The diagnosis of a terminal illness brings with it a host of questions, fears and concerns: “Will I be able to handle the pain?” “How will my family care for me?” “How can I afford quality end-of-life care?” And the question we hear most frequently: “Can I stay at home?”
Faced with a life-limiting prognosis, some 90 percent of patients prefer to remain in their homes, using the bed they know, surrounded by people they love, continuing the routines that make them comfortable. Whether they live in their family home, an adult living community or a nursing home, they want to age—and die—in place.
For terminally ill patients, hospice makes that possible. Hospice patients are cared for by an interdisciplinary team of hospice experts, including a physician, nurses, hospice aides, social workers, chaplains and volunteers who provide medical care, spiritual, social and emotional support to terminally ill patients and their families.
“Hospice care typically is provided in a patient’s home. This allows the patient to stay in a familiar setting surrounded by family and friends,” says Patty Perry, R.N., patient care administrator for VITAS Innovative Hospice Care® of Miami-Dade/Monroe.
Yet the perception persists that hospice means going to—or ending up in—a place. Hospice isn’t a place. Hospice is a philosophy of care; it focuses on enhancing a patient’s comfort and overall quality of life during the last months of life. By treating physical symptoms and providing pain management, as well as addressing emotional and spiritual concerns, hospice can make the dying process more meaningful for patients and their loved ones.
When There’s a Crisis, There’s Continuous Care
But what happens when the patient has a medical crisis and experiences, for example, uncontrolled pain, intractable nausea, uncontrolled bleeding or severe confusion? Even then, hospice offers options to help the patient remain at home.
“Patients often experience acute symptoms when dealing with a terminal illness, as well as emotional, spiritual and psychosocial challenges,” says Rosario Salas, RN, CHPN. “This can make it difficult for patients to continue to receive care in their residence and it can be overwhelming for family members. But when things get difficult, VITAS can be there around the clock.”
VITAS provides Intensive Comfort CareSM—a service (referred to by the Medicare Hospice Benefit as “continuous care”) that puts a trained nurse or home health aide at the bedside up to 24 hours a day.
“It means a hospice patient doesn’t have to choose between the comforts of home and care at a hospital,” says Rosario, who, as a VITAS patient care administrator in Broward County, oversees that program’s Intensive Comfort Care teams.
“When the patient is most vulnerable to confusion or disorientation, VITAS Intensive Comfort CareSM keeps her in familiar surroundings. She feels at home and calm, surrounded by her own things and with her loved ones near,” says Nadine Brimo, R.N., team manager for VITAS Innovative Hospice Care® of Palm Beach County home care team. “Our staff also helps to ease the fears and feelings of helplessness family members may experience at such a time. The patient gets the care she needs, and the family gets the support and guidance they need too.”
