Posted by
Darlene on Wednesday, August 12, 2009 10:56:30 PM
This started as a comment on the Hospice kills blog. Because it was so long I couldn't post it, but it all needs to be said. I just want people to be aware, and understand what Hospice involves.
I am a Hospice nurse and proud of it!! First, let me briefly try to explain eligibility.Medicare has criteria that a person has to meet to qualify for benefits. They are different, depending on what the problem is. Ex: Cardiac (heart problems), Alzheimers, HIV, ect. These are standard for all Hospice's.A Dr has to order an evaluation. By doing this, he is saying that if the disease follows the "normal" course, the patient's life expectancy is 6 months or less. Order obtained, a nurse evaluates, and if appropriate, admits. Then the Dr is contacted for orders. We (at my Hospice) keep our patients on the same meds (unless they choose to stop meds), adding pain meds, anti nausea meds, and meds to decrease anxiety if needed. I will not say that pain is not a major concern for most hospice nurses...AND IT SHOULD BE!!! Often people who are terminally ill are in pain, and they (the patient)often say "please promise I won't die in pain".Now, we educate the family members who are caring for them at home on MANY things. Changing a bed with a person in it, feeding, changing an adult diaper, medications, wound care, thhe list goes on.... We are available 24 hours a day 7 days a week to answer a question, assess a loved one, provide a shoulder to cry on, to hold a hand and tell someone "You are doing a good job, you are keeping your _____ at home where they are surrounded by people who love them". I am so sorry that some of you have had such horrible experiences, but it is not like that with every Hospice!! Often one person is in charge of the care (Health care POA) This is the person who the patient has decided will make the decisions that they would make if they could. It is a very hard position to be in...I have also taken care of my mother as she died with metastatic bone cancer. I did promise her that her pain would be controlled, and I had to fight to get more medicine!! No, I didn't want her snowed, but she deserved to have her pain controlled. Yes she was confused at times, but at other times very lucid. She chose not to eat or drink, because it made her feel sick. We were lucky enough to have her tell us that...but if she couldn't have we may have assumed it was secondary to medication side effects....
Bottom line.....PLEASE don't deny a loved one Hospice care. Look in to the company...meet with the team, ASK QUESTIONS!! But don't assume that they are all the same. THEY ARE NOT!!!
Each and every patient I have cared for holds a special place in my heart, and I'm glad that I had the opportunity to help them and their families through this time in their lives.