Quality Hospice Care Improves Over Time

10/09/2009

It takes time to deliver to patients all that the Medicare Hospice Benefit offers.

 

America’s hospice programs are being rushed. Short-stay patients,  those referred for hospice care mere days before death, typically are in a state of acute medical, emotional and family trauma. Hospices only have time for emergency medical response, family crisis intervention and hurried attempts to maximize quality of life in the few precious days before the patient dies.

 

Although the Medicare Hospice Benefit is intended to provide comprehensive, quality care to those who are expected to live six months or less, half of all hospice patients nationwide receive only three weeks of care before they die. A third of hospice patients receive care for less than one week, according to the National Hospice and Palliative Care Organization.

 

That crisis-management approach is in sharp contrast to the hospice ideal: building trusting relationships; controlling distressing symptoms such as pain; encouraging meaningful emotional closure for loved ones; and facilitating a peaceful dying experience for the patient and grief support for loved ones.

 

As important as crisis support is, hospice is about living. While hospice can work miracles when someone is referred in crisis, we can do so much more for patients and families if we're given three weeks—or better yet, three months—instead of three days to provide care. The more time the hospice team has to support the patient and family, the better the quality of life for the patient and the better the memories for loved ones following the death.

 

Customizing care to meet end-of-life needs

 

Hospice interdisciplinary team members care for each patient as an individual; his or her needs always come first. That kind of service reduces family calls to their physician’s office and prevents unnecessary trips to the emergency department. “And hospice provides timely communications to patients’ physicians,” adds Joel Policzer, MD, VITAS senior vice president and national medical director, “so they are never out of touch.”

 

VITAS Telecare support ensures that the patient and family have 24-hour direct access to experienced hospice staff, adds Policzer. Just a phone call away, these professionals can be a reassuring voice at 3 a.m., and they also can assess, advise and dispatch clinicians in moments.

 

When there is a crisis or a spike in symptoms VITAS Intensive Comfort Care® staff offer up to 24 hours per day of medical management in the patient’s home, where most people hope to remain at the end of life.

 

Caring for body, mind & soul

 

With time to get physical pain under control, there also is time to evaluate psychosocial pain. “Patients often learn to embrace this important stage of life, making connections, repairing relationships, rediscovering simple pleasures and making their peace with death,” says VITAS Social Worker Lori Reardon, MSW. “Hospice helps patients live each day.”

 

When the end comes, VITAS’ goal is not to let any patient face death alone, Reardon adds. “Members of the team gather to be with their patient and to support loved ones at the final moments, and for a year or more after-ward. We help families to grieve, to live and to remember.”

 

By Pippa Steinhart, RN, General Manager, VITAS Innovative Hospice Care® of Collier County. VITAS works with healthcare professionals in Collier County to bring quality of life to patients at the end of life. For more information, contact VITAS at 866.928.4827