Articles for Our Patients ~ Kathy Yeatman-Stock, L.C.S.W.


What is Hospice and Palliative Care?

Author: Kathy Yeatman-Stock, L.C.S.W. • Language: ENG

When is it the right time to ask about hospice?
Now is the best time to talk with your doctor and healthcare providers about end of life care options. Asking for information about hospice care when you are not under stress allows for information to be processed and a greater understanding obtained of what hospice care means. It allows for discussions with family members to occur when you are not pressured or forced to make decisions because of a sudden health crisis.
 
Once your wishes are identified it is important to make your decisions known in writing. This involves completing an advance directive which can then be given to your healthcare providers. You can obtain an advance directive from the hospital or at The Cancer Care Center. Please contact me at me if you want more information.
 
The National Hospice and Palliative Care Organization (NHPCO) is another resource available to you which provides specific information about end of life care, advance directives, and hospice organizations. You can call NHPCO’s Helpline at 1-800-658-8898 or visit their website at www.nhpco.org.

What is hospice care?
Hospice is a specialized form of care for individuals with a terminal illness who are assessed to be at an advanced stage of their illness.
The focus of care is on comfort, symptom management, and quality of life. It provides emotional and spiritual support to the patient and his/her loved ones.
 
Hospice is a philosophy of care provided by a multidisciplinary team that believes in an individual’s right to die free of pain with dignity and in his/her choice of environment. Although many individuals die at home with hospice care, patients who reside in a nursing home or assisted living facilities can receive care. Hospice is available to any age, religion, race, and illness. Hospice care is covered under Medicare, Medi-cal, most private insurances, HMO’s and other managed care organizations.

When is hospice care appropriate?
When the goal of care is on comfort and no longer cure and when the prognosis is a matter of months and not years then it is appropriate for considering hospice care. Your physician will communicate the prognosis and certify when an individual is at an advance stage of his/her illness and that there is a lack of response to treatment. The physician may refer to a life expectancy of six months or less and explain that a hospice referral is appropriate.

How does hospice care work?
If hospice care is agreeable to an individual, the physician will make a formal referral or write an order for hospice care to begin. If an individual wants more information about hospice services, a representative from a hospice agency can schedule a visit to explain their services and answer questions. A physician’s order is not needed for an individual to receive an explanation of services.
 
Once an individual has received an explanation of services and has signed consents to begin care, a multidisciplinary team is assigned. The Registered Nurse assigned will be the coordinator of all services as determined by the attending physician to provide symptom management and comfort. Also on the team is a Home Health Aid who is available to assist with personal care, a Social Worker who provides counseling, emotional support, and community resources, and a Spiritual Care Coordinator who assists with spiritual support to the patient and family. In addition, there are trained hospice volunteers who are available as needed.
 
Every hospice patient has access to their team and visits are scheduled to meet the patient and family/caregiver’s needs. It is common that the Nurse will visit weekly as well as the Home Health Aid. The other team members may visit one to two times a month but will change the frequency based on the need. Hospice care is available 24 hours a day, 7 days a week.
After a patient’s death, bereavement support is offered to the family/caregiver for at least one year. These services can include telephone calls, visits, and/or mailings about grief and support groups.
Referrals to community resources can also be given.

What is palliative care?
Palliative care shares the same principals and philosophy of care as hospice care. Its’ goal is to provide comfort and focus on quality of life. Palliative care involves a team oriented approach that provides physical, emotional, and spiritual support for the patient and family. Palliative care teams can be found in hospitals and home programs. The difference between palliative care and hospice care is related to the stage of an individual’s illness. As stated earlier, hospice is offered at the end stage of the illness whereas palliative care can be provided earlier in the illness. Palliative care can include aggressive treatments such as radiation or chemotherapy in order to reduce the pain and physical suffering. It is viewed as an approach to care that helps improve the quality of life of the patient when eligibility for hospice does not exist.

Patients have a right to make decisions about their health care and about their wishes for care at the end of life. I hope this article has provided information that will serve as a start for discussing end of life care options with your loved ones and your health care providers. If there is further information needed about advance care planning and end of life care, I can be reached at the Cancer Care Center at 909/865-9958 or kathy.yeatman-stock@pvhmc.org.
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