When you have identified the things you value (see Planning Your Care), and how you feel about types of care, make an appointment to talk with your doctor and health care team. Topics to cover include:
- Review your values with your health care professionals.
- Ask your health care professionals to explain what choices you have and what to expect with different approaches to your care
- Ask what treatments will best help you achieve the things you value.
- Set goals for your care with your team based on your values.
- Renew this conversation every once in a while, particularly if you have had a change in status, or have different goals for your care. It is recommended that patients with heart failure or serious illness renew this discussion every year.
Hospice Care
It’s important to understand that hospice care is not just for people on their deathbed.
Hospice care is a philosophy of care. But hospice care also is a specific insurance benefit to cover the cost of therapy that maintains or improves quality of life for a patient with a disease that can’t be cured. This is also the case if the patient has declined aggressive treatment to cure it.
Patients must be certified by a physician that their life expectancy is less than six months if the illness runs its expected course. This process is repeated after a set amount of time according to Medicare guidelines. Patients are either certified again or taken off hospice care if their condition improves. They can decide to be off hospice as their condition changes.
Hospice Care Benefits:
The many benefits of hospice care include:
- A team approach: Physicians, nurses, social workers, home health aides, spiritual advisers, therapists (physical, occupational, and speech), dietitians, and volunteers help ensure a patient is comfortable and prepared for the end of life, striving to achieve a good death.
- Medications: Medicine that makes patients feel better are continued or added. Some medications that don’t affect how a patient feels can be stopped (such as cholesterol pills).
- Medical equipment: The hospice company provides all equipment needed for care such as walkers, wheelchairs, hospital beds and bandages if needed.
- Care at home: Most people receiving hospice care receive care where they live with family or paid caregivers providing most care, and the hospice team visiting from time to time.
- Respite care: all patients receiving hospice care are eligible for short stays in hospice facilities or nursing homes to give family caregivers a break from care.
- General inpatient care: Patients may be admitted briefly to either a nursing home or the hospital under hospice care when symptom relief can’t easily be achieved at home.
- Grief and loss counseling: Patients and loved ones receive bereavement support in advance of death, and family receive support for a year after death.
Hospice care can take place in more than one setting depending on the illness, degree of support from family and friends, money concerns, and what the patient prefers. This includes inpatient hospice, residential facilities such as skilled nursing facilities or assisted-living residences, or home.
Hospice care helps families care for the person as they approach the end of life. People who choose hospice care agree to not go to the emergency room or hospital to treat their main diagnosis. The goal of hospice care is to support the person and their family as illness takes its natural course.