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A Guide to Hospice Care
Seven Benefits of Choosing Hospice Care- from Catholic Health Services
1. Familiar Environment - Hospice care may be provided in the comfort of a patient’s home, a facility, or in another healthcare setting.
2. A Comprehensive Plan - A comprehensive plan involves an interdisciplinary team of healthcare professionals addressing all aspects of a patient’s illness with importance on controlling pain and discomfort.
3. Personalized Care and Support - Hospice professionals are on-call 24 hours a day 7 days a week. Respite care is also available.
4. Hospice Care Respects a Patient’s Wishes - A hospice program allows the patient and their loved ones to voice their opinions and become involved in treatment and care options.
5. Hospice Lessens Financial Burdens - Under hospice supervision, out-of-pocket costs are significantly reduced.
6. Bereavement Counseling - Hospice helps families deal with their emotions by offering guidance from social workers, chaplains, and bereavement coordinators. Hospice offers such services before and after the loved one’s death.
7. Spiritual Care - Chaplains provide support to patients and their families, regardless of religious background. If the patient is in a hospice facility, the pastoral care provided by hospice supplements the pastoral care which is presumed to have been given by the person’s own Catholic priest. If the person is receiving hospice care at home, the primary responsibility for pastoral care is with their local Catholic pastor and parish. (When to Call a Priest, www.crookston.org)
“What is Catholic Teaching on Hospice Care?”
- The Arlington Catholic Herald
Catholic moral principles for the treatment of the dying are set forth in a document published by the USCCB entitled “Ethical and Religious Directions for Catholic Healthcare Services.”
In principle, there is an obligation to provide patients with food and water, including medically assisted nutrition and hydration for those who cannot take food orally. However, medically assisted nutrition and hydration become “morally optional” when there is no reasonable expectation of prolonging the person’s life or if it would be “excessively burdensome” for the person or cause significant physical discomfort. “Medication capable of alleviating or suppressing pain may be given to a dying person, even if this therapy may indirectly shorten the person’s life, so long as the intent is not to hasten death."
Questions to Ask When Choosing a Hospice Provider
1. Is the staff, where nurses are located, able to be reasonably responsive if you should have urgent needs? This is of particular concern if the hospice has patients spread out over a great distance. You don’t want to wait two hours to receive help in a crisis.
2. What are the types of medical professionals employed by the hospice?
3. Is the hospice owned privately or is it non-profit? Patients at for-profit hospices tend to have lower care needs and stay in hospice longer than those of non-profit hospices.
4. Does the hospice have a good relationship with a pharmacy?
5. What levels of care are offered by the hospice as defined by Medicare? Level 1 – Routine home care Level 2 – Continuous home care – 8 to 24 hours of care Level 3 – General inpatient care Level 4 – Respite care
6. If one needs to go to a hospital or nursing home, with which ones does this hospice work?
7. Will staff come to the home if there is a crisis at any time of the day or night and on weekends?
8. What services do volunteers perform and how are they matched to meet your needs?
Hospice Myths
- from Hospice Foundation of America
- Myth: Hospice is giving up. Truth: Hospice is medical care toward the goal of comfort and dignity for someone who’s life is drawing to an end.
- Myth; Hospice is only for cancer patients. Truth: Today, while many hospice patients have cancer, the majority have other life-limiting illnesses such as end-stage heart, lung, or kidney disease, or Alzheimer’s and other dementias.
- Myth; Hospice is where you go to die. Truth: The vast majority of hospice patients receive care in whatever setting they call “home”. In some instances, hospice is a “place” for people whose pain cannot be adequately managed in their home setting.
- Myth: Hospice means you are going to die soon. Truth: Studies show the exact opposite. Although hospice care neither hastens death nor prolongs life, patients with certain illnesses actually live somewhat longer, with hospice care, than those with the same illness who do not choose hospice care.
- Myth: You can’t keep your own doctor if you enter a hospice program. Truth: Your family doctor or specialist is encouraged to remain engaged in your care. The hospice physician works closely with your doctor to determine the specific medical needs that will be addressed in your individual plan of care.
- Myth: It is your doctor’s responsibility to bring up hospice. Truth: While it is the physician’s responsibility to determine whether a patient meets the medical eligibility criteria to receive hospice services, it is appropriate for the patient or caregiver to initiate the discussion of this choice.
- Myth: If you choose hospice care there is no turning back. Truth: You are free to leave a hospice program at any time for any reason without penalty.
- Myth: If you choose hospice you won’t get any other medical care. Truth: While the hospice team will provide the aspects of care for the illness that qualifies you for hospice services, you are still free to seek treatment for unrelated illnesses or conditions.
- Myth: Hospice requires a DNR (Do Not Resuscitate) order. Truth: While many people wish to have a DNR to avoid unnecessary medical intervention and hospitalization, you are not required to have a DNR to receive hospice care.
- Myth: All hospices are he same. Truth: Hospices may be nonprofit or for-profit. They may be community based in service or they may serve multiple communities, counties, and states from a central location. They may be independent or be part of another organization such as a hospital. But all hospices participating in Medicare meet the same basic requirements.