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| The following are questions we all may have at some time in our lives. They may be in response to our personal experiences or those of our loved ones. The most important thing to remember is that there are options available. |
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1. When should a decision about entering a Hospice program be made and who should make it?
It’s appropriate to discuss all care options, including Hospice, at any time during a life-limiting illness. By law, the decision belongs to the patient. Though some people view Hospice as giving up, most Hospice families say that being in Hospice gave them precious quality time with their loved ones.
Because it can take some time for Hospice professionals to tailor palliative care and pain management to each person, it is best to begin some level of professional care before a crisis exists. Families often feel it is "too soon" to begin Hospice care and wait until death is very near. Bringing Hospice professionals in at the last minute potentially limits their effectiveness. A better approach is to arrange introductory home meetings or Hospice visits well in advance of need and obtain counseling from a Hospice professional who can provide helpful suggestions on care arrangements. Put the support network in place before you need it. |
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2. Who should raise the possibility of Hospice care ~ a doctor, the family, the patient?
You and your family should feel free to discuss Hospice care at any time with your physician, other health care professionals, Hospice staff, clergy or friends. |
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3.What if our physician doesn't know about Hospice?
Most physicians know about Hospice. Many however, hesitate to "recommend" Hospice to families as it appears they have given up hope. It is the patient and the family's right and privilege to request information on Hospice at any time. If your physician wants more information about Hospice, it is available from Hospice of St. Mary's 24 hrs a day, Hospice Network of Maryland, (410) 729-4571, or the National Hospice Help line, 1-800-658-8898. |
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4. Can a Hospice patient ever return to aggressive curative medical treatment?
Certainly. Patients can be discharged from Hospice and return to aggressive therapy or go on about their daily lives. A patient may relinquish their Hospice benefit at any time and return to aggressive treatment. If a patient's condition improves, the Hospice team may recommend discharge. If a discharged patient should later need to return to Hospice care, Hospice will be available at that time. |
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5. What does the Hospice admission process involve?
Hospice will first contact the patient's physician to make sure he or she agrees that Hospice care is appropriate for this patient at this time. A Hospice nurse or social worker will then visit the patient and family.
The patient will be asked to sign consent and insurance forms. These are similar to the forms patients sign when they enter a hospital. The Hospice Informed Consent Form states that the patient understands that care is palliative ~ aimed at pain relief and symptom control ~ rather than curative. Services available will be described. The Medicare election form explains how electing the Medicare Hospice benefit affects other Medicare coverage for terminal illness. |
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6. Is there any special equipment or changes I have to make in my house before Hospice care begins?
The Hospice staff will assess your needs, make recommendations, and help make arrangements to obtain any necessary equipment. The need for equipment may be minimal at first, but may increase over time. The Hospice staff will provide ongoing assistance to continue to make home care as convenient, comfortable and safe as possible.
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7. How many family members or friends does it take to care for a patient at home?
There's no set number. An individualized care plan will be developed that will address, among other things, the amount of care giving need in your situation. Hospice staff visits regularly and are accessible 24/7 to answer questions and provide support. |
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8. Must someone be with the patient at all times?
This will depend upon how ill the patient is when he or she is admitted to Hospice. Because one of a patient's most common fears is the fear of dying alone, Hospice generally recommends that someone be home with the patient as the end of life nears. |
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9. How difficult is caring for a dying loved one at home?
It's never easy emotionally and sometimes can also be physically and mentally draining to care for a terminally ill loved one. Nights especially can be very long, lonely and scary near the end of a long, progressive illness. Hospice provides uniquely qualified nursing staff, home health aides and volunteers available to consult with and educate the patient and family. This support may allow a potentially scary time to be especially rewarding to the patient and family. See question 16. |
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10. What specific assistance does Hospice provide home-based patients?
Hospice provides a team of nurses, social workers, counselors, home health aides, clergy, therapists, and volunteers to care for each patient/family. Each team member provides assistance based on his or her area of expertise. In addition, Hospice helps provide medications, supplies, equipment, hospital services, and additional helpers in the home, if and when needed.
While most direct patient care is provided by family and friends, Hospice volunteers are available to assist with errands and to provide a break and time away for caregivers. |
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11. Does Hospice do anything to make death come sooner?
Hospice does not speed up or slow down the dying process. Just as doctors and midwives lend support and expertise during the time of child birth, Hospice provides its presence and specialized knowledge during the dying process. |
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12. Is caring for the patient at home the only place Hospice care can be delivered?
No. Although the majority of Hospice patients are cared for at home, care may also be provided for patients living in retirement communities, assisted living facilities and nursing homes. Many times however, it is the patients' wish to remain at home where they feel comfortable and safe. If available in the area, a Hospice House may offer the comfort of a home, with care that may not be available at home. |
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13. Can a person who lives in a nursing home have Hospice?
Yes. Hospice care can provide an extra 'layer of care' for a person in a long term care or assisted living facility. The Hospice interdisciplinary team supports the patient/family unit as if they were in a regular home setting. The nurses collaborate with the nursing home staff to ensure pain and symptom control. The Hospice principles of care and comfort can help enhance the care to a very deserving but underserved population. |
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14. How does Hospice "manage pain"?
Hospice nurses and doctors are uniquely trained in the latest approach to medications and devices for pain and symptom relief. In addition, physical and occupational therapists are available to assist patients to remain as mobile and self-sufficient as possible.
Hospice believes that emotional and spiritual pain are just as real and in need of attention as physical pain, so it addresses each. Trained counselors and members of the clergy may be available to assist family members as well as patients. |
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15. What is Hospice's success rate in battling pain?
Very high. Using some combination of medications, counseling and therapies, most patients can have their pain managed at an acceptable level.
Will medication prevent the patient from being able to talk or know what's happening?
Usually not. It is the goal of Hospice to allow the patient to be free of pain but also alert. By constantly consulting with the patient, Hospice has been generally successful in reaching this goal. |
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16. Does the nurse stay at the house?
No, but the Hospice nurse is only a phone call away 24/7 anytime a visit is needed. If there is a crisis the nurse will stay with the family until the crisis is resolved. |
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17. Is Hospice care covered by insurance?
Hospice is covered by Medicare, Medicaid and most private insurance policies. To be sure about your specific policy, check with your health insurance provider. However, no patient is turned away as a result of their ability to pay. |
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18. If the patient is eligible for Medicare, will there be any additional expenses to be paid?
Medicare covers all services and supplies for the Hospice patient related to their terminal diagnosis. |
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19. If the patient is not covered by Medicare or any other health insurance, will Hospice still provide care?
Hospice of St. Mary's provides care regardless of a patient's ability to pay. We support ongoing fundraising events which offset cost of those not insured or comfort items which may not be covered by insurance. The Hospice staff will assist families in finding out whether the patient is eligible for any coverage he or she may not be aware of. However, care will always be provided. |
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20. What happens after the patient dies?
Hospice provides continuing contact and support for family and friends for a minimum of 13 months following the death of a loved one. Hospice of St. Mary's also sponsors bereavement groups and individual support for anyone in the community who is grieving the death of a loved one. |
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