Hospice Care – Dying with Dignity

Hospice care provides in-home care for terminally ill patients, including pain management, wound care, housekeeping and personal care services, spiritual care, social workers, and bereavement counseling. Hospices may provide medical equipment, such as hospital beds, perscription medications related to the hospice diagnosis, and personal supplies such bath products or incontinent supplies.

Medicare and many private insurance companies provide a hospice benefit. This allows a person who might ordinarily be hospitalized or be admitted for nursing home care to be able to be with their family in familiar surroundings during the last part of their life. Each person deserves to die with dignity, surrounded by loved ones, and without pain.

Hospice provides care for patients with cancer, alzheimers, dementia, heart disease, pulmonary disease, AIDS, and other terminal illnesses. Hospices were originally a shelter or lodging for travelers, pilgrims, foundlings, or the destitute, especially one maintained by a monastic order. Today’s modern hospices are a heathcare facility with a staff of workers who make “house calls”.

I have worked many years for different hospice services, and although all provided good care, there are some differences that can matter to the consumer. When your physician decides to refer a family member to hospice care, ask to be able to select the agency. Do your homework. Make phone calls. Some of the things you may want to ask are:

1.) What is your nurse to patient ratio? Home Health Aide to patient ratio? Who is your medical director? How will he work with my physician in providing care?
2.) What hours is your office open? What is the procedure for needs after hours? What is your response time on calls after hours?
3.) How often does your chaplain visit and what bereavement services do you offer including support groups or individual grief counseling?
4.) What is your protocol for pain management?
5.) What if my loved one needs hospitalization after beginning hospice care?
6.) How many routine visits does your staff make to each patient?
7.) What medications, supplies and equipment will you provide?

When you have made your decision, notify your physician and he or she will make the referral. Then the hospice agency will contact you to arrange a time to come and evaluate the patient and complete necessary forms. Let the hospice representative know what your needs are for routine visits, whether or not you want chaplain visits, and what your expectations are for care. If the patient has a Power of Attorney, Living Will, or Do Not Resuscitate Order, have a copy of it to give to the agency for their files. This will enable them to respond appropriately in an emergency situation.

Hospice nurses are very caring, loving people. It takes a special person to care for the terminally ill. Each nurse gets to know the patient and the family, and most attend funerals when the patient passes. Hospice workers can help the patient deal with end-of-life issues so death will be more peaceful, and can also educate the family on the dying process so they will know what to expect.

It is painful to know a loved one is terminally ill. But having hospice to provide care can alleviate some of your daily concerns so you can make the most of the time you have with your loved one. Sadness is to be expected and should be expressed. Issues should be discussed. You should not encourage denial or false hope in the patient. Each person, as they are able, should be allowed to make decisions concerning their death, funeral wishes, etc.

Death is a part of life that many find difficult to discuss, but to be allowed to die with dignity is a human right each of us should claim.

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