Entering Hospice
When should a decision about entering a hospice program be made, and who should make it?
At any time during a life-limiting illness, it's appropriate to discuss all of a patient's care options, including hospice. By law, the decision belongs to the patient. Understandably, most people are uncomfortable with the idea of stopping aggressive efforts to "beat" the disease. Hospice staff members are highly sensitive to these concerns and always available to discuss them with the patient and family.
Will I still be able to make my own decisions regarding my care?
Yes. You and your family are in charge of your care.
What if our physician doesn't know about hospice?
Most physicians know about hospice. The patient and family should feel free to discuss hospice care at any time with their physician, other health care professionals, clergy or friends. If your physician wants more information about hospice, it is available from the National Council of Hospice Professionals Physician Section, medical societies, state hospice organizations, or the National Hospice Helpline (1-800-658-8898). In addition, physicians and all others can also obtain information on hospice from the American Cancer Society, the American Association of Retired Persons, and the Social Security Administration.
What does the hospice admission process involve?
One of the first things the hospice program will do is contact the patient's physician to make sure he or she agrees that hospice care is appropriate for this patient at this time. (Most hospices have medical staff available to help patients who have no physician.) The patient will be asked to sign consent and insurance forms. These are similar to the forms patients sign when they enter a hospital.
The hospice election form says that the patient understands that the care is palliative (meaning that is aimed at pain relief and symptom control) rather than curative. It also outlines the services available. The form Medicare patients sign also tells how electing the Medicare hospice benefit affects other Medicare coverage.
Is hospice affiliated with any religious organization?
No. While some churches and religious groups have started hospices (sometimes in connection with their hospitals), these hospices serve a broad community and do not require patients to adhere to any particular set of beliefs.
Will my advance directives be honored by Alive Hospice?
Yes. It is your right to choose your advance directives. We do not require a DNR (Do Not Resuscitate) order, and we will review all options with you.
Do you provide any advance directives resources?
May I still use my regular doctor?
Yes. We encourage you to continue seeing your primary care physician. Our team continues to communicate with your primary care physician while you receive our care.
Can a hospice patient who shows signs of recovery be returned to regular medical treatment?
Certainly. If the patient's condition improves and the disease seems to be in remission, patients can be discharged from hospice and return to aggressive therapy or go on with their daily life. If the discharged patient should later need to return to hospice care, Medicare and most private insurance will allow additional coverage for this purpose.
What will happen if I outlive my prognosis?
We continue to provide the same care for you as long as you remain hospice eligible. You will not be given less service regardless of how long you are in our care, and your costs will remain the same.
Does hospice do anything to make death come sooner?
Hospice neither hastens nor postpones dying. Just as doctors and midwives lend support and expertise during the time of childbirth, hospice provides its presence and specialized knowledge during the dying process.
Pain Management
How does hospice manage pain?
Hospice believes that emotional and spiritual pain are just as real and in need of attention as physical pain, so it can address each. Hospice nurses and doctors are up to date on the latest medications and devices for pain and symptom relief. In addition, physical and occupational therapists can assist patients to be as mobile and self-sufficient as they wish, and they are often joined by specialists schooled in music therapy, art therapy, massage and diet counseling.
Finally, various counselors, including clergy, are available to assist family members as well as patients.
What is hospice's success rate in battling pain?
Very high. Using some combination of medications, counseling and therapies, most patients can attain a level of comfort that is acceptable to them.
Will medications prevent the patient from being able to talk or know what's happening?
Usually not. It is the goal of hospice to have the patient as pain-free and alert as possible. By constantly consulting with the patient, hospices have been very successful in reaching this goal.