Long Term Care and Hospice: Working Together

Hospice care can sometimes be difficult for some people to discuss since few of us want to think about the final chapter in a loved one’s life. But residents of Dubuque and elsewhere are encouraged to think of hospice, not as the end, but the next step in a process of quality care for someone special.

Employees at Above and Beyond Home Health Care and Hospice have heard plenty of questions and concerns about the relationship between long-term care and hospice care, or whether these programs should be thought of as separate or as part of the same continuum of care for a particular patient.

The “continuum of care” option makes sense: someone dealing with terminal health conditions or even chronic, progressive physical health conditions likely will need to make a transition from standard care to hospice care at some point.

This transition could take place in an assisted living facility or even home health care situations, where different medical professionals like massage therapists can visit a patient’s home on a regular basis.

Even if their immediate condition is stable, improving, or they don’t need hospice care in the short-term, at least, they or their family will have been provided information about long-term care and hospice services that can be utilized in the future.

There is always the possibility that discussions about long-term care and hospice care may be overwhelming and stressful to think about, especially if someone is switching quickly from “doing fine” to “needing a lot of help” to “receiving hospice.”
But it’s important that this information is shared since it can help prepare people for these discussions in the future and also get them comfortable with some of the processes and terminology.

Sense of community

Similarities between long-term care and hospice care can include access to the same types of employees. At a home health care agency, there could be employees who are trained in working with hospice patients as well as home health care patients.

For instance, massage therapists are able to provide soothing treatments for anyone. Massage therapy can reduce pain, provide comfort and generally help people relax.

It produces healthy endorphins, removes toxins, and can help improve motion and flexibility. It also can be especially welcome to someone in a hospice situation.

Social workers also are an important part of the process. Social workers can provide explanations and local resources.

Having similar employees at the long-term care and the hospice level can provide “closeness,” which is discussed in a 2008 research paper in Gerontology. The piece looked at the role of various stakeholders in end-of-life and long-term care settings, including family caregivers, licensed/registered staff, paraprofessional staff and employees of nursing homes. They found that a common theme of all the groups is being able to provide care and build relationships, which better benefits overall care to the patient or patient at whatever point they are in the care process. They also suggested that social workers should be included in these collaborations to a greater degree.

Current needs

The Gerontology study also said that 24 percent of older adults die in long-term care settings, which can include nursing homes, assisted living communities and patient homes. It also said that past studies into the topic of care in these points of someone’s life have often focused more on problems in the delivery of care, (poor pain management, poor communication, poor procedures/protocol, etc., rather than looking for possible ways to make things better.

The topic of “good deaths” or “bad deaths” in a long-term care situation seems to be an area that has a lot of potential benefits for patients/patients but there isn’t a lot of firm data or research.

Modern Health, an online wellness resource, said that the current system needs a better way to decide whether someone who needs long-care right away and hospice care soon should be given choices to relocate to a care facility or stay home.

It said that often patients are told that they have to relocate, even if they potentially only have a few months of life left and will likely pass away at the new facility.

This particular article said that providers often blame Medicare for requiring relocation for long-term care, but actually Medicare can pay for in-home care in some situations, which is generally where people would like to complete their life if given the choice.

Be more aware

This month is a good opportunity to learn a little more about long-term care options. November is Long Term Care Awareness Month, where people can discuss what type of care is available and plan for the possibility of themselves or a loved one needing it in the future.

Financial experts recommend long-term care insurance as a tool to help them afford more options in the future, rather than them or family members having to decide something in a hurry if someone’s health changes rapidly.

Planning ahead can make it easier to make decisions when the time comes and be aware of different types of available challenges and opportunities.

The team at Above and Beyond Home Health Care knows that the care process and the hospice process can be confusing and even emotional. But being aware of different possibilities and trying to collaborate with various employees can go a long way to having things make sense.