What do you know about hospice?

[weegegirl 2]

What exactly do they do? A friend just suggested I contact them, as I am losing my father to lung caner. He only has a few months left and things are just starting to sort of spin out of control. Thanks.

[PhreeZone 20]

Basic in home health care. My quadraplagic cousin was under Hospic care for a bit while the family figured out private care options for her. Its like a basic slimmed down version of the pricey private nurses. They changed her, bathed her and did like things. The plus is they usually have a large well staffed group so if one is sick or calls off you are not stuck looking for an emergency back up. Bad thing is there is no bonding or barely communication since they are there to get in and get out. If you have the $ a private caregiver seems to be much better since they are spending more time with my cousin then even the family is at this point. They also are expanding her options and trying to improve the quality of her life instead of just punching the clock.

Yesterday is history
And tomorrow is a mystery

Parachutemanuals.com

[Stacy 0]

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Basic in home health care. My quadraplagic cousin was under Hospic care for a bit while the family figured out private care options for her. Its like a basic slimmed down version of the pricey private nurses.

ARGH! Wrong. Sorry erk.

I've worked for two different hospices iwhtin the last 5 years (moved). I wouldn't work for anyone else now.

Hospice IS NOT home health. Hospice provides case management services and an interdisciplinary team to complement someone's attending physician, nursing home staff, or private health agency. They hold a seperate license under medicare/medicaid than home health and skilled nursing. Entirely different benefit from home health. Hospice patients can qualify for home health services, but not all home health patients can qualify for hospice.

Guidelines state that to qualify for hospice admission, a patient has to have a prospective life span of 6 months or less IF whatever condition they havve follows an anticipated course. Of course we all knwo you can't predict things to a science- cancers, alzheimers, parkinsons, they are all very different in paths. Patients aren't kicked out of hospice after 6 months, they are constantly reevaluated. We have people who get better on hospice care, they get discharged and are eligible for re-admission when things start to go awry again.

Signing up for hospice basically means you just want to be kept comfortable. Some people still have palliative chemos- they realize the chemo will never cure them but it may keep a tumor small enough to leave an airway open or not press on a nerve.

Hospice case management usually includes visits from an RN 1-5x a week depending on need, a social worker as needed (not just the typical nasty social work services, but counseling services, end of life planning, etc), spiritual care if desired, and if the situation warrants it a home health aid or CNA 1-5x/week. Some hospices contract with expressive artists, all should have a volunteer program (volunteers relieve caregivers so they can do errands, help transport, etc etc), they all have wonderful post-death bereavement services. Some have hospice houses that when pain or a symptom gets unmanageable in teh home there is a place to go to be monitored by a physician for a short time.

May hospice patients have home health in addition, as they need 4 hours a day of care- that isn't provided by hospice, it is additional.

Hospice (at least the not for profit ones which are in my educated opinion the best beyond a doubt) shold not charge for services. Any reimbursement they recieve is via medicare/medicaid benefits and insurance. They will cover all hospice diagnosis related meds (IE if you have cancer som epain medds, or with parkinsons thigns to control tremors, etc etc).

If I missed somethign let me know... it's hard to sum up 5 years of work in one post.

I can say the families I've been lucky enough to work with dont' know how they did without the complementary care. Hospice isn't saying "this is the end" it's just allowing someone to live how they want to at a delicate time. It focuses on quality of life, not quantity of procedures.

• Quote

[PhreeZone 20]

Sorry.. that was my view from the outside looking in on weekends and over phone calls...

Yesterday is history
And tomorrow is a mystery

Parachutemanuals.com

[weegegirl 2]

Thanks, Stacy. That's helpful. I don't know if this is something my dad will go for. He's not the soft, counseling type. He's pretty much in denial right now anyway. He has a hard time excepting help. But I think I will talk to him about it tomorrow and see if I can interest him.

[Stacy 0]

the good thing about it is just as easily as you sign in, you can sign out. Patients can revoke a benefit at any time, whether it is to try the latest treatment, etc. Let him know that giving it a try is worth a shot.

The other perk is they treat not just the patient, but the whole family. counseling services and respite care are available for spouses, children, etc. Sometimes it benefits the loved ones mroeso than the patient at times even.

[RhondaLea 4]

I work for a law firm, and my official title is "estate planning paralegal." In addition to wills and trusts, we counsel clients about such things as health care surrogates (medical powers of attorney) and living wills (collectively "advance directives").

Part of what we discuss is that if the client has reached an end-stage condition, calling in hospice is the way to guarantee that quality of life will be maintained to the extent possible without resort to machinery and complicated procedures. Hospice focuses on dying with dignity. It's an overused phrase these days, but all you ever need is one experience with someone who has no expectation of recovery being tied to life support, and you'll know how valuable it is.

I wouldn't worry about the counseling aspect. Hospice doesn't shove anything down anyone's throat. That's the whole point. Back before we developed all kinds of ways to keep people alive, they died at home when the time came. That wasn't always ideal, because they often died in pain. With hospice, pain is alleviated to the extent possible, essential care is provided, and death is allowed to take its course.

I'm very sorry about your father.

rl

If you don't know where you're going, you should know where you came from. Gullah Proverb

[Droolbaby 0]

A lot of people *especially men* don't take kindly to the term "Hospic". As a paramedic I have run into wives and family members of men who are just stubborn and don't want anyone they are not family with to help or care for them. There is a pride thing that gets in the way. I have known one man who can't do anything on his own and his wife and son try to do everything. They are living off whatever the government can give them, but it is taking its toll on everyone, the father the most. I have stopped at the house at 3 am to help pick him off of the floor after he tried to get up to go to the bathroom on his own only to have a 45 minute battle just to let me help his poor frail wife get him off of the floor and back into bed (which resulted in him taking a swing at me). It may be tough to do, but if he is makingthat turn in his health, for your sake and his, take your time and the two of you talk it out. There are services and professional out there that can come in and help the family talk and make a decision. Just let him know that the family isn't going to dump him into the care of someone else. The family needs to be there just as much, if not more, than the hospic people.

Good luck.

...Happiness is just a drool away....mmmmm....

[artistcalledian 0]

i'm sorry to hear about your father too, my mother died recently due to cancer, i know what you'e going through

________________________________________
drive it like you stole it and f*ck the police

[DJL 235]

My sister worked for Hospice near Ann Arbor after her Master's from UM and before she had children. I don't know much other than that they had someone as intelligent and caring as my sister.

"I encourage all awesome dangerous behavior." - Jeffro Fincher

[arlo 0]

hospice may be the best friend you and your dad can have at a time like this. i'm not sure if this is a state thing or what, but one of the things about hospice is that you agree that you're not going to take any action to cure the disease, so to speak. what this MEANS is that if someone is dying of liver cancer and the chances are 0.1% that they will survive, they won't be attempting to have a transplant or enter clinical trials. i know that sounds hokey but that's the situation my mom was in but we opted not to hospice so we could get her into clinical trials. it was too late by then. also, mom knew that bringing in hospice meant that she was terminally ill and that wasn't gonna happen. she saw them come in with her father and they were a tremendous help and were so very caring and nurturing. they're not like nurse ratchet or anything. it takes a special person to be a hospice nurse and i know a few.

anyhooooo....

this is definitely something to talk over with your dad and hospice can be as much help to YOU as they are your dad...maybe more so. rhonda really hit the nail on the head with her description, as did stacy.
i'm so sorry you and your dad are going thru this. if your dad just found out, it's no wonder he's in denial. that's normal right now.

big hug...
a

[freeflir29 0]

So sorry to hear that Liz. If there is anything I can do for you please don't hesitate to ask.

[wmw999 2,589]

My mother and father-in-law both had hospice involved. In both cases (one surprisingly, one not) it was a very short involvement, yet still totally worth it.

No counseling involved in our case (short, not that necessary). But they did provide in-home oxygen, a hospital bed so that they could sit up more easily (and be easier on the family, who were still the primary caregivers), a wheelchair so they could come out and visit.

But what they did as much as anything was to inform us (e.g. let us know that not talking any more was a sign, that not eating any more was normal and not painful, and that oxygen didn't preserve life in my mother's case, just make it more comfortable).

When a nurse detected that my mother was closer to death than we thought, she made sure that everyone woke up (because that's what we had all wanted) so that we could be there. In my FIL's case, they moved heaven and earth to get him out of the hospital in his last stay, so that he could die at home about 3 hours later -- as he wanted, with his family around him.

I cannot say enough. And they're not touchy-feely if you don't want them to be. They were very matter-of-fact with my FIL, and made sure to be there on his terms. They also made sure that the rest of the family was generally OK, and were just listening posts when needed, and efficient nurses etc. when not.

I'm very sorry you're in a position to be asking this question about your father. That's hard.

Wendy W.

There is nothing more dangerous than breaking a basic safety rule and getting away with it. It removes fear of the consequences and builds false confidence. (tbrown)

[selbbub78 0]

I've had 3 family members go through the hospice service. My grandfather, who stayed at the hospice center itself. They made sure that he had his meds, tried to make him as comfortable as possible, and tried to make the family comfortable as well. My father had at home hospice service where they had a nurse visit him 3 times a week, and they had a doctor come in once a week. They worked with my dad's doctors as well making sure that he was as comfortable as possible. They brought in a wheelchair for him, a hospital bed, and anything else that he needed to try to make things as comfortable as possible. Also, hospice was oncall if anything came up, they were at our house very soon. My grandmother also went through hospice when she had lung cancer. They brought in oxygen, and a walker, and when she got worse, they brought in a wheelchair, and did a lot. They also have programs to help the family get through what is going on. I'm sorry for what you're going through, hospice isn't a bad idea.

CReW Skies,

"Women fake orgasms - men fake whole relationships" – Sharon Stone
"The world is my dropzone" (wise crewdog quote)
"The light dims, until full darkness pierces into the world."-KDM

[Amanda965 0]

Liz, I am very sorry to hear about your father. That is definitely not an easy thing to go through...

I have about 15 patients in my facility on hospice. Although they are alll much older, they all suffer some type of condition, such as cancer, failure to thrive or Alzheimers that has contributed to "six months or less to live." In addition, one grandpa is currently under hospice and the other died on hospice. I have seen nothing but good things. They assist in making the patient comfortable and provide a tremendous relief and support to the family.

Blue skies and SAFE landings!
~Amanda~