Grand County Hospice: How to receive care
“I think my Mother may be dying, but her doctor has not mentioned Hospice. No, I haven’t mentioned Hospice to her doctor. I don’t know what to say.”
“I think my Father is going down hill fast and I talked to his doctor about Hospice, but the doctor said Dad isn’t ready for Hospice yet.”
When you think a loved one is declining, or possibly dying, and your doctor doesn’t recommend Hospice, what can you do? Sometimes people wait until the doctor is ready to write an order for Hospice. This may explain why the average length of time a person spends in Hospice in the United States is two weeks. Many patients and families benefit from working with Hospice longer than 2 weeks. Medicare, our Federal Insurance Program for people over 65, understood this when it set the time line for Hospice care and payment at 6 months. Many private insurance companies will also pay for Hospice care beyond the United States’ average two week period.
What if your doctor never writes an order for Hospice? Some people call us and ask “What can we do?” When we receive a call about a potential Hospice patient we make a visit to the home to evaluate the ill person. We talk to the patient and family and gather data about the sick person’s health status, emotional well being, resources available, help needed, and if they are appropriate for Hospice care. If we believe they could benefit from Hospice care we can contact the personal physician and our Hospice medical directors who are also physicians.
The criteria for Hospice admission is a doctor’s order which confirms that if a person’s condition progresses on a normal course they have 6 months or less to live. When the personal doctor concurs with our assessment he will write an order for Hospice.
What if the Hospice patient doesn’t die in six months? Hospice patients often do well under our care and we can re-certify a patient after 6 months. This re-certification process has the same criteria as the original Hospice admission. A doctor writes an order confirming that the patient has 6 months or less to live if the disease progresses on a normal course.
Sometimes Hospice patients improve so much we no longer believe they are going to die in 6 months or less. We then discharge them from Hospice. We can readmit them in the future if their condition changes and it appears their disease will take their life in six months or less.
In the United States we often refer to doctors as the “gatekeepers” to health care. This means they open and close the gate for access to care. Since doctors are in the business of treating and curing people, they can be hesitant to open the door for Hospice. We continue to educate and assist doctors and the public with the important decision to use Hospice care in a timely way.
People deserve a good death and they deserve time and assistance to define what a good death is for them. If you think Hospice care could benefit someone in your family please contact your doctor or us. We can work with you, your family, your doctor, and our doctors to make it happen. Call us at (970) 877-9074. We have a Hospice Nurse on call 24 hours a day 7 days a week.
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