A number of questions have been asked about the column from last week’s issue regarding the Medicare requirement that two doctors decide that a patient is “six months or less” to live. The definition of a terminal illness is a life expectation that is “six months or less” in the event that the disease continues to run through its usual course. So, in this column, we will expand on this definition. Since Medicare acknowledges that estimating someone’s life expectancy isn’t a precise scientific process The hospice benefit has been developed with this idea in mind. Hospice care is divided into benefit durations: two 90-day time periods that are followed by endless 60-day durations. Thus, a patient is provided hospice treatment for two 90-day benefit times (incidentally taken together, that’s the duration of six months). Prior to the 60-periods of unlimited duration the patient is examined by the Hospice medical director or nurse practitioner to determine if the patient is in compliance with Medicare requirements. If it is found to be the case, the patient gets renewed with hospice staff. Hospice team.
Vickie Wacaster is a patient and Hospice Advocate with Aveanna Hospice (formerly Comfort Care Hospice)
Concerning the 6-month time frame I think that when Medicare introduced its hospice benefits, it required an effective way to monitor its usage and make sure that people were using the benefit to their fullest potential and were not wasting the benefit. So, I’ve done some research and am unable to find out the reason Medicare utilized a 6-month rule instead of a 3 month rule, 9-month, or similar. However, if there was no six-month rule or a the terminal illness rule and terminal illness rule, we’d all be considered to be terminally ill, since at the time we are born, we’re on the opposite side on the continuum of human life.
Hospice care is offered to terminally seriously ill patients who aren’t longer receiving treatment for a cure and have a reduced life time. The patient’s primary doctor typically initiates the referral procedure; case managers, nurses or hospital home personnel, clergy members relatives, or other healthcare professionals could be able to recommend patients. However, a prescription from a physician to evaluate and admission is mandatory. This is why my suggestion is to talk with your doctor first, and if he is of the opinion that hospice could be the best option for you or your loved one, keep in mind that the hospice you select is your choice.
For over four decades hospices in the U.S. have been trying to persuade healthcare professionals (and family members) to select hospice due to its exceptional care in the final stages of life. Unfortunately doctors are uninterested as I am certain it’s difficult to hold these conversations with patients that you’ve provided medical care for over a period of time. Due to the misguided belief that “hospice care is the cause of death,” many patients are not being referred to hospice when they are eligible. Studies show that those who receive hospice treatment live longer and enjoy a greater health than those suffering from similar diseases who don’t receive care from hospice.
Financial worries are a major burden for families and patients who are facing the possibility of a fatal illness. The hospice care program is covered by Medicare, Medicaid, and the majority of private insurance plans, and patients are provided with hospice treatment regardless of their ability to pay for it. Also, hospice provides significant savings for patients and their families by offering high-quality medical equipment (for instance oxygen, hospital bed wheelchair, walker shower chair, overbed table) and medical equipment (for instance, wound care items diapers, wipes, pull-ups) and the medications listed in the plan of Care.
Other hospice benefits are registered Nurses specially trained in the management of symptom and pain (available for emergencies 24/7, 7 all week) and regular visitation by hospice aides who provide individual support, social work and counseling services that help you with your emotional needs and your loved ones, Chaplain services available for your family and you as well as visits from trained volunteers when required.
In the end, there are several myths and misconceptions regarding hospice that keep families and patients from gaining all of the benefits that hospice provides. Our mission in hospice is to cooperate with healthcare professionals from all disciplines and increase knowledge and understanding of how to honour and respect the wishes of patients and their concerns in the final stages of their life.
I treasure in my soul the sentiments from the late Dr. Cicely Saunders (1967): “You matter because you are who you. You are important to the very last second of your life and we’ll do everything we can to make sure you’re able to die peacefully, but also remain alive until the end of time. “.
– Vickie C. Wacaster is a patient and hospice advocate for Aveanna Hospice (formerly Comfort Care Hospice).
The article Delving into Medicare requirements was first published at The Andalusia Star-News.
