Many Americans die in institutions such as hospitals or nursing homes, and some elderly people receive care that does not match their wishes. It is important for older adults to plan ahead and let their caregivers, doctors, or family members know about their end-of-life preferences. For example, if an older person wants to die at home, chooses hospice care for pain and other symptoms, and makes this known to health care providers and family, the likelihood of dying at a hospice hospital reduces unnecessary waste of treatment resources.
If the person is no longer able to make health care decisions for themselves, those decisions may have to be made by a caregiver or family member. Caregivers need to consider several factors when choosing hospice care, including the older person's desire to seek life-extending treatment, how long they can live, and the preferred care environment.
What is palliative care?
Palliative care is a specialized medical service for people with serious medical conditions such as cancer or heart failure. Patients undergoing palliative care may receive medical care or palliative care tailored to their symptoms, as well as treatments aimed at curing their serious illness. Palliative care aims to enhance an individual's current care by focusing on the quality of life of the individual and their family.
Who can benefit from palliative care?
Palliative care is a resource for anyone with a serious medical condition, such as heart failure, chronic obstructive pulmonary disease, cancer, dementia, Parkinson's disease, and many other conditions. Palliative care is helpful at any stage of the disease and is best provided as soon as possible after the patient is diagnosed.
In addition to improving quality of life and helping relieve symptoms, palliative care can also help patients understand their medical options. Organized services provided through palliative care may be helpful to any older person who has a lot of general discomfort and disability in their later years.
Who makes up the palliative care team?
The palliative care team is made up of a number of different professionals who work with the patient, family members, and other doctors of the patient to provide medical, social, emotional, and physical support. The team consists of specialist doctors and nurses who provide palliative care, as well as other staff such as social workers, dietitians and pastors. A person's team may vary depending on their needs and level of care. To begin palliative care, a person's healthcare provider may refer them to a palliative care specialist. If they do not recommend it, the person can ask for a referral from a healthcare provider.
Where is palliative care provided?
Palliative care can be provided in hospitals, nursing homes, outpatient palliative care clinics and certain other specialist clinics or at home. Medicare, Medicaid and insurance policies may cover palliative care. Veterans may be eligible for palliative care through the Department of Veterans Affairs. Private health insurance may cover the cost of certain services. Health insurance providers can answer questions about what they will cover.
Visit the National Hospice and Palliative Care Organization website to find palliative care https://laterlifeglobal.top/go/?url=aHR0cHM6Ly93d3cubmhwY28ub3JnL2ZpbmQtYS1jYXJlLXByb3ZpZGVyLw%3D%3D near you
Adriana's story
Adriana developed anemia while undergoing breast cancer treatment. A palliative care specialist recommended her blood transfusions to control her anemia and relieve some of the fatigue she was experiencing. Controlling her symptoms helped Adriana continue her radical chemotherapy. Treating her anaemia was part of palliative care.
In palliative care, a person does not have to give up treatment that may cure a serious illness. Palliative care can be provided alongside curative care and can begin at the diagnostic stage. Over time, if the doctor or palliative care team decides that the ongoing treatment is no longer helpful, there are two possibilities. Palliative care can transition to hospice if the doctor believes the person is likely to die within six months (see What does the six-month hospice requirement mean?). ）。 Alternatively, the palliative care team can continue to help increase the emphasis on comfort care.
What is hospice?
More and more people are opting for end-of-life care at the end of life. Hospice care focuses on the care, comfort, and quality of life of seriously ill patients near the end of life.
Hospice care is designed for situations where, at some point, a serious illness may not be cured, or a patient may choose not to receive certain treatments. Patients who begin hospice care understand that there is no way to cure him or slow the progression of the disease by trying to do it.
Like palliative care, hospice provides comprehensive comfort care as well as support for the family, but in hospice, attempts to cure the patient's illness stop. Hospice care is provided for people with terminal illnesses. If doctors believe that if the disease is allowed to develop naturally, he will only live for six months or less, hospice care will be triggered.
It is important for patients to discuss end-of-life care options with their doctor. Sometimes, people don't start hospice care quickly enough to make the most of it to help everyone. Or some people may not benefit fully because they are not eligible for end-of-life care as soon as possible. Starting end-of-life care early may be able to provide months of meaningful care and quality time with loved ones.
Where is hospice provided and who provides it?
Hospice care is a method of care, so it is not limited by a specific location. It can be offered in two types of settings – at home or in a facility such as a nursing home, hospital, or in a separate hospice.
Hospice teams bring together a group of people with special skills – including nurses, doctors, social workers, spiritual counsellors, and trained volunteers. Each person works with the dying person, caregiver, and/or family to provide the medical, emotional, and spiritual support needed.
A member of the hospice team visits regularly and is usually available by phone 24 hours a day, 7 days a week. Hospice care may be covered by Medicare and other insurance companies. Check if the insurance covers the person's special circumstances.
Dolores' story
Choosing end-of-life care doesn't have to be a permanent decision. For example, Dolores was 82 years old when he learned of his kidney failure. She thought she had lived a long, good life and didn't want to undergo dialysis, so Dolores began hospice. A week later, she learned that her granddaughter was pregnant. After talking to her husband, Dolores changed her mind about using hospice care and began undergoing dialysis, hoping to see her first great-grandchild one day. Shortly after the baby was born, doctors said Dolores' blood pressure was too low. That's when she decided to re-enroll in hospice.
It is important to remember that stopping treatments aimed at curing a disease does not mean stopping all treatments. A good example is older adults with cancer; If doctors determine that cancer development does not respond to chemotherapy and the patient chooses to go into hospice, chemotherapy is stopped. Other medical care may continue as long as it helps. For example, if the person has high blood pressure, Ta will still take medication for it.
Source: www.nhpco.org/palliativecare/explanation-of-palliative-care. © Copyright National Hospice and Palliative Care Organization.
While hospice care provides a lot of support, the day-to-day care of people dying at home is mostly provided by family and friends. The hospice team instructs family members on how to care for the dying person and even provides respite care when caregivers need to rest. Respite care can be as short as a few hours or as long as several weeks.
Advance care planning and end-of-life decisions
When a person is diagnosed with a serious illness, they should prioritize early advance care planning conversations with family and doctors. Studies have shown that patients who participate in advance care planning are more likely to be satisfied with their care and receive care that meets their wishes.
PREPARE for Your Care, partially funded by the National Institute on Aging, is an interactive online program that helps people fill out advance directives and express their wishes in writing. The tool is available in English and Spanish.
What are the benefits of hospice care?
Family members of people who received care through hospice programs were more satisfied with the end-of-life event than those who did not receive hospice services. In addition, people who received hospice care were more likely to be able to manage their pain and less likely to receive further tests or take medications they no longer needed than those who did not use hospice care.
What does the six-month hospice requirement mean?
In the United States, people enrolled in Medicare can receive end-of-life care if they believe that the disease is allowed to continue and the patient has less than six months to live. It is difficult for doctors to predict how long an older patient will live. Health often declines slowly, and some people may need help with daily living for more than six months before they die.
If they think a hospice program might help, they should talk to their doctor. If Ta agrees, but believes it's too early for Medicare to cover these services, then the person can investigate how to pay for the services needed.
What happens if a person receiving hospice lives longer than six months?
If the doctor continues to prove that the person is still dying, Medicare can continue to pay for hospice services. If the health care provider still believes the patient is less than six months old, they may also choose to leave hospice for a period of time and come back.