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Long-Term Hospice Care

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How Long Are Patients Expected to Survive Under Hospice Care
By AtHome Healthcare Team

Having a loved one declared terminally ill is a stressful and challenging situation to find oneself in. Not only does the patient go through a lot of physical and mental stress, but their family also suffers from psychological trauma and needs time to accept the severity of the situation. Often, the patient’s family remains in denial and requires psychological assistance to come to terms with reality.

Families and friends who are concerned about the state of their terminally ill loved one try to do everything in their power to make the last days of the sick patient as bearable as possible. They want to ensure that their loved one’s pain is minimized and that their final days are filled with maximum comfort, love, peace, and support.

For this, hospitals encourage the patient to be put under hospice care to maintain or improve the quality of the final months of their life. Doing so helps control the symptoms and pain of the patient suffering from the life-ending disease and provides great psychological comfort to the family as they can cherish some memorable time before the final goodbye.

The many benefits that hospice care can offer are often pushed and encouraged by the medical facilities and healthcare practitioners when dealing with terminally ill patients. Moreover, if certain conditions are met, the complete expenses of being under hospice care are covered by the American Medicare system.

Continue reading the rest of the article to learn about hospice care and what happens if a patient can live longer than six months.

What is Hospice Care, and How Does it Work?

Hospice care is a particular type of clinical treatment explicitly designed to deal with patients suffering from life-limiting diseases. Like any other medical treatment that focuses on reducing the discomfort and pain of a patient, hospice care also involves different methods and treatment plans that help control a patient’s physical and mental distress.

However, the only difference is that, unlike most medical treatments that aim at curing a patient’s sickness or disease, hospice care’s goal is not designed to offer treatment or cure. Instead, hospice care’s primary purpose is to reduce and alleviate a patient’s symptoms approaching death to make their final days or months easier on their body and mind.

The main objective of hospice care is to maintain and improve the quality of their remaining life to allow them a chance to cherish their final moments with their family and friends.

Hospice care can be provided at a hospital, a private clinic, a skilled nursing facility, a nursing home, foster care for adults, or at the patient’s residence. However, for a patient to qualify for Medicare aid for their at-home hospice care expenses, a certified doctor or nurse must submit evidence to prove their homebound status. 

Who Gets Put Under Hospice Care?

Only patients suffering from life-limiting diseases are allowed to receive hospice care. Suppose the state of the patient’s disease is found to be only life-threatening or curable. In that case, the patient is put under palliative care instead.

Moreover, for a patient to qualify for hospice care, a certified healthcare practitioner must provide medically attested evidence that proves the patient’s terminal condition. If, at any point, the patient’s condition seems to be moving towards healing or improvement, they are immediately shifted to a more suitable medical treatment designed to focus on treatment.

Furthermore, hospice care will only be provided to a patient whose life expectancy is six months or less. Any patient expected to outlive six months is offered a different treatment plan or is put under palliative care instead.

What Are the Common Illnesses that Hospice Care is Designed to Cover?

To qualify for hospice care, a patient’s clinical condition needs to be attested to be largely untreatable. Some common illnesses that hospice care is designed to cover include:

Terminal Heart Diseases

If a patient’s cardiovascular disease has reached a point where recovery seems impossible, they are put under hospice care. Their hospice care treatment often includes medication that thins their blood and reduces any sensation of pain or discomfort. Moreover, at times, the patient’s heart can continue to function with the help of a machine.

Final Stage Cancer

Suppose a patient has cancer in its early stages. In that case, they are put under palliative care that includes radio and chemotherapy to treat the disease. However, suppose a patient’s condition worsens and becomes untreatable after moving to the final or fourth stage. In that case, they are encouraged to seek hospice care.

Terminal Renal Diseases

Although renal failure can sometimes be cured with a kidney transplant, not everyone is fortunate enough to receive a kidney on time. Suppose the patient’s body seems to be shutting down after renal failure. In that case, they are put under hospice care, including pain medication and dialysis to keep the patient’s distress low during the final months.

What is Palliative Care, and How is it Different from Hospice Care?

Like hospice care, palliative care is also a special clinical treatment designed for patients suffering from severe illnesses or injuries. However, unlike hospice care, palliative care treatment aims to cure disease and restore health and is intended for patients suffering from life-threatening diseases. 

Palliative care is not restricted to a specific period. Patients can continue to receive palliative care for any period required for the treatment. If the patient’s condition deteriorates and becomes incurable, they are removed from palliative care and shifted to hospice care instead.

Moreover, just like hospice care, palliative care can also be provided at a hospital, a skilled medical facility, nursing or foster care home, or at the patient’s residence.

Medicare will continue to pay for palliative care expenses as long as a licensed healthcare practitioner can provide evidence for any signs of recovery. However, to receive Medicare for at-home palliative care treatment, the patient must submit doctor-attested documents that prove the patient’s homebound status.

Why do Hospitals and Healthcare Practitioners Push Hospice Care?

Many hospitals have to suffer the penalties of being unable to control or prevent high numbers of 30-day mortalities. As a result, in recent times, many hospitals and doctors have been seen pushing and encouraging terminally ill patients to go under hospice care to avoid the penalties that come with frequent 30-day mortalities.

Although doctors and medical facilities often recommend putting a patient under hospice care to improve the quality of their remaining time, many incidences of facilities prematurely pushing patients into hospice care have also been reported. 

Is Long-term Hospice Care Possible?

Although unusual, cases of patients under hospice care for multiple years have been recorded. This happens when a patient can live longer than six months, despite being terminally ill.

Continue reading below to learn about how long-term hospice care becomes possible.

What happens if a Hospice Patient Lives Longer than Six months?

One of the most challenging tasks that create controversy around hospice care is determining a patient’s life expectancy. In some situations, an experienced doctor can accurately estimate a patient’s life expectancy due to the terminal severity.

However, this is not always the case. Sometimes the doctor’s prediction gets proven wrong, and the patient can outlive the life expectancy of six months. Due to this, many critics and people disagree regarding putting any patient under hospice care and argue that patients should not be encouraged to lose hope for living and the treatment medication should be continued till the patient’s last breath.

When a hospice patient can live longer than six months, different procedures and steps follow the event. Firstly, a new round of clinical tests and medical examinations are carried out to assess the patient’s disease to understand how the patient is still alive.

Suppose any signs of recovery or health are witnessed through the examinations and test results. In that case, the patient is removed from hospice care and is immediately put under palliative care to speed up the recovery process. Once again, the patient is placed on treatment medication, and hope is reignited.

However, if no notable sign of recovery or wellness is witnessed despite the new round of medical examinations and tests, the patient does not get put under palliative care. Instead, the situation is considered a result of luck, and the patient is still considered terminally ill.

Will Medicare Continue if a Hospice Patient Lives Longer Than Six Months?

A patient can usually only qualify for Medicare if the licensed doctor can prove the patient’s life expectancy of six months or less. However, when a hospice patient has outlived the six months, Medicare requires that all clinical tests be repeated.

If the test results can prove signs of recovery, then the patient would have to apply for Medicare to cover the palliative care expenses. However, suppose the results show no hope of betterment. In that case, the patient’s certified doctor must resubmit the new developments that prove a patient’s continued terminally ill condition.

Suppose the resubmitted reports and test results can prove that the patient will not be able to survive another six months. In that case, Medicare will continue to cover hospice care expenses.

This process can be repeated as many times as required, as long as the patient continues to survive despite being terminally ill.

What Are the Four Different Levels of Hospice Care?

Four different levels of hospice care treatments are designed to cater to the needs of other patients who are suffering from various life-limiting diseases. However, the one thing that all the four levels of hospice care have in common is that they aim to alleviate discomfort, physical pain, and emotional stress from the patient’s life to make their last days more bearable.

By receiving a suitable level of hospice care, a patient and their family can work together through the physical and psychological trauma and live every remaining day together to the fullest. Many terminally ill patients have enough comfort to live out their bucket list dreams.

Moreover, Medicare covers all four levels of hospice care as long as a licensed healthcare practitioner submits the required test results and clinically attested documents.

Medicare has defined the four different levels of hospice care as follows:

Level 1: Receiving Hospice Care Treatment at Home

Suppose a certified doctor can provide evidence proving the patient’s homebound status. In that case, all the checkups, medication, and treatment will be carried out as per procedure at the patient’s residence.

Moreover, apart from controlling the physical symptoms, hospice care will also include psychological therapy and emotional counseling for both the patient and their family to help them get through this difficult time.

Furthermore, the at-home hospice care team also helps the patient carry out everyday tasks such as eating, walking, bathing, medication management, etc.

Level 2: Receiving Continued Hospice Care

A terminally-ill patient must receive continuous hospice care treatment if the severity of their medical condition requires around-the-clock assistance. In such a situation, the skilled nurses and hospice caregivers are appointed to live at the patient’s residence or provide uninterrupted supervision if the patient is admitted to a hospital.

This level of hospice care benefits the family as they no longer have to shoulder the responsibility of caring for the patient by themselves and can focus on their other occupational duties.

Level 3: Receiving Inpatient Hospice Care

Suppose a patient’s condition cannot be helped at their home. In that case, they have no choice but to be admitted to a medical facility to receive inpatient hospice care.

The medical facility could include a hospital, a skilled nursing facility, a nursing home, or foster care for adults.

Level 4: Receiving Respite Hospice Care

Unlike level 3, which requires the patient to be admitted throughout their illness, respite hospice care requires a temporary hospital stay. This happens if the patient’s condition temporarily worsens or if the patient’s family has to leave town for a little while.

Final Thoughts

Being put under hospice care can be difficult for both the patient and their family; however, the treatment can help reduce pain, discomfort, and psychological stress.

Learn more about hospice care and palliative care.

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