“Dying” and “pleasant experience” don't usually appear in the same sentence.
Mike Walding's exposure to hospice care — first, when his mother died last Christmas Eve and, months later, before his father died — led him to link such words.
“I cannot tell you what a wonderful thing (hospice care) was,” the Omahan said.
Hospice care is provided to terminally ill people who have decided to stop pursuing treatments to extend their lives. The focus of their care shifts to keeping them as pain-free as possible.
More people across the U.S. are taking advantage of hospice care, but many are waiting too long to use it, said Joanie Kush, vice president of hospice and palliative care for the Visiting Nurse Association. Among VNA patients, she said, more than 50 percent use the hospice benefit for seven days or less.
“They are enacting that benefit very, very late in their terminal disease,” Kush said.
That may be due in part to a lack of knowledge about the hospice coverage provided by Medicare, she said. It also could be linked to a reluctance among all parties to recognize when a patient is terminally ill, the Medicare Payment Advisory Commission reported.
The care is offered for homes, hospice houses, hospitals or inpatient residential centers. Besides Medicare, private insurers and Medicaid cover the cost of hospice care under certain conditions.
A record number of dying people in the U.S. — an estimated 1.65 million patients — received care from the nation's hospices in 2011, the National Hospice and Palliative Care Organization reported this week. More than 44 percent of those who died in the U.S. in 2011 were under the care of a hospice program, the group said. That's up from nearly 42 percent in 2010.
Walding learned about hospice after his 88-year-old mother, Arlene, had kidney failure after months of treatment for a disease that required frequent blood transfusions. Following her doctor's OK, Arlene was taken by ambulance to Hospice House-The Josie Harper Residence at 74th and Cedar Streets.
The move got Walding's mother out of the hospital to a setting where she could lie quietly without being connected to any IVs. She did use an oxygen concentrator to help her breathing.
Walding said his mother was unconscious when she was taken to the hospice house. The only time she moved on her own for the last 2½ days of her life, Walding said, was when the family and a chaplain prayed over her. Gary George, the executive director of Hospice House, said many people have never heard of hospice care. Surviving family members, he said, “will say to us, 'We really wish we'd come sooner' or 'We wish we'd known sooner.'”
A few days on hospice is not enough time to get the full benefits of the service, said Diane Randolph, director of Methodist Hospital's hospice program. Earlier engagement, she said, allows the patient and the family to have access to a variety of services: chaplains, counselors, therapists, nurses, dietitians and physicians.
“There's a lot of benefits to going on hospice,” Randolph said.
When the health of Walding's 90-year-old father, Jack, started to fail in August, Walding was able to get him into hospice care right away. Walding's father, though brokenhearted by his wife's death, was pleased with the hospice care she had received, Walding said.
Walding's father was able to stay in the independent living center where he had been a resident. Walding said VNA nurses came once or twice a day, for two to three hours at a time, for the last two and a half weeks of Jack's life.
“They can make the experience as pleasant as it can be,” Walding said. “They can make it more palatable.”
How to get hospice benefits
You can get Medicare hospice benefits when you meet all of these conditions:
» You're eligible for Medicare Part A (hospital insurance).
» Your doctor and the hospice medical director certify that you're terminally ill and have six months or less to live.
» You sign a statement choosing hospice care instead of other Medicare-covered benefits to treat your terminal illness. (Medicare still will pay for covered benefits for any health problems that aren't related to your terminal illness.)
» You get care from a Medicare-approved hospice program.
Source: Centers for Medicare and Medicaid Services
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