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Palliative care is a concept and it is a service. Palliative care aims to relieve suffering and to improve quality of life for patients with advanced or terminal illness. It also addresses the needs of families of these patients. Palliative care is provided by an interdisciplinary team and is offered in conjunction with other forms of medical treatment.
Palliative care programs include a variety of resources—medical and nursing specialists, social workers, and clergy—to deliver the highest quality of care to patients with advanced illness. Vigorous pain and symptom control is a central part of all stages of treatment.
The palliative care approach decreases the length of hospital and ICU stays and eases patient transitions between care settings, resulting in increased patient and family satisfaction. Successful palliative care programs use an array of delivery systems, from consultative services to inpatient units.
Do not quit reading this section because of the word “Hospice.” If there is one statement that has been said many times over, it is this: “I wish I had called earlier.”
What is Hospice Care?
Hospice is special end-of-life care for people with life-limiting illnesses, as well as a way to support their loved ones. A type of care, rather than a specific place of care, it focuses on comfort rather than cure. It neither accelerates nor postpones a person’s death. Additional services include partnership with healthcare professionals and educational initiatives. The mission is to provide care, so that each person can live each day as fully as possible with dignity, comfort, and peace.
Who is Hospice Care For?
Hospice serves those who have illnesses that can no longer be cured. Care is provided for patients with a variety of illnesses, including but not limited to: end-stage dementia, congestive heart failure, end-stage Parkinson’s disease, chronic obstructive pulmonary disease, ALS (Lou Gehrig’s Disease), cancer, AIDS, and other end-stage chronic diseases. A person is eligible for hospice care when life expectancy is 6 months or less.
What Does Hospice Do To Help Patients With Life-Limiting Illnesses?
Hospice, together with a patient’s physician, helps manage a patient’s physical symptoms and pain, allowing him or her to live more fully and with dignity. Hospice also helps ease the emotional burden that patients and their loved ones may have, thereby increasing the quality of the time they have together.
What Does Hospice Do To Help Caregivers And Other Family Members?
Hospice social service specialists offer emotional support and resources to cope during this difficult process. Hospice delivers medications and equipment, assists with personal care needs such as baths, and helps with practical matters such as running errands or relieving the caregiver for needed time away. Often, what is needed most is simply a kind ear and experienced guidance on what to expect. Hospice also offers bereavement counseling, so that family and friends can prepare for the loss and manage their grief.
Who is a Part of the Hospice Team?
The patient and his or her loved ones are at the center of the hospice team. Patients and caregivers are supported by a team that works with each patient to help manage the pain and control the symptoms associated with illness and to provide personal, respectful care. Hospice team members include:
- Medical Director: The Director oversees the care plan and consults regularly with other team members. The Medical Director also works with the patient’s primary physician.
- Nurses: Hospice nurses provide compassionate and skilled nursing care. They work closely with the physician to manage pain and symptoms, individualize patient care, and inform and support the patient’s loved ones.
- Social Service Professionals: Experienced social service professionals nurture and care for the patients’ and families’ emotional needs through all stages of the illness. They provide counseling and assistance with a variety of areas including, but not limited to, social and economic needs, advance directives (such as living wills), Medicare/Medicaid and Supplemental Security Income information, and funeral arrangements.
- Home Health Aides: Home health aides provide personal care and comfort for patients by assisting with cleanliness and the safety and emotional support of the patient.
- Spiritual Counselor: Clergy members offer spiritual guidance and support. They assist the patient’s minister, rabbi, or other spiritual representative in whatever capacity chosen. They also can conduct funeral services, if requested.
- Volunteers: Volunteers are specially screened and trained to provide companionship and assistance to patients during the last stages of their illnesses.
- Bereavement Experts: Hospice may have licensed mental health professionals offering bereavement assistance to survivors following the death of their loved one. Individual and family counseling and support groups are available as well. Support is extended to family members for as long as 13 months after a loss.
At What Point Should We Involve Hospice?
A person can enter a hospice program of care when a physician believes life expectancy is 6 months or less. While many people believe that hospice care is unavailable or inappropriate until a patient reaches the last days of his life, there is actually much that can be done many months earlier to enhance one’s quality of life. Pain and symptom management, emotional support and guidance, assistance in organizing a patient’s affairs, and support for caregivers and loved ones are just a few of the many benefits available well before the end of life. Entering a program of hospice care earlier also allows more time for a person to consider his choices and to make his wishes known to loved ones. Such forethought relieves the caregivers of making difficult decisions on their own.
How Do I Become Enrolled In A Program Of Hospice Care?
Patients need a referral from a physician consenting to work with the hospice team. Anyone can make the initial referral to the program, including the patient, family members, clergy, a hospital discharge planner, or the interdisciplinary team of a long-term care or assisted living facility.
How Is Hospicare Care Paid For?
Most people have Medicare, Medicaid or private insurance that covers the cost of hospice services.
What If My Loved One Is Not Quite Ready To Enter A Program Of Hospice Care?
Hospice is happy to provide information about all of the services available. The staff will be happy to help you learn more about how hospice can work to meet your specific needs at any point in the course of care. Hospice care acknowledges that patients and their families are always in complete control of their own choices and decisions.
What Hospices Are Available?
Ask your doctor, your hospital social worker or case manager, your friends, or look in the phone book. The TN Department of Health licenses hospices; go to www.tn.gov/health for more information.