Hospice is defined as a model and philosophy of care that focuses on providing palliative care to patients with terminal illness, focusing on decreasing patients’ pain and other symptoms, attending to their and their family/loved one's emotional and spiritual needs, and providing support for their caregivers.  These services are available as part of the decision- making process with your primary care physician, care planning in long term care facility, or part of the discharge planning process within the hospital setting.

          It is important to consider Hospice care for an individual who is first entering the last weeks to months of life and second the individual who has decided to forego additional therapies that offer life-prolonging treatments with the focus on maximizing comfort and quality of life.

          Hospice is offered in various settings. Services offered by hospice include caring for both the patient and offering support for family members. Other services included symptom control and management, psychosocial and spiritual care, nursing, and bereavement care.

          Hospice team members include physicians, advance practice clinicians, nurses, pharmacists, social workers, chaplains, and other providers whose goals are to help provide maximal quality of life measures for those individuals with advanced or terminal illness who are no longer receiving life prolonging care.

           There are certain limitations to hospice. The primary limiting factor is the patient, specifically if the patient and/or the family is not be ready for hospice. This is where it is important to consult with the Hospice care team for guidance. Secondly, Medicare provides a fixed sum of money from which all provided medical care is to be paid. The limitations to insurance coverage include the lack of insurance coverage for some expensive palliative treatments for the terminal illness, including specific anticancer treatments, radiation therapy, and dialysis. There are also services that can be offered. Some hospice companies offer personal care services that can be covered by other insurances such as Medicaid or VA. However, patients may leave and return to the hospice program at any time, as long as they continue to meet the eligibility criteria (including a prognosis of under six months). This prognosis does not mean that the patient will pass in six months. It means that they have chronic conditions such as COPD, Cancer, or Dementia that if left untreated will end their life in six months or less. Patients can receive hospice services for extended periods of time as long as they meet the recertification criteria (i.e. weight loss, falls, infection, pain medication management changes).

           In conclusion, hospice can be an avenue for patients to consider depending on where they are in their disease process and how they would like to have their care managed. Hospice provides options for both families and patients with many services to choose from that can be individualized with emphasis placed on maximizing comfort and quality of life.

Vallerie Jain, MD, is accepting patients at White River Health Family & Specialty Care (Batesville: 870.262.1530) and at White River Family Care (Newport: 870.512.2500).