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HOSPICE
A team of compassionate, specially trained caregivers assist, support and comfort the dying patient and their family. This is a comprehensive program of care provided by physicians, nurses, counselors and other professionals designed to keep the patient comfortable and alert at home, while emotional support is given to all family members. An Interdisciplinary Team approach is used to provide hospice care. The team is made up of the patient, a primary caregiver (family or friend of the patient), patient's primary physician, the hospice medical director (a physician), a nurse, social worker, chaplain, and volunteer. Other possible members of this team include a personal care aide, homemaker and physical, occupational or speech therapist. All treatment measures are designed to promote comfort. The goal of hospice is to respectfully permit the patient to remain fully alert and functioning within the family network at home while experiencing little or no symptoms of the disease. Some call this "quality of life". We call it the right to live fully right up to the last moment.
 
Nursing Service
Description of Service:
Professional nurses who provide services to patients in the privacy of their own homes under the direction of their personal physician and/or the hospice medical director. Care is provided to maintain patient comfort without sedation when pain is a concern. Other symptoms of illnes, such as nausea, constipation, shortness of breath, fatigue, etc are addressed as needed. The Patient and primary Caregiver are instructed in use of all comfort measures and what to expect as the disease progresses. Nurses answer questions and provide loving support and encouragement. They give of their knowledge, their hearts, and their hands at all times.

 
Eligibility Requirements:
To qualify for hospice care, the patient must have a doctor's signed diagnosis of a terminal illness with six months or less life expectancy, a decision to forgo any curative treatment, a willing and able caregiver (family member or friend) when unable to be alone, and a preference to die at home.
Additional Notes:
A nurse will visit with you and your family to answer your questions about hospice care before a decision must be made to choose this type of care. It is recommended that anyone you want involved in making this decision be present during this informational visit so all questions can be answered to your satisfaction.  
 

 

Physician Supervision
Description of Service:
The Hospice Medical Director is a licensed doctor knowledgeable in pain control and other relief measures.  He will direct care you receive or advise your personal physican, according to your preference and the desire of your doctor.  Most personal physicians prefer to let the Hospice team physicians prescribe pain and comfort relief measures as this is a speciality in medicine they may not feel as adept at.  
Eligibility Requirements:
Medicare and Medicaid eligibility guidelines are followed.  Many insurances now cover Hospice Services too.

Social Service
Description of Service:
The social worker will make an assement visit and any follow-up visits that you want.  The PATIENT AND FAMILY receive assistance in identifying and coping with the concerns facing them as end-of-life decisions must be made.  The social worker compassionately supports the patient as they prepare their family for continued life.  Assistance is given in making funeral arrangements if desired.  Expression of love are shared and dreams fulfilled as much as time will allow.  The Social Worker must keep in contact by phone or visit at least every two weeks and then will follow the family for thirteen months following the death of their loved one to provide any assistance necessary.
Eligibility Requirements:
Medicare and Medicaid eligibility guidelines are followed. Many insurances now cover Hospice Services too.
 
The patient and family are encouraged to begin hospice services as soon as a terminal diagnosis has been made as there is much to do to prepare and there is seldom enough time to compete the work.  Many physicians have a difficult time telling a patient their true prognosis.  They want more than anything for their patient to live.  Ask your doctor to tell you the truth (if you want to know it) so that you will have more time to do what you want to do.  Actually, Hospice care has been known to increase the time a person has to live.  It almost always improves the quality of the time left, if started early enough. 
 
Pastoral Care
Description of Service:
Services of a pastor will be arranged for any family requesting this service. Spiritual concerns are addressed by the Hospice Chaplain at the request of the patient. Spiritual advice is not forced on anyone. No denomination is encouraged over any other. The patient's needs and desires are respectfully acknowledged. The Hospice Chaplain will make initial contact with each patient. Any additional contact will be at the request of the patient or family.
Eligibility Requirements:
Medicare and Medicaid eligibility guidelines are followed.
Additional Notes:
No one is urged to accept the beliefs of another. Support and encouragement in your chosen faith are offered.
 
 
Personal Care Aide
Description of Service:
Personal hygiene care, such as a bath, shampoo, shave and other grooming, makes one feel good and look better.  The Aide provides care in the unhurried, private atmosphere of your home.  The amount of care provided is determined by what you feel and want at that time.
Eligibility Requirements:
Medicare and Medicaid eligibility guidelines are used for most payment sources.
Volunteer
Description of Service:
The hospice volunteer has been trained to respond to you in a way only a friend can.  the volunteer GIVES YOU TIME to talk, to remember, to think, to act, to sleep.  The volunteer will BE THERE WITH YOU and for you so that your primary caregiver can go to the store, the bank, the post office, the beauty shop/barber, pick the kids up from school, go to church or any place else knowing that you will not be alone.  The volunteer WILL BE THERE FOR YOU.  The volunteer will GIVE TO YOU and will GIVE TO YOUR FAMILY without ever expecting anything in return. 

 
Medications, Equipment and Medical Supplies.
Description of Service:
VNA Hospice provides all medicines, equipment (such as a hospital bed, etc.) and medical supplies (such as catheters and bandages) related to the terminal illness.
Eligibility
Requirements:
A licensed physician must write prescriptions. The Interdisciplinary Team can and do recommend options for Patient choice. Medicare and Medicaid eligibility guidelines are followed.  Many insurances now cover Hospice Services too.  

Additional  Notes:

 Prescriptions, equipment and supplies are most often provided by VNA Home Medical Equipment to avoid delays, especially after hours, and to reduce expenses. VNA Hospice makes every effort to comply with Patient wishes.
   
Therapy Services
Description of Service:
Physical Therapy, Speech Therapy, Occupational Therapy are given only as comfort measures.  No attempt is made to begin an exercise program that will benefit the patient in no way except to exhaust them.  In some cases, brief periods of exercise or therapy have eased some discomfort such as backache or muscle spasms.  Threapy is provided ONLY as a relief from discomfort.
Eligibility Requirements: Medicare and Medicaid eligibility guidelines are followed.  Many insurances now cover Hospice Services too.
   
Housekeeping Services
Description of Service:
Light housekeeping assistance may be provided as a comfort measure for the patient and as an aid to the primary caregiver.  Housekeeping support for a few hours each week to do routine housework frees the primary caregiver so they can spend more time with their loved ones.
Eligibility Requirements:
The Interdisciplinary Team must recommend and approve such assistance.
Levels of Hospice Care
 
 
I.  Routine Care
Description of Service:
A plan of care is designed specifically to meet your needs each day. Your personal preferences as well as medical, spiritual and sociological needs are taken into consideration in developing your plan of care. It is changed as your needs change.
Eligibility Requirements:
The interdisciplinary team will discuss your needs with you and offer all available support.
Additional Notes:
The Patient and Family are instructed to contact the Hospice Nurse at any time of the day or night should a need or question arise that requires attention before the next regularly scheduled visit. Every effort is made to maintain you comfortably in your own home despite ongoing changes in your needs. Medication and equipment is often ordered and available for your use before you need it to avoid late night and weekend disruptions to your comfort. You will be asked to call your VNA Hospice nurse BEFORE calling an ambulance as most needs can be met more quickly and more comfortably at home. Should hospitalization be necessary, your nurse can facilitate your admission to avoid unnecessary procedures or delays in the hospital admission process.
  
II.  Inpatient Care
Description of Service:
Short periods of inpatient care may be provided for acute symptom control (i.e. General Inpatient Services) or to permit a day or two of rest for the family caregiver (i.e. Inpatient Respite Services).
Eligibility Requirements:
The interdisciplinary team will discuss your needs with you and offer all available support.
Additional Notes:
The Patient and Family will be instructed to contact the Hospice Nurse BEFORE calling an ambulance for transport of the patient to a hospital or nursing facility. This is to avoid the discomfort and the delays often encountered in busy emergency departments. Arrangements made by the Hospice Nurse will also bypass any unnecessary procedures (such as lab work and X-rays) considered routine in most hospitals.
 
 
III.  Continuous Care
Description of Service:
During a medical crisis, the Patient may benefit from a brief period of continuous home nursing. Staffing is arranged as necessary to best meet the needs of the Patient. This service is most often needed during the last hours or days. In all cases, the Patient has requested to be allowed to stay in their own home if at all possible. The Patient's comfort and well-being are the primary concern.
 
 
IV.  Bereavement Support
Description of Service:
For 13 months following the death of a loved one, VNA Hospice provides support and encouragement for the family and close friends. Memorial Services are held at least once every year in more than one area for the convenience of those wishing to participate. Support Groups form and disband as the needs arise.
Additional Notes:
Call to request information or a support group to meet your needs. 1-800-286-5892.
Payment Methods:
Medicare, Medicaid, Private Insurance, Private Purchase and Charitable Contributions are used to purchase all hospice services provided.


 

 

Email: cbryant@vnasemo.com