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Experts offer answers concerning hospice care

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ROCHELLE B. BIRKELO
March 5, 2012
— It's common for the word "hospice" to come up in conversations with co-workers, neighbors, family and friends.

But do you really understand what hospice is, how it works and who is eligible to use the program?


The Gazette asked Lisa Brown, community relations manager of Agrace HospiceCare, and Nancy Bracken, director of Mercy Hospice Care, to answer these questions:


Q: What is hospice?
Bracken: It is an approach to caring for terminally ill individuals that stresses relief of pain and uncomfortable symptoms. This philosophy helps them live out the time they have remaining to the fullest extent possible. Hospice does not shorten or prolong life. Rather it focuses on comfort care, not curing the illness.
Brown: Hospice care is a form of palliative care that allows patients to remain independent at home while focusing on comfort rather than cure.

In addition to nursing care, hospices provide spiritual support and the assistance of social workers, dietitians, physicians and bereavement counselors.


More than 95 percent of Agrace services are provided in the patient's home or the place they call home, such as a long-term care facility.


Q: Who is eligible?
Brown: Hospice is available to anyone with a life-limiting condition and a prognosis of six months or less.

Anyone can refer a person to hospice. It doesn't need to be a physician who makes the initial call to Agrace.


Bracken: The patient must have been diagnosed with a life-limiting diagnosis. Hospice care is not limited to just patients with cancer. The physician must certify that the patient has a life expectancy of not more than six months. Their attending physician then refers the patient to hospice.
Q: What services does your hospice

provide?


Bracken: The care is provided by a specially trained team that cares for the "whole person" including his or her physical, emotional, social, and spiritual needs. In addition, the family is of equal concern to the hospice team.

The team consists of the physician, registered nurses, medical social workers, certified nurse aides, chaplains, bereavement counselors, volunteer coordinators and volunteers.


The nurses and nurse aides provide nursing care on an intermittent basis. Needed medical equipment and medical supplies are covered as needed. All drugs used for symptom control or pain relief and any medications related to the admitting diagnosis are provided by hospice.


Any physical or occupational therapy that may be needed to increase endurance also is covered. Short-term respite—up to five days—is provided to allow rest for the primary caregiver. Short-term inpatient care is provided for symptom control in Mercy Hospital and Trauma Center. On call, 24-hour, seven-day-a-week professional services are available for support and care as needed.


Brown: Agrace's interdisciplinary team of experts in pain and symptom management cares for patients daily throughout south central Wisconsin—Dane, Rock, Green, Jefferson and Walworth Counties—helping them meet their end-of-life goals.

Agrace has a team of medical directors, nurses, social workers and chaplains available to answer questions or make home visits to patients seven days a week year around.


If symptoms cannot be managed at home and require a short-term stay in a medical environment, Agrace's inpatient unit in Fitchburg provides a homelike setting.


The inpatient unit also provides respite care so at-home caregivers can have a short break to rejuvenate and care for themselves while their loved ones are being taken care of by Agrace.


Grief support programs offered by Agrace HospiceCare are free to anyone in the community, regardless if Agrace has served them.


More than 1,100 volunteers help enhance the quality of life of Agrace patients through direct care programs such as life-review, vigil and companion services.


Q: Who pays for these services/programs?
Brown: Medicare, Medicaid and most private insurances pay for Hospice. Community support provided through the Agrace HospiceCare Foundation ensures that no one is turned away because of an inability to pay.
Bracken: Hospice services are paid for by Medicare, Medicaid, private insurance companies and self-pay. No patients are denied services from Mercy Hospice Care because they can't pay.
Q: What are the benefits of choosing a hospice for your loved one?
Bracken: The philosophy of Mercy Hospice Care emphasizes comfort, dignity and quality of life. It allows our patients and families to be empowered to achieve as much control over their lives as possible. A patient is able to die free of distressing and uncomfortable symptoms in the comfort of his or her own home surrounded by family and loved ones.

In addition, surviving family members and significant others are supported through their grieving process for 15 months after the patient's death.


They are offered bereavement mailings, one-on-one counseling sessions and bi-monthly support group meetings. Quarterly memorial programs are held to celebrate the lives of patients who have died as well as to re-connect with the surviving families.


Brown: Hospice brings compassion, comfort and dignity to the dying process by supporting both the patient and his or her loved ones.

When physical, emotional and spiritual needs are addressed through quality care, studies have shown that hospice patients live one month longer, on average, than non-hospice patients with the same illness.


On a national level, hospice helps reduce health care costs by bringing a care team to a person's home rather than the person traveling to the hospital when their illness requires medical attention.



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