Hospice is End-of-Life Care with Comfort and Dignity

For senior caregivers, the word “hospice” is a double-edged sword. Hospice is end-of-life care, so the inevitable is on the horizon. The care recipient is terminal and the focus of care shifts from extending the quantity of life to preserving the quality of life left.

November is National Hospice Month and a great opportunity to thank those who make the care recipient’s final months, weeks, and days comfortable and as pain-free as possible. As hospice care turns 40 this year, Caregiverlist invites you to learn more about this special breed of caregiving.

The National Hospice and Palliative Care Organization (NHPCO) defines hospice care as a specialized kind of care for those facing an end-of-life illness, their families and their caregivers that:

  • addresses the physical, emotional, social, and spiritual need of patients
  • provides care in the patient’s home or in a home-like setting
  • concentrates on making patients free of pain and as comfortable as they can be so they and their families can make the most of the time that remains
  • includes family members an essential part caring for the patient
  • stresses quality of life over length of time left

Hospice centers on caring, not curing. That care is delivered holistically by an interdisciplinary team that consists of physicians, nurses, in-home caregivers, therapists, counselors, and social workers. Their combined goal is to provide compassionate and comprehensive care that includes patient pain management and family support so the care recipient can die pain-free and with dignity.

The number of patients and families utilizing hospice has steadily increased over the last few years. In 2013, an estimated 1.5 to 1.6 million patients received hospice services. The median length of hospice service in 2013 was 18.5 days.

Who pays?
The Medicare hospice benefit, established 1982 by the U.S. Congress, is the predominate source of payment for hospice care. As of today, 42 states also offer Medicaid coverage for hospice. Private insurance and VA benefits cover this end-of-life care as well.

Few caregivers, especially family caregivers, are prepared to handle the events and changes that happen at the end of life. To that end, the Hospice Foundation of America has published a guide called The Caregiver’s Guide to the Dying Process. The booklet is designed to help the caregiver

  • address the needs of the dying by providing descriptions of the physical, emotional and spiritual changes occurring near the end of life
  • help to understand and recognize what is happening physically and emotionally to the terminally ill care recipient
  • suggestions for what you, as the caregiver, can do to ease distress and make
  • the dying person as comfortable as possible
  • information to help you, as the caregiver, communicate effectively with the hospice team
  • insight on how you might feel as the caregiver for someone who is dying ideas of how to care for yourself

My personal experience with hospice occurred with my good friend (and senior) Louie. Louie knew he was dying. At the time, he was in the hospital and asked to go home, where he could spend his last days surrounded by his family in the home he’d shared with his late wife and look upon the garden he’d tended for the last 45 years. Hospice brought a hospital bed into the greatroom, where he could look out onto the backyard and his garden. They eased his pain with generous doses of morphine so he showed no signs of physical duress as family and friends came to hold his hand and say goodbye. All the while, members of the hospice team were in and out, making sure everyone involved had all they needed to make Louie’s passage as warm and peaceful as possible. They made it possible for Louie to die at home, as he wished, listening to his favorite big-band music as they attended to his comfort. It was a beautiful and natural way to die and I will forever be grateful to them all for their inestimable services.

Join the NHPCO hospice community on Facebook and help ensure all Americans get access to quality end-of-life care.

Obama's Grandmother Passes

Regardless of your political choice for president, you can share in the sadness of Barack Obama's Grandmother passing away just a day before the election.  Madelyn Payne Dunham, 86, died peacefully in her Honolulu home on Sunday night, after battling cancer.  She chose to stay at home with care provided by a caregiver.

Hospice training teaches that emotionally, it is easier to go through the process of grieving when you are able to plan for the death and say goodbye ahead of time.  Barack learned this, he said, when he did not make it to his Mother's side before she passed away.  As he did not want that to happen again, he took time off from his historic campaign to visit his Grandmother a couple of weeks ago.

Still, death of a loved one is never convenient or easy, even with knowing ahead of time.  While visiting France one summer, I went to dinner at a small country restaurant.  The owners were a married couple who made the rounds to all the tables to chat with their guests.  Upon learning that I worked in senior care, they told me to be sure to visit the bathroom before I left.  There was a mural painted on the bathroom wall that included the 17th Century Nun's Prayer.  I later had my Mother write it in calligraphy and framed it for my Senior Care Agency's office wall.  Many caregivers who passed through the doors asked about it and requested a copy and now it is included as a resource on Caregiverlist.

 

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Hospice Volunteering Opportunity

Hospice provides many services to terminally ill patients, from end-of-life planning to hands-on care with a Registered Nurse who will manage the overall care.  A Certified Nursing Aide is available for bathing visits and assistance with personal care.  Hospice also provides a Social Worker to assist with managing family and personal issues.  In addition, many hospice services provide volunteers who will visit the hospice pateint to offer companionship services and assist them with any specially requested tasks.

If you have lost a loved one and are looking for new activities to fill your day or have an interest in becoming a caregiver, contact a local hospice company to find out about possible volunteer opportunities.  You will gain as much as you give.

 

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Barack Obama: Taking Time Out for Grandma

This week, Barack Obama's campaign announced that he will be taking time off from the campaign trail to visit his ailing Grandmother in Hawaii.  Barack's Grandma, Madelyn Dunham, age 86, is in declining health and her situation has become critical after being discharged from the hospital.

We will all be Caregivers at some stage of life.  As a family or professional caregiver, you will experience the daily challenges of assisting someone else with their "activities of daily living".  This is the term used in the care industry for all the tasks we engage in throughout the day from eating to bathing to exercising.  Seniors with memory loss may also require additional reminders to maintain their daily schedule.

Hospice training teaches that the healthiest way to lose a loved one is to be able to plan ahead for their death.  This allows you to better come to terms emotionally with the expected loss and to have quality time to share with them to say the things you would like.  Just being able to say goodbye makes the loss a little easier. 

I have found that this only comes true after the person you love has passed on.  It is still difficult to make peace with the loss ahead of time, as you are still dealing with anger, sadness and perhaps denial.

I respect Barack for maintaining a relationship with his Grandmother and for making the time to spend with her to say goodbye.  This sets a nice example for dealing with the loss of a loved one for other's to follow.  And it also highlights how much more difficult caregiving can be when you are a long-distance caregiver.  Caregiverlist tries to assist in long-distance caregiving by providing information on services in each state.

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Hospice Care: When Should It Begin?

Hospice care was developed as a care solution for terminally ill patients.  Usually family members are involved in care services when a senior or someone younger is terminally ill.  Medicare does provide for hospice care services for seniors and provides certified nursing aide caregivers, social workers and registered nurses to visit the home to assist with the senior's care needs.  Family caregivers often do not realize Medicare will pay for hospice care services for seniors to help support them.  Yet the support of hospice can make a difficult situation a little easier to manage.

Hospice will also assist with the emotional aspects of terminal illness for both the senior and their family and for professional caregivers, along with bereavement care. In addition, hospice will provide a Certified Nursing Aide to assist with tasks such as bathing.  My grandmother moved in with my Aunt when she became terminal with cancer.  While my Aunt wanted to provide for her care, it was exhausting.  She appreciated the regular check -in visits by the hospice staff.  The hospice Certified Nursing Aide assisted her with bathing assistance visits and the Registered Nurse gave her feedback on the progression of the cancer.

Hospice care may begin as soon as someone is diagnosed as terminally ill.  There are many companies which provide hospice care and your medical doctor can usually provide a referral.

Learn more about hospice care services directly from the hospice foundation.  http://www.hospicefoundation.org/

 

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