When a loved one has a short time left and requires medical care in the end of their life then most families choose hospice to assist with care. Hospice care can be a great service to families and patients, allowing them to focus on spending as much quality time as possible in these final times of a patient’s life. End of life care, or hospice can come in many forms. Most hospice centers provide the same basic services but can be significant differences in special services provided and/or the quality of service you receive on basic services. It is crucial that the right hospice care is chosen.
To assist you in making a more informed choice, we have put together this guide to choosing the right hospice care. Our hope is that this information will help you in asking the right questions and looking at the right things when choosing hospice care for you or your loved one.
To begin, let’s talk about what hospice care actually is. Hospice care is also called “comfort care” or “end of life care”. It generally focuses on keeping a patient comfortable for the remainder of the time left. Some centers will also offer services for the families to help with bereavement, but this is something you will need to shop for when choosing care.
Palliative care is a specific kind of hospice care that helps people with terminal illnesses live out their last days comfortably. Unlike hospice care, palliative care can start the moment the patient is diagnosed. Palliative treatment includes pain management, specialized medication, physical therapy and other tasks and services.
Choosing the Right Type of Hospice Care
On a basic level, and according to Medicare, there are four different levels of hospice care. All levels of service should provide nursing services, physician services, health aide services, medication, medical equipment and supplies. It’s possible to experience one or all levels of hospice care depending on the patients need as well as the duration of treatment.
Level 1: Routine Home Care
This is the most commonly received hospice care. Patients choose to receive hospice services from their place of residence. This includes assisted living facilities and nursing homes. This does not include specialized hospice care facilities, which are considered an continuous home care facility. Many patients prefer to spend their last days at home or in the place they are used to living. If the patient’s care does not require inpatient care this is a great option.
Level 2: Continuous Home Care
This is the 2nd most commonly chosen type of hospice care. This is round the clock care given in a patient’s home, where the patient is most comfortable receiving their end of life care. This level is most appropriate when the patient has symptoms that are hard to control or are out of control. Having a medical professional in the home at all times is critical for the comfort and care of the patient and this allows them to experience their care where they are happiest and most comfortable, rather than at a hospice care facility or a hospital. If the patient’s symptoms become controllable and not severe the patient may be moved back to level one care. If the patient becomes worse, the level may escalate to level three hospice care.
Level 3: General Inpatient Care
This level of hospice are involves the patient being placed in an acute care hospital or hospice care facility. If neither are available in the area the patient will likely be transferred to the hospital. General inpatient hospice care involves staff at the care center working very closely with the general physician to adjust medications and do what’s necessary to get the patient back to a comfortable level.
Level 4: Respite Care
This level of hospice care is performed to provide temporary relief to a patient’s caregiver when they get exhausted or need a break. The patient can be moved to a care facility for no more than five days to fall under this level of care. The purpose of respite care is to guarantee a patient’s needs are met 24 hours a day while the regular caregivers get the rest they need to be effective caregivers when the five days is up. Patients can receive respite care at a hospital, hospice facility, or a long-term care facility. This is meant to be a temporary level of care, then the patient returns to their home or care facility.
Finding a Hospice and Palliative Care Expert
You should always schedule a meeting with a potential hospice and palliative care expert. This will give you a first-hand first impression of the facility and/or of the type of people who will be providing care for you or your loved one. You’ll know if they are the type of people you can handle spending some time with, if they get along with you and/or the patient and if they seem genuinely caring and interested in helping. Take the time to make sure you and your loved one get along with the caregivers, that you feel comfortable, and that you are not ignoring healthcare red flags before you commit to their hospice services.
Here are some of the basic services hospice centers and caregivers should provide:
● Bathing and dressing the hospice patient daily
● Food preparation for all meals eaten by the patient
● Laundry and chores that are required for daily living and upkeep of living area
● General companionship and friendly bedside manner, key for patient comfort
● Transportation to and from doctor’s appointments, attending the appointment with the patient
● Medication administration, note-taking for doctors and overall responsibility for pain and comfort
● Counseling and advice when the patient needs it, being an advocate for the patient,
How do you find a hospice service provider that you trust? Well, there’s a few basics you can look for when shopping for hospice care. First, you can make sure the hospice center or caregiver is accredited by the CHAO or the JCAHO. The Community Health Accreditation Partner and the Joint Commission on Accreditation of Healthcare Organizations are third party organizations. The Accreditation means they have reviewed their services and found them to be acceptable.
Make sure the hospice is Medicare certified. A hospice that qualifies for Medicare certification must counseling, doctors appointments, food preparation, and auxiliary services. They actually need to provide 16 different services to qualify for Medicare certification. If you’re a Medicare beneficiary, you will need to find a hospice that is Medicare certified in order for it to be covered, but even if you aren’t this is a good indicator of a good care facility.
Another good indicator is the number of years the hospice has been running. Any service that has been running for at least three years should be on the list of potential hospice services. Three years is a good enough time to get testimonials and reviews.
Word of Mouth Recommendations
As always, the best way to find the best services is from word of mouth recommendations. Talk to your doctors and medical professionals. They are a great place to start asking about hospice care. Another great place is friends, family members, and anyone else with knowledge of hospice care.
This includes those that have had loved ones in hospice or have worked in hospice care.
Doctors Who Get Paid for Referrals
Be sure you check to be sure your doctors are not getting paid for referrals to hospice care centers. This can be deceptive and you will not necessarily be getting a good recommendation. Look for referrals from doctors who are not connected orr getting paid from hospice care service providers.
It is never easy to choose end of care services for a loved one. Hospice care is not something we want to shop for and comes only as a necessity when us or our loved ones need it. In that light, the most important thing is to go with your instincts, and choose a hospice care facility or caregiver that will make your loved one comfortable and happy. After all, that is what is most important during these last precious days.