Frequently Asked Questions Regarding At Home and Inpatient Hospice Care

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1 Frequently Asked Questions Regarding At Home and Inpatient Hospice Care

2 Contents Page: Topic Overview Assistance in Consideration Process Locations in Which VNA Provides Hospice Care Determination of Type of Hospice Care Needed Considering Selecting (Electing) to Enter the Hospice Benefit Process for Entering VNA Hospice Care Once in VNA Hospice Care Pain Management Costs and Payment for Hospice Care About VNA Inpatient Hospice

3 At Home and Inpatient Hospice Frequently Asked Questions Hospice Overview Question: What is hospice care? Answer: Hospice care is a compassionate and holistic approach to care for patients with a life limiting illness. In hospice care, particular attention is paid to efforts to improve patient comfort through reduction of pain and suffering and overall symptom relief. In addition, hospice care helps the patient and their loved ones best cope with their situation through emotional and spiritual means. Assistance When Considering Selection of (Entering) Hospice Benefit Question: Does VNA provide assistance to people considering hospice care? Answer: Yes. VNA, through our unique and free of charge Caring Decisions program will arrange for one of our trained counselors to meet with you, discuss your specific circumstances and review the hospice benefit and your care options. Locations in which VNA Provides Hospice Care Question: In what areas does VNA provide Hospice services? Answer: VNA offers in home hospice services throughout Butler and Armstrong counties, northwest Westmoreland county and parts of surrounding counties. VNA also provides Hospice care in our new Inpatient Hospice at 115 Technology Drive, Butler, PA Please contact the VNA for additional information on coverage areas for in home hospice services or information on inpatient hospice care at Question: Where do VNA professionals provide hospice care? Answer: Trained VNA hospice professionals provide hospice care in: Patient s home Home of a family member, friend or loved one Personal care or assisted living facility Skilled nursing facility Hospital VNA Inpatient Hospice Question: Can I receive hospice care if I reside in a nursing home, personal care home or a long term care facility? Answer: Yes. If you meet the requirements for hospice care, it can be provided for you while you reside in these types of facilities. Contact the VNA at for information regarding eligibility requirements for hospice services.

4 Question: Once admitted to the VNA Inpatient Hospice, can I return home or to the home of a child or other caregiver? Answer: Yes. This is the goal of our inpatient hospice services. We strive to have your symptoms, including pain and suffering, under control and stable so you can return to your home or the home of a friend or loved one. Determination of Type of Hospice Care Needed Question: How is it determined if Hospice care is provided in home or at the VNA inpatient facility? Answer: A review of the patient s medical history, symptoms and needs is conducted by one of our specially trained hospice staff. From this, we develop an understanding of the treatment required that will best address the patient s symptoms. In addition to the medical evaluation, the assessment includes review of the support from family and friends available for the patient. Patients requiring round the clock care and/or more intensive intervention to manage their symptoms are the most likely candidates for inpatient care. The criteria for determining an ongoing plan of hospice care is complex. Please contact the VNA at to arrange a no obligation assessment, based on these and other considerations, a trained VNA hospice professional will plan the appropriate course of care. Question: Are all hospice patients confined to bed? Answer: No. Often, patients receiving hospice care have a significantly higher quality of life than they had prior to entering the VNA hospice program. The reduction in pain and the management of symptoms allow the patients to more comfortably visit with family and friends, watch television, talk on the phone and engage in many other normal life activities. Question: Does a patient have to be close to death to be referred to VNA Hospice? Answer: No. Early referral to the VNA Hospice program allows improved quality of life and initiation of the medical support and counseling available to help you select the course of care that is best for you. Early involvement of VNA allows us to better tailor our efforts to the specific circumstances and to better enhance the quality of life and support for the patient and the patient s family and other loved ones. Considering Selecting (Electing) to Enter the Hospice Benefit Question: When is the right time to initiate hospice care? Answer: The circumstances which make hospice care a viable consideration can come from a sudden, severe change in health due to a stroke or heart attack or may result from a continual decline in quality of life or increase in pain and suffering due to a conditions such as ALS, cancer, heart failure, lung disease and Alzheimer s. Often the patient or their families inquire as to the expected progression of the patient s symptoms and ways to help the patient best manage their pain and suffering. Many people, including physicians, are reluctant to bring up the hospice option. To some people, electing to enter hospice care represents throwing in the towel. This cannot be further from the truth, in that, patients who take advantage of hospice services often live longer with a greatly improved quality of life. The most obvious signals indicating hospice care should be considered include; an increase in pain or other symptoms, repeated hospital and emergency room visits, failure to respond to treatment or recover

5 from an illness, atypical weight loss, and decreased physical and/or mental functioning. Hospice care can also allow the patient to stay at home and minimize repeated hospitalizations. Question: I ve been told it is too early for me to request hospice care, is there any other help? Answer: It is never too early to seek information regarding hospice services. Any patient with a lifelimiting illness who no longer responds to curative treatment may be considered to elect hospice care. VNA offers a full range of nursing, therapy and counseling services. In addition, we offer companion services, home heath aid services and home medical monitoring services and countless other services as well. Our overall goal is to help you stay in your home, independently, as long as possible. Our social workers and counselors are available to meet with you and help plan the most appropriate program of support for you and your specific circumstances and needs. Question: How do I enter into a conversation on hospice with my healthcare provider? Answer: It is the patient s right to discuss the option of hospice care at any time. It can often be helpful for the patient and the patient s family to speak with their physician, agencies like the VNA, other healthcare professionals, clergy, counselors and friends as soon as they are comfortable doing so. A first step is often simply asking your physician if hospice care would be appropriate based on the patient s overall health situation and availability of support. Question: Is cancer the primary reason patients enter hospice care? Answer: No. Cancer is certainly one of the reasons a patient may require hospice services. However, VNA Hospice services are called upon for patients with a variety of life limiting illnesses including, but not limited to: heart disease, chronic respiratory disease, Alzheimer s disease or dementia, kidney failure, liver disease, neurological disease, AIDS, ALS and any other life limiting illness. In addition, hospice services are sought by people of all ages and demographic groups. Question: Is it true hospice may hasten my death? Answer: Hospice does not prolong or hasten death. VNA Hospice's care focuses on comfort and minimizing pain and suffering. Hospice does not seek a cure for the illness but rather works to keep the patient comfortable through the reduction of pain and the management of symptoms. Question: Do I have the option to return to the hospital while I am in hospice care. Answer: Hospice patients can return to the hospital if there is a change in their condition, that will benefit from curative treatment develops. This can occur, for example, if a hospice patient develops problems unrelated to their initial entry into the hospice benefit. However, VNA Hospice must coordinate the trip to the hospital otherwise the patient may bear unexpected expense. Question: Is caring for a sick loved one at home challenging? Answer: Caring for a sick loved one can be very rewarding. However, caring for a sick loved one can also be very demanding. These demands include the physical and emotional burden placed on the caregiver, the patient and the other members of the caregiver s home. As a patient s condition deteriorates unforeseen needs often develop. This can include the sudden need for equipment, medical attention and off hours need for care. Emergencies occur out of the blue take a significant toll on all involved. VNA hospice staff is available around the clock and on weekends to consult with the family and to make visits when needed. Our inpatient hospice is available for patients requiring more intensive care. For those who do not have a support system, VNA can help them meet their needs. VNA can also often offer a respite break for caregivers who have been providing primary care and support within their home.

6 The Process for Entering into Hospice Care Question: What does the admission process involve? Answer: A phone call to VNA at is all that is needed to begin consultation, counseling and the admission process. After the call is received, VNA will contact the patient s physician for confirmation hospice care is appropriate for the patient at this time. A registered nurse, with extensive experience in hospice care, will contact the patient or family (as requested) to schedule a mutually convenient time for an initial discussion on the hospice care benefit. Question: Will someone support me in my transition into VNA Inpatient Hospice Answer: Yes. VNA provides ongoing support to the patient and the patient s family throughout the hospice process. Question: Can patients be admitted directly from the hospital to the VNA Inpatient hospice? Answer: Yes. VNA Hospice admissions staff works closely with hospital discharge coordinators and physicians in the hospital within our service area. Together, we can coordinate discharge, ensure room availability for inpatient hospice patients and order needed equipment. As appropriate, after discharge, our nurses will see patients in their homes or in our inpatient hospice. Question: I am concerned my physician does not know about or support in hospice care. What should I do? Answer: Selecting or seeking information on hospice care is always your choice. If your physician wants more information, we invite him or her to call Or you may call us, and we will contact your physician. Once In VNA Hospice Care Question: How long can a patient receive hospice care? Answer: Indefinitely, as long as the patient s condition meets the criteria for hospice care. A registered nurse will provide regular input regarding changes in the patient s condition that impact hospice eligibility. In addition, if a patient in hospice care improves they can discontinue services or, if in our inpatient hospice, can return home. In the event the patient s condition declines, resumption of care or readmission into our inpatient hospice can be arranged. Finally a patient may decide to discontinue or revoke hospice care at any time. Question: Is it possible for a VNA hospice patient to return to non hospice medical treatment? Answer: Yes. The goal of the VNA hospice service is to help improve your quality of life, reduce pain and suffering, and stabilize your healthcare requirements. If your condition improves, and you choose to do without hospice services, discharge from the hospice program is possible and often recommended. If the need for hospice services once again becomes apparent, readmission to hospice care can be arranged. Medicare and many private insurance plans will cover the discharge and re admission into hospice. Medicare coverage empowers hospice qualified patients to enter and leave hospice care as warranted. Question: Do VNA Hospice patients have to give up their primary care (regular) physician?

7 Answer: No. VNA Hospice patients whether at home or in our inpatient hospice can continue to be served by their own physician. Our highly trained care team works with each physician to develop and implement the most appropriate care plan possible for that specific patient. Pain Management Question: How does VNA hospice manage pain? Answer: VNA nurses and doctors are experts on the latest medications and methods to alleviate pain and relieve symptoms. In addition, our nurses and doctors work closely with pharmacists specializing in hospice and symptom management. VNA specialists work with counselors and other specialists, as needed, to help the patient cope with pain and the emotional burden they may be experiencing. In addition, specialists schooled in music therapy, massage, nutrition counseling and other therapies together with social workers, volunteers and chaplains are available to assist family members as well as patients. Question: How successful are hospice services in battling pain? Answer: Trained pain management medical professionals are part of the VNA hospice team. This team receives ongoing education and routinely consults with doctors that are experts in pain management. These professionals are extremely in managing pain and improving the overall quality of life for the patient. Question: Will the patient be given medication that will prevent them from being able to talk or know what is happening? Answer: This is seldom the case. VNA strives to help patients be as comfortable and alert as they desire so they can enjoy the companionship of family, friends and loved ones. Costs and Payment for Hospice Care Question: How are the costs of hospice services paid? Answer: Medicare, Medicaid and most commercial insurances have a hospice benefit. These insurances require patients have a life limiting disease and a life expectancy of six months or less to be eligible to receive a full range of medical and support services. Question: What do I do if I do not have enough money or insurance to pay for hospice services? Answer: VNA is a not for profit community based agency serving all, regardless of ability to pay. VNA will do all within our power to help both the patient and the patient s family through this challenging time by providing a counselor to help explore all available options. About the VNA Inpatient Hospice Question: Can family visit while I am at the VNA inpatient hospice? Answer: Yes. The VNA Inpatient Hospice allows unlimited visitation by the patient s family and friends. Every patient has a private room minimizing the impact of visitors on other hospice patients. Question: Are pets allowed at the VNA Inpatient Hospice?

8 Answer: Yes. VNA recognizes your pet is part of your family. Your pet (dog, cat), is allowed to visit you within our inpatient hospice. Please contact VNA if you have questions regarding visits by other pets. Question: What services are provided to the patients at the VNA inpatient Hospice? Answer: The VNA Inpatient Hospice is staffed by highly trained nurses and physicians. These skilled individuals work to help you best address and cope with all aspects of your illness. In addition social workers, pastoral support, aides and volunteers are part of the VNA Inpatient Hospice team. Question: Does VNA hospice provide help (bereavement support) to the family after the patient dies? Answer: VNA provides ongoing support for family and friends for 13 months.following the death of a loved one. VNA also provides a wide variety of community outreach programs and support groups in our service area. These support groups are open to anyone in the community who has experienced the death of a family member, loved one or friend and provide support for beyond 13 months. Question: Is VNA hospice affiliated with any religious organization or other hospice? Answer: No. VNA is an independent organization not affiliated with any other hospice, or religious organization in the state or Pennsylvania or elsewhere. We serve the entire community without restrictions or consideration of race, religion or any other demographic attribute. It would be a privilege to speak or meet with and address any questions or concerns. Please contact our customer care center at to speak with one of our trained hospice professionals.

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