Hospice Care & Home Care: Working together to care for your loved one
I began my “quest” to determine whether or not my Dad should be on hospice care when both the home care aide who showers and shaves my 95-year-old dad three times a week, and the nurse at the assisted living center where he lives told me that they thought we should consider arranging for Hospice care. They could see a steady increase in his personal-care needs and ER visits. They assured me that hospice is not just for “end-of-life” care, and that it would provide more of the care he now needs.
Certification for Hospice Care
The first step was to get his PCP, a caring gerontologist, to certify that he was eligible for and would benefit from hospice care. When Dad and I went to see the Dr., he first performed a thorough examination and then told us kindly but firmly that Hospice is end-of-life care and that Dad was not yet ready for it, because his condition would not be considered terminal and his life expectancy could very well exceed six months (Hospice care requirements).
Hospice vs. Home Care Services
Dad’s Dr. pointed out that with some changes in medication, some in-home physical therapy (to help prevent falls) and some in-home speech therapy (to help prevent choking), it was possible that Dad could improve his quality of life more at this stage by staying on home care. He went on to explain that, in Dad’s case, even if someone were to certify him as eligible for hospice, he would require a combination of home care and hospice care. This can vary from patient to patient, but it is definitely something every caregiver should consider.
Dad has Type II Diabetes. Currently, a nurse comes in to his home seven days a week to check his blood sugar and administer an insulin shot. Diabetes is not considered a terminal illness, and diabetic care is one of the home care services Dad would require along with hospice. Although hospice provides some of the same services as home care, diabetic care is not one of them, nor are the kinds of physical therapy and speech therapy Dad requires. If your loved one has diabetes or another chronic illness that is not considered terminal, you should definitely compare the services offered by hospice care and home care. You might have to choose between services or arrange for a combination of both.
State Laws Vary
For now, we have decided against hospice care for Dad. That may or may not be the right decision for you and your loved one. The point is, you need the advice of a trusted doctor who knows your loved one and the laws of the state in which you live.
I live in Utah, a state that allows hospice care in assisted living facilities. Beverly informed me that in ND, you cannot have hospice services in assisted living. “It’s very sad to require someone to move from their assisted living home in order to get hospice services, but it’s a state regulation. Hospice care requires that someone be with the patient 24/7. Although DTN Home care does not provide hospice care, we are recommended by hospice agencies to provide expert home care support services to those on hospice who don’t have sufficient family care available 24/7.” Before you choose hospice care over home care or a combination of both, be sure to find out what your state and your insurance allows.
Benefits of Hospice care
Depending on the life expectancy and other medical and social needs of your patient, hospice can be an excellent care choice. A few of the benefits are:
- You and your family will work with a hospice team, consisting of medical professionals, aides and volunteers, to set up a comprehensive plan of care that meets your needs. For more specific information on a hospice plan of care, call your national or state hospice organization.
- You could reduce the number of ER visits and inpatient hospitalizations. Because a physician and hospice nurse are on-call 24/7, under certain conditions, he/she will make “house calls” and can give medical care and prescribe medications on the spot, sometimes preventing calling EMTs. A trip in the ambulance can be costly and emotionally traumatizing for both the patient and loved ones. Check with your hospice provider to see when they consider house calls warranted.
- Hospice includes management of pharmaceuticals and medical equipment. In some cases they are provided as part of the service.
- You will have 24/7access to care and support for loved ones preceding and following a death. Companionship and spiritual support will also be provided as needed.
After Six Months
If your loved one lives longer than 6 months, he/she can still get hospice care, as long as the hospice doctor recertifies that the patient is terminally ill, with a life expectancy of 6 months or less. Hospice care can continue for two 90-day benefit periods, followed by an unlimited number of 60-day benefit periods. At the start of each period, the hospice doctor must recertify that the patient is terminally ill with a life expectancy of 6 months or less, in order to continue Hospice care.
Remember that home care Services like DTN Home Care can supplement hospice services with diabetic care, skilled nursing, assistance with activities of daily living (ADL’s) such as bathing, toileting, ambulating and medication administration, and more. Call us today at 701.663.5373 for a free consultation.
By Marti Lythgoe, DTN Home Care Writer/Editor
This blog is not intended to be medical advice. Please contact your own team of specialists.
Learn more about Hospice care by checking out these online resources:
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