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How Long Can You Be on Hospice Care?
One of the most
common questions about hospice care is, “how long can someone be on hospice?”
Understanding the duration and criteria for hospice can help patients and their
families make informed decisions during challenging times.
While most
patients only experience its benefits for days and weeks, hospice is available
when a patient’s physician certifies that they have six months or less to live,
as explained further below, with recertification available if the patient
outlives that six-month period and continues to meet hospice criteria.
What is Hospice Care?
Hospice is
defined as supportive care that focuses on comfort and quality of life. Hospice
is available for patients with a terminal illness and a life expectancy of six
months or less if their illness runs its normal course, as certified by a
physician.
Can hospice help?
Hospice
services include:
Some companies
like Amedisys also offer specialized programs to care for certain diagnoses
like dementia, heart failure and more.
Understanding
how long hospice care can be provided first starts with having a strong grasp
of the eligibility criteria.
To be eligible
for hospice, the patient must be considered terminally ill with a life
expectancy of six months or less if the disease runs its normal course, as
certified by a physician. The hospice physician uses their clinical expertise
and information from a comprehensive assessment to determine life expectancy.
Signs the patient is declining from the terminal illness include progressive
weight loss, frequency of hospitalizations, increasing weakness or fatigue,
difficulty with daily activities and more.
The patient
must also elect to stop curative treatments in favor of the comfort and quality
of life measures hospice provides. The physician will work closely with the
hospice care team on a personalized plan of care focused on pain and symptom
management and comfort so patients and families can make the most of their
remaining time together.
How Long Can Patients
Receive Hospice Care?
Patients can
receive the benefits of hospice care as long as they continue to meet the
eligibility criteria. If a patient lives longer than the original six-month
certification period, physicians can re-certify them to remain on hospice care
if the disease progression still indicates a life expectancy of six months or
less.
Although
patients cannot receive curative treatment while on hospice care, if a
patient’s condition improves significantly so that they are no longer
considered terminally ill, they will be discharged from hospice care. Patients
can also choose to opt out of hospice care at any time during the service.
One of the most
famous examples of how hospice can extend beyond six months is former President
Jimmy Carter. As of this publication, Jimmy Carter has received hospice care
for more than a year, spending that precious remaining time with his family in
his home. His legacy will be one of normalizing end-of-life conversations,
sparking hope that more patients and families will seek out the benefits of
hospice and embrace them sooner rather than later.
What are the Benefits of
Hospice Care?
One of the most
common phrases we hear from families is, “we wish we had chosen hospice
sooner.” By accepting help early, patients and families can expect a range of
benefits at the end of life:
Pain and
Symptom Management
Pain and
symptom management is a central tenant of hospice care, providing comfort and
the best quality of life possible for patients at home. Hospice care combines
pharmacological and non-medication tactics to manage physical, emotional,
psychosocial and spiritual pain for the patient and caregiver.
Holistic
Care
Hospice is a
unique Medicare benefit providing care with a full, interdisciplinary care
team. Holistic care is a patient-centered approach that focuses on caring for
the whole person, including their physical, emotional, psychosocial, and
spiritual well-being.
Supportive
Care Environment
Having hospice
care at home fosters a sense of security, familiarity and peace, which can
contribute to a patient’s overall sense of well-being.
Advance Care Planning
Hospice care
encourages open communication and advance care planning discussions, allowing
patients to express their desires for the final weeks and months of their life.
This can help avoid unwanted medical interventions that could diminish quality
of life by ensuring patients are getting the care they need and want.
How Do You Know When It’s
Time for Hospice?
If you’re
caring for a loved one with a terminal diagnosis, there are several key signs
that it may be time to start talking about hospice care:
Their doctor
has given a prognosis of six months or less.
Their health or
disease symptoms are worsening with frequent trips to the hospital or doctor’s
office.
They have
decreased appetite or pain/nausea interfering with their ability to eat and
drink.
They sleep more
throughout the day and night.
There are
noticeable behavior changes in mental clarity, confusion, forgetfulness, or
irritability.
Activities of
daily living like feeding oneself, bathing and dressing independently become
more difficult.
Caregivers are
overwhelmed and unable to manage care on their own.
What Are the Four Levels of
Hospice Care?
As you research
hospice, you may come across different levels of hospice care. Moving into
different levels can be triggered by changing circumstances or needs of the
patient or caregiver. Here are the four levels of hospice care all
Medicare-certified agencies provide:
Routine Home
Care
This is the
most common type of hospice care. The full team conducts intermittent visits
wherever the patient calls home, providing a comfortable and familiar
environment.
Respite Care
Respite care is
available when caregivers need a break. Patients are admitted to a long-term
care facility or other inpatient facility with 24-hour nursing available. The
patient can stay in the facility for up to five days/five nights and returns to
routine level of care on day 6. The hospice team coordinates the plan of care
and can arrange transport patients to and from the facility as needed.
Continuous
Home Care
This level of
care is for short-term urgent healthcare needs or symptom crises that can still
be feasibly addressed at home. The hospice team provides at least eight hours
of continuous care within a 24-hour period. When symptoms are controlled, the
patient returns back to routine care.
General Inpatient Care
If pain and
symptoms related to the patient’s terminal illness can no longer be controlled
at home, the patient may be appropriate for General Inpatient (GIP) care. The
hospice team facilitates the patient’s transfer to a hospital, long-term care
facility or hospice inpatient unit and will continue coordinating the plan of
care. Patients will return home to routine home care once pain and symptoms are
managed.
How to Get Started with
Hospice Care
If you’re ready
to start talking about hospice care with your family, Amedisys is here to
support you through every stage. Contact Amedisys Hospice in Mobile, Alabama
at 251-343-0989 for more information.
Ensuring Safety in Hospice Care: A Commitment to ExcellenceThe importance of safety in the workplace for healthcare providers cannot be overstated. As we approach OSHAs Safe and Sound Week in August, it is an opportune moment to highlight the critical measures we undertake to ensure a safe work environment for our staff and patients. This communication aims to inform our referral sources about our safety protocols and provide valuable tips that medical professionals may find beneficial for maintaining safety in their workplaces.Our Commitment to SafetyIn hospice care, where the environment can be unpredictable and emotionally charged, maintaining rigorous safety standards is paramount. Our commitment to safety is evidenced by our comprehensive safety programs, continuous staff training, and adherence to OSHA guidelines. According to the Bureau of Labor Statistics (2023), healthcare workers face a higher rate of workplace injuries than workers in most other sectors, with nearly 5.5 injuries per 100 full-time workers annually. This statistic underscores the importance of our ongoing efforts to mitigate risks and promote a culture of safety.Staff Training and EducationOngoing Training: All our staff undergo regular training sessions that cover the latest safety protocols, emergency procedures, and the proper use of personal protective equipment (PPE). Research has shown that continuous education significantly reduces the incidence of workplace injuries (Smith et al., 2022).Ergonomic InterventionsProper Lifting Techniques: Back injuries are a common concern in healthcare settings. We emphasize training on proper lifting techniques and the use of mechanical lifts when necessary to prevent musculoskeletal injuries (Anderson et al., 2020).Infection Control MeasuresStrict Hygiene Protocols: Adherence to stringent hygiene protocols, including regular handwashing, use of sanitizers, and appropriate use of PPE, is mandatory. These measures are crucial in preventing the spread of infections among staff and patients (CDC, 2022).Mental Health SupportCounseling Services: Recognizing the emotional toll that hospice work can take, we offer counseling services to support our staffs mental health. Studies have indicated that mental health support reduces burnout and improves job satisfaction among healthcare workers (Jones et al., 2021).Safety Tips for Medical ProfessionalsWhile our safety protocols are robust, there are additional tips that medical professionals may find useful in enhancing their safety at work:Use Technology WiselyTelehealth Services: Where appropriate, leverage telehealth services to reduce the need for physical interactions, thereby minimizing exposure to infectious diseases.Stay InformedContinuing Education: Keep abreast of the latest safety guidelines and best practices through continuing education programs. This knowledge is vital for adapting to new challenges and improving workplace safety.Promote a Safety CultureOpen Communication: Foster an environment where staff feel comfortable reporting safety concerns without fear of retribution. An open communication culture is essential for identifying and addressing potential hazards promptly (Davis et al., 2019).Personal Protective Equipment (PPE)Proper Use and Disposal: Ensure the correct use and disposal of PPE. Improper handling can negate the benefits and increase the risk of contamination.Safety in the workplace is a fundamental aspect of providing high-quality hospice care. By implementing rigorous safety measures and continuously educating our staff, we strive to create a secure environment for both our employees and patients. We encourage our referral sources to adopt similar practices to enhance safety within their own organizations. Together, we can build a safer healthcare system for everyone. Call us today to learn more!ReferencesAnderson, J., Williams, M., & Smith, T. (2020). Ergonomic interventions in healthcare: A review of the evidence. Journal of Occupational Health, 62(4), 311-319. https://doi.org/10.1002/joh.22023Centers for Disease Control and Prevention (CDC). (2022). Infection control in healthcare settings. Retrieved from https://www.cdc.gov/infectioncontrol/index.htmlDavis, K., Turner, M., & Wrenn, G. (2019). Promoting a culture of safety in healthcare. Healthcare Management Review, 44(2), 123-135. https://doi.org/10.1097/HMR.0000000000000199Jones, A., Phillips, R., & Brown, L. (2021). Mental health support for healthcare workers: A systematic review. Journal of Occupational and Environmental Medicine, 63(1), 54-62. https://doi.org/10.1097/JOM.0000000000002025Smith, R., Johnson, P., & Martinez, S. (2022). The impact of continuous education on workplace safety in healthcare. American Journal of Industrial Medicine, 65(3), 233-245. https://doi.org/10.1002/ajim.23394U.S. Bureau of Labor Statistics. (2023). Occupational injuries and illnesses among healthcare workers. Retrieved from https://www.bls.gov/iif/
How Much Do You Really Know About Arthritis?Arthritis is a term that many people associate with older adults experiencing pain in their joints. But did you know that arthritis, itself, is not a diagnosis, but a term that describes dozens of diseases and conditions? According to the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), the word arthritis means joint inflammation, and may be used to describe any condition affecting the joints, for people of all ages. In fact, arthritis impacts one in five adults in the United States and is the leading cause of work disability.To help you better understand arthritis, weve posed five questions below that explore common arthritic diseases, who is at risk and how to manage these conditions. How many types of arthritis are there?There are more than 100 types of arthritic diseases, which can impact the joints, tendons, ligaments and bones by causing stiffness, swelling and pain. According to the Centers for Disease Control and Prevention (CDC), some of the more common types of arthritis include the following:Osteoarthritis. This kind of arthritis occurs when joints in the body break down. Its most commonly experienced in the hands, hips, knees and back.Rheumatoid arthritis. This is an autoimmune disease, meaning the bodys immune system causes deterioration by attacking its own tissues. It can damage the joints in the hands, wrists and knees. Potentially, it could also impact the lungs, heart and eyes.Gout. This type of arthritis tends to impact only one joint at a time. During a flare-up, uric acid crystals form within a joint and cause pain, swelling and tenderness. Often, it impacts the big toe.Fibromyalgia. By causing pain throughout the body, fibromyalgia can have a significant impact on a persons quality of life and ability to work.Juvenile arthritis. Also known as childhood arthritis, this condition impacts nearly 220,000 people younger than 18. Its caused by an immune system that is overactive and results in swelling in the joints. What are signs and symptoms to look for?Because there are so many types of arthritis, and because symptoms may overlap with other conditions, it can be difficult to diagnose. The Arthritis Foundation says that if youre experiencing the following signs and symptoms you should consider talking to a doctor:Tenderness, pain, swelling and/or stiffness in one joint or several jointsRedness on or around a jointA joint that feels warmTrouble moving a joint or engaging in your day-to-day activitiesAny joint symptoms that concern youWho gets arthritis?Anyone can get arthritis, no matter their age, gender or cultural background. However, some groups of people face a higher risk than others for certain types of arthritis. For example, according to the CDC women face a higher risk for fibromyalgia, osteoarthritis and rheumatoid arthritis while men are more likely to develop gout. Further, its not uncommon for people experiencing other chronic conditions, such as obesity, diabetes and heart disease, to also have arthritis.Other risk factors can include:Age, with the risk increasing as you get olderFamily history, with some types of arthritis have a hereditary connection, including rheumatoid arthritis, lupus and ankylosing spondylitisWeight, with people who are overweight or obese facing an increased risk for osteoarthritis impacting the knees and other jointsSmokingCertain infectionsAn injury to a jointService in the military Are there actions you can take to lower your risk for arthritis?Possibly. While there is no magic pill that can protect you from arthritis, some people may be able to reduce their risks or at least delay the onset of certain types of arthritis, according to the Arthritis Foundation. For example, maintaining a healthy weight may help lower your risk for osteoarthritis; quitting (or never starting) smoking may help prevent rheumatoid arthritis; and eating a healthy diet that is low in sugar and alcohol as well as purines (thats a chemical compound that turns into uric acid) may help decrease your risk for gout. What can you do to manage your arthritis?If youve been diagnosed with arthritis, there are a number of steps that you can take that may help to ease pain and decrease inflammation. Those include:See your healthcare provider regularly and follow their advice. They know you best and can help you devise a plan to address your symptoms and help you continue to do the things you enjoy in life.Move more. It may sound counterintuitive, but physical activity may actual help reduce pain and improve the way you feel and move, according to the CDC. Try out a variety of joint-friendly activities, such as cycling, swimming, walking and tai chi. If working out is new to you, talk to your doctor first. With their approval, start small, aiming for five to 10 minutes at a time, and work towards the goal of 150 minutes per week, along with two days of strength-building activities. Manage your weight. Weight can put additional stress on your joints. Aim to reach or maintain a healthy weight through diet and exercise. If youre struggling, ask your doctor for advice.Make healthy eating choices. Research shows that some foods can help control inflammation, while others may contribute to inflammation. People living with arthritis may benefit from an anti-inflammatory diet, which includes fish, nuts, beans, fruits and vegetables (the Mediterranean Diet is a good place to look for guidance, according to the Arthritis Foundation). At the same time, try to limit the foods you eat that cause inflammation, including processed foods like white bread and pastries, fried foods, soda and sugary beverages, red meat and processed meats, along with margarine, shortening and lard. Take care of your mental health. Any chronic condition can take a toll on how youre feeling. And if the condition is limiting your usual activities, as arthritis may do, it can be especially stressful and isolating. If youre feeling hopeless or anxious, or youve lost interest doing the things that once brought you joy, find help. Talk to your primary care provider or connect with a counselor or therapist. A support group might also be useful. The Arthritis Foundation is a good place to start if you think you might benefit from a virtual group.As mentioned, there are more than 100 different types of arthritis, ranging from common to rare. While weve touched on some of the more frequently asked questions, theres still a lot to learn about these conditions. If youre concerned about pain, swelling or tenderness youre experiencing in your joints, talk to your healthcare provider today. To find out more about Healthcare Insurance Plans that include Medicare, Individual & Family, Health & Dental and Vision, call BlueCross BlueShield of Alabama at 251-344-2115.
Tough Conversations: When Is It Time for Seniors To Stop Driving?Driving is more than just a mode of transportation; its a symbol of independence that many cherish. However, as we age, it becomes crucial to recognize when driving may no longer be safe. The decision to stop driving is significant and depends on a persons ability rather than age. The decision can be influenced by a gradual change in ability or a sudden shift due to illness or other factors.Typical changes caused by aging often affect driving abilities. For example, changes in depth perception are very normal as we age. And many people lose the flexibility that allows them to, for example, turn their head quickly to check the roadway. Others may find their reaction time slowing down. None of these changes are about the personthey are strictly about the aging body.How do we know when its time to stop driving or for our older loved one to stop? Asking this question gets to the heart of the matter: Is it better to keep society safe or for this person to continue driving? Whether youre answering that question for yourself or asking your loved one about their driving, it will help guide the thought process and the conversation. Here are some more tips.Thinking About Ones Own Driving AbilitiesFor some seniors, the realization that its time to hang up the keys comes from self-awareness of their diminishing driving skills. Recognizing signs like difficulty seeing at night can lead to voluntary decisions to limit driving. Many older adults choose to start making changes by avoiding nighttime driving or busy highways. They might also limit themselves to familiar routes or shorter trips, using alternatives for longer distances.Self-regulation is a smart way to stay safe while keeping some independence and a feeling of control. It also makes it easier for seniors to get used to other ways of getting around besides driving.Starting the Conversation With an Older Loved OneTalking to an older loved one about reducing or stopping their driving can be very challenging and should be planned with care. If someone were to tell you that you should stop driving, your natural reaction would likely be that you are losing your independence, and you might become defensive about the issue. You might worry about becoming dependent on others to do the things you want and need to do, and when. After decades of driving, the conversation probably wouldnt sit well with you.A gentle way to start this dialogue with an older loved one is by asking reflective questions that encourage self-assessment. You might ask them, Would you feel comfortable driving your grandchild? Such questions can help older adults realize the potential risks without feeling pressured. Other questions can focus on the car rather than the person. Ask questions about dents or scratches not by asking, How did you do that? but rather, How did that happen? or even Can I help you arrange to get that fixed?Right at Homes RightConversations guide can be an invaluable resource for approaching this sensitive subject. It provides structured advice on how to have important discussions like this without causing offense or distress.Exploring Alternative Transportation OptionsBear in mind that you do want to encourage your older loved one to keep getting out of the house. Losing the ability to drive can have disastrous effects on the social connections and activities we all need for our mental health.Fortunately, giving up driving doesnt mean giving up mobility. Seniors have various alternatives to driving themselves:Public transportation: Buses, trains, and subways can be excellent options for seniors, especially in cities with robust transit systems.Community senior services: Many communities offer shuttle services specifically for seniors, which can be a convenient and safe way to get around.Ride-hailing services and taxis: Services like Uber and Lyft offer convenient, door-to-door service at many locations.Family and friends: They are often more than willing to help by providing rides, especially for important appointments or events. Walking: If health permits and distances are manageable, walking is both practical and healthy.The transition from driving can be challenging, but it opens up new opportunities to explore different and potentially rewarding modes of transport. With the right approach and support, older adults can navigate this change smoothly, maintaining their independence and safety. Right at Home offers a wide range of services to help seniors remain independent. This includes transportation to appointments, leisure outings, and running errands. Other services include a myriad of homemaking/companion and personal care services. Contact Right at Home in Alabama at 251-459-8672 for more information.
About Amedisys Hospice Care in Mobile, ALWe provide high-quality hospice care in Mobile, wherever you call home. Hospice care gives people facing a terminal illness comfort and a better quality of life. Your personalized care plan may include nursing care, pain and symptom management, hospice aides, emotional and spiritual support, and more. We are here for you 24/7, with a strong commitment to quality and patient satisfaction. We are also here for your loved ones, offering social work services, respite care and bereavement counseling. Hospice costs are usually 100% covered by Medicare, Medicaid and private insurance for eligible patients. Tell us your goals and wishes. Were listening. Pain Management: The hospice team may prescribe medications to help ensure that pain and other symptoms are well-managed ensuring your loved one feels as comfortable and alert as possible.Hospice Aide Services: Hospice aides provide at-home help with basic self-care and hygiene needs to support activities of daily living.Social Work Services: Social workers provide emotional support and counseling for how to cope with grief, help with end-of-life conversations, planning and more.Skilled Nursing Care: The hospice nurse visits regularly to check on the patient and assess how your loved one feels, to administer medications and coordinate with the rest of the hospice team.Hospice Volunteer Companionship: Families in hospice can receive additional support from trained volunteers who provide companionship and some help with transportation or other practical needs.Chaplain Spiritual Support: Families have different spiritual needs about the end of life, and our chaplains provide spiritual care and bereavement support for all.Bereavement Support: After the loss of a loved one, families can receive up to one year of support and guidance from trained bereavement counselors.Therapy Services: The Amedisys bereavement support team facilitates both virtual and in-person bereavement support groups.Hospice Care for Veterans: Amedisys is proud to participate in the We Honor Veterans program to cater to veterans unique end-of-life-needs.Amedisys Hospice-Mobile, services these Alabama counties: Baldwin, Butler, Conecuh, Escambia, Mobile, Monroe, & Wilcox.Call us today at 251-343-0989 to find out how Amedisys Hospice Care in Mobile can help.