• October 7, 2019 /  Basics, Miscelleaneous

    Elder Care Management logo
    The past few months we have been talking about life transitions- when should you get more care in the home and when is a good time to move. This month’s topic, when should Hospice be brought in?

    Hospice is a service covered by Medicare, and most other insurance carriers, that provides end of life care for those with a terminal diagnosis that is likely to lead to their death in six months or less. The individual must have a referral from a physician to be eligible for hospice. For those who are unsure about hospice services, hospice agencies will often do a courtesy visit to discuss end of life and whether their loved one meets the hospice enrollment criteria. There are many hospice agencies to choose from- most major health systems have their own hospice agency in house, and others are run as for-profit or non-profit agencies.

    Hospice staff includes physicians, nurses, home health aides, social workers, chaplains, and bereavement counselors that are brought to a patient’s home, community, or clinical setting. The comprehensive approach to services brings comfort and support to patients and their loved ones, relieving much of the mystery that surrounds death and its attending complications. For most people, hospice services are brought in the last two weeks of life; a sad fact knowing that having hospice support earlier might have brought much-needed peace of mind to both the caregivers and patients.

    Hospice does demand conversations.

    Care Managers are supporters and facilitators of conversations.  We encourage all our clients to discuss critical topics dealing with health and finances with those they love and trust. End of life discussions can be fraught with emotions yet are some of the most rewarding conversations family members can have.

    How do you see your end days? If you were like my mom, you want to die peacefully in your sleep with clean clothes on and a smile on your face. Nothing maudlin, no embarrassing or undignified scenarios, just a calm, controlled ending. (I smile as I write the word “control” because death is the one thing that most of us will never control.)

    Here are some simple guidelines to consider when thinking about your end of life choices. First, what is most important to you? For some people who have strong faith beliefs, their wishes might include heroic measures taken to ensure that they are alive for as long as possible. For others, the focus might be more pain oriented, hoping to remain comfortable and pain-free without regard to how long they continue to live.

    A review of a POLST or Five Wishes is a good place to start to determine whether you want all life-sustaining measures or whether you want to be allowed to die with limited intervention or comfort measures only.

    Establishing who your Power of Attorney is and conveying your wishes to them is important, in addition to a conversation with your Primary Care Physician. Make an appointment with your doctor and have the doctor complete a POLST with you. Be sure to notify your health care provider of the name of your power of attorney accompanied with the appropriate documents.

    Finally, we encourage you to read and learn. Being Mortal by Atul Gawande, The Art of Dying Well by Katy Butler and The Five Invitations by Frank Ostaseski, are wonderful books to help guide you in aging and dying well.

    At Elder Care Management of Northern California we partner with families, elders, community members, and employers to tackle the tough issues of elder care.  Please visit our website at www.ecmnca.com or call (916) 206-4420 to get more information about our services.

    Posted by Michael Storz @ 1:36 pm

    Tags: , , , , ,

Leave a Reply

Your email address will not be published. Required fields are marked *

* Copy This Password *

* Type Or Paste Password Here *