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Can anyone tell me a little bit about how Hospice works?

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Mike 03 Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Jan-25-09 08:18 PM
Original message
Can anyone tell me a little bit about how Hospice works?
Edited on Sun Jan-25-09 08:22 PM by Mike 03
I've been reading books about "death and dying" by people who work for hospice, but I'm not clear as to how people become hospice workers or how hospice works.

Hospice seems amazing, and I have never even a heard a bad word about Hospice, and my best friend's wife worked for Hospice way back but I have no way of contacting her now. I am worried about the cost. Does insurance pay for Hosptice? And who are Hospice workers? Are they nurses or doctors or physicians' assistants?

I should know this, but I don't. Things took a turn for the worse here fast, and I was not prepared.

I am trying to inform myself about all of these issues, but I have to confess I'm not a billionaire and the oncology textbooks and new research papers alone are almost exhausting my credit limits, so plesae don't think I'm being lazy about trying to find resources and information. I'm just so burnt out and exhausted.

If anyone could even recommend some way to find out more about hospice and how it functions, it would be very much appreciated.

Are there any books on this topic?

Thank you in advance.
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H2O Man Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Jan-25-09 08:22 PM
Response to Original message
1. I was a volunteer
many years ago. In this area, the county Hospice had an ad for volunteers. I took a training course with others. When the medical professionals identify an individual/family in need of assistance, the volunteer is part of a treatment team. It can involve anything from just sitting quietly with people; listening to concerns; helping on running errands; to hearing some of the most insightful and fascinating "life lessons."
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Muttocracy Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Jan-25-09 08:23 PM
Response to Original message
2. this hospice group has a pretty good website
Edited on Sun Jan-25-09 08:25 PM by Muttocracy
http://hospicare.org/

A group I've heard good things about in NY. - Their links page may be helpful.

Is this for a family member? :hug:
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MADem Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Jan-25-09 08:25 PM
Response to Original message
3. I think this link may be helpful to you.
http://www.hov.org/

Click through to all the links, including the WHO PAYS? and WHEN IS IT TIME? ones. There are links within links, and lots to read. I think most of your questions will be answered here--this is a not-for-profit agency in AZ.

I hope things take a turn for the better. It happens...
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Mike 03 Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Jan-25-09 08:35 PM
Response to Reply #3
8. Thank you so much. These links are excellent.
I feel so bad asking this question and yet I have to bookmark this thread and check back, because posting this question feels like defeat, in a way that I can't quite explain.
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MADem Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Jan-25-09 08:41 PM
Response to Reply #8
13. No need to thank me. And don't feel badly.
It's not defeat to prepare for every contingency. It's simply smart planning.

So be smart, and plan as time and energy permit. It'll be nice if you can toss those plans aside, but there's no harm in making them--if you don't need to use them, you can take the information you've gained and use it to help others.
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Tansy_Gold Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Jan-25-09 08:25 PM
Response to Original message
4. Call your local hospice agency.
Your doctor should have additional information.

Hospice is entirely free. There is no cost to the patient.

They have outpatient services and their own facilities.

They have doctors, nurses, whatever is needed.



Tansy Gold
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JohnnyLib2 Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Jan-25-09 08:29 PM
Response to Original message
5. Here is another link.
http://arizona.uscity.net/Hospice/

I'm sorry that your family may be reaching this point, but think you are very wise to look at Hospice care. One of the benefits can be kind and accessible medication for pain. Typically, there is an M.D. medical director, nurses on staff,and some wonderful volunteers. I'm sure that urban areas have a bigger staff/program.

Generally, an oncologist or family physician or hospital discharge worker will make a referral or provide you with local information when the time is right.

All best wishes.
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Lucinda Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Jan-25-09 08:30 PM
Response to Original message
6. I think it may depend on your state and the patients needs. My fellas mom
was at home and a nurse came by regularly with pain meds for her. I don't think a doctor ever came to the home, but her care was supervised by a MD. I believe everything was covered through her medicare coverage. Hospice doesn't step in until the end stage of illness though, at least in my experience.



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elleng Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Jan-25-09 08:31 PM
Response to Original message
7. Here's something.
http://www.hospicenet.org/html/faq.html

Why are you asking? Not being nosey, but want to provide relevant info.

Hospice provides services in peoples homes AND in hospitals AND in nursing homes; costs covered by govt/medicare-aid. Family often suggests contributions to relevant/local hospice in memory of . . .

Hospice nurses sat with us and my Mother in nursing home in her last hours, and had been working with nursing home doctors and nurses prior to that time. They provide many services.
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Warpy Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Jan-25-09 08:36 PM
Response to Original message
9. Hospice services are generally covered by Medicare
and most insurance policies.

The service is geared toward giving the family respite while allowing the dying person to remain at home unless hospitalization is necessary to get pain under control. Hospice focuses on the patient's overall comfort and the family is supplied with a pack of emergency medication should it become necessary. They also help organize things when the patient dies.

Hospice services for my mother while she was able to get out of bed to a bedside toilet chair was an aide 3 days a week for bathing and bowel care plus nurse evaluations at least weekly. They also provided a volunteer sitter for a few hours every week that allowed my dad to get out of that house and run errands (although he did that anyway, whenever she'd fall asleep). I didn't get called for help until she was too weak to get out of bed. I was surprised my dad hung in there so long but hospice is what made the difference.

Hospice will keep the person as comfortable as possible while taking much of the pressure off the family.

Medicine can't fix everything, especially when it comes to cancer. Hospice is called in when the patient has had enough, when it's time to focus on comfort and on living the rest of his or her life as well as possible.

They were called in when my mother refused dialysis (You're going to do WHAT? GET THE HELL OUT OF HERE!!!) and were wonderful. I say this as an RN and as a daughter.
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mrreowwr_kittty Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Jan-25-09 08:36 PM
Response to Original message
10. Most hospices are pretty good but some are better than others
I used to sell long term care insurance and I got to know some care home owners and health care providers. Here in Greater Phoenix, there is one hospice that seemed to be preferred over the rest. I'd recommend contacting a local nurse's union and some long term care facilities (nursing or group homes) to see if there's a hospice company they like to work with. If you have the time, set up appointments with hospices in your area so that you can get an overview of the services they offer. Typically, the care will be given in the client's home or nursing facility. The client will get nurse visits, pain medication if required, counselors to help the client and loved ones, and volunteers to help with errands and to give the family a break.
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Mike 03 Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Jan-25-09 08:38 PM
Response to Original message
11. Thank you all for your input. I'm bookmarking all of your responses.
They are all going to be helpful. It's just to hard to face this right now, but I will have to face it soon enough.

Thank you very much. Your advice and the web links and sources you have suggested is going to help a lot.
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WillowTree Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Jan-25-09 08:39 PM
Response to Original message
12. If the patient is on Medicare, they pay for everything.
When my Mother came home from the hospital for the last time, she went into the Medicare hospice program. There was a nurse who managed her care and consulted with the doctor when necessary. They arranged for a hospital bed and oxygen equipment and an alternating pressure pad to prevent bedsores and supplies and meds and everything else that we needed. There were also home care workers who came every couple of days to bathe her and help us out for awhile and grief counselors for the rest of to talk with if we needed it and to help us make funeral plans. When we needed more morphine, we just went to the pharmacy they'd arranged for near Mom and Daddy's house and signed for it. We were billed for nothing.

And, though we didn't need to use it, there was also an inpatient hospice facility where she could go if she needed more acute care or if we needed a break from taking care of her 24/7. That would have been paid for in full, as well, had we needed it.

Her hospice care was arranged for through her oncologist and they just billed Medicare. That was really all there was to it in our case.
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Mike 03 Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Jan-25-09 08:44 PM
Response to Original message
14. Thank you all, this information is excellent and so very helpful.
I can't thank you enough.


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MannyGoldstein Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Jan-25-09 08:44 PM
Response to Original message
15. My Heart Is With You
I don't know anything about hospice care, but my sister works for a Cancer Lifeline, a great non-profit in Seattle that helps people with cancer and their families. She probably knows quite a bit about this, and other options - if you're interested, shoot me a private message and I can ask her to give you a call.
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tavalon Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Jan-25-09 09:49 PM
Response to Original message
16. Call your local hospice
They can give you every bit of information you seek. I seem to remember something about not being able to get insurance to cover until it was certified that the person had less than 6 months to live, which is silly because how does one make such a prediction. You or the person in question will be seen by nurses, social workers, attendants as needed but usually much of the day to day care is taken up by your family with the hospice nurses teaching.
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Mike 03 Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-26-09 07:59 PM
Response to Original message
17. A big Thank You to all of you
I felt so lazy making this post because I know there are places I can find this info out. But for some reason I was scared, and just so tired and afraid of what I might find about how much it would cost or how compicated it might be to get this going.

You are all so kind, and I'm just so grateful.

Thank you from the bottom of my heart. You have all given me some place to start.
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