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 Common Myths about Hospice Care: Let’s Talk Transitions

Common Myths about Hospice Care: Let’s Talk Transitions

This blog on Hospice Care launches a new section of our web site to educate people on the valuable services provided to you and loved ones when receiving Hospice, Palliative, Home Health and Home Care services. 

They are valuable services that intersect on some levels with different primary objectives regarding patients. The common thread is they all work together with a common goal of quality of life.

Our first blog article will feature information about hospice care. The majority of the information in this blog is from our friends from Transitions LifeCare, a 501 (C)(3) nonprofit organization based in Raleigh.

Originally founded as Hospice of Wake County in 1979, Transitions LifeCare provides a comprehensive circle of expert care and support: Hospice, Home Health, Palliative and Grief Care.

The blog below first appeared on Transitions LifeCare’ s blog “Let’s Talk Transitions” and is shared with their permission.

Common Myths about Hospice and the Facts

Myth #1: Hospice is where you go when there is nothing more the doctors can do. 

Some people have the wrong idea about what hospice care means. Many people hear hospice, and they think “brink of death” care or “nothing more can be done.” In reality, hospice helps people with life-limiting illnesses live to their fullest with the best care possible. It’s true that most people receiving hospice care die; however, true hospice care is about living. This is the first in a series of some of the most common misconceptions about hospice.

Fact: Hospice is not a place but a type of care provided when patients have a life-limiting illness. Hospice physicians, nurses, social workers, spiritual care counselors (chaplains), and aides are experts at managing pain and other symptoms, addressing psychosocial concerns, and helping patients and families with unfinished business. Hospice offers a volunteer network tailored to each individual’s interests and needs. In my perspective, this is doing quite a bit.

Myth #2: Patients have to be DNR to enroll in hospice

Some people have the wrong idea about what hospice care means. Many people hear hospice, and they think “brink of death” care or “nothing more can be done”. In reality, hospice helps people with life-limiting illness live to their fullest with the best care possible. It’s true that most people receiving hospice care die, however true hospice care is about living. This is the second in a series of some of the most common misconceptions about hospice.

Fact: Many patients and physicians believe that a patient must agree to a Do Not Resuscitate Order (DNR) prior to admission. Signing a DNR means that you do not want to be resuscitated with CPR or other means should your breathing or heart stop.

While the majority of patients do elect to have a DNR order in place, it may not be the right choice for everyone.

Our clinical staff begins the discussion of overall goals of care on admission, and often through that discussion or on subsequent visits, the patient comes to a better understanding of what Full Code and DNR mean in the context of their illness and goals.

The goal of hospice is comfort and patient centered care, and no decision should ever be forced or coerced.

Myth #3: Hospice will stop all medications except those treating pain and agitation.

Some people have the wrong idea about what hospice care means. Many people hear hospice, and they think “brink of death” care or “nothing more can be done”. In reality, hospice helps people with life-limiting illness live to their fullest with the best care possible. It’s true that most people receiving hospice care die, however true hospice care is about living.

This is the third in a series of some of the most common misconceptions about hospice.

Fact: Hospice patients are often on many medications when they are enrolled. The admission period is a time for reevaluation of the current medication list, as many medications are no longer effective, or may have significant side effects which outweigh the benefits.

For example, hospice patients who have heart failure will likely continue on all of their usual heart medications and diuretics (fluid pills) to help control their symptoms, but may stop their cholesterol medication or osteoporosis medication as it may take years to reap the benefits of these.

Each patient’s medication list and clinical picture is evaluated individually to determine which medications will be covered by hospice based on the underlying diagnosis.

Myth #4: Hospice is only for the last days of life

Some people have the wrong idea about what hospice care means. Many people hear hospice, and they think “brink of death” care or “nothing more can be done”. In reality, hospice helps people with life-limiting illness live to their fullest with the best care possible.

It’s true that most people receiving hospice care die, however true hospice care is about living. This is the fourth in a series of some of the most common misconceptions about hospice.

Fact: Hospice patients and families receive care for an unlimited amount of time, depending upon the course of the illness. There is no fixed limit on the amount of time a patient may continue to receive hospice services. 

The Medicare benefit, and most private insurance will pay for hospice care as long as the patient continues to meet the necessary eligibility criteria. 

Hospice care is most beneficial when there is sufficient time to manage symptoms and establish a trusting relationship with the hospice caregivers. When patients are referred very late in their disease process, there is often very little time to do the important work of supporting the patient and family. 

Many patients who enroll in hospice say, “I wish I would have started sooner.”

Our final thoughts and advice

This is wonderful information from Transitions LifeCare.  When we first read it our biggest takeaway was that you can go on Hospice and as Gina says “Graduate."  You can get better and that’s one of the many benefits of hospice services.
 

Every person is unique.  It’s important to discuss your goals with your family and geriatric professionals with a Hospice like Transitions LifeCare.  To help position the various services as far as features and costs, we put together the educational table below contrasting the various service options available to you.

 

HOME HEALTH HOME CARE

HOSPICE CARE

PALLIATIVE CARE
MD order needed? Yes No Yes Yes
Visit frequency Typically 1-3 visits/ week per discipline based on patient’s needs and progress Client decides- can be daily Typically 1-3 visits/ week per discipline for nursing and aides, 1-3 visits/ month social work and spiritual care Typically one visit every 2-4 weeks
Visit duration Typically about 1 hour Client decides – can be 24/7 Typically about 1 hour Typically about 1 hour
Payment Medical Insurance, Medicare, Medicaid Private pay, VA Aid and Assistance, Medicaid, some LTC policies and some Medicare plans Medical insurance, Medicare Medical insurance, Medicare
Services may include PT, OT, ST, RN, SW and CNA visits Personal care and companionship – includes meal prep, light housekeeping, laundry, medication reminders RN, SW, Spiritual Care and CNA visits NP, RN and CNA

Social Worker

Where services are provided HOME HEALTH HOME CARE HOSPICE CARE PALLIATIVE CARE
Private Home YES YES YES YES
Independent Senior YES YES YES YES
Community YES YES YES

Assisted Living Facility YES YES YES YES
Skilled Nursing Facility NO YES YES YES
Hospice Facility NO YES YES NA

If you have questions or would like our help talking to a knowledgeable geriatric professional, please call us at 919-436-1871.
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