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The Idea of a “Good Death”

No one likes to think or talk about death and dying. But it’s a reality we all face-more and more people are taking charge of how they will live out their final days. This becoming known as the “good death.”

Through life, we want to have as many new experiences as possible but in the end what really matters are the simple things. This is found in many cultures and known as socioemotional selectivity theory. We simply want companionship. Most importantly, the patient must be content with the decision. Which means, as hard as it may be, ask them what would make them comfortable-giving a sense of control. A “good death” can be achieved just by talking about it.

In recent research, patients and families claim there are three important factors to consider.

Being pain free
Being in a good head space
Patient is in an environment comfortable for them
Hospice’s main goal is helping with all of these factors. With legislation changing constantly, hospice care is becoming easier to choose. Nearly all insurance (private and public) covers hospice care. 80% of patients are cared for at home, making them feel as comfortable as possible. In return, making for a “good death.”

All in all, comfort and being content are the top priorities. Hospice care professionals take pride in honoring the wishes of the patient.

So take the time to think about how you would prepare for your “good death.” What would make you most content at the end?

The History of Hospice

The term hospice is derived for the word “hospitality.” Dating back to medieval times, it was know as a place where ill travelers could stay during their journey. It was until 1948 was the term “hospice” used in medicine. Dame Cicely Saunders created the first modern hospice in London, St. Christopher’s Hospice.

Here is a timeline of the history of hospice.

1965: Florence Wald, then Dean of the Yale School of Nursing, invites Saunders to become a visiting faculty member of the school for the spring term.

1967: Dame Cicely Saunders creates St. Christopher’s Hospice in the United Kingdom.

1968: Wald takes a sabbatical from Yale to work at St. Christopher’s and learn all she can about hospice.

1969: A book based on more than 500 interviews with dying patients is published, entitled, On Death and Dying. Written by Dr. Elisabeth Kubler-Ross, it identifies the five stages through which many terminally ill patients progress. The book becomes an internationally known best seller. Within it, Kubler-Ross makes a plea for home care as opposed to treatment in an institutional setting and argues that patients should have a choice and the ability to participate in the decisions that affect their destiny.

1972: Kubler-Ross testifies at the first national hearings on death with dignity, conducted by the U.S. Senate Special Committee on Aging.

1974: Florence Wald, along with two pediatricians and a chaplain, founded Connecticut Hospice in Branford, Connecticut. The first hospice legislation is introduced by Senators Frank Church and Frank E. Moss to provide federal funds for hospice programs.

1979: The Health Care Financing Administration (HCFA) initiates demonstration programs at 26 hospices across the country to assess the cost effectiveness of hospice care and to help determine what a hospice is and what it should provide

1982: Congress includes a provision to create a Medicare hospice benefit in the Tax Equity and Fiscal Responsibility Act of 1982

1993: Hospice is included as a nationally guaranteed benefit under President Clinton’s health care reform proposal. Hospice is now an accepted part of the health care continuum.

2005: The American Heart Association and the American College of Cardiology release new guidelines about treating heart failure that includes recommendations that hospice care education be provided early in the course of an illness.

2014: Forty years after the creation of Connecticut Hospice, NHPCO and its affiliates celebrate 40 years of hospice care in the US.

Hospice and Cultural Consideration

Houston is known for being the top city for cultural diversity, passing New York City and Los Angeles. Understanding how different cultures approach death is very important. Through hospice, we provide grief services for everyone involved, but cultural practices are often overlooked. There are many transitions that happen at the end of life and through these transitions there things you should consider.

a patient’s perceptions of health and suffering;
a patient’s perceptions of death and dying;
accepted health care practices and remedies;
accepted religious and spiritual beliefs, practices, and rituals;
communication patterns and common forms of expression;
the role of family, relationships

Once these things have been observed, the hospice provider can give the patient the proper care. The patient may believe that pain and death are a part of the journey of life. They may also believe that their family must be involved in all areas of their care. Some have religious limitations or rituals important to their end of life process.

Some may want nondisclosure about the serious illness of their loved ones. The reasoning behind this is discussing death is impolite in some cultures, or they don’t want unnecessary anxiety felt by their loved one. However, in 1990 the Federal Patient Determination Act and Patient Self Determination Act were passed, emphasizing the need for the patient’s consent.

The way to handle these situations is to be respectful of different cultural practices. By having respect and appreciation it will be easier to form a relationship with the patient and their family. Expanding your knowledge of different practices is important as well. The goal of hospice is to bring comfort to the patient and understanding their beliefs is a big part of that.

7 Hospice Myths and Misconceptions

Hospice care isn’t always the easiest thing to talk about and many people don’t have a clear idea what hospice actually is. Even after 25 years, most Americans aren’t aware of the advantages hospice brings. This mostly comes from our country’s resistance to talk about death. However, hospice is undoubtedly this best choice for end of life care. Not only for the patient, but the family as well. It’s so important to talk about and dismiss the myths that surround the hospice community.

The definition of hospice is a type of care and philosophy of care that focuses on the palliation of a chronically ill, terminally ill or seriously ill patient’s pain and symptoms, and attending to their emotional and spiritual needs. Here are seven of the most common myths of hospice

Hospice is a place– Actually, hospice care takes place wherever the patient needs. 70% of hospice patients are cared for in their homes.

Hospice is only for Cancer patients or AIDS patients– Statistically, more than half of hospice recipients are diagnosed with other terminal conditions. Serving families coping with the end-stages of chronic diseases, like emphysema, Alzheimer’s, cardiovascular, and neuromuscular diseases.

Choosing hospice means you have given up– The beautiful thing about hospice is that it helps families share in the end of life process, through personal and spiritual connection. Many families find immense comfort when looking back, knowing they did everything possible to make their loved ones final hours peaceful and comfortable.

Hospice is just for the patient– Hospice is a family-centered program, focusing on the grieving families just as much as the patient. Many hospice providers reach out the community as well.

Hospice is only for the elderly– Hospice care is for all ages. However, most patients are seniors.

Medicare won’t cover services– Beneficiaries can use their Medicare hospice benefits anytime they choose.

Hospice isn’t for people who need a high level of care– Most hospices are Medicare-certified, requiring that they employ experienced medical and nursing personnel with skills in symptom control.

What is Hospice?

Contact:

Jerry Mosbacher

832.410.3192

[email protected]

Accredited Hospices of America is specialized type of care for those facing a life-limiting illness, their families and their caregivers.

Accredited Hospices of America care addresses the patient’s physical, emotional, social and spiritual needs.

Accredited Hospices of America care also helps the patient’s family caregivers.

Accredited Hospices of America care takes place in the patient’s home or in a home-like setting.

Accredited Hospices of America care concentrates on managing a patient’s pain and other symptoms so that the patient may live as comfortable as possible and make the most of the time that remains.

Accredited Hospices of America care believes the quality of life to be as important as length of life.

Choosing to elect hospice care is an important decision that can greatly benefit the quality of life for a patient with a life-limiting illness in addition to proving support to a patient’s family during a difficult time.

To help you better understand how hospice care can benefit you or a loved one, we recommend that you review our list of Frequently Asked Questions (FAQs) listed below:

Is hospice for those with cancer only?

No, Hospice patients are living with a wide range of diagnoses including heart disease, cancer, dementia, lung disease and others. However, regardless of a patient’s condition or age hospices open their doors and their hearts to all persons diagnosed with life-limiting illnesses and their families.

Hospice is NOT a place.

Hospice services can be provided to a person with limited life expectancy and his/her family, wherever they live. This means a patient living in a nursing facility or long-term care facility and his/her family can receive specialized visits/contacts from physicians, nurses, aides, chaplains, social workers, and volunteers, in addition to other care and services provided by the nursing facility. The hospice and nursing home will have a written agreement in place in order for the hospice to serve residents of the facility.

How does hospice care begin?

Typically, hospice care starts as soon as a formal request or a ‘referral’ is made. Accredited Hospices of America will visit the patient within 48 hours of referral, pending the physician’s approval, providing the visit meets the needs and schedule of the patient and family/primary caregiver. Hospice care begins within a day of two of referral. However, in urgent situations, hospice services may begin sooner. The patient of a family member may “self-refer” and request an evaluation for eligibility for receiving hospice services.

What specific assistance does hospice provide?

Accredited Hospices of America hospice patients and their families are cared for by a team of doctors, nurses, social workers, counselors, aides, spiritual, caregivers, therapist, and volunteers- working together in a team to address the patient’s and family’s identified needs. In addition, hospices help provide medications, supplies, equipment, hospital services, and additional helpers in the home, as appropriate.

How does hospice manage pain?

Accredited Hospices of America’s nurses and physicians are experts in the latest medications and devices for pain and symptom relief. In addition, physical and occupational therapists assist patients to be as mobile and self-sufficient as possible, and they are often joined by specialists schooled in music therapy, are therapy, diet counseling,and other therapies. Accredited hospices of America believes that emotional and spiritual pain are just as real and in need of attention as physical pain, so it addresses these, as well. Counselors, including spiritual caregivers, are available.

Is there any special equipment or changes I have to make in my home before hospice care begins?

Accredited Hospices of America will asses your needs, recommend any necessary equipment, and help make arrangements to obtain it. Often the need for equipment is minimal at first and increases as the patient’s needs change.

Is hospice covered by insurance?

Hospice coverage is widely available provided by Medicare nationwide, by Medicaid in Texas, and by most private health insurance policies. To be sure of coverage, families should, of course, check with their employer or health insurance provider.

If the patient is eligible for Medicare, will there be any additional expenses to be paid?

Medicare covers all services and supplies related to the life-limiting illness for the hospice patient. In some hospices, the patient may be required to pay a 5% “co-payment” on mediation and a 5% co-payment for respite care.

When should a decision about entering a hospice Program be made and who should make it?

At any time during a life-limiting illness, it is appropriate to discuss all of a patient’s care options, including hospice. By law the decision belongs to the patient. Because hospice care includes family members and other caregivers, they are also considered an important part of the decision-making process. Sometimes, people have concerns about changing the focus of care from disease-modifying to focus on comfort care and quality of life. Accredited Hospices of America’s staff members are highly sensitive to these concerns and are always available to discuss them with the patient, family and physician.

What is Palliative Care?

If you are not familiar with the term ”palliative” care, it is a medial specialty focused on managing the physical and emotional impact of serious illness. Sometimes people think palliative and hospice care are synonymous. They are not. Some organizations provided both hospice and palliative care. Hospice is a specific branch of palliative care for those with a terminal diagnosis. It is important to know you DO NOT have to forgo curative treatment or have a terminal diagnosis to receive palliative care.

ACCREDITED HOSPICES OF AMERICA AWARDED GOLD SEAL OF APPROVAL FROM THE JOINT COMMISSION

June 12, 2015
Contact: Debbie Mosbacher 832.408.7999 [email protected]
ACCREDITED HOSPICES OF AMERICA AWARDED GOLD SEAL OF APPROVAL FROM THE JOINT COMMISSION
HOUSTON, TX, JUNE 12, 2015, Accredited Hospices of America today announced that it has earned The Joint Commission’s Gold Seal of Approval® for Hospice Accreditation by demonstrating continuous compliance with its performance standards. The Gold Seal of Approval® is a symbol of quality that reflects an organization’s commitment to providing safe and effective care.
Accredited Hospices of America underwent a rigorous on-site survey in June, 2015. During the survey, compliance with hospice care standards reflecting key organization areas was evaluated, including the provision of care, treatment and services, emergency management, human resources, individual rights and responsibilities, and leadership.
Established in 1988, The Joint Commission’s Hospice Accreditation program supports the efforts of its accredited organizations to help deliver safe, high quality care and services. Accreditation by The Joint Commission and the gold seal serve as an indication that the organization has demonstrated compliance to these recognized standards of safe and quality care.”
Accredited Hospices of America is pleased to receive accreditation from The Joint Commission, the premier health care quality improvement and accrediting body in the nation,” added Jerry Mosbacher, Administrator, Accredited Hospices of America. “Staff
from across our organization continue to work together to strengthen the continuum of care and to deliver and maintain optimal hospice services for those in our community.”
The Joint Commission’s hospice standards are developed in consultation with health care experts, home care providers and researchers, as well as industry experts, purchasers and consumers. The standards are informed by scientific literature and expert consensus to help organizations measure, assess and improve performance.
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The Joint Commission

Founded in 1951, The Joint Commission seeks to continuously improve health care for the public, in collaboration with other stakeholders, by evaluating health care organizations and inspiring them to excel in providing safe and effective care of the highest quality and value. The Joint Commission accredits and certifies nearly 21,000 health care organizations and programs in the United States. An independent, nonprofit organization, The Joint Commission is the nation’s oldest and largest standards-setting and accrediting body in health care. Learn more about The Joint Commission at www.jointcommission.org.

Accredited Hospices of America in Houston, Texas is a leading provider of hospice care and our goal is to provide the best and most comprehensive hospice care services available. Hospice care is not a standardized service; therefore, hospices cannot, and do not, provide the same level of care. We are different from other hospices in the Houston area because of our dedication to excellence and the inclusion of families in our care plans.

Accredited Home Health Care of America

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