If you have a question about The Carpenter Health Network, feel free to contact us or browse the Frequently Asked Questions using the categories on the left.
St. Joseph Hospice
Where can hospice services be provided?
Hospice can be provided wherever the person is residing, such as: their home, a nursing home, an assisted living community, a hospital, or hospice.
How much will hospice services cost?
Medicare beneficiaries pay little or nothing for hospice, and most insurance plans, HMOs, and managed care plans include hospice coverage.
How long can hospice care be provided?
Hospice patients and families can receive care for six months or longer, depending on the course of the illness.
Does choosing hospice mean giving up?
Hospice focuses on living; living as fully as possibly up until the end of life and aggressively managing symptoms such as pain. With hospice care, the focus changes from trying to cure the underlying disease to treating the symptoms caused by the disease, so that the patient is comfortable.
Can hospice care prolong the life of someone diagnosed with a terminal illness?
Hospice and palliative care may prolong the lives of some terminally ill patients. In a 2007 study, the mean survival was 29 days longer for hospice patients than for non-hospice patients. In other words, patients who chose hospice care lived an average of one month longer than similar patients who did not choose hospice care. Longer lengths of survival were found in four of the six disease categories studied.
The largest difference in survival between the hospice and non-hospice cohorts was observed in congestive heart failure patients where the mean survival period jumped from 321 days to 402 days.
The mean survival period was also significantly longer for hospice patients with lung cancer (39 days) and pancreatic cancer (21 days), while marginally significant for colon cancer (33 days). Source: Connor S.R., Pyenson B., Fitch K., Spence C., Iwasaki K. Comparing hospice and non-hospice patient survival among patients who die within a three year window. Pain Symptom Management; 2007 March; 33(3):238-46.
Does hospice require switching doctors?
The primary doctor can continue to follow and be involved in the patient’s care. The Carpenter Health Network has physicians who are board-certified in hospice and palliative care, who are available to assist the primary physician in the care of the patient.
Is hospice care only for those diagnosed with cancer?
No. Hospice services are available for anyone who has a life-limiting illness. People who suffer from heart disease, dementia, stroke, lung disease, liver failure and renal failure may be eligible. Over fifty percent of hospice patients have illnesses other than cancer.
Is hospice the same as traditional home health (THH)?
No. The focus of THH is rehabilitative, while the focus of hospice is comfort care and the enhancement of quality of life. Hospice provides volunteers, chaplains (spiritual care counselors), around-the-clock clock bedside care (continuous care), and up to 13 months of bereavement services. THH does not provide these services. THH visits are usually 1-2 times per week where hospice visits can average 4-5 times per week.
Is hospice the same as palliative home health (PHH)?
No. PHH combines the medical model of THH and the psychosocial model of hospice and is provided to those patients who wish to continue curative treatment such as chemotherapy, radiation, and dialysis. PHH visits are performed by palliative care trained staff, visit duration is much the same as hospice, and cases are reviewed weekly by a palliative care team, just like hospice. The main difference between hospice and PHH is the frequency of visits. While hospice staff may see a patient 4-5 times per week, PHH visits, though longer in duration, are more similar to THH (1-2 times per week). Hospice also offers around-the-clock bedside care (continuous care), if needed. For more information about PHH, visit AIM Home Health.
Does hospice provide much in the way of services?
Besides our most important asset, our staff, hospice also provides medications, equipment (such as oxygen), and supplies related to symptom management of the terminal illness.
Is it possible that there’s no hospice agency in my area?
Less than one percent of Medicare beneficiaries live in an area where hospice is not available.
Are hospice services for the patient only?
Hospice provides support to the patient, family members, and caregivers. Up to 13 months of bereavement services such as telephone calls, cards, and memorial services are available to loved ones.
What criterion is necessary to be admitted to hospice service?
To qualify for hospice care, the following conditions must be met: 1) Two physicians must agree that the patient has an estimated life expectancy of six months or less, if the illness runs its normal course; 2) The patient and family desire palliative care; 3) A physician has been identified to coordinate care of the patient and the patient must reside in agency’s service area.
What are some of the diagnoses of patients who receive hospice care?
Diagnoses may include: cancer; chronic obstructive pulmonary disease; heart disease; dementia (Alzheimer’s); end stage renal disease; stroke; end stage liver disease; failure to thrive; unspecified debility; Lou Gehrig’s disease; Parkinson’s disease; and AIDS.
What is an advanced directive?
An Advanced Directive is a document that provides a person the opportunity to give directions about future medical care. It can also serve as a legal document designating another individual (proxy or health agent) to make decisions for you if you are unable to make those decisions yourself. This document will express your wishes if you become incapacitated. It covers your specific preferences for the kind of medical treatment you want or don’t want. It contains how you want people to treat you, and what you want your loved ones to know. NOTE: Advanced Directives are not necessary for a patient to receive AIM Palliative Home Health.
What types of advanced directives are there?
- A Medical Power of Attorney for Health Care: This type of advanced directive allows you to name an individual to make health care decisions when you are not able to do so. This person may also be referred to as a proxy or health care agent.
- Living Will: A living will specifies whether you would like to be kept on artificial life support if you become permanently unconscious or dying and unable to speak for yourself.
- Do Not Resuscitate/DNR Order: A DNR order exists in a written order from a doctor or in a living will, and states that resuscitation should not be attempted if a person suffers a cardiac or respiratory arrest. A DNR order is commonly created when a person who has an inevitably fatal illness wishes to have a more natural death without painful or invasive medical procedures that will not reverse the outcome of the terminal illness.
- LaPOST document: Created with input from health care and legal professionals across the state and approved in 2010 by the Louisiana Legislature as Act 954, the Louisiana Physician Orders for Scope of Treatment (LaPOST) document is a best-practice model for patients with serious, advanced illnesses to state their preferences for end-of-life treatment in a physician’s order. Learn more about LaPOST at http://www.lhcqf.org/.
How does hospice manage pain?
Hospice physicians and nurses are experts at pain and symptom control. They are continually developing new protocols for keeping patients comfortable, alert, and as independent as possible. Nurses trained specifically in palliative care know which medications and combinations provide the best results for each patient.
What is home health care?
Home health care refers to any type of medical care that is provided to the patient in their home. Home health care usually includes assisting persons who are recovering from illness, injury or surgery; those who are disabled or chronically ill; persons diagnosed with a terminal illness who wish to continue curative treatments such as dialysis, chemotherapy, or radiation; and those who require therapeutic treatment and/or assistance with the essential activities of daily living (ADLs).
What is a home health agency?
A home health agency (HHA) is an organization that provides services, including skilled nursing care and home care aide services, as well as occupational therapy, physical therapy, speech therapy, and medical social services. If you use a home health agency, the agency will hire and supervise the clinical staff that comes into your home. The agency assumes full liability for all care and is responsible for all employee taxes and benefits.
What is a “needs assessment”?
If home health care is deemed necessary by a physician, your home health agency will conduct a “needs assessment,” which is a detailed evaluation of your situation that confirms the need for services ordered and identifies any other beneficial services. The assessment is usually made by a registered nurse and helps the agency tailor a care plan to meet your needs. After reviewing it with you and before finalizing the plan, the agency advises your physician of its assessment and presents the plan for his/her approval. The plan outlines details, including treatment goals, the specific services and level of care that will be provided, and any medical equipment and supplies that may be required.
What is a Medicare certified home health agency?
A Medicare certified home health agency has met federal requirements for patient care management, called Conditions of Participation, set forth in federal regulations. These agencies can therefore provide home health services that are eligible for reimbursement by Medicare.