- Air hunger (breathing problems)
- Loss of Appetite
1 AnswerTreating a terminal disease itself may not be possible or may be at odds with hospice care. Therefore, treating the symptoms themselves is important for improved comfort and quality of life. These symptoms may include:
1 AnswerCaregiver demand is driven by the steady increase in our elder population and functional impairment. As the number of elders rises, so does the number of needed caregivers. The number of people 65 years old and older in the U.S. is expected to rise by over 100% between 2000 and 2030, at a rate of 2.3% each year. Unfortunately, however, over that same 30-year period the number of family members who are available to provide care for these older adults is expected to increase by only 25%, at a rate of 0.8% per year.
1 AnswerCaregiving exerts a tremendous toll on caregivers' health and well-being, and accounts for significant costs to families and society.
Family caregiving has been associated with increased levels of depression and anxiety, as well as greater use of psychoactive medications, poorer self-reported physical health, compromised immune function and increased mortality. Over half of caregivers indicate that their decline in health compromises their ability to provide care.
1 AnswerConsider the unique advantages and disadvantages of hospice care to decide whether it is right for your situation.The decision about whether hospice care meets an individual's personal, physical and medical needs should be determined by the person who is ill and medical practitioners who are familiar with him or her. It may also be important to get input from family members and friends who may be responsible for providing some of the hospice care.
Hone your list of potential programs based on availability and services, and learn the right questions to ask to ensure that your needs will be met by the hospice staff. Visit the hospice and meet the staff. If you are young and healthy and only planning far ahead, maybe you will want to volunteer at a hospice.
1 AnswerFor many people, hospice represents an important choice -- allowing more autonomy and choice in directing final medical care than traditional treatment that focuses on life-saving procedures and cures. Hospice may be most fitting for those who want to:
- Be treated at home or in a more homelike setting and avoid hospital admissions
- Focus on treating their symptoms rather than on curing their illness
- Have the help of a team of people to assist with their comfort care, and emotional and spiritual needs
1 AnswerThe option is not the best fit for every person who has a terminal disease -- particularly those who feel strongly that hospice care signifies "giving up on life" rather than facilitating a good death. Hospice care is probably not a good choice for those who:
- Worry that working with a number of different healthcare workers may invade their privacy
- Wish to pursue experimental treatments or clinical trials for their conditions
- Are more comfortable receiving medical care in a traditional hospital setting
1 AnswerTo find funding for hospice other than through Medicare:
- Check your Medigap insurance for hospice coverage. Medicare supplemental insurance is designed to cover the "gaps" between what Medicare does and does not pay. For home hospice care, the most common gap needing coverage is aide services -- provided on more than a part-time or intermittent basis, or when there is no skilled care component.
- Check whether your life insurance, annuities, health insurance or long-term care insurance can help you pay for hospice care.
- Check what family or personal assets are available, such as reverse mortgages.
- Check other options, such as charitable funds, veteran's benefits, county indigent care programs or Indian Health Services.
1 AnswerIf a hospice's charges are more than Medicare will pay, the person being admitted may be responsible for paying the rest. Before care begins, the hospice must tell the person how much of the bill Medicare will pay. The agency must inform the person, in writing, of any items or services that are not covered by Medicare and how much will be due for them. The hospice then sends bills directly to Medicare.
An individual may be charged for:
- Treatments or services designed to cure a terminal illness or not related to comfort care
- Room and board if the person is receiving hospice in a facility -- except for temporary respite care
- Care in an emergency room or inpatient facility and ambulance transportation, unless arranged by the hospice provider or unrelated to the terminal illness.
1 AnswerMedicare pays a fixed amount for most hospice services, including:
- Doctor services and nursing care
- Physical therapy, occupational therapy and speech-language pathology services
- Medical social services, hospice aide services and homemaker services
- Medical equipment, such as wheelchairs and walkers, and medical supplies, such as bandages and catheters
- Drugs for symptom control or pain relief (though a copayment is sometimes required)
- Counseling, including dietary counseling, counseling about care of the terminally ill person, and bereavement counseling
- Short-term inpatient care for pain control, symptom management and for respite, with a 5% co-pay amount
1 AnswerIn order for a terminally ill person who is going to hospice to be covered by Medicare Part A:
- The hospice provider must be certified by Medicare
- A doctor and the hospice medical director must verify that the person is terminally ill -- meaning that he or she probably has less than six months to live if the illness runs its normal course
- The person or his or her medical representative must sign a statement choosing hospice care instead of standard Medicare-covered benefits -- although Medicare will continue to cover health problems unrelated to terminal illness.