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FAQs about hospice, home care answered

Posted on Monday, November 25, 2013 at 2:57 pm

With increased attention being focused on ways to decrease health care costs and provide care in the most cost effective ways possible, patients and their families may have many questions about health care and home care in particular.

Donna Giovinazzo and Brenda Monks, nurse techs with Lincoln Medical Home Health and Hospice, pause for a photo as part of National Home Care and Hospice Month. Home Health Aide Week was a recent week celebrated during the month.

Donna Giovinazzo and Brenda Monks, nurse techs with Lincoln Medical Home Health and Hospice, pause for a photo as part of National Home Care and Hospice Month. Home Health Aide Week was a recent week celebrated during the month.

The theme for National Home Care and Hospice Month for 2014 is “Home is the Center of Home Care”, and for good reason. Studies show that home care can be very cost effective and can decrease costly admissions and readmissions to a hospital. Sometimes families and caregivers need support to help an elderly loved one remain in the home. Some individuals need help with bathing, light house work or meal preparation. Some patients who are discharged after a hospital stay need the skilled support of a nurse or therapist to recover.

Patients also may have difficulty managing their medications or understanding how to monitor blood sugars or provide wound care. Other families may be concerned about the deteriorating status of a patient, and what types of support can be provided to allow the patient to stay at home until the end of life.

Lincoln Medical Home Health and Hospice offers answers to some of the most frequently asked questions about home care.

What is home health?

Medical Home Health is a physician ordered service designed to enable patients to maximize their ability to function safely at home by teaching patients and their caregivers how to provide effective, appropriate care. Symptom management, medication management, infusion therapy, wound therapy, mobility, and home safety issues are among the many needs covered. The goal is to assist the patient and caregiver to learn to care for themselves and eventually manage their own care, whenever possible.

How do I qualify

for home health?

Your physician must determine your need for home-based care and write an order for the care. Medicare, Medicaid, and most private insurance companies have homebound and skilled needs requirements. Medicare patients must also have a documented visit with a physician within 90 days prior to the start of home care or 30 days after the start of home care. This visit with a physician must be related to the need for home health services.

What does it mean to be “homebound”?

Does this mean I can’t ever leave my home? You are considered “homebound” if you have difficulty leaving home by yourself, require great assistance to leave home, and/or do not leave home frequently, due to your medical condition. An occasional trip to the barber shop, beauty parlor, church services, or a physician’s appointment is ok. Driving yourself to the store, frequent outings to non-treatment type locations would indicate that you don’t need services provided in your home.

What does it mean to have “skilled” care services?

Medicare regulations define “skilled services” as services that must be performed by a professional clinician that are reasonable and necessary for the treatment of your illness or injury. For example, care provided by a registered nurse or licensed therapist is considered “skilled”. The Lincoln Medical Home Health and Hospice team will determine with you and your physician the kind of skilled care you will need.

Is medical home health daily or 24 – hour continuous care?

No. All care is intermittent, with the frequency of visits determined by the physician and home health clinician. Typically, visits are 30 minutes to an hour long (depending on your needs) and from one to three times per week. While some patients will require daily visits if ordered by the physician, this is NOT typical. Nurses teach the patient and/or caregivers how to provide care when possible. For patients with private insurance or some Medicare Advantage plans, the total number of visits that will be covered is determined by the insurance company.

What if I need someone to help me with personal care at home?

If you also need skilled services, then the home health agency can provide a Home Health Aide to assist you with personal care on an intermittent basis. If you do not require any skilled services, but only want someone to provide personal care or stay with the patient several hours a day, then you need non-medical home care that can be provided by a personal sitter or private duty non-skilled home care agency. Although Lincoln Medical Home Health does not provide sitter or homemaker services, our staff is familiar with these resources and is available to help you research the availability of these services.

What is Hospice Care?

Hospice care is a type of home care that is provided to patients who have been diagnosed with a terminal illness and who have a limited life expectancy. Patients and families who choose hospice care have determined that they no longer wish to pursue aggressive curative treatment for their disease, but want to focus on comfort care and caregiver support. Hospice services are provided by an interdisciplinary team composed of nurses, a physician, hospice aides, social workers, a bereavement coordinator, volunteers and pharmacists.

Isn’t hospice care for cancer patients?

No. Hospice is for patients with a terminal disease, weather that disease is cancer or other end stage conditions. Patients must meet medical criteria that determine their eligibility to receive hospice care. A large number of hospice patients have advanced dementia, congestive heart failure, chronic lung disease, end-stage liver disease, or other conditions. Hospice patients do not have to be homebound and are encouraged to be as active as possible for as long as possible.

Is it true that once a patient elects hospice that they will die very soon?

This depends on the patient’s condition when admitted to hospice. If the patient is extremely debilitated or actively dying at the time of admission, then a stay with hospice can be limited to a few hours to days. However, receiving hospice care does not mean giving up hope or that death is imminent. The earlier an individual receives hospice care, the more opportunity there is to stabilize his or her medical condition and address other needs. The emphasis of hospice care is symptom management and pain relief to provide the optimum quality of life for the patient and support for the family.

Can I continue to use my own doctors once I start hospice?

Patients may keep their own physician, who will work closely with the Hospice Medical Director to plan and carry out care. Patients typically do not continue to make visits to their doctor, but call the Hospice agency to meet their needs and communicate with their physician(s). If a hospice patient improves and chooses to resume aggressive treatment, then hospice can be revoked and the patient resumes care under his or her physician.

Where can a patient

receive hospice care?

Although some hospices are inpatient facilities, routine hospice care usually takes place in the comfort of home, but can be provided in any environment in which an individual lives, including assisted living facilities and nursing homes. Currently, Lincoln Medical Home Health and Hospice provides hospice care in the patient’s home, assisted living facilities and at Donalson and Lincoln Care Centers.

How is hospice care paid?

Hospice care is a Medicare benefit. Most private insurers also cover hospice care as well. The benefit will pay for all care, equipment and medications associated with the patient’s terminal diagnosis. Lincoln Medical Home Health and Hospice is committed to caring for all patients, regardless of an individual’s ability to pay.

The public is encouraged to call the agency at (931) 433-8088 or visit the website for Lincoln County Health System at http://www.lchealthsystem.com/ .. This website provides answers to questions about not only home health and hospice care, but the many services offered by the Health System. Questions can also be mailed to susie.compton@lchealthsystem.com or debbie.kilpatrick@lchealthsystem.com.