By Elder Services of the Merrimack Valley

QUESTION: My husband has been ill for quite some time. We have been getting in-home services covered by a Medicare agency. The social worker recently spoke with me about switching over the care to a hospice agency. This is a very difficult decision for me. What would be the benefit for us?

ANSWER: There are many difficult decisions patients and their families may eventually face when entering the last stage of life. When an individual has a terminal illness there may come a time when there are no curative treatment options available or the person for either emotional, spiritual or physical reasons believes it is in their best interest to cease extraordinary treatment interventions.

Hospice, also a Medicare benefit, is essentially a transition from "curing" to "providing comprehensive patient/family support and comfort." The hospice benefit is not only for the last few weeks or days of life. Choosing hospice sooner can offer many benefits in the last six or more months of life.

The initial referral for hospice care requires a statement from the patient's physician that this is an appropriate approach to care at this time and it is reasonably expected the patient only has six months to live. It is important to point out a patient can be re-certified after the six month period and remain under the care of the hospice team. There are also instances when the patients' conditions actually improve and they no longer require hospice care and once again receive care through traditional Medicare.


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Hospice is a team-oriented approach to providing care that includes a physician, nurse, social worker, counselors, home health aides, therapists and volunteers. While 24-hour care is not provided, staff are on call 24 hours a day.

One spouse whose husband received hospice care prior to his death said how helpful it was to her to be able to speak with someone regardless of the time of day when a crisis arose or she just needed additional support.

In many instances, the service level through hospice far exceeds what was previously provided through the standard Medicare benefit. Any family member or close friend who has been providing care for someone with a life-limiting illness runs the risk of physical or emotional burnout at some point. For this reason alone, the hospice benefit can make a positive difference and enable the caregiver to remain in the role.

The average person may not be aware hospice can be provided in a private home, hospital, skilled nursing facility, assisted living residence or in a free-standing hospice house. There may be individual circumstances when the patient's needs cannot adequately be met in a private residence and one of the other options could be available.

Sincere appreciation is extended to Andrea LeBlanc, vice president, Merrimack Valley Hospice for collaboration on this column. To learn more about the hospice benefit, call 1-800-933-5593.

Are you struggling caring for an older adult or having difficulty locating resources? Our experienced staff are available for no cost consultations in the home, office or community. Call 1-800-892-0890. Do you have a question? Direct correspondence to ro@esmv.org or Elder Services of the Merrimack Valley, Inc. 360 Merrimack Street B#5, Lawrence, MA 01843. Rosanne DiStefano is the Executive Director of Elder Services of the Merrimack Valley, Inc.