General Hospice FAQs

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.

• 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/.

Palliative care is a term used to denote treatment and care provided to a patient to address the discomforts and symptoms of any illness, at any stage. Palliative care is offered in a various of settings including clinics, hospitals and home.

Hospice is a type of palliative care. Hospice is not a “place” but rather a unique philosophy and approach to end of life care that focuses on both the patient as well as their family. Hospice care is holistic, addressing physical, emotional, spiritual, and practical concerns.

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.

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.

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.

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.

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.

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.

Medicare beneficiaries pay little or nothing for hospice, and most insurance plans, HMOs, and managed care plans include hospice coverage.

Hospice patients and families can receive care for six months or longer, depending on the course of the illness.

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.

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.

Hospice can be provided wherever the person is residing, such as: their home, a nursing home, an assisted living community, a hospital, or hospice.

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.

Less than one percent of Medicare beneficiaries live in an area where hospice is not available.

No. Palliative Home Health (PHH) such as the AIM Home Health combines the medical model of Traditional Home Health (THH) such as STAT Home Health and the psychosocial model of hospice, such as St. Joseph Hospice. PHH 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.

No. The focus of Traditional Home Health (THH) such as our STAT Home Health is rehabilitative, while the focus of hospice is comfort care and the enhancement of quality of life. Hospice such as our St. Joseph 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.