What to Expect From Hospice Care

The time has come to discuss a subject no family wants to discuss. You must decide about putting a loved one, or yourself, in hospice care. You need to understand what hospice care is and what to expect before you make this life-changing decision. Where Hospice Care is ProvidedHospice care can be provided both in the home and in a facility, such as a nursing home or hospital. Most families find they have more control over services and care if it is provided in the home rather than a facility.

Home hospice care is also preferred to keep the patient happy and comfortable in their final days. Hospice services are provided for most people where death is expected within six months, although the time period can be shorter or longer.

Medicare, Medicaid and most insurances pay fully for hospice care. All quality hospice care services, whether it is provided in a hospital or in the home, will be fully licensed and insured.

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They must meet state requirements for the service, but also must meet federal guidelines in order to quality for Medicare and Medicaid. It is best to know what those guidelines are and be sure services are in compliance before hiring a company. Hospitals and nursing home facilities providing hospice care each offer a different range of services within that category, so you must have an honest discussion of exactly the type of services that will be provided to your loved one. Some things to discuss are:

• Pain management, how that will be administered, and how often will it be given.
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• Food and drink availability and how meals or food will be given. Will services stop when they can no longer eat normally or will it continue with a feeding tube?
• Companion care and whether someone will visit and stay with them regularly when the family isn't there.
• The method to address family concerns with care, should they come up.
• The method of handling regular doctor evaluations and what happens should the patient actually get better or is found to no longer be affected by terminal illness.

In-Home CareHospice care in the home typically includes at least one family member who is responsible as the primary caretaker. This person oversees things like medical care, meals, any therapies, daily hygiene and routines. Hospice care services, most of the time with most accredited companies, include a team to assist the family member or members with caring for their loved one in their final days. The team includes:

• The patient's primary doctor
• A hospice doctor
• Certified nurses
• Social workers
• CNA's or home health workers
• Clergy
• Therapists, including those for physical, speech and memory therapy
• Volunteers

Hospice services take on a holistic approach to care for both the patient and family.

That goes far beyond physically caring for the patient and also includes spiritual and emotional counseling for both the terminally ill and their family. It also includes some practice help, such as house cleaning and running errands. Most also includes grief counseling and bereavement care for after the patient has died. Hospice Care StepsThe first thing that happens is your loved one's physicians recommends them for hospice care. A hospice care representative will call or visit you and the patient within 48 hours in most cases. They take down a lot of information, ask questions and probably have reports from the doctor to go over with you. The next thing that happens is the hospice team creates a care plan for the patient.

The primary focus of the plan is pain management. However, it also includes other aspects like various therapies, medical evaluations, hygiene and even other services the family will need. Those other services include things like meal preparation, help and transport to doctors or medical facilities, counseling with family members about what to expect as their loved one moves closer to death, and spiritual needs. Nurses will likely visit the home at least a couple of times a week to monitor pain management and medications. Most hospice companies have nurses handle 12 to 15 patients, so be sure to ask those you are considering what the workload is. Those with more patients than that may not be a company that can give your family and loved one the attention they need. Home health care workers come more often as they help with preparing food for the patient, hygiene, remembering medication, companion care, sitting with the patient, assistance in getting the patient out of the bed or out of the home for outings and other basic needs. Volunteers typically handle an array of needs for the family and can be brought in as needed. They do things like clean the home, preparing meals for the family, respite care for the patient so family members can time away, running errands, and companion care for the patient. Clergy offer spiritual services, which become a priority as time goes on.

Many people may have questions, concerns or emotional issues that rise as their family member nears death. A number of people are not members of a local church these days, so a clergy member they can call on and talk to provides an invaluable support during the process and afterward. Preparing for DeathThere are a lot of things to deal with as a love one nears death. Things like funeral planning, estates, dividing up personal items and other issues are just some of the issues families must handle. Beyond that, there is the unknown of what to expect as your loved one gets closer to death. This is often an uncomfortable experience for most and hospice workers, from doctors to nurses to counselors, can help families understand the death process and properly prepare both emotionally, financially and physically. While the six months before death can be a difficult time for everyone, seeking a good hospice care company can make it easier. It can also relieve some of the stress of daily activities so that you can spend the final moments of your loved one's life enjoying them and spending as much quality time with them as possible.