From the Department of Health
and Human Services Center
for Medicare and Medicaid Services (CMS):
- “The Medicare program recognizes
that terminal
illnesses do not have predictable courses; therefore,
the benefit is available for extended periods of time
beyond six (6) months provided that proper
certification is made at the start of each coverage
period.”
- “Physicians, hospitals and
skilled nursing facilities are
urged to recommend hospice care to beneficiaries
whom they determine may benefit from it.”
- “The certification
of terminal illness of an individual
who elects hospice shall be based on the physician’s
or medical director’s clinical judgment
regarding the
normal course of the individual’s illness.”
What Your Patients Want
- 83% of Americans want to die at home,
cared for by loved
ones and supported by in-home health care professionals,
according to findings of a national survey presented to
National Hospice and Palliative Care Organizations in
November of 2004.
- 88% of respondents said they would
consider using hospice if they or someone they knew
were terminally ill.
- 98% of respondents whose family
had previously been served
by hospice said it was a positive experience.
Respondents said the most important aspects of a good death were:
- Dying with family members present
- Dying with dignity
- Dying pain free
- Dying with benefit of spiritual
counseling
Referenced from: Quality of Life Matters.
End-of-Life care news & clinical findings for
physicians. Vol. 6, Issue 4 Feb/Mar/Apr 2005.
From the AMA website, H-140.966
Decisions Near the End of Life: ”Physicians have
an obligation to relieve pain and suffering and to promote
the dignity and autonomy of dying patients in their care.
This includes providing effective palliative treatment
even though it may foreseeably hasten death.“
Referenced from: In Search of
A Good Death:
Observations of Patients, Families and Providers; Steinhauser et al.
Annals Internal Medicine 2000; 132: 825-832. |
"From
our first breath, we are each born to die. As a nurse
and ordained chaplain, I have been privileged to walk
with many wonderful people to the Valley of the Shadow
of Death. But then came the pending death of my beloved
Richard Ray. When our doctor stated it was time for
hospice, my husband became very withdrawn. Hospice
for him meant all had been done and it was time to
die.
This was far from the truth as he was soon to find out. Our experience
was a long way from gloom and doom to a truly wonderful, memorable and
cherished time. Such compassionate, caring individuals provided quality,
up-to-date care. I have only one regret: that we didn't call hospice
sooner."
Rosemary
Hanley, RN, Ordained Chaplain.
“Patients are not looking
for better end-of-life care,” says Susan LeGrand,
a palliative-care physician at The Cleveland Clinic. “They‘re
looking for not having to die.” Doctors, patients
and families all avoid talking about death--and the
need for patients to make their own decisions about
how it happens--until the end is very near. ” Because
they won‘t talk about it,” says Sloan-Kettering‘s
Foley, ”patients get themselves into circumstances
where they don’t want to be.”
Kathleen Foley, Neurologist at
Memorial Sloan Kettering Cancer Center in New York.
Referenced in Forbes Magazine, from www.forbes.com,
August 19, 2004, "Must We Die In Pain?" by
Matthew Herper.
Hospice works to honor the wishes
of those Americans with terminal illness who prefer
to die in their own homes and on their own terms.
In 2003, of those
who died under hospice care:
In contrast, of all Americans who died in 2003:
Non-cancer diagnoses continue to
rise along with the number of patients
served by hospice
Referenced from: Quality
of Life Matters.
End-of-Life care news & clinical findings
for physicians. Vol. 6, Issue 4 Feb/Mar/Apr 2005. |
