hospice

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hospiceWhat is Hospice?

Choosing hospice care is a difficult decision. Hospice is a program of care and support for people who are terminally ill. Hospice care is normally for people who will not live more than six months duet to the terminal illness. Whenever possible, include the person who may need hospice care in all healthcare decisions.
  • Hospice helps people who are terminally ill live comfortably.
  • Hospice isn’t only for people with cancer.
  • The focus is on comfort in hospice, not on curing an illness.
  • A specially trained team of hospice professionals and caregivers provide care for the “whole person,” including physical, emotional, social, and spiritual needs.
  • Hospice Service typically include physical care, counseling, drugs, equipment, and supplies for the terminal illness and related conditions.
  • Hospice care generally is provided in the home.
  • Hospice providers will provide family caregivers with support support.

Hospice Services:

Hospice care is usually given in your home. Depending on your terminal illness and related conditions, the plan of care your hospice team creates can include any or all of these services:
  • Doctor services
  • Nursing care
  • Medical equipment (like wheelchairs or walkers)
  • Medical supplies (like bandages and catheters)
  • Prescription drugs
  • Hospice aide and homemaker services
  • Physical and occupational therapy
  • Speech-language pathology services
  • Social worker services
  • Dietary counseling
  • Grief and loss counseling for you and your family
  • Short-term inpatient care (for pain and symptom management)
  • Short-term respite care
  • Any other Medicare-covered services needed to manage your terminal illness and related conditions, as recommended by your hospice team

 

Hospice Interview Articles

Maureen Stefanides at NewYork-Presbyterian Hospital with her father, Joseph Andrey, waiting to move to a nursing home despite their efforts to arrange for 24-hour care at his apartment for hospice care.

Joseph Andrey was 5 years old in 1927 when his impoverished mother sold him to the manager of a popular vaudeville act. He was 91 last year when he told the story again, propped in a wheelchair in the rehabilitation unit of a nursing home where it seemed as though age and infirmity had put a different kind of price on his head.

Craning his neck, he sought the eyes of his daughter, Maureen Stefanides, who had promised to get him out of this place. “I want to go home, to my books and my music,” he said, his voice whispery but intense.

He was still her handsome father, the song-and-dance man of her childhood, with a full head of wavy hair and blue eyes that lit up when he talked. But he was gaunt now, warped like a weathered plank, perhaps by late effects of an old stroke, certainly by muscle atrophy and bad circulation in his legs.

Now she was determined to fulfill her father’s dearest wish, the wish so common among frail, elderly people: to die at home with hospice care……..

‘Where’s My Dad?’

Photo

hospice
“I want to go home, to my books and my music,” Mr. Andrey said while in a nursing home and as his daughter continued to try arrange hospice care for him at home.

Credit
Victor J. Blue for The New York Times

Mr. Andrey’s health worsened after he was widowed in 2009. But the less he could walk, the more he loved being home after brief hospital stays, nested with his Nat King Cole albums, cared for by live-in aides through Medicaid.

Ms. Stefanides was not prepared for the abrupt end of that way of life. Her father was in Lenox Hill Hospital for a urinary tract infection in spring 2011 when a discharge worker called her at school: He would not be sent home, because his home health agency, Excellent, had ended his services, and no one was there to care for him. Instead, he was to go to a nursing home for rehabilitation.

“Absolutely not,” Ms. Stefanides declared, rushing over. His hospital bed was empty. “Where’s my dad?” she cried.

He had been whisked to Kateri Residence, a Catholic nursing home on West 87th Street. And for more than a year, as his legs atrophied and he begged to go home, she was unable to get him out: No home health agency would take him.

Agencies like Excellent no longer wanted high-hours home care cases like her father’s, explained Jack Halpern, the chief executive of MyElderAdvocate.com, when she briefly hired him to try to get her father home. Such cases were no longer lucrative.

She came to realize that it was the start of a larger upheaval. The administration of Gov. Andrew M. Cuomo was shifting billions in public spending on long-term care to private managed-care companies, which were paid a flat Medicaid rate for each enrollee. Key players were shunning fragile clients like her father in favor of seniors robust enough to bike to a social adult day care center for table tennis.

“They don’t want heavy-care people, so they’re denying them services,” Mr. Halpern said later. “Everyone’s getting shoved into nursing homes.”

The nursing home, Kateri (which has since been sold and renamed), had financial incentives to keep Mr. Andrey: For up to 100 days, Medicare would pay roughly double Medicaid’s daily rate for regular nursing home care. Later, he was relegated to a unit with so little staff that he rarely left bed. Finally, in spring 2012, when he was showing signs of dementia, Kateri declared him a permanent resident and moved to take his whole income.

At the last moment, Ms. Stefanides cobbled together his escape: She persuaded Gentiva Health Services, a national company, to provide eight hours of home care on weekdays — much less than the live-in care he had before — while her husband, still freelancing, signed papers promising to do the rest. In reality, the schedule relied on her visits and a neighbor’s vigilance.

They managed, barely, for a year. But in 2013, they faced the same problem, only worse. The home care company, under new ownership, dropped her father, and NewYork-Presbyterian Hospital sent him for rehabilitation — to DeWitt.

“When the elevators open, you get this terrible stench,” Ms. Stefanides said of DeWitt’s upper floors at night. “I was hearing people screaming for help and nobody coming. My father was on the verge of tears — in his defecation for three hours, and he kept ringing the bell.”…………

 

 

To Read more about this hospice care article click below

Fighting to Honor a Father’s Last Wish: To Die at Home – The New York Times.