Throughout my career I have heard many families express that admitting their loved one to hospice meant giving up hope and meant encouraging the death of their loved one. Simply, this should not and is not the case. Hospice is a useful tool providing a comfortable life for those with a life prognosis of six-months or less.
Below are nine common misconceptions regarding hospice care and the truth about the benefits of hospice care.
1.Hospice Care Encourages a Quicker Death.
Hospice care is not meant to be used as a tool to encourage death. Quite opposite in many ways. Hospice is a team of medical professionals that assist with care centered on comfort, dignity, and assisting with the needs of the diagnosed and their loved ones. It is a time when curative care is no longer effective .
Yes, the patient does have to be diagnosed with a disease which creates a life expectancy of six months or less; however, many individuals re-certify and stay on hospice for more than a year.
2. Hospice is geared toward those with cancer.
While patients are admitted to hospice care with a terminal cancer diagnosis, that is far from the only condition that qualifies a patient. Many chronic diseases such as heart disease, lung disease, liver disease, and many neurological diseases such as Alzheimer’s Disease can be determined as an appropriate admitting diagnosis. Ultimately, a hospice qualification depends on the disease prognosis of the life-limiting illness.
3. The patient must give up their personal physician.
While many patients chose to transition to the medical director/doctor within the hospice agency caring for them; this is not a requirement. In fact, a patient can request to have their personal doctor oversee their care or better yet, work directly with the hospice medical director to determine the best care options.
4. Once admitted to Hospice the patient must sign a DNR.
In general, Medicare-certified hospice’s do not require a DNR on file. However, there are certain hospice companies that may require a DNR prior to admittance. Fortunately, the patient and their family have the option to pick which hospice organization best fits their needs.
5. Hospice care is not covered by many insurances and can be very expensive.
This is not true. Hospice services are not only covered for Medicare and Medicaid/Medi-Cal patients but many other HMO and PPO insurance plans help pay for hospice care.
6. A patient cannot be considered for hospice unless their physician recommends it.
A patient or family member can request for a hospice evaluation. If during this evaluation it is determined the patient would qualify, then the referring can write the order for hospice admittance.
7. All medications are taken away once someone is admitted to hospice.
While some medications focused on prevention will be stopped this does not mean all medications will be taken away. Primarily those medications geared at curing the disease will be removed. Medications for pain, comfort, and used to relieve current symptoms of disease will remain in the plan of care.
8. Hospice can only be provided at home.
Hospice can be provided wherever the patient stays. This can be in their own home, in a skilled nursing facility or even an assisted living environment.
9. All hospice programs are the same.
While all hospice companies are required to meet the basic Medicare requirements, that does not mean they are all the same. There are hundreds of hospice organizations throughout Southern California. While they all provide the same basic holistic medical care team; many go way above and beyond. I have worked with companies that provide music therapy, bereavement programs for families for years after their loved-one’s passing, and even companies that manage to provide care-giving services for lengthened time periods (at no charge to the client). Not all hospice companies are the same.
Ultimately, hospice can be an amazing tool to provide comfort and appropriate care for a loved-one. It does not mean they are going to pass away tomorrow, next week, or even next month. It allows for the patient to instead focus their treatment on measures that make them comfortable versus the constant focus on curing a disease.
A life care manager/geriatric care manager can be a useful tool in opening up the topic of hospice care within the family. A care manager, having extensive knowledge of the client can help advocate, assist with the care planning, and monitor the hospice care in a neutral way enabling the patient to receive the exact treatment they prefer.
Further, a care manager understands that the transition to hospice is a difficult one for everyone involved. We can make sure to additional outside services, equipment, and care that is needed is in place. Help with the day-today duties that are often overlooked and cause additional stress for family members. We can help monitor medication changes, insurance billing, and other items that are confusing and troublesome for patients and their family. And simply, we can be there as a professional resource for everyone involved to make sure as the plan of care changes all parties (the patient, family, and medical team) are all on the same page with support and care.
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