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myths about hospice care

Common Myths about Hospice Care: Transitions

New to our web site: Hospice, Palliative, and Home Health Information

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. We hope to dispel common myths about hospice care by defining the roles of each service.
The common thread is they all work together with a common goal of quality of life.
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. 

It seems like some people have the wrong idea about what hospice care means. They 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 psycho-social 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

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.

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

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. Above all, the biggest takeaway is that you can start Hospice services 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 HEALTHHOME CARE

HOSPICE CARE

PALLIATIVE CARE
MD order needed?YesNoYesYes
Visit frequencyTypically 1-3 visits/ week per discipline based on patient’s needs and progressClient decides- can be dailyTypically 1-3 visits/ week per discipline for nursing and aides, 1-3 visits/ month social work and spiritual careTypically one visit every 2-4 weeks
Visit durationTypically about 1 hourClient decides – can be 24/7Typically about 1 hourTypically about 1 hour
PaymentMedical Insurance, Medicare, MedicaidPrivate pay, VA Aid and Assistance, Medicaid,
some LTC policies and some Medicare plans
Medical insurance, MedicareMedical insurance, Medicare
Services may includePT, OT, ST, RN, SW
and CNA visits
Personal care and companionship – includes meal prep, light housekeeping, laundry, medication remindersRN, SW, Spiritual Care and CNA visitsNP, RN and CNA

Social Worker

Where services are providedHOME HEALTHHOME CAREHOSPICE CAREPALLIATIVE CARE
Private HomeYESYESYESYES
Independent SeniorYESYESYESYES
CommunityYESYESYES

Assisted Living FacilityYESYESYESYES
Skilled Nursing FacilityNOYESYESYES
Hospice FacilityNOYESYESNA

Further Information

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

Read next: Common Myths about Palliative Care: Transitions

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