WELC

<a href=”http://westchesterendoflife.org/faqs/questions-about-hospice-and-palliative-care/#q1″>What is Hospice?</a>
<a href=”http://westchesterendoflife.org/faqs/questions-about-hospice-and-palliative-care/#q2″>When should a decision about entering a Hospice program be made — and who should make it?</a>
<a href=”http://westchesterendoflife.org/faqs/questions-about-hospice-and-palliative-care/#q3″>What if our physician doesn’t know about Hospice?</a>
<a href=”http://westchesterendoflife.org/faqs/questions-about-hospice-and-palliative-care/#q4″>Where can Hospice be provided?</a>
<a href=”http://westchesterendoflife.org/faqs/questions-about-hospice-and-palliative-care/#q5″>Is Hospice affiliated with any religious organization?</a>
<a href=”http://westchesterendoflife.org/faqs/questions-about-hospice-and-palliative-care/#q6″>Who is eligible for Hospice care?</a><!–more–>
<a href=”http://westchesterendoflife.org/faqs/questions-about-hospice-and-palliative-care/#q7″>What services does Hospice provide?</a>
<a href=”http://westchesterendoflife.org/faqs/questions-about-hospice-and-palliative-care/#q8″>Who supplies these services? </a>
<a href=”http://westchesterendoflife.org/faqs/questions-about-hospice-and-palliative-care/#q9″>Can my doctor continue to treat me under Hospice?</a>
<a href=”http://westchesterendoflife.org/faqs/questions-about-hospice-and-palliative-care/#q10″>How does Hospice manage pain?</a>
<a href=”http://westchesterendoflife.org/faqs/questions-about-hospice-and-palliative-care/#q11″>Is Hospice covered by insurance?</a>
<a href=”http://westchesterendoflife.org/faqs/questions-about-hospice-and-palliative-care/#q12″>What does the admission process involve?</a>
<a href=”http://westchesterendoflife.org/faqs/questions-about-hospice-and-palliative-care/#q13″>What are the advantages of Hospice care?</a>
<a href=”http://westchesterendoflife.org/faqs/questions-about-hospice-and-palliative-care/#q14″>Is Hospice involved if a patient needs to be hospitalized?</a>
<a href=”http://westchesterendoflife.org/faqs/questions-about-hospice-and-palliative-care/#q15″>Does hospice do anything to make death come sooner?</a>
<a href=”http://westchesterendoflife.org/faqs/questions-about-hospice-and-palliative-care/#q16″>Does receiving Hospice care mean giving up on life?</a>
<a href=”http://westchesterendoflife.org/faqs/questions-about-hospice-and-palliative-care/#q17″>Will the pain medication prevent the patient from talking, hearing, or knowing what is happening?</a>
<a href=”http://westchesterendoflife.org/faqs/questions-about-hospice-and-palliative-care/#q18″>Are the pain-killers addictive?</a>
<a href=”http://westchesterendoflife.org/faqs/questions-about-hospice-and-palliative-care/#q19″>What if the patient improves?</a>
<a href=”http://westchesterendoflife.org/faqs/questions-about-hospice-and-palliative-care/#q20″>What diseases are most common among hospice patients?</a>
<a href=”http://westchesterendoflife.org/faqs/questions-about-hospice-and-palliative-care/#q21″>How difficult is caring for a dying loved one at home?</a>
<a href=”http://westchesterendoflife.org/faqs/questions-about-hospice-and-palliative-care/#q22″>Is there any special equipment or changes I have to make in my home before hospice care begins? </a>
<a href=”http://westchesterendoflife.org/faqs/questions-about-hospice-and-palliative-care/#q23″>How many family members or friends does it take to care for a patient at home? </a>
<a href=”http://westchesterendoflife.org/faqs/questions-about-hospice-and-palliative-care/#q24″>What happens if the patient can no longer be cared for at home?</a>
<a href=”http://westchesterendoflife.org/faqs/questions-about-hospice-and-palliative-care/#q25″>Must someone be with the patient at all times?</a>
<a href=”http://westchesterendoflife.org/faqs/questions-about-hospice-and-palliative-care/#q26″>Does hospice provide 24-hour continuous nursing care in the home?</a>
<a href=”http://westchesterendoflife.org/faqs/questions-about-hospice-and-palliative-care/#q27″>What is palliative care?</a>
<a href=”http://westchesterendoflife.org/faqs/questions-about-hospice-and-palliative-care/#q28″>What is the difference between palliative care and hospice care?</a><strong>
</strong><a href=”mailto:info@westchesterendoflife.org”>Other questions?</a>

<span><a id=”q1″ name=”q1″></a>What is Hospice?</span>
Hospice is a concept of health care that provides holistic services for the physical, emotional, and spiritual needs of terminally ill patients and their families. The goal of hospice is not to cure illness nor hasten death, but to ease a patient’s passage from life. Hospice is a special kind of care for people who are living  with an end-stage disease. With hospice, pain and discomfort are controlled with expertise and compassion. The unit of care is the family as well as the patient, and they choose from an array of services that ease the physical, psychological, social and spiritual stress that come at this time. The family receives ongoing support even after the patient dies.

<span><a id=”q2″ name=”q2″></a>When should a decision about entering a Hospice program be made — and who should make it?
</span>At any time during a life limiting illness, it is appropriate to discuss all of a patients care options, including hospice. By law the decision belongs to the patient. Understanding the hospice option enables the patient to have more control and choices about their end-of-life care. Hospice care is for people who have decided not to pursue further curative care, who want to emphasize comfort and improve their quality of life, and minimize suffering.

<span><a id=”q3″ name=”q3″></a>What if our physician doesn’t know about Hospice?
</span>Most physicians know about hospice. If your physician wants more information about hospice, it is available from the Academy of Hospice Physicians, medical societies, state hospice organizations, or the National Hospice Helpline, 1-800-658-8898.

<span><a id=”q4″ name=”q4″></a>Where can Hospice be provided?</span>
About 90% of hospice care is received while patient continues to live in a personal residence, although some patients live in nursing homes, assisted living facilities, or hospice centers. In some cases, it is also available in hospitals.

<span><a id=”q5″ name=”q5″></a>Is Hospice affiliated with any religious organization?</span>
Hospice care is not an off-shoot of any religion. While some religious organizations have started hospices, all hospices serve a broad community and do not require patients to adhere to any particular set of beliefs, or belong to any particular religion.

<span><a id=”q6″ name=”q6″></a>Who is eligible for Hospice care?</span>
Individuals are eligible for hospice care who:
• have a life-limiting condition with a short prognosis
• have the support of their physician, need palliative care services, and wish to  remain at home or in the environment of their choice
• seek caring support during the final stages of life

<span><a id=”q7″ name=”q7″></a>What services does Hospice provide?</span>
Hospice provides the following services:
• seamless patient comfort and pain control
• nursing visits
• medical/social assessment
• family, individual and group psycho-social and spiritual counseling
• coordination of equipment and supplies
• support for caregivers
• physical, occupational, speech, or alternative methods of therapy, if requested, such as  pet therapy, music therapy, acupuncture, in some cases.
• dietary and nutritional advice
• homemaking and certified nurse aide assistance
• spiritual guidance
• grief and bereavement support for family members after the patient’s death

<span><a id=”q8″ name=”q8″></a>Who supplies these services?</span>
The Hospice team includes doctors, nurses, nursing assistants, social workers, counselors, spiritual caregivers, and volunteers. Services are provided by registered and licensed hospice nurses, certified nurse aides, medical social workers, nutritionists, therapists, chaplains, and volunteers.

<span><a id=”q9″ name=”q9″></a>Can my doctor continue to treat me under Hospice?
</span>Yes.  The interdisciplinary hospice team works directly with the patient’s own doctor, if the patient so wishes. The hospice staff with the doctor develop an individualized plan of care to meet the patient’s needs. Hospice staff functions as the “eyes and ears” of the patient’s physician and consults with the physician in the signing of new orders for treatment and/or medication.
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<a id=”q10″ name=”q10″></a>How does Hospice manage pain?</span>
Hospice nurses and doctors are up to date on the latest medications and devices for pain and symptom relief.. Using some combination of medications, counseling and therapies, most patients can be kept pain free and comfortable. It is the goal of hospice to allow the patient to be pain free but alert. By constantly consulting with the patient, hospices have been very successful in reaching this goal.

<span><a id=”q11″ name=”q11″></a>Is Hospice covered by insurance?</span>
Hospice coverage is widely available. It is provided by Medicare nationwide, by Medicaid in 42 states, and by most private insurance providers. To be sure of coverage, families should of course check with their employer or health insurance provider. In Westchester several of the hospices offer care regardless of the patient’s ability to pay. Lack of financial means should not be a deterrent to choosing hospice care.

Medicare beneficiaries may receive hospice care for two 90-day benefit periods, either consecutively or at intervals, followed by a 30-day period. At the beginning of each period the doctor must certify that the patient is terminally ill. If necessary, an extension period may be approved after the above have been used. If a patient changes his mind, or his condition improves, he or she can cancel hospice services.

<span><a id=”q12″ name=”q12″></a>What does the admission process involve?</span>
The patient’s family, a friend, the patient’s physician, or a pastor can suggest or request hospice care. Hospice will contact the patient’s physician to verify whether he or she agrees that hospice care is appropriate for the patient at this time, and the physician is asked to sign a referral form. The patient will be asked to sign consent and insurance forms. A hospice liaison nurse will make the first visit to the home to discuss the details of the program with the family. An early referral enables the hospice team to develop the relationships that meet the needs of the patient and caregivers.
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<a id=”q13″ name=”q13″></a>What are the advantages of Hospice care?</span>
• Hospice care enables terminally ill patients and their families to remain together in the comfort and dignity of their home and to die in familiar surroundings.
• Hospice care is a cost-effective alternative to the high costs associated with hospitals and traditional institutional care.
• Hospice treats the person, not the disease; focuses on the family, not only the individual patient; and emphasizes the quality of life, not its duration.
• Hospice care relies on the combined knowledge and skill of a team of professionals including physicians, nurses, certified nurse aides, social workers, counselors, chaplains, and volunteers.

<span><a id=”q14″ name=”q14″></a>Is Hospice involved if a patient needs to be hospitalized?</span>
Yes, if the patient’s condition requires symptom control, or respite care.
<span>
<a id=”q15″ name=”q15″></a>Does hospice do anything to make death come sooner?</span>
Hospices do nothing either to speed up or to unduly prolong the dying process. Just as doctors and midwives lend support and expertise during the time of child birth, so hospice provides compassionate support through its presence and specialized knowledge during this particularly difficult time. Hospice services are designed to bring comfort, to control pain and other symptoms, and to address the emotional, social, and spiritual needs of both the patient and his or her loved ones.
<span>
<a id=”q16″ name=”q16″></a>Does receiving Hospice care mean giving up on life?</span>
Many people are uncomfortable with the idea of stopping an all-out effort to “beat” a disease. Hospice care focuses on enhancing the quality of life in its final stages. It seeks neither to shorten nor prolong life. A patient can choose to leave hospice care at any time and return to aggressive curative treatment for the disease. The choice is always the patient’s. A physician’s referral to hospice care usually indicates that no other curative measures are appropriate.

<span><a id=”q17″ name=”q17″></a>Will the pain medication prevent the patient from talking, hearing, or knowing what is happening?
</span>Usually not. It is the goal of hospice to enable the patient to be pain free but alert. Even if the patient appears to be groggy, their hearing is preserved and working

<span><a id=”q18″ name=”q18″></a>Are the pain-killers addictive?</span>
Not in the doses and frequency they are given to these patients. The goal of these medications is to enable the patient to be pain free and function to the best of his or her ability, despite the illness.

<span><a id=”q19″ name=”q19″></a>What if the patient improves?</span>
Hospice patients do improve! A patient can sign out of hospice any time their condition improves or they decide to pursue aggressive, curative treatment.

<span><a id=”q20″ name=”q20″></a>What diseases are most common among hospice patients?</span>
About 60 percent of hospice patients are cancer patients, but an ever-increasing number of patients with other diseases (including Alzheimer’s or dementia, ALS, heart disease, lung disease, AIDS, stroke/coma, kidney disease and liver disease for example), receive hospice care.
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<a id=”q21″ name=”q21″></a>How difficult is caring for a dying loved one at home?</span>
It is never easy, and sometimes can be quite hard. Yet many caregivers have said it was an especially rewarding period of their lives, a time when they could express love and caring in a personal and meaningful way. One of the first things hospice will do is work with the patient and caregivers to prepare an individualized care plan. The hospice team works closely with the patient and caregivers to address their needs. At the end of a long, progressive illness, nights especially can be very long, lonely and scary. So, hospices have staff available around the clock to consult with the family and give the regular caretaker a break, if the need arises.

<span><a id=”q22″ name=”q22″></a>Is there any special equipment or changes I have to make in my home before hospice care begins?</span>
Your hospice provider will assess your needs, recommend any equipment, and help make arrangements to obtain the necessary equipment. Often the need for equipment is minimal at first and increases as the disease progresses. Hospice will assist in any way it can to make home care as convenient, clean and safe as possible.

<span><a id=”q23″ name=”q23″></a>How many family members or friends does it take to care for a patient at home?</span>
There is no set number. One of the first things a hospice team will do is to prepare an individualized care plan that will, among other things, address the amount of care giving needed in your situation. Hospice staff visits regularly and are always accessible to answer medical questions and provide support. Hospice volunteers are usually available to assist with errands and to provide an occasional break.
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<a id=”q24″ name=”q24″></a>What happens if the patient can no longer be cared for at home?</span>
Sometimes this happens despite the best efforts of both hospice and the patient’s family. Some hospice programs have inpatient units, some use dedicated hospital beds for hospice patients. Or the patient may be admitted to the hospital and continue to receive the interdisciplinary hospice care.

<span><a id=”q25″ name=”q25″></a>Must someone be with the patient at all times?</span>
In the early weeks of care, it’s usually not necessary for someone to be with the patient all the time. Later, however, since one of the most common fears of patients is the fear of dying alone, hospice generally recommends someone be there continuously. Some of Westchester’s hospices have specially trained volunteers who are available to come into the home and sit vigil with the patient in the last days of life, in cases where the family members cannot constantly be at the patient’s bedside. Hospice can also provide trained volunteers for respite care, to give family members a break. The plan of care will be adjusted with the changing needs of the patient and family, to minimize suffering and improve the patient’s quality of life.

<span><a id=”q26″ name=”q26″></a>Does hospice provide 24-hour continuous nursing care in the home?</span>
Yes, but only in times of crisis. Generally the home care program provides intermittent, skilled visits on an as-needed basis to support the patient and a primary care giver, often a family member. 24-hour on-call services are provided for emergency or acute care needs. If 24-hour continuous nursing care is necessary, most hospices will provide continuous care for a limited number of days.

<span><a id=”q27″ name=”q27″></a>What is palliative care?</span>
Palliative care is interdisciplinary health care specializing in relief of suffering and achievement of the best quality of life for patients with advanced illness, and their families.  It is offered simultaneously with all other appropriate medical treatments, such as blood transfusions, chemotherapy or radiation, if they are necessary to alleviate pain or enhance the quality of life. It does not include experimental procedures, and is supportive care rather than curative.

<span><a id=”q28″ name=”q28″></a>What is the difference between palliative care and hospice?</span>
Palliative care supports seriously ill patients from the point of diagnosis throughout the course of their illness.  It may be provided concurrent with other medical treatment, including curative treatment.  Hospice focuses on providing supportive care for patients who are at the end-of-life and are no longer receiving curative treatment.

“While hope for a miracle cure may not be evident in hospice philosophy,” states Jay Mahoney, former president of the National Hospice Foundation, “hospice care can be an extraordinary expression of hope and individual courage.” This philosophy of hope for compassion, meaning and quality of life at the end is at the heart of the hospice movement.

<span>Have other questions?  <a href=”http://westchesterendoflife.org/join/contact-us/”>Contact us</a> or see these references:</span>

<strong><a href=”http://www.carolinasendoflifecare.org/” target=”_blank”>Hospice of the Carolinas</a>
<a href=”http://www.hospiceweb.com/” target=”_blank”>Hospice Web</a>
<a href=”http://www.hospiceotp.org/” target=”_blank”>Hospice of the Panhandle, Inc.</a>
<a href=”http://www.prospecthospice.org/” target=”_blank”>Prospect Home Care Hospice</a>
<a href=”http://www.capc.org/” target=”_blank”>Center to Advance Palliative Care</a></strong>