What is Hospice?
A wedding takes place in a beautiful white house with floor-to-ceiling windows that look over a tranquil lake decorated with snow. As the wedding song plays, a father walks the bride down the aisle. Everyone sheds tears, especially the father. Besides being happy for his daughter as she enters a new phase of her life, he knows that the wedding could be his last happiest memory since it is held at a hospice.
Hospice is a place for people at the very last phase of their lives. When a patient is in the later stages of a severe illness, medical therapies may no longer improve the situation but only increase their pain. So instead of treating the disease, the philosophy of care is to treat symptoms and make the patient live their remaining time as happily and comfortably as possible.
If you are new to this term, this article will provide all the essential information you need to know about hospice, which will guide you to make a better decision.
What does hospice care provide?
Palliative care and symptom control are the focal points of hospice. The goal is to help the dying live with dignity and ease physical pain and emotional needs. The care teams comprise a nurse, assistant, social worker, bereavement coordinator, and volunteers. The medical director manages the hospice team and adjusts to the patient’s needs. A hospice team’s primary responsibility is to coordinate all services for patients and their families.
These services include:
Nursing care focuses on the patient’s physical symptoms.
Hospice aide that provides personal care, including bathing and grooming.
Social work visits help coordinate resources from the community and in the family.
Bereavement support for the family after the patient has passed away.
How is hospice care provided?
Hospice care is available at home or in a supportive community. Usually, inpatient treatment is needed when patients have symptoms they cannot deal with at home (e.g., uncontrollable vomiting, acute pain, etc.). It can happen in a hospital, or long-term care community and patients can still return home when they are ready.
The care staff works around the clock to keep in touch with patients and their families, whether at home or hospital. Regular sessions, usually led by hospice nurses or social workers, keep family members informed about the patient’s health and prepare them for what to expect. Families can also express their concerns, learn about death and the dying process, and gain tremendous support and stress relief by attending family gatherings.
Almost everyone who lives in hospice is receiving end-of-life care, and their family is aware of this fact. Hospice care also provides “after-death” care – which we call “bereavement care” – for the families.
Bereavement is the period of grief following a loss. The hospice care team works with family members to assist them in getting through the grieving process. Family members will receive help from trained volunteers and professional counselors through regular visits, phone calls, and other forms of contact, as well as through support groups. The café team can refer family members and caregivers to other medical or professional services if necessary. Typically, bereavement services are provided one year after the patient’s death.
Who qualifies for hospice care?
When determining eligibility for hospice, a doctor must certify that the patient is terminally ill with a life expectancy of no longer than six months.
The situation certainly needs consultation and approval from professionals, such as the health care team, discharge planners, doctors, local health departments, and hospice organizations. However, whether to begin care or not could be highly personal. Even if the patient fits the conditions above, they cannot admit to hospice without agreement.
Types of hospice care
There are four types of hospice care, each tailored to a patient’s specific need. Two are in the home, and the other two take place in healthcare communities. A patient may get one or all four types during their hospice stay.
Routine home care
Routine home care is the most common type of hospice care. This is provided at the patient’s home, whether it is an assisted living home or in a senior healthcare community. The care team, which includes home health nursing aides, RN case managers, licensed practical nurses, social workers, spiritual care specialists, community educators, and volunteers, will make a regular visit at home.
Many patients prefer routine home care because it allows them to remain in their familiar surroundings. It also makes it more convenient for family and friends to visit on their own time.
The care team will bring medical equipment and medications to the patient’s home and make regular visits as needed. Some group team members may attend the holiday visit daily, while others may come once a week or as needed. Telecare services are available to the patients 24/7 to answer questions, and, if necessary, the team will send a professional to the patient’s home.
According to the stats from the Hospice Valley, the average cost of routine home care from day 1 to day 60 is $199.25, and from day 60+, the payment would be $157.49.
Continuous home care
Continuous home care is more intense than routine home care, which provides ongoing assistance to patients experiencing acute symptoms (e.g., intractable pain or nausea, breathing difficulties, bleeding, agitation, seizures, or changes in the state of consciousness). This is usually only done for a short period to enable patients to stay at home through a more challenging situation.
Just as routine home care, continuous home care comes with two different prices based on the needs. The hourly rate of constant home care is $59.68. If the care needs for 24hours, the total rate would be $1432.41 (data from the Hospice Valley).
General inpatient care
General inpatient care is recommended for treating symptoms that cannot be adequately controlled at home. This usually exists in short-term cases at a hospital’s hospice unit or a long-term care home.
Many patients and their families prefer free-standing hospice communities, which have a more tranquil and home-like environment for patients to receive general inpatient care. Also, arrangements can be made for visitors to stay overnight.
Short-term general inpatient care costs can range from $744 to $1045.66 per day, as reported by griswoldhomecare.com.
Respite care is short-term inpatient treatment designed to help family caregivers and patients. Caring for a chronically or terminally ill family member can be emotionally and physically exhausting for all parties involved. The patient is usually admitted to a hospice community for a brief time if necessary. It also relieves family caregivers of their daily obligations, which reduces stress. Respite care is only available for a few days, in crises when the family needs to be away or needs a break.
The price may vary in different communities, but the average daily rate of inpatient respite care is about $416.09, as stated by Hospice Valley.
Hospice vs. Long-term care homes
Although some of the services that hospice and long-term care homes provide are mutually inclusive, their mission is the main difference between hospice and long-term care homes.
Hospice concentrates on making the dying process more comfortable and acceptable for those who have realized that death is inevitable. On the other hand, a long-term care home provides full-time skilled healthcare staff to seniors who require higher care. When the condition has deteriorated for a patient living in a long-term care home, they can transfer to a hospice.
How long do patients usually live in hospice?
According to research from the Journal of Palliative Medicine, around 35.7% of hospice patients die within a week. The average length of stay in hospice is 76.1 days.
Hospice is design for patients have less than six months to live. However, many patients can live longer.
According to the survey, 12-15% of patients can live for more than six months. It is challenging to predict how long each person will live because each situation is unique. The study found that patients under 65 are more likely to live for more than six months after being referred to hospice.
What if the patient gets better?
Miracles do happen!
People who get hospice care are more likely to recover. Because their food and medicinal needs are satisfied, and the care process provides them with additional attention and emotional support.
Patients will be discharged when their condition improves enough to start treatment or when life expectancy is determined to be more than six months.
The live discharge also happens when the patient feels better and starts to look for more aggressive treatment. As we said, hospice care is a very personal option, and it may vary hugely from person to person. A report from Health Affairs says that nearly 20% of patients are discharged from a hospice for many reasons. It could either be the patients’ own decision or the decision from the professional medical teams, but a patient can return to a hospice if needed.
Who pays for hospice care?
Knowing that taking care of patients is already burdensome for the family, many health plans can cover the expense of hospice. The Provincial Health Plans cover hospice care provided in a hospital in Canada. Medicare Health Care Benefit covers the United States. If the patients and their families choose to receive care at home, they can use private insurance to cover the palliative care services or pay from their pocket.
Hospice care provides care for patients with less than six months to live. Throughout the dying process, the care team provides support and resources to the patients and their families, including at home and in a community. Patients and their families discuss whether they should receive hospice care ongoing, as it is a very personal decision. See our post on“How to Communicate with Seniors” to find out the tips.