Despite the growing population of elderly Americans, few fully understand an important program designed to help people with terminal illnesses: the Medicare/Medicaid hospice program. Hospice, which is designed to provide care for patients with terminal illnesses, has long been viewed fearfully as a last step to keep a person as pain-free as possible while they die. However, we all know that sometimes medical predictions are inaccurate and people with terminal illnesses can enter remission periods that greatly extend their life.
Recently, courts forced a change in Medicare regulations that require patients to continue to be eligible for hospice care for longer than six months. Participating in hospice programs, the patient now applies for terms of care. First, patients can receive two 90-day terms of care, and after that can re-apply for unlimited 60-day terms of care. Thus hospice can provide care for those who have a terminal illness but are not necessarily near death. Hospice care is only revoked if, upon reapplying for a term of care, doctors determine that the patient no longer has a terminal illness. Hospice patients receive palliative care and pain management for their terminal illness, as well as access to a nurse who is on call 24/7, and help treating medical problems other than those related to the terminal illness.
This is one of the ways in which the U.S. Bureau of Labor Statistics predicted that nursing jobs would grow. Their prediction that America would move away from standard hospital care to more outpatient services is being played out. Hospice nurses are equipped to handle colds, the flu, and other ailments that would normally send a patient to a physician or even an emergency room if they couldn't gauge the seriousness of a health problem. Hospice nurses also aid a patient's doctors by drawing blood and tracking health. Hospice also assigns licensed, professional social workers to help families with advice, counseling, and resources to help cope with the stress of a life-threatening illness. As part of the new healthcare law, the Centers for Medicare and Medicaid services (CMS) will require states to comply with changes to the hospice program when they legally take effect in 2013. On January 1, 2011 the reforms will require that a nurse practitioner or doctor must meet with the patient in person at the end of the six month period of care to re-certify eligibility.
Here are some important facts about hospice from the U.S. Department of Health and Human Services' Centers for Medicare and Medicaid Services:
- Hospice provides comfort and support services to people who are terminally ill. It helps them live out the time they have remaining to the fullest extent possible.
- Hospice care is provided by a specially trained team that cares for the ?whole person,? including his or her physical, emotional, social, and spiritual needs.
- Hospice provides support to family members caring for a terminally-ill person.
- Hospice is generally given in the home.
- Hospice services may include drugs, physical care, counseling, equipment, and supplies for the terminal illness and related condition(s).
- Hospice isn?t only for people with cancer.
- Hospice doesn?t shorten or prolong life.
- Hospice focuses on comfort, not on curing an illness. Medicare covers the following hospice services for your terminal illness and related conditions:
- Doctor services
- Nursing care
- Medical equipment (such as wheelchairs or walkers)
- Medical supplies (such as bandages and catheters)
- Drugs for symptom control or pain relief (may need to pay a small copayment)
- Hospice aide and homemaker services
- Physical and occupational therapy
- Speech-language pathology services
- Social worker services
- Dietary counseling
- Grief and loss counseling for you and your family
- Short-term inpatient care (for pain and symptom management)
- Short-term respite care (may need to pay a small copayment)
- Any other Medicare-covered services needed to manage your pain and other symptoms, as recommended by your hospice team You can get Medicare hospice benefits when you meet all of the following conditions:
- You?re eligible for Medicare Part A (Hospital Insurance).
- Your doctor and the hospice medical director certify that you?re terminally ill and have 6 months or less to live if your illness runs its normal course.
- You sign a statement choosing hospice care instead of other Medicare-covered benefits to treat your terminal illness.
- You get care from a Medicare-approved hospice program.