New Medicare Rules for Hospice Care

Patients face new regulations

New Medicare regulations regarding hospice care now require that patients who have been through two full rounds of hospice to meet in person with a hospice doctor or nurse practitioner to determine whether they are actually in need of end-of-life care. This presents a difficult issue, because there is no specific way to determine how far someone is from death. A quote, from NewsObserver.com:

In about half of cases, patients consult the service three weeks before they die and a third become patients just one week before death.

Cooper Linton, vice president of marketing and business development with Hospice of Wake County, said it's unusual for patients to be in hospice care for extended periods, but it's not unheard of.

"We're trying to estimate the life expectancy of people, and that's more an art than it is a science," Linton said.  "In our own personal lives, we know of people who did not live as long as we thought they would, and those who live far longer than they were told they would."

It remains to be seen whether this change will be beneficial or detrimental, but with concerns already being raised by providers about possible cost increases, the debate is certainly not over.

How Hospice Helps

Hospice care covers both mind and body

Hospice care is certainly about comfort and pain control at a physical level, but those are not the only aspects that are carefully looked after. This quote from a MyFox Tampa Bay article explains:

"We do have a lot of medicines and treatments to make people comfortable and peaceful at the end of life," said Dr. Michele Marziano, with Lifepath Hospice. "It helps the person who is dying, and helps the family too to see their patients in comfort at the end of life."

That includes medicine to relieve pain, nausea and vomiting, and oxygen to make breathing easier. There's specialized radiation and chemotherapy to ease discomfort.

But Dr. Marziano says there is also a focus on emotional pain.

"Hospice educates the families for what to expect, and that's really helpful," she said. "We have the social workers, chaplains, volunteers -- it's a team approach to help relieve the suffering and pain of families."

As Dr, Marziano stated, hospice takes great measures to meet the needs of patients and their loved ones and, with word of the effectiveness of this type of care spreading, the popularity of hospice care is expected to continue rising at a solid rate.

The Many Facets of Hospice Care

Reasons to choose hospice

Many think of hospice as a program that offers emotional support to those with terminal illness, and it does, but hospice today is an integrated program that offers much more than just emotional support; the list of hospice services covers doctors, nurses, home health aides, medical equipment and supplies, spiritual, dietary and other counseling, continuous care during crisis periods, bereavement services and trained volunteers who help in the home. Hospice isn’t supplementary support for patients who are desperately ill; hospice care actually supplants regular medical care, empowering the patient themselves (along with medical staff) to determine what treatment they want as they near the end of life. This not only improves the patient experience but, according to a 2007 Duke University study of hospice care, reduces end-of-life medical costs by an average of $2,309 per hospice beneficiary.

This quote, from an article in The River Journal, does a fantastic job of describing the many facets of hospice care. In addition to making patients more comfortable, studies are now showing that the benefits of hospice care can actually extend the lives of those patients beyond other with similar ailments who choose to undergo hospital care. Hospice care puts patients in control, creating a program catered to the individual, which ensures the best care possible.

Hospice Gives Hope

Hospice care is about hope, not loss

Hospice care serves many purposes, most of all to make the later stages of life an enjoyable time for patients, friends and family. In an interview for the Colombus Telegram, one hospice social worker explained what her job entails:

"My job is to help individuals and their families to realize that hospice is not always just about dying, but it's an important time of living their lives," said Lisa Weber-Kohler, Columbus Community Hospital social worker. "It can be a time to retain hope, not necessarily for a cure, but to re-establish family relationships, to review their lives and talk about how they want to be remembered."

With advanced pain management and other measures in place to ensure maximum comfort, patients are free to enjoy these renewed connections for as long as possible wherever they desire, be it at home or in a care center.