 |
  |
||||||
 |
 |
 |
 |
 |
 |
||
 |
|
||||||
|
|||||||||||||||||||||||
|
|
Guidelines for Hospice Care and Treatment The following guidelines have been developed to assist in making decisions about Hospice care. It is important that patients and families understand the benefits they are entitled to, as well as any financial responsibility they may retain. These guidelines, though extensive, are not meant to be all-inclusive. If you have any questions concerning coverage, please call 1-800-717-3811. Palliative Care Often physicians will recommend palliative care (comfort care) to their patients when it becomes clear that pursuing aggressive curative treatment is no longer realistic. Typically patients are referred to Hospice to receive care in this specialty. The focus of Hospice is to provide the best quality of life possible for patients and families. Hospice specializes in pain and symptom management. Often the symptoms are not physical, but spiritual, emotional, or social. Hospice attempts to control pain in such a manner that patients are able to remain alert and active to the extent possible. Informed Consent Electing hospice care is a personal decision that Hospice at Home takes seriously. It is crucial that certain information be thoroughly understood upon entry into Hospice. Therefore significant time is devoted to the initial visit. For example, it is understood that Hospice neither hastens nor prolongs the natural dying process and that the patient has the right to exercise choice with respect to services. This includes the right, at any time, to receive care from another source if a specific therapy is at odds with the Hospice philosophy. Included in the informational visit are discussions of the current care plan and how it may be modified in a Hospice medical plan of care. Interdisciplinary Team and the Plan of Care A team of professionals will care for each patient and family. This team designs a Plan of Care structured to meet the unique needs of each patient and family in cooperation with the attending physician. The hospice team manages decisions about specific treatments or therapies, while the hospice medical director, in consultation with the patient's physician, makes the final decision regarding hospice provided medical treatment. Items Included with Comprehensive Hospice Coverage Most public and private insurance providers, such as Medicare, Medicaid, or Blue Cross/ Blue Shield cover a multitude of items that may be recommended in a Plan of Care. Some of the treatments often recommended in a Plan of Care that are typically covered under a hospice benefit include:
Items Excluded from Comprehensive Hospice Care Hospice provides care that is palliative in nature: that is, care which has the primary purpose of providing comfort to the patient. Treatments rendered with the primary purpose of curing the illness or treatments which extend the length of life, while compromising the quality of the time remaining, are contrary to the Hospice philosophy of care. These modalities are generally not provided for under the comprehensive hospice benefit, but will be evaluated on a case by case basis. Supportive Care Services Hospice examines all options available for financial assistance for the cost of care and treatment. No one is turned down for hospice services due to an inability to pay. In the absence of coverage by either public or private insurance, individuals will still benefit from the following hospice services:
Note: Under supportive care medications are not covered and medical equipment is loaned based on availability of the items requested. Availability of Care Hospice patients have the ability to reach Hospice by phone 24 hours a day. In the evenings, the Phone Triage Nurse (a nurse who is an expert in making evaluations and decisions over the phone) will work with the patient or family to determine if or when a nurse, or other team member, should be sent to the home. There are occasions when patients or families require Continuous Care, that is, support that involves the Hospice staff for many hours. These extended visits are covered under the typical Hospice benefit because they are occasionally crucial to symptom management. Hospice does not, however, provide around-the-clock care. The primary care of the patient is the responsibility of the family. Families that elect to employ private duty care givers, will do so at their own expense. IV Hydration and Tube Feedings IV Therapy for hydration, while not typically encouraged for most patients, will be considered when a patient has dehydration symptoms and other methods of relieving the discomfort (such as the use of ice chips) have failed. Hospice will provide care for patients requiring tube feedings when the patient is already receiving tube feedings upon admission to hospice. It is the responsibility of the patient or family to supply the nutritional products used for tube feedings. Hospice will supply the product if or when nutritional supplements have been donated to the organization. Experimental Medications Hospice at Home has a protocol for evaluating, and potentially including, experimental medications in the Hospice Plan of Care. Hospice evaluates the use of these medications, intended exclusively for palliation, on a case by case basis. Hospital Stays Hospital visits are usually not necessary, nor are they encouraged, for the vast majority of Hospice patients. When a patient and family make the decision to go to the hospital for treatment that is not an emergency and/or could have been treated in the home by the Hospice team, the Hospice benefit can not be accessed to cover charges. When choosing hospital care, the family revokes (voluntarily surrenders) the Hospice benefit, in order to access alternate insurance benefits. The patient can continue to receive supportive care from Hospice with funding being provided by community support. Upon discharge from the hospital, the Hospice philosophy of care will be reviewed and the family will make the decision whether or not to reassign the Medicare benefit to the Hospice program. Complementary Therapies
Complementary therapies can work alongside conventional treatments, helping to
improve quality of life and reducing stress. We offer patients a range of
complementary therapies including massage and aromatherapy. Discussing Hospice < BACK | NEXT > Managing the myths
| |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||