As Americans age, they are making greater use out of hospice care, which is offered to terminally ill patients at the end of their lives. Deciding to place yourself or a loved one into hospice care can be one of the most difficult of a person's life, and many are unaware that they have a choice of programs. Elder law attorneys at Pintas & Mullins offer some advice and a few tips on how to choose the right hospice.
Hospice programs involve comprehensive care for those near the end of their lives; the focus is on comfortable, at-home care, to relieve pain as much as possible. Although most hospice patients receive care in their homes, it is possible to receive hospice care while residing in a nursing home, even for those on Medicare.
Unfortunately, during the time most are considering a hospice program, they are in the midst of a health care crisis or have just received dire news. In other words, they are typically not in the best state of mind to research in-depth on the programs available to them. The good news is that hospice choices are growing, and now available in most communities throughout the country.
It is important to remember that, like nursing homes, hospices are sometimes run by large, for-profit corporations that may not always have the patients' best interests at heart. This is why doing research before choosing a facility is so important - not every hospice provides the same quality of care.
Advocacy groups like the American Hospice Foundation have been around for many years, collecting data on U.S. hospices during that time. Soon (within the next two to four years), it will release a tool to help consumers compare hospice programs using evaluations conducted by both primary caregivers and Medicare and Medicaid.
Before that becomes available, families need to do their own work, interviewing different hospice programs within their communities. During these interviews, caregivers often come to patient's homes and answer any questions they may have. How receptive they are to these questions and requests is the first indicator of how well a program is run.
Second, it is important to choose a program that has a solid foundation; avoid hospices that have only been around for a few months or even up to a year. The more established and stable a hospice is the better. You may be able to glean knowledge from friends, doctors or nurses who have heard about that program's reputation.
Third, ask about the staff's response times, whether they will be available in evenings and weekends, and how long the patient will need to wait in an urgent situation. Additionally, consumers should ask about the services the hospice provides. Although there is a set or standard services most are expected to give, the degrees and intensities of these vary.
For example, "continuous care," refers to the very last hours or days of someone's life, when 24/7 care is necessary. Ask the hospice if they will provide a caregiver at home during this time, if they will see the patient through to their death, and if the family will be supported. Another important service is inpatient facilities, in case complex health issues arise. Most hospices rent out units in hospitals or nursing homes to care for their patients who need additional services.