Laura Mahoney, RN, LMSW, a social worker with Bethesda Hospice Care, is aware of many hospice care myths that can deter seniors and their loved ones. In this article, Laura addresses nine of them for us.
Debunking 9 Different Hospice Care Myths
Myth 1: Going into hospice care means a person is giving up. Laura says that one of her former patients was so misinformed about hospice he thought she was there to give him a lethal injection.
Another version of that same hospice care myth – the role of hospice is to simply load a patient up with morphine.
“This is not at all what hospice is about,” Laura says. “Hospice is for people when treatment for an illness is no longer effective or the patient doesn’t want any more aggressive treatment. We are there to provide comfort care, ease pain, and give our patients the best quality of life possible.”
Myth 2: Once a person enters hospice care they can never leave. “A person does not have to stay in a hospice program,” Laura says. “They are free to sign out at any time.”
To enter hospice, a physician must sign an order stating that a person has less than six months to live due to an illness. Hospice care organizations periodically review each patient’s case to see if they should remain in the program. After six months, the patient could remain in hospice care if a physician feels that their passing is still likely to occur within the next six months.
According to Laura, hospice care does not provide aggressive treatment for a terminal illness, but rather pain management and comfort care. But there are situations when things change. She relates the story of a woman who entered hospice care because she no longer wanted to undergo chemotherapy. “While in hospice care she began to feel better and decided to leave the program and begin chemotherapy again,” Laura says.
Myth 3: A hospice care patient can’t keep their own physician. “Hospice patients get to choose their physician,” Laura says.
Myth 4: While in hospice care, you will not receive medical care for any other injury or illness. Hospice is about providing comfort care for the condition that has led to a terminal diagnosis, but it doesn’t keep a patient from receiving treatment for other medical needs.
“A person can still go to their eye doctor or any other specialist,” Laura says. “It’s just that anything not related to their terminal illness does not fall under hospice services.”
Laura suggests that since there are many different Medicare Advantage plans, people should check with their insurance before scheduling a medical appointment or procedure.
Myth 5: Hospice care is too expensive. According to Laura, people with Medicare or Medicaid receive extensive coverage for hospice expenses. “All services that hospice provides are covered 100 percent by Medicare and Medicaid,” she says. Veterans Affairs also provides coverage for hospice.
Patients not covered under these programs would have to check with their private insurance carriers. Laura says many private insurances cover hospice care, and may work with a list of preferred hospice providers, and therefore require preauthorization.
Myth 6: Hospice care only occurs in the hospital. Hospice care rarely occurs in the hospital, according to Laura. It’s most often provided in private homes and senior living communities. The exception is that if symptoms cannot be controlled in these settings, a hospital may be required to get the symptoms under control. After that occurs, the patient can return to their home or senior living community. Hospice care team members will continue to check with the patient during their hospitalization for symptom management purposes.
Myth 7: Hospice care is only for people with cancer. Hospice is not restricted to cancer patients. To be eligible for hospice care, a person must have a condition where life expectancy is less than six months, and when there is no treatment available that would be effective or the patient declines further treatment. The Hospice Care Medical Director determines if the person’s condition qualifies. Some examples include:
- End-stage Alzheimer’s disease
- Parkinson’s disease
- Lewy-Body dementia
- End-stage liver disease
- Kidney failure
- End-stage heart disease
- Amyotrophic lateral sclerosis (ALS)
Myth 8: Hospice care is just an organization of volunteers. “All hospices must provide certain professional services,” Laura says. She lists Bethesda’s hospice services as an example:
- RN case manager
- Hospice aides
- Chaplains
- Social workers
- Physicians
- Therapists
- Dietitians
These professionals not only care for the patient, they educate family members who participate in caregiving about how to best support and care for their loved one in hospice. “Family members are very grateful for the help and education hospice provides,” Laura says.
Myth 9: Once the hospice care patient dies, hospice services end. When the patient dies, the family is not neglected. Bereavement support is offered for an additional 13 months at no cost.
According to Laura, hospice patients are more concerned about their loved ones than they are about themselves. “It gives them comfort to know that we will be helping their loved ones after they have passed.”
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