The National Association of Home Care and Hospice (NAHC) recognizes November as National Home Care and Hospice Month and chose the theme “Hospice = Love in Action” to represent the services that home hospice provides to countless patients. For patients who have a terminal illness, their lives and the lives of their families may have been completely focused on fighting their disease for months or years. The hope of treatment, of course, is for cure or improvement. Where can patients and families turn when continuing treatment cannot change an outcome, or even worse, causes the quality of life to become so poor, that aggressive, curative treatment is no longer beneficial or desired? For many patients with terminal illness, hospice can be a welcome answer.
What exactly is hospice? Susie Compton, RN, Administrator for Lincoln Medical Home Health and Hospice explains, “Hospice is a philosophy of care that focuses on symptom control and quality of life, not curative treatment. Hospice care, which is provided as a benefit of Medicare and Medicaid and many insurance plans, is a team-oriented approach to medical care, pain management, and emotional and spiritual support tailored to a dying patient’s needs and wishes”. A team comprised of physicians, nurses, a social worker, bereavement coordinator, spiritual counselor, and volunteer coordinator looks at not only the patient’s needs, but the needs of the caregivers as well. For patients who qualify, comprehensive end-of-life care including nursing and medical care, medical equipment and supplies, and medications related to the terminal condition can be delivered in the patient’s home, whether that home is a residence, assisted living facility, or nursing home.
Hospice is frequently associated with cancer, but there are many chronic illnesses and conditions in which a patient is considered to be terminal with a limited life expectancy. Ellen Poarch, RN Case Manager for Hospice, explains, “Patients with end stage dementia, terminal neurological conditions, end stage lung, liver, and heart disease and evidence of decline in their health status due to long term debilitating chronic diseases may also be eligible to take advantage of hospice. Patients must meet certain physical criteria that indicate that they have a limited life expectancy. And of course, patients and their families must be ready to focus on comfort measures and stop curative treatments”.
Nancy Thomas, RN, has been a home care and hospice nurse for several years. She states, “Sometimes patients and families worry that by electing hospice they are ‘giving up’, but hospice offers incredible support in situations where continuing aggressive therapy will not change the outcome and may decrease the quality of life. There also is no requirement that the hospice beneficiary be homebound. In fact, hospice patients are encouraged to do as much as possible for as long as possible. Quality of life is paramount in the hospice treatment plan.” Another thing to remember is that a patient is not locked into the benefit once he or she elects it. If the patient decides to pursue aggressive therapy, it’s possible to revoke the benefit. If there is a substantial improvement, a patient can be discharged from hospice and assume the insurance coverage they had previously. Patients can also re-elect hospice at a later date as long as they meet eligibility requirements. There is no waiting period.
Linda Mills, LCSW is the Social Worker, Bereavement Coordinator, and Volunteer Coordinator for the Hospice Program. “I have several roles in hospice. From the time a patient is admitted, my focus is on support for the patient and family. What are their psychosocial needs? Are they prepared for the loss that occurs with debilitating disease and death? What resources do they need? How can I help them through the process of letting go?” Mills continues, “I don’t think most people realize that hospice support doesn’t end with the death of a patient. Families and caregivers continue to receive bereavement support for 13 months following the death of a loved one”.
“The Hospice theme this year truly expresses the way our hospice team feels about what we do”, states Compton. “Hospice is Love in Action. I frequently get asked if I think my job is ‘sad’, and my response is ‘definitely not’. It is the most rewarding thing I have ever done as a nurse. In 30 years of nursing, I have seen a lot of death. It’s a natural event that we will all inevitably face and yet so few people will discuss advance directives or what their wishes are at end of life until they are faced with a crisis situation. What an honor and a privilege it is to help patients and families feel supported and prepared to handle a life limiting illness. That support can ease fears, reduce distressing symptoms, and improve the quality of life. What greater service can you provide as a health care worker?”
How can the public find out more about hospice? Interested individuals may contact the agency at 931-433-8088 or visit the Lincoln County Health System webpage at http://www.lchealthsystem.com/lincoln_medical_home_health_hospice.aspx The nursing and social work staff at Lincoln Medical Home Health and Hospice is available to consult with terminally ill patients or their families who are not yet in a hospice. The consultation can occur at the agency, in a hospital, nursing home, other facility, or at home, and may include counseling on care options and advance care planning.
The public is also invited to attend this year’s annual Hospice Memorial Service, to be held Sunday November 16th at 2:00pm at First United Methodist Church, 200 N Elk Avenue, Fayetteville. This event is held in honor and remembrance of those hospice patients who have passed away this past year. It is open to anyone who has lost a loved one and would like to be part of a service offering support and encouragement.