Hospice Care

Hospice Care

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  • 4 Answers
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    A answered
    Hospice care is flexible and can be molded to fit the different needs and lifestyles of patients and their caregivers. Care is primarily focused on making the patient as comfortable as possible when a cure can no longer be expected. 

    Hospice services can include:
    • Medical and physical care for the patient
    • Management of the best prescribed pain-control treatments
    • Emotional and spiritual support for patients and their loved ones
    • Assistance with practical issues for patients and caregivers
    The different levels of hospice care include:
    • Home care is provided in a private home, nursing home, assisted living facility, or other group home. The hospice staff offers hands-on care, assessment of your loved one’s condition and symptom management. They also help you and other caregivers learn how to provide day-to-day care. Hospice services include updates about what is happening and assisting the patient and caregivers to plan for the future.
    • In-home crisis care (also called continuous care) is short-term care that is available in the home when symptoms cannot be managed by the usual caregivers. Under some health insurance plans, between 8 and 24 hours of nursing support for crisis care can be provided in the home each day for a limited number of days. The hospice provider determines when such care is needed and for how long. Depending on the needs of the patient, he or she might remain at home or be hospitalized for pain or symptom management following in-home crisis care.
    • Inpatient hospice care is delivered in healthcare facilities such as a hospital, nursing home, or hospice facility. This type of care is used to manage pain or other symptoms that cannot be addressed at home. The length of stay depends on how long it takes to control the symptoms. If needed after the symptoms have been controlled, hospice can help make arrangements for continued care in another care setting.
    • Respite care provides time for home caregivers to rest while the patient is cared for in an inpatient setting or nursing facility for up to five days.
    In some very advanced cases, the majority of hospice care is provided at home though the patient or loved ones choose that death occur somewhere else. Though this is likely to be a very difficult subject to discuss, it may be best to make a decision like this early enough so that everyone is comfortable with what occurs during the final days and hours.       
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    A , Nursing, answered
    Hospice care is a Medicare benefit that people are entitled to elect if they have a prognosis of 6 months or less. It encompasses a set of services that can improve the quality of their life for the remaining time that they live. For that reason alone, hospice should be considered sooner rather than later. The hospice team are experts in pain and symptom management which assists patients and their families with managing the distress that they feel. The hospice team takes a approach which includes family members and caregivers and this is an opportunity for people to discuss their concerns and receive support from a team of people who understand.
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    A , Hospice Nursing, answered

    Hospice care is end-of-life care for all people, not just those with cancer. I am currently caring for people with end stage heart disease, emphysema, and old age. About half of our patients have non-cancer diagnoses. As long as you are not seeking aggressive, curative treatment, and the doctor feels you have approximately six months or less to live, you are appropriate for hospice. Hospice focuses on comfort and quality of life, and supports the patient and family.

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    A Oncology Nursing, answered on behalf of
    This is a very simple question that presents a not so simple answer. It's actually a self-reflecting question -- have you given up hope? Accepting hospice care may mean that you have drained all curative options for your life-limiting disease, and some turn to hospice only as a last option. However, some turn to hospice well before the end of their life to find answers. These people may be gifted by relearning their spiruality with the hospice chaplain or receiving simple, unfettered answers from their hospice nurse. They may actually live longer than expected from the reduction of pain and mental suffering that is synonymous with having an excellent hospice team care for you and your family. And, the best part is that the hospice benefit can be revoked at any time. For instance, if your doctor finds a new, promising treatment for your disease you may elect to leave hospice and try the treatment. Starting hospice care means that you have made a difficult decision that may benefit you, as well as your loved ones, as you enter a very natural part of the life cycle.
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    A , Geriatric Medicine, answered

    It was in 1967 that the term “hospice” was first utilized by Dame Saunders in London to describe the type of specialized services and care that patients with terminally ill diseases were receiving. The term hospice is used when a patient can no longer be treated and cured from a disease and has been given 6 month of life to live. The idea of hospice care is to make the dying patient as comfortable as possible in the last phases of their life. This is also referred to as palliative care, which helps relieve the symptoms associated with the disease. In order to achieve a level of comfort care is offered twenty-four hours a day and seven days a week. However, it is important to note that hospice care is not solely limited to take place in a hospital setting. It is quite popular for an individual to receive hospice care in their home, nursing home and even private hospice locations. 

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    A Thoracic Surgery (Cardiothoracic Vascular), answered on behalf of
    The reality of hospice care requires a number of adjustments -- from accommodating the annoyance of having strangers around performing intimate care tasks to facing the fact that death is near. There are steps to take and resources to turn to for help in arranging for ongoing care and in making the mental and physical adjustments that may be needed.

    Create a care plan: Because the team care concept involves many players, you will need a good plan to coordinate it. The hospice team will do this.

    It is essential that the person who is ill and their family members are involved in setting up the type and plan of care so that the person can have more control over his or her life and more fitting care in the final days. It is also important to find a hospice provider the person and his or her family can work with, and one that will provide the person with comfort and respect -- important reasons to carefully screen the hospice care agency.

    Deal with personal issues: Take some steps to preserve a sense of privacy as caregivers come and go from your home.

    To cover emergencies, be sure that all care providers have complete contact information for those who should be notified -- and that they are aware of the patient's medical preferences and directives, such as Do Not Resuscitate (DNR) orders and advance directives.

    Make modifications for care at home: Consider a number of ways to ensure a residence is free from hazards and supports care at home. Receiving hospice care at home is simply not an option for many people unless changes are made to their existing homes. To provide a safe place in which to receive care, there are some easy and obvious changes to make -- and some more drastic changes that may require professional construction help.

    Of course, choosing which modifications to make and deciding whether to invest the time, expense and disruptiveness in making the more ambitious changes will depend on a number of factors -- most importantly the person's condition and whether it is likely to deteriorate quickly.
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    A Oncology Nursing, answered on behalf of

    Some of the medications given through hospice are medications on which the body becomes physically dependent upon; meaning if the patient were to be on a specific medication for a long enough amount of time, and this medication was then abruptly stopped, that patient would most likely go through the signs and symptoms of withdrawal. That being said, for the most part we do not worry about this with hospice patients, cancer patients, or patients with severe chronic pain. For these patients narcotics are necessary to control their pain and have quality of life. Hospice patients are not given more medication than they need. They also will most likely need these medications for the duration of their life. Many hospice patients are able to take these medications while still living at home, and if anything the medications have a positive impact in their life because these patients can now participate in activities that were otherwise restricted by pain.

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    A Oncology Nursing, answered on behalf of

    Hospice care is for the terminally ill.  The actual criteria to be placed in hospice care is for a primary care provider to deem a patient has less than 6 mos to live.  This is not a magic number, you will not be discharged from hospice after six mos.  This is simply a starting point. 

    Hospice care teams include nursing, nursing assistants, spiritual care, physician, and social workers.  Each work together and meet on a set schedule to discuss the needs of the patient.  The amount of time each discipline spends with the patient is based on the needs at that time.  Often, early in hospice, there maybe little time spent with the nurse and direct care of the patient.  As the patient's condition deteriorates, more time may be spent with the family and patient.

    Some hospice programs do provide 24 hour care, many do not.  Care of the patient is often done so in the patient's home, by family members.  There are some hospice facilities in the United States.  Some hospitals have hospice wings.  Each hospice company is slightly different in what they have to offer.  It is important to talk with you primary care provider early in a terminal illness, so that early referral to hospice can be made.

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    A Oncology Nursing, answered on behalf of

    It can depend on which hospice... just in my area alone there are three separate and independent, individual hospices- although I believe there are rules regulating how close they can be to one another and the territories they cover etc.-

    Although, even though each hospice does things a bit differently, they all offer the same services. I would assume this to be the same nation-wide. For the most part, hospice services provide more of a visit-type service to the patient versus 24-hour care. The patient would receive weekly visits from nursing; as well as visits from a chaplain and a social worker. If needed a home health aid would also be available for a couple visits a week to assist with bathing and dressing. Hospice also pays for all medications related to the terminal diagnosis, as well as any needed medical equipment.

    If the patient is in crisis, either experiencing an uncontrolled symptom such as pain or difficulty breathing, or the patient is actively dying; under these circumstances hospice does and will provide 24-hour care. A one on one nurse can be sent to the patient's place of residence for up to 72 hours to assist with a patient in need. Another option if the patient needs 24 hour care is the inpatient unit. Most hospices have an inpatient unit where patients can go to receive care as well; they are meant for short-term stays but as long as the patient continues to have a symptom that needs treatment, they may continue to stay in the unit and receive 24 hour care.

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    A , Nursing, answered

    Hospice workers are usually seasoned healthcare professionals who have, for many reasons, chosen to focus their expertise on working with terminally ill patients and their families.  The hospice team can consist of nurses, social workers, chaplains, and other healthcare professionals as needed.  The focus of their care is both the patient and their family/caregivers. 

    Many hospice nurses have worked in other areas of medicine but move into hospice to assist patients with end of life care. They find this career path very rewarding and families clearly appreciate their compassion, empathy, and skill when caring for their loved one. The relationships made during this time are very special. In fact, more than one family has been surprised and touched when members of the hospice team who have cared for their loved one show up at funerals.

    In addition to healthcare professionals, many hospices have specially trained volunteers who assist the families with respite care and other services. 

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