Why choose hospice?

Hospice is a program of care that provides comfort and support for persons with life-limiting conditions and their families. Hospice is a choice to stop diagnostic testing and life-prolonging treatments, instead aiming to make the person comfortable by relieving their symptoms and pain for the length of their illness.

Receiving hospice services does not mean an individual is imminently dying. Being on hospice means a person wants to have the best quality of life for as long as he/she is able. It means a person wants to be able to enjoy family, accomplish goals, and enjoy life while they are living! At Avalon Home Health & Hospice we help our patients Start Strong. Be Strong. And Finish Strong.

An individual is generally admitted to hospice when it is determined their life expectancy is approximately 6 months or less if the disease follows its normal course. This does not mean that care will only be provided for 6 months. Hospice can continue to be provided as long as the physician and the hospice team can certify that the patient’s condition is declining and remains life-limiting.

Studies have shown, patients often improve once under hospice care, whether temporarily or for a longer period of time. If the patient’s condition dramatically improves and stabilizes, the patient can be discharged from hospice and possibly participate in other programs such as Home Health or Personal Care Services depending upon the needs of the patient. If his/her condition again declines, hospice care can again resume at that time.

Why we provide Hospice

Hospice is a family-centered approach that includes a primary caregiver, whether that be a spouse, family member, or friend. The Avalon Hospice Team is comprised of a medical director, nurses, aides, social workers, chaplains, and volunteers. Together they focus on the patients and family’s needs, providing services and assistance as the patient and family desire. The goal is to keep the patient as pain-free, comfortable, and symptom-free as possible, in the home of their choice.

When should you start a hospice program?

Any person facing the advancing stages of any terminal illness is eligible for palliative care. Hospice care is appropriate when the following conditions are met:

• The physician thinks that the patient will live six months or less if the disease runs its normal course

• Aggressive treatments are not working or providing relief to the patient

• The patient, family and physician agree and understand that the focus of hospice care is on comfort (pain control and symptom management), not cure.

Palliative care becomes appropriate when treatments are no longer effective and the burden of the disease becomes too much to bear for the patient and family. Our goal is to provide relief from physical and emotional pain so that the patient and family can spend their remaining days with comfort and dignity.

Where is your hospice care provided?

Hospice is a philosophy of care, not a place. Most hospice patients receive care in their home or the home of a relative or friend. Palliative care can also be provided in many long-term care facilities, assisted living facilities, hospitals or nursing homes.

How is hospice care different from other types of home health care?

For most home health care providers, the goal is to get the patient well. In hospice, the staff and family recognize that the patient will not get well. They focus on comfort and support, rather than cure. All members of the care team - the physicians, nurses, social workers, grief support and spiritual care counselors, aides and volunteers - work together to coordinate care.

Avalon Home Health & Hospice’s palliative care also focuses on supporting the family in physical and emotional support. The hospice team will monitor the caregiver and/or family for signs of stress and fatigue and can offer assistance options. One option is helping to provide or organize respite care where the patient could stay in a facility for a short period of time, or a few hours of respite to run errands, or get much needed rest. The hospice team teaches the family how to be involved in their loved one's care.

Hospice care does not end when a patient dies. Avalon Home Health and Hospice’s grief support staff and volunteers maintain contact with the family for up to13 months after the death of a patient through may different outlets. Our staff is always available by phone, will send out mailers that focus on loss, and can even pay visits to families that need extra support.

Who Pays for Hospice?

Hospice is provided regardless of ability to pay. Hospice is a covered service under Medicare Part A, Medicaid, and most insurance companies.

What if you get better?

If the patient's condition improves, he or she can be discharged from hospice and return to aggressive treatment or resume daily life. If the patient should later need to return to hospice care, Medicare and most insurance programs will allow additional coverage.

What if your doctor does not mention hospice?

The patient and family should feel free to discuss hospice care at any time with their physician, other health care professionals, clergy or friends. Everyone is urged to prepare Advance Directives that spell out the type of care we want to receive at the end of life.

Who can refer a patient to a hospice program?

Anyone can refer a patient to a hospice program. To be admitted, a patient must:

• Agree to treatment aimed at comfort rather than cure

• Have an incurable disease resulting in a limited life expectancy, as certified by a physician

• The physician must write on order to start hospice services.

What does the hospice admission process involve?

When a patient is referred to Avalon Home Health & Hospice, the nurse will call the patient's home to set an appointment for evaluation. At the appointment the nurse will provide a head to toe assessment of the patient, educate about hospice and palliative care, and answer any questions the patient and family may have. The patient will be asked to sign a consent form confirming that he or she understands that hospice care is palliative (aimed at comfort and pain relief) rather than curative.

What services can you expect on Hospice?

The hospice team will provide the following services in the home, whatever that setting is:

• Manage pain and other symptoms, alleviate suffering associated with a terminal illness.

• Support patient and family through the emotional, psychosocial and spiritual aspects of dying

• Provide medications, medical supplies and equipment undefined

• Teach family members skills needed to care for the ill family member undefined

• Provide regular nursing visits to assess symptoms, adjust medications, and teach patient and family about the changes which are occurring

• Provide certified hospice aides to assist with bathing, light housekeeping and assistance with meals

• Provide counseling for patient and family to help in dealing with end-of-life issues, assist with understanding Medicare and Medicaid, and in finding and coordinating community resources.

• Deliver special services such as speech therapy and physical therapy if needed to improve the quality of life.

• Make short-term inpatient care available when pain or other symptoms become too difficult to manage at home

• Make 5 day respite care available to relieve family and provide a short rest

• Have a nurse available on-call 24hrs per day, 7 days per week to address questions, concerns and make home visits as needed after hours

• Provide grief support and counseling after patients death

Is Hospice care only for cancer patients?

No. Hospice care is for patients with a life-limiting illness with a prognosis of approximately 6 months. This includes but is not limited to: Alzheimer’s, heart disease, lung disease, Lou Gehrig’s (ALS), stroke, liver disease, kidney disease.

Is hospice only for people who have “no hope”?

No. With hospice, the miracle isn’t in the cure---it’s in the caring. Because patients get substantial relief from pain and other symptoms—and their families are supported by a caring hospice team—they can choose exactly how they will spend their final months of life. This means they have a meaningful, dignified, peaceful end-of-life experience.

Is Hospice only for the patient?

No. Meeting the needs of the patient and the family is a top priority. The family unit is at the center of all decision making. Hospice recognizes that it takes many caregivers to meet the unique needs of each patient.

Does Hospice “dope people up” so they become addicted or sleep all the time to make them die sooner?

No! When patients have a legitimate need for pain medication, they do not become addicted to it. Hospice has constant access to the medical director to discuss medication options until we find the best combination for each patient for optimal comfort. Giving patients the medications they need to have their symptoms controlled--whether it be pain, anxiety or other symptoms—will not hasten death.

Is Hospice only for people who have a few days to live?

No. Unfortunately, many people enter the program too late to fully benefit from the many services available to them and their families. It is a good idea to talk with the physician, or contact hospice during a life-threatening illness to obtain information and discuss as an option. The information given will help patient and family in making choices if and when hospice is appropriate.