There are a lot of completely false assumptions about hospice care in America . For instance not a week goes by that I don’t get an email from someone wanting to know if his grandfather (or mother or sister) should “enter” a hospice. Or “go to a hospice” and “be registered there”.
Actually almost all hospice care these days takes place not in an IPU (hospice-speak for “In-Patient Unit”) but at home. True, there are senior care facilities attached to hospices, but even this is no longer the norm. It’s been found that in-home hospice care is more comfortable — and cheaper. And it makes sense for everyone.
Second, a lot of relatives and friends of the terminally ill believe that you can only get hospice care a few days before death occurs. That too is not true. In fact, it’s a bad idea to leave that kind of care to the very last moment.
The best and most sensible way to die, if one really must? By acquiring hospice care in the last months of life. That way pain medication (if any is needed) can be effectively administered, nursing routines can be established, fear is lessened, and the patient can usually get some control over how he intends to leave life.
Is it expensive? Well Medicare pays most of the costs, so the answer is: considering what you get, no it’s not. Is it valuable?
Invaluable, actually. As over 1.2 million people in this country have discovered.
You say that Medicare pays most of the costs, but how do you get their support? Do you have to have a doctor say that you are within 3 months of dying?
THe stories I’ve been told by friends and in my own experience is that doctor estimates about when a person is likely to die or either much too optimistic or excessively pessimistic. Is this a reason to get a “second opinion” which will make one eligible?
Of all the questions and blogs you post, i think the information about hospice care is the most important. Anyone can have an opinion about wills or whom to tell about a sickness and when, and it is possible to disagree or agree on any position. But the straight facts you provide on this, and on the funeral industry, should be compulsory reading for everyone who has anything to do with death and dying. Meaning every living person. Keep up the good work!
As a matter of fact, a doctor does have to say that the individual is within six months of dying in order for a patient to be approved for hospice care under Medicare rules. It is absolutely true that doctors’ estimates of an individual’s longevity can be way off — but Medicare and insurance companies need some estimate from the medical profession, however iffy the prognosis. If the medical estimates turn out to be on the pessimistic side, and the patient lives longer than expected, Medicare will continue to pay, and the hospice continue to treat.
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Good advice, Judy. I would add that most areas, even rual areas are covered by an agency now a days. Hospice as a rule is for patients with a six month prognosis. Since none of us has the crystal ball handy, there are patients that stay on much longer. I would much rather have a referral on the “early” side then one that is so late in the process it is difficult to offer much help or support. My advice would be if you think you or someone you know may need hospice, call a local agency and get some general information.