel as comfortable as possible. Care can take place anywhere. Patients can even receive treatment in their own homes, where they are most comfortable.

Some diseases may require more specialized care than others. The patient can also choose to stay in a facility that can give them easy, 24-hour access to nurses, medication, and medical equipment needed for their comfort.

It is always best to consult with a doctor regarding this decision. The hospice staff will meet with the patient’s physician to talk about the current symptoms, medical history and life expectancy. Then they will let you know which options are available to you.

COMMUNICATION

Pick a hospice service that helps you feel at ease. You are going to have to ask and answer some extremely difficult questions. Death is a tough subject to discuss. Clear, caring communication is absolutely essential.

A quality hospice program will give you all the time and personal attention you need to ease your mind.

Part of picking hospice involves having the right feeling. If the hospice staff is personable and makes you feel comfortable, that’s a good sign.

REFERRALS

Every patient who receives hospice treatment must be qualified by a physician. Usually, this means there is a life expectancy of six months or less.

Since some physicians may hesitate to broach the subject of hospice care, you may need to bring it up yourself. Ask whether hospice care would be appropriate and which services might be most helpful to ease the end-of-life process.

You can also approach a hospice facility directly to ask about their services. They will help you determine which care is most appropriate.

Hospice care has been growing since the 1990s. Many people are realizing that it is possible to die with peace and dignity. Hospice can help the end-of-life experience a little easier for the patient and loved ones.

When is it time for hospice?

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“When is the right time?” A growing number of caregivers are finding that the correct answer to the question is, “As early as possible,” as they discover all of the advantages hospice has to offer the patient as well as the caregiver.

Special needs require the services of specialists. Hospice professionals are specialists in end-of-life care, and should be called upon during the first stages of a terminal illness.

Six Months or Less to Live

A person of any age is eligible for hospice after being certified by a physician as having a life expectancy that may be six months or less, depending on the course of the disease. If a patient lives beyond six months after admission they can continue to receive services as long as a physician continues to document the patient’s eligibility.

Hospice services are covered by Medicaid and many types of insurance, although many not-for-profit hospices generally provide services regardless of the person’s ability to pay.

Making the Most of the Final Stages of Life

Hospice care enables the individual and their families to experience the final stage of life together, in the setting most comfortable for them. In most cases, the person remains at home, close to family and friends while under professional medical supervision. Karen Ann Quinlan Hospice, like many hospices around the country, assigns a care team to each hospice patient. The hospice interdisciplinary team may include a physician; nurse; social worker; bereavement counselor; chaplain; and volunteers. Each team member is focused on the person, not the illness, making sure that all physical, emotional and spiritual needs are met.

Pain Management

Hospice has a unique approach to pain management – another advantage of entering hospice care earlier. The care team always works to manage the patient’s pain as expediently and efficiently as possible. Addressing pain and other symptoms in their early stages, rather than waiting until they become severe, is a priority.

In addition to determining the appropriate medications for pain and other symptoms, members of the care team identify the best ways to administer the medication to the satisfaction of the individual patient. 

When is the right time to have that “difficult” conversation

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We Procrastinate.  We’re not proud of it, be we all do it.  It’s no secret that many of us “hit the ground running” each day; come up for air on weekends and marvel, perplexed and vexed, at the passage of time.  No wonder talking “face to face” has been put on hold.  Multi-tasking and technological advances, such as voicemail, email, facebook, tweeting and text-messaging, have nearly rendered dialogue as an archaic art form.

 

And yet, we know there are really important circumstances that warrant more than a perfunctory “fly by” chat with our spouse, child, colleague or friend.  Serious illness is one of the critical issues requiring a deliberate and sensitive discussion with our loved ones.  The value of having a true “heart to heart” talk with our family regarding our health, health care wishes and future health care cannot be underestimated.

 

A recent survey, conducted by the Conversation Project, reported that 90% of people say that talking with their loved ones about end-of-life care is important, but only 27% have actually done so.

 

80% of people say that if seriously ill, they would want to talk to their doctor about end-of-life care. 7% report having had an end-of-life conversation with their doctor.

 

Similarly, 70% of people surveyed say they want to die at home, but in reality, 70% die in hospitals or institutions.

 

            I would urge everyone to make the time for meaningful, albeit challenging, conversations about life-changing issues.  If you find the task daunting, there are many wonderful social workers, counselors and clinicians in your community that are trained to help.  You’ll be so glad you did!

What type of support, services can I expect when placed in hospice care?

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Hospice provides support and comfort for people who need end-of-life care. Opting for hospice care is one of the most compassionate decisions you will ever make. You can receive hospice care in your own home, a residential facility, such as the Karen Ann Quinlan Home for Hospice in Fredon, or in assisted living centers, nursing homes and hospitals. Some patients receive care in the homes of friends or family.

 

According to the Hospice Foundation of America, a third of all Americans choose hospice care when they are dying. But hospice isn’t only for the dying. Loved ones also benefit from hospice care, as workers will support them through some of the most difficult moments in life.

 

Here are some of the support services you can expect from Karen Ann Quinlan Hospice:

  • Every patient who receives hospice treatment must be qualified by a physician. All care is directed by your primary physician.
  • Nursing care and services are provided by or under the supervision of a registered nurse. At Karen Ann Quinlan Hospice our nursing staff is available to patients and families 24-hours a day.
  • Medical Social Service is provided by a qualified social worker under the director of a physician.
  • Our hospice Medical Director will oversee the general needs of the patient working in tandem with the attending physician which includes palliation and management of the terminal disease and related conditions.
  • Home Health Aides provide personal care services. Aides’ services are provided under the general supervision of a registered nurse.
  • Chaplain Services are available to provide/facilitate spiritual counseling.
  • Volunteer services are available to assist the patient/caregiver in any one of a multitude of ways from providing comfort and respite to the family, an avenue of socialization for the patient; assistance with shopping, etc. All volunteers have completed a Karen Ann Quinlan Hospice training course.
  • Bereavement Services are provided for 13 months following the patient’s death to family and significant others. Additionally, the Joseph T. Quinlan Bereavement Center holds bereavement and grief recovery support groups in all the communities served by Karen Ann Quinlan Hospice.

 

The staff at Karen Ann Quinlan Hospice is trained to offer peace of mind in addition to medical care. We hear it so many times, patients and families tell us: “We wish we’d called hospice sooner.” Patients and families can benefit most from hospice care when they seek support earlier rather than in a crisis.

 

The best way to determine if you or your loved one could be helped by hospice is to call us at 800-882-1117. There is no cost and calling does not commit you or your loved one to hospice care. Perhaps there are other resources in the community that could be of help to you; our social workers or nursing team will help guide you.

Who chooses my hospice provider?

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You do. It can be in consultation with your physician or you may consult with the hospice of your choice. According to Medicare today, “a patient is free to choose any qualified agency offering him/her services.” Your physician or the hospice professional staff can determine if your illness is hospice appropriate according to Medicare/Medicaid guidelines.

Sadly when you or family members speak to the doctor or a hospital social services department about hospice, asking the right questions can come with a lump in your throat. Once we come face to face with that difficult decision, it will be a very trying time; a loved one has been diagnosed with a terminal illness.

When met with the prospect of hospice care, first ask for what hospices are available and then if you need to get information from the hospice of your choice, there are very basic questions that should be asked.

• What specific services are offered?

• How often will a nurse or hospice staff visit?

• Are they accredited?

• Is care available seven days a week, 24 hours a day?

• Does the hospice provide pharmacy and home health equipment?

• What social services are available?

• What spiritual support and/or anticipated grief counseling is provided?

• Do they have certified trained volunteers?

• Can the hospice provide services in a nursing home, hospital or a home for hospice?

Patients have the basic right:

• To choose any Medicare-certified agency.

• To be told when Medicare will not cover a service.

• To receive services the doctor ordered.

• To be involved in care planning.

• To choose to transfer to another hospice provider if unhappy with current agency.

Do hospice patients live longer than those who do not choose hospice?

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Recent studies have shown that hospice care may prolong survival as much as 29 days or more for terminally ill patients. Two studies in the Journal of Pain and Symptom Management in 2004 and 2007 reported in both cases patients who chose hospice care lived an average of one month longer than similar patients who did not choose hospice care. In addition, a new study released by the New England Journal of Medicine found that some cancer patients who received palliative care lived, on average, almost two months longer than those who received standard care. Researchers also found that patients receiving palliative care correlated a higher quality of life through the final stages of their illness. “With earlier referral to a hospice program, patients may receive care that results in better management of symptoms, leading to stabilization of their condition and prolonged survival, “ wrote the authors of the study from the New England Journal of Medicine.

“There’s an inaccurate perception among the American public that hospice means you’ve given up,” said J. Donald Schumacher, president and CEO of the National Hospice and Palliative Care Organization. “Those of us who have worked in the field have seen firsthand how hospice and palliative care can improve the quality of life and indeed prolong the lives of people receiving care.”

Researchers cited several factors that may have contributed to longer life among patients who chose hospice. Patients in a weakened condition sidestep the risks of over-treatment when they make the decision to receive hospice care.

Second, hospice care usually improves the monitoring and treatment patients receive.

And primarily, the hospice model of care provides a team focused on the emotional and spiritual wellbeing, as well as the physical health of the patient.

Support and training for family caregivers are provided as well. Combined, this may increase the patient’s desire to continue living and make them feel less of a burden to family members. In total, facing end-of-life decisions is being proven to be more stable when the body is being treated in its entirety, mind and spirit.