Hospice is a service for terminally ill individuals whose physician anticipates a life expectancy of six months or less. After a physician certifies this expectation, a hospice agency will assess what level of care is appropriate for the individual/client. The four levels of hospice care are routine, general inpatient, continuous home and respite care. Hospice benefits through Medicare, Medicaid and private insurance companies apply to payments for equipment, supplies and medications “related to the terminal illness,” and the client must elect for those benefits to be activated.
Staff members who work together to create an interdisciplinary practice to provide care and palliation of symptoms include physicians, nurses, medical social workers, chaplains, bereavement specialists, hospice aides, volunteers and therapists. The hospice philosophy, much like that of the Good Samaritan Society, is crafted within and around a continuum of care. Team members provide support to the client while also caring for and supporting each other, whether their needs are professional or personal in nature. Hospice staff should always be available to answer questions, provide emotional support and make home visits.
Within the Good Samaritan Society, hospice clients also have the support of spiritual ministries. The Society accepts people of all faiths, including their beliefs and desired resolutions within their personal and spiritual lives. Every individual has their own story, and it’s very common for a client to be drawn to closer examination of their spiritual life as they continue along their end-of-life journey. Spirituality enhances tolerance and acceptance of the dying process for both the clients and their family members. Supportive faith communities enhance the ease of transition as well.
Although people often associate hospice with cancer, individuals in hospice may have any number of other diseases. Likewise, though hospice clients often have pain management needs, some have none. Symptom management needs vary greatly and can include symptoms such as anxiety, nausea, vomiting, constipation and shortness of breath. One symptom may aggravate or create another. For example, unmanaged anxiety may create shortness of breath, which can affect tolerance of activity and increase an individual’s risk for falls.
If a client’s care needs become too great for the caregiver or if the caregiver is feeling overwhelmed, placement out of the home may become the best option for care. A client could transition to a hospice residential or assisted living setting or a skilled nursing center with professional caregivers. Sometimes, symptom management relief must be temporarily provided in an acute care or hospital setting.
It’s important for caregivers to know that they are not alone. Support and services are available to help provide holistic end-of-life care for their loved ones.
By Marti Straatmeyer, RN, BSN