FICTION or FACT – The truth about hospice

Hal Friedman

Hal Friedman, Director of Business Development, Gilchrist Hospice Care

Prior to working for Gilchrist Hospice Care I worked for 30 years in hospitals and home care. My background is Respiratory Care and I thought I knew what hospice was when Gilchrist hired me a little over 3 years ago.

It quickly became obvious I had very little knowledge about hospice care. I have tried to outline some of the common myths many people believe to be true about hospice.

Fiction:  Hospice is a place.

Fact: Hospice is not a place, but a concept of care. More than 90% of the hospice services provided in this country are home-based. Care provided in the home allows families to be together when they need to most–sharing a loved one’s final days peacefully, comfortably and with dignity.

 However, there are times when more intensive medical intervention is needed. At these times, patients might be admitted to Gilchrist’s inpatient Centers.

 Fiction:  Hospice means giving up hope.

Fact: When faced with a life limiting illness, many patients and family members tend to dwell on the imminent loss of life rather than on making the most of the time that remains. Hospice helps patients reclaim the spirit of life. It helps them understand that even though death can lead to sadness, anger and pain, it can also lead to opportunities for reminiscence, laughter, reunion, and hope–the hope that Hospice can help a patient live the remainder of his or her life to the fullest.

 Fiction: Hospice services are very expensive because 24-hour on-call services are provided.

Fact: Although Hospice staff is available 24 hours a  day/7 days a week, the services cost less than the care provided in hospitals.

 Fiction: Hospice only serves persons diagnosed with cancer.

Fact: Historically most hospice patients had a diagnosis of  cancer. But today, more than 50% of patients seek Hospice care for a non-cancer diagnosis, such as Alzheimer’s disease and dementia; end-stage heart, lung, brain, and kidney diseases; infectious diseases, including HIV; and diseases of the nervous system, such as Parkinson’s and ALS (Lou Gehrig’s disease).

 Fiction:  A patient needs Medicare or Medicaid to afford Hospice services.

Fact: Insurance coverage for Hospice is available through Medicare, Medicaid, private insurances and managed care plans. In addition, community contributions enable Hospice to care for all terminally ill individuals regardless of their ability to pay.

 Fiction:  A physician decides whether a patient should receive Hospice care and where.

Fact: The role of the physician is to recommend care, whether through hospice or traditional curative care. Before admission into a hospice program, a physician must certify that a patient has been diagnosed with a terminal illness and has a limited life expectancy. It is then the patient’s right to determine if Hospice suits his or her needs and which program to enter.

 Fiction:  To be eligible for Hospice care, a patient must already be bedridden.

Fact: Hospice care is appropriate at the time of the terminal prognosis, regardless of the patient’s physical condition. Many of the patients served through Hospice continue to lead productive and rewarding lives. Together, the patient, family and physician determine when Hospice services should begin.

 Fiction:  After six months, patients are no longer eligible to receive Hospice care through Medicare and other insurance companies.

Fact: According to the Medicare hospice program, services may be provided to terminally ill Medicare beneficiaries with a life expectancy of six months or less. However, if the patient lives beyond the initial six months, he or she can continue receiving Hospice care as long as the attending physician or Hospice physician recertifies that the patient is terminally ill. Medicare, Medicaid and other private insurance companies will continue to cover Hospice services as long as the patient continues to have a terminal prognosis and a recertified  life expectancy of six months or less.

 Fiction:  Once a patient elects Hospice care, he or she can no longer receive care from the primary care physician.

Fact: Hospice reinforces the patient-primary physician relationship. The patient’s primary care physician is encouraged to be a part of the patient’s care team. Hospice works closely with the primary physician and considers the continuation of the patient-physician relationship to be of the highest priority.

 Fiction:  Once a patient elects Hospice care, he or she cannot return to traditional medical treatment.

Fact: Patients have the right to cancel Hospice care at any time, for any reason and return to standard medical treatment. If a patient’s condition improves or the disease goes into remission, he or she can be discharged from Hospice and return to curative care, if so desired. If a discharged patient wants to return to Hospice care, Medicare, Medicaid, and most private insurances and managed care plans will allow readmission. Besides having the right to discontinue Hospice care at any time, patients also may change hospice programs if necessary or desired.

 Fiction:  Once a patient elects Hospice care, he or she will die quickly.

Fact: Hospice care neither hastens or prolongs death. Hospice allows nature to take its course. Often, once Hospice care begins, a patient’s quality of life improves which may lead to a longer than anticipated life.

 I hope this helps!

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