hospice care

Here are some signs and symptoms to consider that it may be time to talk to a doctor and begin thinking about end-of-life choices and options:

• A life-limiting illness or terminal diagnosis
• Frequent hospitalizations/ER visits
• Frequent calls to doctor’s office
• Frequent falls
• Progressive weight loss
• Profound weakness/fatigue
• Frequent infections
• Continuous use of Oxygen
• Difficulty in swallowing
• Increased edema/swelling
• Uncontrolled or increased pain
• Difficulty in breathing
• Progressive renal insufficiency
• Uncontrolled nausea or vomiting
• In emotional, social or spiritual distress
• Progressive decline in health despite therapy
• Patient and family requests no further aggressive treatment
• Change in mental status
• General decline

Hospice care can be provided in any of the following settings:

• Private Residence
• RCFE- Residential Care Facility for the Elderly (Board and Care)
• Assisted Living Facility
• Independent Living
• SNF- Skilled Nursing Facility
• Hospital

Our hospice interdisciplinary team includes:

• Medical Director
• Hospice Manager
• Nurses
• Home Health Aides
• Social Worker
• Bereavement Coordinator
• Chaplain
• Volunteers
• Patient Advocates

Hospice is 100% covered by Medicare, Medi-Cal, and all health insurance plans.  Even if you have Medicare Advantage or Part D Supplemental Drug Insurance, traditional Medicare will cover all costs associated with hospice (including drugs).

Here is what is included at no-cost to patients:

• A physician-led interdisciplinary team of nurses, social workers. chaplains, bereavement counselors, and volunteers
• Home visits by any and all members of the interdisciplinary hospice team as needed
• Medications related to the hospice diagnosis and medications which alleviate physical, psychosocial, and emotional pain
• Delivery of medications to patient’s home, SNF, ALF, RCFE or wherever patient is receiving hospice care
• 24/7 nurse line and on-call support
• Medical Equipment (ME) delivered to patient’s home
• Supplies (such as bandages and catheters)
• Bereavement services for loved ones for a minimum of 13 months after death

Why should I start thinking ahead regarding my treatment wishes at end-of-life?

• 80% of people say they prefer to die at home, but only 20% actually do
• 82% of people say it is important to put their end-of-life wishes in writing, but only 23% of people have actually done it
• 80% of people say if they are seriously ill they would like to speak with their doctor about end-of -life care, yet only 7% of people have actually had an end-of-life discussion with their doctor
• 59% of families of patients were much more likely to rate hospice care as excellent when their family member received hospice care for more than three days

What is Advance Care Planning?

• A collaborative process  between health care providers, patients,  and family members
• Ability to make decisions about future health care concerns, even through periods of incapacity
• Thinking through one’s values and preferences
• Talking about one’s values and preferences
• Documenting them and sharing the information

How do I start the process of Advance Care Planning?

• Select a spokesperson to speak as your agent, when you’re unable to
• Consider your wishes for care based on your priorities, beliefs & values
• Discuss wishes with loved ones, designated agent, physicians and medical team
• Document and share copies of your decisions, with loved ones and health care providers
• Periodically review and make changes to these documents, as conditions change

Complete an ADVANCE HEALTH CARE DIRECTIVE (AHCD):

• Document that allows you to designate a “surrogate” that can make health care decisions for you, when you are not able to speak for yourself
• An AHCD is NOT about death and dying
• An AHCD does not have to be notarized, only witnessed by two individuals
• A State of California approved form is preferred

What is POLST?

• POLST = Physician Orders for Life-Sustaining Treatment
• A physician order recognized throughout the medical system
• Portable document that transfers with the patient
• Brightly colored, standardized form for entire state of CA
• For more information and to access approved forms visit: www.capolst.org

Why POLST?

• Patient Wishes often are not known
• POLST and AHCD are meant to go hand-in-hand
• The Advance Health Care Directive (AHCD) may not be accessible
• Wishes may not be clearly defined
• POLST allows treatment choices
• POLST gives direction and allows health care professionals to know and honor your treatment wishes for care

• POLST
• California Advance Directive
• Aging with Dignity / Five Wishes
• California Coalition for Compassionate Care
• California Health Care Foundation 
• Caring Connections
• Prepare for Your Care
• The Conversation Project
• Coda Alliance (Go Wish Cards)