What is Hospice & Palliative Care?
Hospice is an approach to compassionate, expert medical care and supportive services for patients with a life-limiting illness and those individuals important to them. Hospice provides pain and symptom control, spiritual and emotional support while encouraging the highest quality life possible for patient and family alike.
The primary focus of this mode of caring is to assist you or your patients to be free of pain and distressing symptoms so that you can live each day as fully and comfortably as possible. The Hope Health Care team is available 24 hours a day, 7 days a week, every week of the year. We’re here when you need us, for as much as you need us, for as long as you need us.
Palliative care is a medical specialty that follows the tenets of hospice care by enhancing the quality of life for patients with serious illness. Palliative Care reaches the family of those patients who are ill with support for them as well. Palliative Care focuses on collaboration between caregivers and practitioner, stressing the importance of effective communication to alleviate pain, symptoms and the stress that typically accompanies a chronic condition.
Hospice is synonymous with palliative care, while palliative care does not always include the limits of the Medicare Hospice Benefit. A guiding philosophy of hospice is always palliative in nature; that is, always seeking to bring comfort often associated with a terminal, or life-limiting illness. The beauty of hospice is that rather than a patient having to choose between quality of life and quantity of life is more often than not, given both.
A study, published in the Journal of Pain and Symptom Management (March 2007) indicated that patients who chose hospice care lived; on average, 29 days longer than those who did not choose hospice with similar diseases.
Unique Medical Care
The Hope Health Care team consisting of physicians, advanced nurse practitioners, nurses and pharmacists who control pain and manage symptoms, supply needed medication, monitor drug interactions and provide medical equipment and supplies needed to keep you comfortable. Our clinical team will discuss medical decisions with you and your family, allowing you and your family to direct your preferences of care.
Hospice Aides are specifically trained to help with activities of daily living (ADLs) such as bathing, feeding, dressing, ambulation, transfers, dental care and other elements of personal hygiene. One of our service differentials that makes us a bit different than other hospice providers is that our aides can also provide light comfort touch and massage. While not licensed massage therapists, our Hospice Aides have been trained by Licensed Medical Massage Therapists to provide basic knowledge that allows our staff to bring comfort through aromatic oils and massage.
Emotional Support, Social Support and Planning
Our social workers are valued resources in assisting with the emotional issues of a life-limiting illness, particularly for the loved ones of a critically ill person. The Hope Health Care Social Workers can help you with various important, but stressful paperwork such as insurance paperwork and other financial matters. They can also discuss decisions regarding medical care, choosing a healthcare power of attorney, a living will or assist by helping you find community support, admission to a different living environment or in military resources/benefits or volunteer support.
Spiritual and Bereavement Care
At Hope Health Care, we provide Chaplains and Counselors that can help to address spiritual and emotional issues, regardless of faith preference of denomination. You can count on their availability and their ability to help you find peace. Bereavement counseling is provided to surviving members of the patient’s family to help them through the months following the death of their loved one.
Levels of Care
Hope Health Care, like all Medicare Certified hospices are required to provide four different levels of care. The difference between hospice providers of care are found in how they manage and transition patients between the levels of care. This is a differentiating factor between the experienced and the inexperienced hospice teams.
The experienced Hope Health Care team provides the following four levels of care:
Routine Hospice Care
This is the level of the Medicare Hospice Benefit that is most often used in patient care Nationwide. This level of care can be provided at or any place that the patient calls home. Visits are scheduled by a team of hospice professionals to ensure that medical, spiritual, emotional and personal care is met.
When a patient and family experiences a crisis, Hope Health Care can arrange a level of care that can help alleviate the crisis. Nursing care can be provided at the bedside a majority of a 24 hour period until the crisis subsides. Once the crisis subsides, the Hope Health Care RN Case Manager can begin Routine Home Care again.
General Inpatient Care
When a patient experiences pain or symptoms that cannot be managed at home, the Hope Health Care team can assist the patient by transferring them to a contracted Inpatient Facility. Once the symptoms and pain are controlled, the patient can be transferred back to the place that they call home.
General Inpatient Respite Care
Care giving can be very hard work for family members. When the caregivers need time away from their caregiving responsibilities, Hope Health Care patients can stay in a contracted inpatient facility for up to five days of rest.
Your Hope Health Care Team
Your Hope Health Care team is focused on interdisciplinary care whose goal is to aggressively manage pain and control symptoms for the person with a life limiting illness. We also provide empathetic and proactive emotional and spiritual support to those we serve including family members, significant friends and supportive caregivers.
Your Hope Health Care team works together, with the direction of our Hospice Physician and the patient’s Primary Care Physician to develop a plan of care that is specific to each individual patient’s need, desires and wishes. Our team is available to you, your loved ones and those who serve as your caregivers, 24 hours a day, 365 days a year including Holidays.
The Hope Health Care Team includes:
Hospice Physicians, in collaboration with your Primary Care Physician (the physician most closely associated with your care) along with the Hope Health Care Team, create a plan that manages pain and uncomfortable symptoms associated with your illness.
Skilled and compassionate, your nurse will be your professional care manager. Your nurse will provide direction in addressing your clinical needs helping to manage your pain and control nagging symptoms. Your nurse will also help to coordinate care with our other team members in order to help support your family and caregivers give you the best physical, emotional and spiritual care possible.
Advanced Practice Nurses assist our physicians and our team and serve as a bridge of clinical excellence to you. When called upon, they give the clinical team greater flexibility and can perform face to face visits for the Hospice Physicians.
Hospice Aides or Certified Nursing Assistants (CNAs) are specifically trained to help you with activities of daily living such as bathing, dressing, range of motion activities, ambulation, transfers, feeding, other personal care such as massage and aromatherapy, as well as companionship and light housework such as a load of laundry or changing linens.
Specially trained to assist you and your family deal with the emotions that come with end of life care, our social workers are compassionate professionals who can assist you in combating anxiety and fear associated with the unknown. Our social workers are able to help find and coordinate with you and your family community resources that help make your care easier on all involved. Our social workers can assist with end of life planning, including advanced directives, durable powers of attorney and figuring out confusing insurance benefits.
Most oftentimes called Chaplains, our Spiritual Counselors are adept in active listening and can help guide you and your family through questions you may have about weighty matters. Chaplains are available to share silent moments with you to advance the ministry of presence. Our Chaplains can provide understanding and help to relieve the stress sometimes found in relationships at the end of life.
Our Hope Health Care bereavement professionals help you and your family through the different phases of grief and the end of life process. Our team will continue to follow your family and provide support for up to 13 months.
Speech, Physical, and Occupational Therapists
These specialized care givers are available through contracted agencies when the need arises for improving functional aspects of your care.
Our Hope Health Care dieticians are the specialized team members who assist you, your family and our team formulate food that tastes good to you, is high in nutrition and meets the goals of your care plan.
Our trained volunteers are the heart of care. These are individuals who give of themselves and their time to you and your family to create quality moments. They can assist with caregiving tasks and may help with household chores, errands, companionship and special projects.
Hope Health Care believes that it important for people to have the correct information in order to make an informed decision about hospice.
The sooner misconceptions can be addressed, the sooner you can get the care that will help keep you comfortable at home. In the end, having this information may help you assess whether or not the hospice benefit is the appropriate choice for you and your family.
Myth: Electing hospice means giving up hope.
Isn’t it ironic that we have elected to call our company Hope Health Care? If we could describe what we do for people in one word, it would be exactly that…HOPE! Hospice focuses on caring for you and your family with all of our goals being keeping you comfortable. We help you set clear goals, creating a comprehensive care plan that is interdisciplinary. We strive to keep you in the environment where you want to be, as safely as possible. You maintain as much control as possible, with dignity and empathy driving our care plan suggestions.
Myth: Hospice is a place.
Hospice is not usually thought of as a place. Hospice is more of a philosophy allowing us to bring the care to you, wherever you call home. Our team of medical professionals develop a care plan that will meet goals related to pain, symptoms, quality of life and family support. Most times, we are able to dramatically decrease pain, getting you to a place of comfort and peace.
Myth: Hospice is only for the last weeks or days of life.
Wrong! Hospice was actually initially designed as a benefit that extended to six months. The earlier you receive hospice care, the better opportunity we have to help you stabilize your medical condition and address other needs that may be of concern to you.
Myth: Hospice is only for Cancer patients.
While hospice was initially built upon a “Cancer Model”, more patients with non-cancer diseases receive hospice care. Some of the more common illnesses include: Heart Disease, Lung Disease, Alzheimer’s Disease/Dementia, Stroke & Coma, Liver Disease and Kidney Disease.
Myth: Hospice only "treats" the patient.
Hospice is not just for the patient, but for their family and significant caregivers as well. The emphasis for you is on managing pain and uncomfortable symptoms, while providing support services to you and your family is also important. Bereavement Care and counseling may continue for up to 13 months to the surviving family members and caregivers.
Who Pays for Hospice?
Medicare / Medicaid Hospice – This benefit provides a daily reimbursement rate. The daily rate covers the service delivered by your care team, medications related to your end stage illness as well as medical equipment and supplies that help to provide you comfort.
Private Insurance Companies – Different companies have different policies that have their own rules regarding hospice care benefits. Your hospice coverage will be verified prior to the first visit by your Hope Health Care team member. You will be informed of covered services, deductibles and co-payments related to your hospice care coverage. Hope Health Care will request that you sign a form to allow Hope Health Care to bill your insurance company for your hospice care coverage of benefits. Hope Health Care will work with you to help you determine what deductibles and or copayments, if any, that you need to pay and be responsible for so that you can continue to receive hospice care in the place you call home. If your private insurance deductibles and copayments are not paid, you risk the loss of your hospice service until payment such payments are made.
Private Pay – Some individuals have the ability to pay for hospice directly out of pocket. For people who choose to approach hospice care from this payment source, Hope Health Care has a fee schedule that allows those with private resources to access care in this way.
Uninsured? – If you need services and have no means to pay for the services that we provide, one of our social workers can help assess your individual situation. Our goal is to make services available to all who need them; regardless of your ability to pay, to as many people as possible, to the extent that funds are available for such care.
What is not covered?
- Nursing Facility Costs (room and board)
- Inpatient care at non-contracted facilities
- Sitter Services
- Medications not related to your end stage illness
- Non-hospice related diagnosis’ or conditions
- Ambulance transportation not included in the plan of care
- Treatment for the end stage illness that is not included in your plan of care
Who Is eligible for Hospice?
Who Is eligible for Hospice? Hospice care is for people who have a life expectancy of about six months or less if the disease progresses at its normal course. Hospice care is for those people who choose to focus on comfort, symptom relief and adding days to their lives as opposed to aggressive treatment for the healing from disease.
Diagnoses most commonly associated with hospice care include the following as well as other illnesses or diseases:
- Heart Disease
- Stroke or Coma
- Respiratory Disease
- Liver Disease
- Neurologic Diseases
- Alzheimer’s Disease/Dementia
- Kidney/Renal Disease
Generalized eligibility criteria include frequent hospitalizations; frequent infections; progressive, unintentional weight loss; deteriorating functional abilities; and overall decline in condition. Hope Health Care offers disease specific care plans for these and other end stage illnesses. For more specific information on hospice guidelines for determining prognosis, please see GUIDELINES for DETERMINING PROGNOSIS.
Benefits of Earlier Admission
Nearly all patients are able to receive hospice care as soon as their physician believes; based on his or her best medical judgement, that they most likely have approximately six months or less to live.
Hospice was not intended only for the last two to three days of life. Hospice was not intended to be a crisis service. Hospice is a program that was designed by forward thinking pioneers that intended for the benefit of hospice to be six months. An early hospice admission allows both you and your family to receive the full benefit of hospice as it was designed. Additionally, when pain and other symptoms are effectively controlled, people not only feel better, they have a great potential to live longer.
According to the Journal of Pain & Symptom Management, patients who chose to pursue comfort actually lived; on average, 29 days longer than patients with similar diseases who did not choose hospice care. For those patients who had certain types of carcinoma, they figured into the positive results as well: Lung Cancer (39 days longer); Colon Cancer (33 days longer); Pancreatic Cancer (21 days longer); and Congestive Heart Failure – CHF (81 days longer).
Some benefits of choosing hospice earlier for you as the patient include:
- Effective pain & symptom management resulting in less discomfort and fewer trips to the hospital
- Full emotional, spiritual and psychological support
- Earlier intervention may decrease stress levels and could possibly result in a more positive quality of life
- A reduction in unnecessary and frequent readmissions to the Emergency Department / Hospital
- Assistance with focusing on personal goals
Some benefits of choosing hospice earlier for your family include:
- Providing an opportunity for closure and saying good-bye
- Becoming knowledgeable and comfortable with what is happening with you in your disease process
- Achieving a level of peace with your circumstances
- Giving them a sense of control in helping you to the best of their ability
- Receiving support and expert assistance in preparing your memorial service and
- Saving money on expenses related to your medication, medical equipment and supplies related to your hospice illness
Early admission to Hope Health Care allows you and your family to build stronger and longer relationships and improve your overall care. Remember, we focus not only on body, but mind and spirit as well. In National Surveys over the past 20 years, hospice families have indicated in overwhelming numbers that they wish they would have known about hospice earlier!
Aromatherapy & Massage Touch
How Hope Health Care can add this modality to bring comfort.
Why have a Aromatherapy Program in a hospice setting?
- Aromatherapy can help to control pain, nausea and anxiety
- Aromatherapy can help to control odors
- The stress and agitation with patient’s decreases, thus they are calmer and happier
- When the patient is in a calmer, peaceful state, both the families and staff benefit
- Patients tend to live with better quality of life when they are in a calmer state
- Many essential oils properties include antibacterial, antimicrobial, anti-fungal and anti-viral actions – this is of benefit during cold and flu season.
How does Hope Health Care use essential oils in the hospice setting?
Diffuse with a Diffuser/Nebulizer
Place 1-3 drops on a cotton ball, present in a medicine cup (with a lid) for individual inhalation as needed
Blended in lotion or cream to be used during a neck massage, hand or foot rub
During bed baths & regular bathing routines
While Hope Health Care does not currently include licensed medical aroma therapists or massage therapists as part of our team, licensed medical massage therapists who employ aromatherapy in their practice have trained the Hope Health Care team Hospice Aides to be able to provide comfort via aromatherapy and massage.
COURAGEOUS – Program for Veterans
Hope Health Care’s COURAGEOUS Veteran Program salutes men like Byron Gordon and recognizes the special needs that veterans of combat and war bring to caregiving. Because our military veterans have given so much to protect and care for us and our Country, we at Hope Health Care strive to give that same level of commitment and attention to detail to those veterans’ who entrust their care to our team.
Overcoming difficulty and persevering is nothing new to Marine Corporal Byron C Gordon.
Gordon, along with nearly 75,000 other American and Philipino soldiers and civilians were a part of the largest surrender in United States military history in April/May, 1942. Gordon and his “buddies” were forced marched approximately 65 miles with little to no food or water to Japanese prisoner camps after the fall of Bataan and Corregidor during World War II. Gordon survived the tortuous POW Camps, O’Donnell and Cabanatuan, the forced labor details of the Manilla shipping docks, the voyage of the Hellship Nissyo Maru and finally, the slave labor camps in the mountains of Japan before being liberated in August, 1945. As one of less than 75 American soldiers still left from this period of U.S. military history; Gordon, at 97 years still epitomizes the characteristics of the COURAGEOUS Veteran’s Program: perseverance, mental strength and service to his fellow man without fear of the future.
Advancing Hope – Public Speakers Bureau
Hope Health Care provides speakers for various groups and organizations throughout our service area. The speakers who participate in this vital community program are highly trained and committed professionals. Many speak from their own professional and personal experience.
Community Speakers Bureau
Our speakers deliver presentations to a variety of audiences including civic groups, professional associations, faith communities, businesses, senior centers, public libraries and various other community groups who are interested. We have topics of interest that include subjects that are inspiring, informative and entertaining. We can design something specific for you and your group or you can choose from our list of presentations to meet your needs.
If you represent a hospital, facility or association seeking continuing education for your team, we offer several interesting topics to expand your knowledge and skills – many with CEU credits. Workshops can be designed to meet the needs of your clinical staff and customized to fit your audience. Topics of interest may include:
- Care at the End of Life
- The Dying Process
- Pain & Symptom Management
- Nutrition and Hydration
- Grief and Bereavement for the Caregiver
- Advanced Directive in the Care Setting
- Hospice and Palliative Care Overview
- Resilience – The key to Caregiving
What are advance directives?
“Advance directive” is a general term that refers to your oral and written instructions about your future medical care, in the event that you become unable to speak for yourself. Each state regulates the use of advance directives differently. There are two types of advance directives: a living will and a medical power of attorney.
What is a living will?
A living will is a type of advance directive in which you put in writing your wishes about medical treatment should you be unable to communicate at the end of life. Your state law may define when the living will goes into effect, and may limit the treatments to which the living will applies. Your right to accept or refuse treatment is protected by constitutional and common law.
What is a medical power of attorney?
A medical power of attorney is a document that enables you to appoint someone you trust to make decisions about your medical care if you cannot make those decisions yourself. This type of advance directive may also be called a “health care proxy” or “appointment of a health care agent.” The person you appoint may be called your health care agent, surrogate, attorney-in-fact, or proxy. In many states, the person you appoint through a medical power of attorney is authorized to speak for you any time you are unable to make your own medical decisions, not only at the end of life.
Why do I need an advance directive?
Advance directives give you a voice in decisions about your medical care when you are unconscious or too ill to communicate. As long as you are able to express your own decisions, your advance directives will not be used and you can accept or refuse any medical treatment. But if you become seriously ill, you may lose the ability to participate in decisions about your own treatment.
What laws govern the use of advance directives?
Both federal and state laws govern the use of advance directives. The federal law, the Patient Self-determinationAct, requires health care facilities that receive Medicaid and Medicare funds to inform patients of t heir rights to execute advance directives. All 50 states and the District of Columbia have laws recognizing the use of advance directives.