In one of our previous blog posts, we looked at the differences between palliative care and hospice. Generally speaking, palliative care describes a type of care provided in association with a chronic illness; hospice care is provided at end-of-life. Insurance* only covers a portion of these services. This is where home care and home health companies can come in to play, as it relates to the total Care Plan whether it be palliative or hospice care.
Case Study
David and his sister have been caring for their Dad and were just told that he now qualifies for hospice care. After contacting several hospice companies, they chose one and were looking forward to the additional care their Dad would be receiving. Care for Dad had increased to several hours a day and even though they shared the responsibilities, it was beginning to take a toll on them. Housekeeping, cooking, bathing, dressing and medication management were surpassing the full-time job mark. You can imagine their shock to learn that insurance would only cover a home health aide 45 minutes a day, 3 days a week. Moreover, the aide will only be able to assist with Activities of Daily Living (ADLs). They expressed their concerns to the hospice company who suggested they consider supplementing Dad's care with a home care or home health agency.
Creating a Care Team
Hospice and Palliative care can be provided by several different people and agencies that work in conjunction to provide patient care. Think of it as having a Primary Care doctor who oversees and guides the care, but uses specialists (a cardiologist, a gastroenterologist, etc.) when needed to address very specific needs. Supplementing palliative or hospice care with a home health agency is very similar; the palliative care or hospice team oversees the Care Plan, but companies like Nurse Next Door can be part of the team to provide services that will enhance your loved one's care. Does your Mom or Dad want a massage? Do you want someone with them 24/7 at end-of-life? In the case study above, David and his sister welcomed support so they could be present simply as a son and a daughter and not worry about things like repositioning, suctioning and mouth care. That's what Nurse Next Door can do. Depending on the type of care you want (medical or non-medical) will determine what type of supplemental company you go to: A home health company can do everything (medical care, ADL care, IADL care) and a home care company can only do ADL and IADL care. Note: Make sure for ADL care, you ensure you have a home health aide or CNA. Learn more about the different levels of health care professionals that may be involved in the care of your loved one.
Care Can Vary and Change
Different palliative and hospice care companies may offer different levels of service. While they all get reimbursed by the same insurance companies, different business models and focuses may change the way that they're able to care for you or a loved one.As a patient's symptoms change or progress, so too should their Care Plan. You know how you make changes to your lifestyle to get a certain result? Like working out and eating healthier if you want to feel better? Care is like that, too; the Care Plan constantly changes to achieve a desired result. Your Mom or Dad's needs will be constantly evolving. Sometimes they'll need the same resources for months, and sometimes the Care Plan will need to change every few days. Understanding this will help you not get frustrated every time something needs to change, or you are given a care recommendation that is new.
4 Questions to Ask When Looking for Care
If you're looking at palliative or hospice care for your loved one, remember that the amount insurance covers will be minimal. When putting together your care team, here are some great questions to ask to help guide your decisions:
1. What is the prognosis?
If it's short and death is imminent, it is easier to handle the cost of 24/7 care. If it's a longer time-frame, finances may impact your decision. BUT always think "investment" instead of straight cost. There are loan options, reverse mortgage options, and insurance policies that may be able to contribute to covering costs.
2. What does Mom or Dad need help with to maintain a quality of life?
Use our Level of Need calculator as a starting point.
3. What are my priorities when choosing a hospice and palliative care company?
If keeping your loved one at home is at the top of your list, consider asking a few more questions:- How many hours will they be scheduled for?- How often will a nurse come out?- What else needs to be coordinated? Nurse Next Door has a great Case Management program just for you, assisting to arrange things like medication delivery, lawn care, and transportation to doctor's appointments etc.
4. What level of home care and supplemental care do I need?
Make a schedule of friends and family who want to be involved in your loved one's care. Who can help often depends on the prognosis. If care is needed for a week, it may be easier for family and friends to cover certain hours. If it's weeks or months, then asking for long-term commitments is more difficult and additional supplemental care from an outside source may be necessary and/or preferred (read about why a home care agency can be a great thing in your life!).Add home care or home health company based on needs. Nurse Next Door is a home health company** and can offer everything from administering medication to ensuring your Mom's lawn is cared for. Finding a company like this can give you great peace of mind. Add additional services such as Meals on Wheels, therapy visits, and grocery delivery. Consider using a pharmacy that has a free delivery service. Nurse Next Door Caregivers can also assist with meal preparation as well.
Caring for an elderly family member who is facing a chronic illness or end-of-life is never easy. We want you to make the most of your loved one's last days and to be truly present. There are professionals ready to walk with you to ensure the best care for your loved one and for you. Want to read more on the topic of end-of-life care? We love Atul Gawande's Being Mortal.
