Things to Consider In Selecting Hospice Care for a Loved One

Helping loved ones talk about, and consider hospice are difficult conversations, to put it lightly. The decision to think about hospice, means that one has to look at their own mortality. Terminal illnesses have a way of forcing the conversation to take place—with the patient, family, or loved ones. The “H” word—hospice, can make people think of the Grim Reaper, and a place where people are euthanized. I’m here to tell you that neither of those are true. The truth is, hospice is life-giving. It’s about supporting someone with a terminal illness through the twilight of their life—supporting them, respecting them, loving them, in the ways that they choose.
As if the conversation alone isn’t enough, choosing a hospice can be just as overwhelming—there are so many to choose from! But are hospices really that different from one another? Fundamentally, they are essentially the same—all hospices must follow Medicare criteria, but can differentiate themselves from others by different ‘perks’ in their services. For example, some hospices may offer alternative therapies such as healing touch, reiki, or acupuncture to help with symptom control. While other hospices may put their extra money towards more visits, and 24-hour bedside support when the patient is actively dying. These are great ‘extras’ for patients and families, and are often used to weigh in the decision process. Choosing depends on what the patient or loved ones need, or value—what’s most important to them.
Medicare sets the tone for hospice care, by dictating that hospices must follow certain criteria. For example, all hospices must have a medical director, nurses, home health aides or certified nursing assistants, chaplains, social workers, volunteers, and bereavement support. Most also have nurse practitioners, as well. Hospices must also provide whatever is needed for the comfort and care of the patient, this includes durable medical equipment, such as a hospital bed, wheelchair, commode, oxygen—whatever equipment is needed for the care and comfort of the patient. This also includes medications related to the terminal diagnosis, and needed for the patient’s comfort. Examples of this include pain medication, and medications for nausea, anxiety, fever, and constipation.
Another one of the major ‘perks’ of hospice care is that the care takes place wherever the patient resides, meaning, the hospice team comes to the patient. This may be the patient’s home, a nursing home, hospital, or assisted living facility. Equipment and medications needed for the care and comfort of the patient are also delivered to the patient’s residence. If your loved one needs a higher level of care than can be provided in the home, or if caregivers need a break, hospice also covers an inpatient level of care, and short-term respite care.
November is National Hospice and Palliative Care Month, right on the cusp of the winter holiday season—what better time than this to connect a loved one to hospice care? Hospice care itself is a gift. It’s a gift of compassion, love, and emotional and physical comfort. What a wonderful way to show just how much you care.

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About Janet Belford

Janet Belford, RN, CLNC, has been a registered nurse for over 24 years, having worked in the pediatric and adult patient populations in critical care, outpatient, case management, and hospice. She is also a Certified Legal Nurse Consultant. She brings to the table a passion about patient rights, informed consent, healthcare integrity, domestic violence, patient and family education, mentoring for fellow nurses, and end-of-life care. It is part of Janet’s mission to ‘be real’ with patients and families, not shy away from ‘difficult conversations,’ and to advocate for patient rights.

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