Hospice care is considered the model for quality compassionate care for people facing a terminal illness. Hospice provides expert medical care, pain management, and emotional and spiritual support expressly tailored to the patient’s needs and wishes.
Support is provided to the patient’s loved ones as well.
Hospice focuses on caring and, in most cases, care is provided in the patient’s home, but may also be provided in freestanding hospice centers, nursing homes and other long-term care facilities.
Hospice services are available to patients with any terminal illness of any age, religion or race.
Hospice is a set of services coordinated by an interdisciplinary team to provide for the physical, psychosocial, spiritual and emotional needs of the patient.
The team consists of the patient’s medical doctor, hospice medical director, registered nurses, hospice aides (certified nursing assistants), social workers, bereavement and spiritual counselors, trained volunteers, speech, and physical and occupational therapists that develops a care plan that meets each patient’s individual needs.
Nursing staff, the medical director and pharmacies must be available 24 hours a day, seven days a week to address emergency needs.
In 2010, the National Hospice and Palliative Care Organization (NHPCO) provided statistics that showed an estimated 1.58 million patients received services from more than 5,000 programs in the United States.
Of those, 1,029,000 patients died under hospice care, with 259,000 patients who were discharged alive for reasons such as extended prognosis, desire for curative treatment and other reasons (known as “live discharges”).
NHPCO estimates that approximately 41.9 percent of all deaths in the United States were under the care of a hospice program.
In March 1974, America’s first hospice began providing services in the home, funded by the National Cancer Institute.
Congress added a hospice benefit to Medicare in the Tax Equity and Fiscal Responsibility Act of 1982, therefore mandating the Center for Medicare/Medicaid Services (CMS) to establish rules and regulations. CMS requires hospices:
• To maintain documentation to prove ongoing individualized care plans for each patient.
• To maintain an effective quality assessment and performance improvement program.
• To maintain an effective infection control program that protects patients, families, visitors and hospice personnel.
• Hospice must supply needed pain and palliative medications, and durable medical equipment, such as a hospital bed or oxygen supplies.
• Hospice must provide needed inpatient care for pain control, symptom management and respite purposes.
The Fayette County Health Department offers a hospice and palliative care program that provides quality and respectful care for all patients that have been diagnosed with a terminal illness and a prognosis of six months or less if the illness runs its normal course.
Palliative care involves addressing physical, intellectual, emotional, social and spiritual needs and to facilitate patient autonomy, access to information and choice along with curative treatments.
Fayette County Health Department hospice has cared for approximately 465 patients since it began seeing patients in 1995 and currently has 15 trained volunteers that provide clerical and day-to-day patient care between one to three hours per week and must document the cost savings achieved through the use of the volunteers.
The FCHD hospice is a member of the “We Honor Veterans” program, established by the NHPCO and the Veterans Administration to honor and reach veterans in the community unreached by coordinated care providers.
The hospice bereavement program continues to make contact with the hospice patient’s family for more than one year following the death and provides grief counseling mailings and memorial services.
The hospice program also provides presentations for the public and individual nursing facilities on end-of-life issues and advance directive education.
For more information, call the health department at 283-7262.
The Fayette County Health Department Home Health is an agency that has provided care to the area since 1976.
The FCHD home health nurses can assist with dressing changes, I.V. administration, diabetic teaching and medication management for those recovering from an illness, accident or surgery.
Presently, Medicare, Medicaid and private insurances are the main pay sources for home care.
Medicare’s home health benefit provides treatment for beneficiaries who have short or long-term illnesses or injuries and who are confined to their home.
It is intended to reduce the need for hospitalization and institutionalization, and to help beneficiaries maintain their independence and quality of life.
In order to be approved for home care services under Medicare, patients must continuously meet the following criteria:
• One must be homebound as defined by Medicare regulations.
• Absences from home should be infrequent and of short duration, but leaving your home for medical care is acceptable.
• You must have a family member or caregiver able and willing to participate in your care if necessary.
Home health agency services must be intermittent or part-time, and must be necessary and reasonable for treatment of the illness or injury.
The services are designed to provide skilled services, which will include the education and teaching of the patient, patient’s family and caregivers to support the rehabilitation and recovery of the patient.
Custodial care (care provided which does not require the skills of a registered nurse, physical therapist, speech therapist or occupational therapist) is not covered by Medicare.
Each home health agency is to report and transmit patient assessment data, within 30 days of completing the assessment, using the reporting Outcome and Assessment Information Set (OASIS).
The OASIS is data collected from each patient used to manage and measure each patient’s care and outcomes (results). Agencies that depend on payments from Medicare/Medicaid are governed by the Centers of Medicare/ Medicaid Services that mandates policies and procedures to run by.
Each agency is required to be licensed in the state, and each state’s department of health is responsible for overseeing and regulating their services.
Medicare requirements include the state license, approval of the department of health, background check of all employees, proof of professional insurance and proof that all nursing staff is state licensed.
The FCHD home health staff provides all aspects of professional health care to those that live within the Fayette County area.
Since January, they have provided more than 2,440 skilled nursing visits; 749 home health aide visits by certified nursing assistants; 1,428 physical therapy visits; more than 50 occupational therapy visits; and 23 speech therapy visits.
For more information, call 283-7262 or visit the health department at 416 E. Edwards St., Vandalia.