THE BEGINNING OF THE END, HOSPICE CARE

Well, the call finally came, “Ms. Reaves, we’d like to re-evaluate your Mother.  She has lost more of her core function and we think she might be a candidate for Hospice care.”

Here’s the thing, dear reader,  I thought Mom was already a candidate for hospice but she wasn’t’ approved the first time she was evaluated.  Now, she is approved and I realize — this could be the end.  My emotions are mixed.  I’m sad one minute then remember her non-existent quality of life and I know it’s appropriate and its time.

The wonderful thing about Hospice care is that the focus is the patient.  The goal is to keep her or him as comfortable as possible.  This means that besides the care Mom is already receiving there will be someone there two to three times a week to make certain she has no pain and is comfortable.

What is Hospice?  I had to ask myself that question and found several definitions.  First, it is a type of care and philosophy that focuses on the palliation of a chronically ill, terminally ill or seriously ill patient’s pain and symptoms, as well as attending to their emotional and spiritual needs.   OK – so what is palliation?  Palliation is a service that makes you feel better even though it can’t cure you.

The term “Hospice” comes from the 11th century where hospitals had an area that  was “hospitality for the sick, wounded or dying”.  In today’s medical and insurance world, it is palliative care for the incurably ill, either in a medical facility, nursing home or at home.  Medicare covers it therefore if you’re a US Citizen or Green Card holder you are eligible.

To qualify for Hospice the patient is evaluated by a doctor or nurse practitioner and he prognosis must be that the person is terminally ill and has less than six months to live.  The truth is many hospice patients live longer than six months at which time they are re-evaluated.  If placed in Hospice again, the six months starts over.

In today’s medical world, (and we know I’m a bit cynical) there is both Hospice care and Palliative care.  Hospice is covered by Medicare, Palliative care is not.  It is often covered by insurance (if you have a PPO) or you can pay out of pocket.  In both cases, the patient is going to die in the “short term” — but it might be more than six months.

This is VERY IMPORTANT:  once your family member goes into Hospice or Palliative Care it means that there are NO MORE CURES. The caretakers want the patient pain free, and supported both emotionally and mentally.

If your parent or grandparent is in an Assisted Living Facility and begins a decline, the Facility prefers them to be in Hospice or Palliative Care.  This means your family member will be receiving more attention but that also means their regular doctor is not in charge anymore.  It’s also a signal that death is not far away – a sobering moment for you and your loved one.