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Residents and hospice care

June 6, 2010
by Kathleen Mears
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After being here for two years with hospice care, Mr. H. has outlived it. On his last day the hospice aide was crying as she said goodbye to the charge nurse. She was here two days a week and took Mr. H. for a walk and then gave him a shower. During most of her visits his wife followed behind encouraging him and pushing his wheelchair. The facility aides will take good care of him, but he will also miss his hospice aide and the time she spent with him.

Outliving hospice services is a strange situation that has happened to other residents here. Some thrive with the one-on-one care provided by hospice and if they live too long they are dropped from the program. Then there are no hospice services available at the end of their lives.

Twenty four years ago, requesting hospice care was like sounding the death knell. My cousin used it when she was dying of breast cancer. Hospice volunteers stayed with her constantly until she passed away. It was a great comfort to her and her parents who were in their 70s. Hospice also allowed her to remain in the familiar surroundings of her parents' home.

Several years later hospice changed its guidelines, so more people were eligible for hospice services. I remember asking a friend who was a hospice nurse how she felt about the changes in the program. She said they were positive and allowed hospice to serve families and assist them to get through the terminal illness of a loved one.

Some family members told me they could not even consider using hospice services. They said they were unable to sign the paperwork. They felt they were giving up on their loved one. That is probably the reason not many families use hospice care.

Recently, a resident of many years became unresponsive due to his terminal illness. His family moved him to a hospice facility so that they could be with him in a different environment until he passed away.

Deciding to use hospice care is probably a difficult decision to make. But because hospice provides services that would not necessarily be provided by the nursing home, family members may choose it so that they feel they have done the most they can for their loved one.

But there will always be residents who will improve because of hospice care and defy the prognosis they have been given.

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I am a Hospice Administrator. A client that had hospice 2 years prior and was discharged off of hospice services due to improved health does not mean that they cannot be re-admitted to hospice services. Medicare guideline state you can re-admit a client back on hospice service at end of life as many times as needed as long as they meet Medicare hospice criteria. Review Hospice Medicare Regulation #418.21

Kathleen Mears

www.ltlmagazine.com/blog/kathleen-mears

Kathleen Mears has been a nursing home resident in Ohio for 20 years. She is an incomplete...