Hospice is a Medicare benefit for those who have a prognosis up a life expectancy of 6 months or less (although people on hospice often live more than 6 months). There are many companies that provide the services offered by this benefit, and any hospice company in your area will gladly send someone to provide a free assessment to see if the patient might qualify for services. These services include skilled nursing visits, a social worker, spiritual counselor, bath aid, coverage for comfort medications, medical equipment, and supplies, as well as other services. An RN case manager will work with your primary care provider and the hospice physician to provide for the patient’s comfort through the end-of-life journey. Hospice is NOT just for the last few days of life – these support services can be provided for many, many months.
If it appears that hospice might be a good option, the hospice company will interact with the primary care physician to obtain his or her consent, although often it is the PCP who has initially referred the patient, to begin with.
Apart from the doctor’s prognosis, Medicare has some specific guidelines that must be followed for each terminal disease, whether it be Cardiac Disease, COPD, Cancer, Respiratory Disease, etc. However, there are some clues that someone might be ready to speak to the doctor about hospice: Unintentional weight loss of 10% of the body weight or more, inability to eat safely or no desire to eat, increased weakness and difficulty walking, a significant increase in confusion, significant fatigue or shortness of breath. With cancer, metastasis and the decision to not further pursue curative measures can be deciding factors.
Often, with the need for hospice comes the need for increased caregiving, which is not a part of the hospice benefit. Caregivers that can actually assist with the patient’s daily functioning, not just serve as companions, are a must. An agency such as Home Health Care, Inc also provides not only such caregivers but RN oversight and supervision of the caregivers.