Help From Hospice

When families are faced with a loved one who is in the final stages of life, the anguish and stress can be almost unbearable. Hospice is a service that can help the whole family, including the one near death, cope with the final months or days of life. Every family we have met that used hospice has been very grateful for the support and comfort and advice given, not only to the person dying, but to the whole family.

A hospice team is trained and experienced in what happens as body and mind are failing. They will explain what to expect which can reduce the fear and anxiety of the unknown. They will give direct help to your loved one such as staying close, talking, soothing fears, and doing personal things such as holding hands, combing hair, and just being a close and personal companion when family cannot be there. The whole concept is to give comfort and dignity to that cherished family member, and to give support to the rest of the family in a very difficult time.

Hospice workers are a fount of knowledge about what to expect in physical and mental deterioration. They can anticipate the progression of decline and give the family forewarning of what to expect. This relieves the stress of the unknown. At the same time they can recommend a good placement for such final care. It could be at home as many people prefer for privacy and familiarity, an assisted living facility, a nursing home or a hospital. Regardless of where, the
hospice workers give much needed emotional support to the whole family. This is especially true if your loved one has severe dementia, has trouble communicating, or is experiencing behavioral problems over which they have no control. Hospice workers can also guide the family in making end of life decisions, because they assisted through those before.

The general rule is that hospice will not be ordered by a doctor unless the person is expected to live less than six months. We have seen people live almost two years and others go in days, but the important part to remember is the doctor’s opinion, based on observation and experience, is what will determine if hospice is warranted. For most people, hospice is paid for by Medicare. This is a surprise to many, because it is not something we think about. But there is an important distinction between the aid and comfort hospice brings, and paying for the care given by a nursing home. If your loved one is moved to a nursing home from a hospital, the care provided by the nursing home is not paid by Medicare because Medicare pays for rehabilitation and for hospice, but not nursing care. That is the family responsibility, unless the loved one qualifies for Medicaid, in which case Medicaid will pay for the nursing home. If your family ever faces this difficult path, make sure you understand who is obligated to pay for the nursing home before a decision is made on admission to a nursing home.

There is no single company that gives hospice care. There are many choices and your doctor, or social workers at hospitals and nursing homes, or geriatric care managers, or elder law attorney can provide names. Cost is not usually the concern, because Medicare will almost always be the payor, if the doctor has recommended hospice. The only concern should be to help you and help your loved one spend their final time together as peacefully and with as much dignity as possible.