Common Myths & Misconceptions About Hospice Care

Transcript:

Hi, my name is Aracely Rios and I am the clinical director here at Angels Grace Hospice. Today, we’ll talk about some of the myths that surround hospice care. The first myth, a hospice care is only for people giving up on life. Ultimately, that’s not true. Hospice is not about dying. It’s about helping patients live life to the fullest with the time that they have left. Multiple research studies show that those with terminal illnesses who choose hospice often live longer and have a better quality of life than those who seek aggressive or invasive medical care at end of life. Another myth choosing hospice means giving up control. That’s also not true. You’re always in control of the level of care and you make graduate or come off hospice at any time. Patients and their families make the final decision about one to choose hospice or who provides their care.

It is important that we listen first and we coordinate the plan of care with the patient, the family and the physician. Another myth is hospice care is expensive. Hospice is a fully funded Medicare Medicaid benefit unlimited in length and is covered by many private insurance companies. Most plans, cover hospice care, medication, supplies and equipment related to the hospice diagnosis with no out-of-pocket expenses to the patient. The care team includes visits from the nurses, other healthcare professionals, social services, certain therapies and spiritual counseling. Another myth hospice only happens at a hospital or a hospice facility. Hospice is provided anywhere a patient calls home. Often that could be in the patient’s home in the home with a family member. It could also mean a hospice care at a nursing home, assisted living facility, independent living facility, or a hospital. Another hospice myth. Once you decide on hospice, you can’t go back.

Patients can revoke hospice participation at any time. Their medical condition may improve or a patient may decide to pursue curative treatment again. And that’s okay. Patients can reapply for hospice benefits at a later time, if necessary. Another myth, hospice care is only for people with a few days or weeks to live. While hospice certainly helps patients and their families during a medical crisis, the fullest benefit occurs when pain and symptoms are managed and patients have the time to make those personal and spiritual connections. Another hospice myth, hospice care ends with the passing of the patient. Bereavement or grief support is an important part of hospice. At Angels Grace Hospice, we offer families a full year of bereavement support after the death of their family member. Our team is able to help with funeral arrangements and other issues that may arise after death. Another myth, hospice is only for people with cancer. Hospice is for patients of any age with a prognosis of six months to live or less. Diagnosis for hospice admissions may include cancer, dementia, heart disease, lung disease, stroke, or coma. Another myth hospice and palliative care are the same. Both provide comfort care during a serious illness. Hospice only begins after the decision to end treatment for a terminal illness. And when it’s clear that the person will not survive, palliative care can begin at diagnosis and happen at the same time as treatment.

 

What is Hospice Care?

Transcript: Oftentimes family members will ask, “Why hospice now?” Hospice in itself is a very intimidating word and families oftentimes have mixed emotions when approached about hospice services. Hospice is appropriate for someone who is facing an end of life type situation, um, or they’ve been given a diagnosis either, …

The Angels Grace Hospice Team

Transcript:

So we are a team and everybody has a role and, and the patient has a different relationship with my experiences, everyone on that team. We don’t all see the same patient because we’re, we’re, we’re, we’re meeting a different need. Usually social work, from my point of view, comes in a little bit later. Often, I may not even be seeing that patient. I may be talking to a family member or someone who’s out of state or a niece who’s been propping up a life that has fallen, fallen apart for her aunt who has had no children. So everyone has a job and we work with a case manager, the nurse who’s the overseer of the team. And we sort of take our lead from the case manager, who’s actually seeing the patient maybe more frequently because she or he are typically in there more times a week. And they may say, “Hey, you know, I’m noticing that so-and-so is having a, is getting sad, he’s getting sadder. Can you evaluate, can you give him some time.” You know, because there’s a difference between sadness and depression. So that’s a one way, for example, the case manager might involve the social work for an extra visit. And that’s a kind of a big part of what the psychosocial component of the team does.

Benefits Of Hospice

Transcript:

Hospice is covered by Medicare and private insurances. We work on Medicare benefit periods. Once you’re deemed eligible for hospice, it’s an ongoing evaluation of your hospice care needs and qualifications. We do accept private insurance and we follow the same guidelines that Medicare puts forward. There are no out of pocket costs for hospice care. We either bill Medicare directly or your private insurance, and we do not bill for the additional co-payments for hospice care. In addition to your care from a team, a team of nurses, physicians, nursing assistants, social workers, chaplains volunteer, that’s all incorporated into what is covered by hospice care. In addition to that, we have equipment. So specialty equipment that you may need; a special bed oxygen, a special wheelchair, special recliner, those items are also covered within that hospice benefit medications. So if you’re on certain medications that are related to your hospice diagnosis, those are also covered by your hospice benefit, whether it’s Medicare or private insurance and supplies, personal care items, briefs, mouth swabs, pads for the bed. Um, certain mitts or wound care supplies is all covered by hospice.

DNR and Hospice Care

 

Transcript:

One of the qualifications for hospice is your prognosis and your life limiting expectancy. One of the things we may discuss with you at that time is a do not resuscitate or a DNR order. That can come from your physician or a physician of our own. You do not have to have a, do not resuscitate to be in hospice care, but it is really the objective of hospice care to keep you home, to keep you comfortable, to keep you safe without doing anything aggressive, invasive, or sending you back to the hospital.

How has COVID-19 affected hospice care?

See more about COVID-19 and Angels Grace Hospice.

Transcript:
Well, COVID 19 has definitely changed the way we do things here in hospice. We have went from seeing our patients twice a week and having our home health aids readily available to provide services, to be limited to maybe one, one visit from the nurse every 14 days. And I understand the limitations because the facilities want to protect their most vulnerable community, and that’s the community that we serve. So we have in place with many limitations, but we have adjusted. We still have a team readily available. Our goal is to make sure that your loved one is able to live out whatever days he or she has as comfortably as possible. To Comfort Always. This is our work.

Understanding Palliative Care

Transcript:
My name is Jeanne Scheel and I’m a nurse practitioner working with Angels Grace Hospice and Palliative care teams. So palliative care is not hospice care. Palliative care is really for the living. The focus in palliative care is on quality of life management of symptoms, looking at the whole person. The person as a whole. Every aspect of them. Of course, the medical, then we factor in the spiritual, mental psychologic. Um, we also support the family through that. Oftentimes when someone comes to palliative care or is referred to palliative care, it may be the first time that they’ve actually addressed the seriousness of their chronic illness or acute illness. If they had a stroke, if they have cancer, um, the beauty of palliative care is that they continue to go through their treatments, and we just add on that extra layer of care. We look at where the person is at, right then not looking at what they can’t do any longer, but what they can.

And that again, helps with quality of life. Even if it’s something very simple, knowing that they probably won’t be the same, that they were a month ago, two months ago, a week ago, but how can we in palliative care, help them to be the best that they can be right then and there, by making those recommendations by working collaboratively with their medical team, what their loved ones with them at the forefront. Palliative care can go on. As long as the patient and loved ones and families want it to go on, there’s really no set limit. I’ve had patients on palliative care, now for a few years. I’ve had patients graduate from palliative care because of the extra care that they’ve gotten and we’ve defined those goals of care, and maybe they’ve moved on to the next step in their journey. Um, I have a lot of patients who do go into hospice care from palliative care. Some of our people use it as a segway into hospice. Maybe they’re not quite ready for hospice palliative care follows them; walks that journey with them and prepares them for the next step, so that when that transition, if it does happen is very seamless and they’re ready and they’re prepared. And it’s really a privilege to be able to be a part of their journey, wherever it leads.