November is National Home Care and Hospice Month
With Thanksgiving on the horizon, people start to think about all the things they are thankful for and for many, families caregivers are at the top of the list. Every November home health and hospice agencies celebrate National Home Care and National Hospice Month to honor healthcare employees such as nurses, clinicians and therapists who have made a positive impact in the lives of those for whom they care.
Home care promotes independence for seniors and allows them to stay amidst familiar surroundings and possessions, which has a positive effect on psychological well-being. Home healthcare in particular is a form of home care that is physician-ordered and performed by someone with special training such as registered nurses and licensed practical nurses. Hospice care focuses on relieving symptoms and pain management for patients diagnosed with a terminal illness
Both hospice and palliative home care focus on helping a person with a serious or life-limiting illness by addressing issues causing physical or emotional pain, or suffering. The goals of palliative care are to improve the quality of a seriously ill person’s life and to support that person and their family during and after treatment. Hospice care is usually provided in the final months of life; sharing the same philosophy of hospice care, palliative care may be provided at any stage during a serious or life-limiting illness.
This new research adds to the body of evidence showing that many patients live longer with hospice and palliative care,
Six important points to know about hospice:
1. Hospice care is usually provided in the home – wherever the patient calls home.
2. Hospice cares for people with any kind of life-limiting illness.
3. Hospice is fully covered by Medicare, Medicaid, and most private health plans and HMOs.
4. Hospice is not limited to six months of care.
5. Hospice is not “giving up”; rather the focus is on caring, not curing.
6. Anyone can contact hospice – so call your local program to learn if hospice is right for you or your loved one.
Rights as a Patient
Federal law requires that all individuals receiving home care services be informed of their rights as a patient. Following is a model patient bill of rights the National Association for Home Care (NAHC) has developed, based on the patient rights currently enforced by law.
Home care patients have the right to:
- be fully informed of all his or her rights and responsibilities by the home care agency;
- choose care providers;
- appropriate and professional care in accordance with physician orders;
- receive a timely response from the agency to his or her request for service;
- be admitted for service only if the agency has the ability to provide safe, professional care at the level of intensity needed;
- receive reasonable continuity of care;
- receive information necessary to give informed consent prior to the start of any treatment or procedure;
- be advised of any change in the plan of care, before the change is made;
- refuse treatment within the confines of the law and to be informed of the consequences of his or her action;
- be informed of his or her rights under state law to formulate advanced directives;
- have health care providers comply with advance directives in accordance with state law requirements;
- be informed within reasonable time of anticipated termination of service or plans for transfer to another agency;
- be fully informed of agency policies and charges for services, including eligibility for third-party reimbursements;
- be referred elsewhere, if denied service solely on his or her inability to pay;
- voice grievances and suggest changes in service or staff without fear of restraint or discrimination;
- a fair hearing for any individual to whom any service has been denied, reduced, or terminated, or who is otherwise aggrieved by agency action. The fair hearing procedure shall be set forth by each agency as appropriate to the unique patient situation (i.e., funding source, level of care, diagnosis);
- be informed of what to do in the event of an emergency; and
- be advised of the telephone number and hours of operation of the state’s home health hot line, which receives questions and complaints about Medicare-certified and state-licensed home care agencies.
NAHC’s affiliate, the Hospice Association of America, has developed the following model bill of rights for all individuals receiving hospice care. It also is based on the patient rights currently enforced by law.
Hospice patients have the right to:
- receive care of the highest quality;
- have relationships with hospice organizations that are based on ethical standards of conduct, honesty, dignity, and respect;
- in general, be admitted by a hospice organization only if it is assured that all necessary palliative and supportive services will be provided to promote the physical, psychological, social, and spiritual well-being of the dying patient. However, an organization with less than optimal resources may admit the patient if a more appropriate hospice organization is not available, but only after fully informing the client of its limitations and the lack of suitable alternative arrangements;
- be notified in writing of their rights and obligations before their hospice care begins. Consistent with state laws, the patient’s family or guardian may exercise the patient’s rights when the patient is unable to do so. Hospice organizations have an obligation to protect and promote the rights of their patients;
- be notified in writing of the care the hospice organization will furnish, the types of caregivers who will furnish the care, and the frequency of the services that are proposed to be furnished;
- be advised of any change in the plan of care before the change is made;
- participate in the planning of the care and in planning changes in the care, and to be advised that they have the right to do so;
- refuse services and to be advised of the consequences of refusing care;
- request a change in caregiver without fear of reprisal or discrimination;
- confidentiality with regard to information about their health, social, and financial circumstances and about what takes place in the home;
- expect the hospice organization to release information only as consistent with its internal policy, required by law, or authorized by the client;
- be informed of the extent to which payment may be expected from Medicare, Medicaid, or any other payor known to the hospice organization;
- be informed of any charges that will not be covered by Medicare, and the charges for which he or she may be liable;
- receive this information orally and in writing within 15 working days of the date the hospice organization becomes aware of any changes in charges;
- have access, on request, to all bills for service the patient has received regardless of whether they are paid out of pocket or by another party;
- be informed of the hospice’s ownership status and its affiliation with any entities to whom the patient is referred;
- be informed of the procedure they can follow to lodge complaints with the hospice organization about the care that is, or fails to be, furnished, and regarding a lack of respect for property;
- know about the disposition of such complaints;
- voice grievances without fear of discrimination or reprisal for having done so; and
- be told what to do in the case of an emergency.
WHAT MEDICARE WILL COVER:
Medicare will help cover home healthcare cost for people with Medicare who meet the following four conditions:
- Your doctor must decide you need medical care at home and make a plan of care
- You must need at least one of the following: Ongoing brief nursing visits less frequently than daily, physical therapy, speech-language therapy or continue to need occupational therapy.
- You must be homebound. This means that you are normally unable to leave home unassisted. Being homebound means that leaving requires a major effort. When you leave home it must be to get medical care or for short infrequent, non-medical reasons such at a haircut, or attend religious services.
- The Medicare program must approve the home health agency caring for you.
What is Hospice?
Considered to be the model for quality, compassionate care for people facing a life-limiting illness or injury, hospice care involve a team-oriented approach to expert medical care, pain management, and emotional and spiritual support expressly tailored to the patient’s needs and wishes. Support is provided to the patient’s loved ones as well. At the center of hospice and palliative care is the belief that each of us has the right to die pain-free and with dignity, and that our families will receive the necessary support to allow us to do so.
Hospice focuses on caring, not curing and in most cases care is provided in the patient’s home. Hospice care also is provided in freestanding hospice centers, hospitals, and nursing homes and other long-term care facilities. Hospice services are available to patients of any age, religion, race, or illness. Hospice care is covered under Medicare, Medicaid, most private insurance plans, HMOs, and other managed care organizations.
How does hospice care work? Typically, a family member serves as the primary caregiver and, when appropriate, helps make decisions for the terminally ill individual. Members of the hospice staff make regular visits to assess the patient and provide additional care or other services. Hospice staff is on-call 24 hours a day, seven days a week.
The hospice team develops a care plan that meets each patient’s individual needs for pain management and symptom control. The team usually consists of:
§ The patient’ s personal physician;
§ Hospice physician (or medical director);
§ Home health aides;
§ Social workers;
§ Clergy or other counselors
§ Trained volunteers; and
§ Speech, physical, and occupational therapists, if needed.
What services are provided? Among its major responsibilities, the interdisciplinary hospice team:
§ Manages the patient’s pain and symptoms;
§ Assists the patient with the emotional and psychosocial and spiritual aspects of dying;
§ Provides needed drugs, medical supplies, and equipment;
§ Coaches the family on how to care for the patient;
§ Delivers special services like speech and physical therapy when needed;
§ Makes short-term inpatient care available when pain or symptoms become too difficult to manage at home, or the caregiver needs respite time; and
§ Provides bereavement care and counseling to surviving family and friends.
If you would like more information on Hospice or Home care please contact me or come to our Wednesday Wellness class on Nov 13in the learning center. We have Twila Rutter from Interim Healthcare speaking on this subject.
Information from Interim Health in Clovis NM (‘Twila Rutter and Sarah Werner) and NAHC