How to Choose a Hospice
What is hospice?
Not all hospices provide exactly the same services. How services are delivered changes from one hospice to another. Below are some areas you should consider when looking for a hospice program. Hospice of Marion County is your hometown hospice. We have been serving our friends and neighbors since 1983 as a not-for-profit, full-service comprehensive organization.
Our expansive program includes our own medical staff of employed physicians, each of whom make up to 90 house call a month. Our specialty programs enhance quality of life for those with cardiac, pulmonary and neurological diseases and our three hospice houses offer premier 24-hour care in homelike settings.
Why Choose Hospice of Marion County?
- How long has the hospice been in existence?
Hospice of Marion County is the only not-for-profit hospice in Marion County. It began as an all-volunteer agency in 1983. Today, it employs 250 highly trained professionals and has 700 trained volunteers to serve the individual needs of our friends and neighbors.
- What services are provided?
The Interdisciplinary Team consists of physicians, palliative care specialists, nurses, certified nursing assistants, social workers, chaplains, bereavement facilitators, pharmacists, equipment providers and more. Read more about what each area has to offer in terms of support.
- Who owns the hospice?
As a not-for-profit organization, Hospice of Marion County is overseen by a volunteer Board of Directors, comprised of the community’s premier leaders in business, healthcare and finance.
- What kind of support is available to the family/caregiver?
The family is considered the unit of care. Just as important as providing comfort measures for the patient is support for the caregiver and the family. We “meet families where they are,” meaning the family decisions are respected at all times and the level of services offered is only what they request.
- How often will a nurse or aide visit?
As often as required. By law, a nurse makes a face to face visit every two weeks, but as the condition progresses, that could become a daily visit. Certified nursing assistants visit at least three times a week to assist in bathing and personal needs. Volunteers fill in where needed for running errands or household tasks.
- How are home caregivers trained?
Our professional staff is encouraged to pursue continuing education credits (CEs) to meet their highest skill level; tuition reimbursement covers those costs. Volunteers are required to pass a 2-hour training program, which is offered monthly.
- What roles do the attending physician and hospice play?
HMC is the only hospice that employs its physicians, known as Medical Directors. Currently, it employs 7 medical directors.
- What does the hospice volunteer do?
Volunteers provide companionship, do errands, offer transportation and serve light meals or perform some housekeeping.
- How does hospice work to keep the patient comfortable?
Our palliative care (comfort medications) are individually compounded by our own pharmacist. Medications are delivered to the patient’s home and are covered by Medicare. Our physicians and nurse practitioners are highly trained in this specific titrating and provide the right amount of medication for each patient. No two patients are alike.
- How are services provided after hours?
Our on call nurses are available 24/7, 365 days a year. In the event of an emergency or acute condition, we offer Crisis Care in a patient’s home, eliminating needs for calling 911 or waiting in the hospital’s emergency room.
- How and where does hospice provide short-term inpatient care?
Our three hospice houses are located throughout the county. We have 64 beds, more than any hospice of our size in the nation.
- Can hospice be brought into a nursing home or long-term care facility?
Yes, our philosophy of care is called Aging in Place. We offer the same level of care wherever a person calls home: a nursing home, assisted living facility, or their private home.
- What quality standards does the hospice meet?
Quality and excellence of care is our gold standard. Our Quality Improvement department continually seeks to meet and exceed the needs of our patients and families. The director, Deb Ronaldo, 352-873-7442, and her staff are available at all times to take care of individual concerns.
Frequently Asked Questions about Hospice
Here are the top 10 questions:
1. When should a decision about entering hospice be made—and who should make it?
At any time during a life-limiting illness, it is appropriate to discuss all of your health care options, including hospice. By law the decision belongs to the patient; a user-friendly legal document called The Five Wishes ensures that the patient’s desires are followed.
Understandably, most people are uncomfortable with the idea of stopping an all-out effort to “beat” their disease. Hospice of Marion County team members are highly sensitive to these concerns and are always available to discuss health care options. Anyone with a prognosis of 1 year to 6 months is appropriate for Hospice care. The earlier a patient is admitted, the better Hospice is able to provide its full scope of services and help the entire family maintain good quality of life. Our pre-hospice program, Transitions, is an appropriate alternative for those with a longer life expectancy (1 year), who may not feel ready for Hospice and are still seeking aggressive treatment such as radiation therapy or chemotherapy.
2. Should I wait for our physician to raise the possibility of hospice or should I ask about it first?
The patient and family should feel free to discuss hospice care at any time with their physician or other healthcare professional. However, a physician is not the only one who can make a referral. Anyone may call hospice—the patient, a family member, clergy or even a friend. Once a call with basic information is made, the admissions team provides all the follow-up required to determine whether the patient is eligible for hospice, and in most cases, begin comfort care within 24 hours. You can call the admissions office at 352-873-7415 to discuss your options. Our admissions nurses will contact your physician if you wish and make all necessary arrangements for your care.
3. Can a hospice patient who shows signs of recovery leave the program and return to active treatment?
Yes. If improvement in the condition occurs and the disease seems to be in remission, the patient can be discharged from hospice and return to aggressive therapy. A discharged patient can return to Hospice of Marion County care when or if it is needed at a later time.
4. Does hospice do anything to make death come sooner?
Hospice does nothing to speed up or slow down the dying process. Just as doctors and midwives lend support and expertise during the time of childbirth, hospice provides its presence and specialized knowledge in pain control and symptom management during the dying process as a natural part of life.
5. Do I have to be living in a private home to receive hospice services?
Although most hospice services are delivered in the home, some patients live in nursing homes, assisted living facilities, residences of friends or relatives, hospitals or one of our Hospice Houses, which are located throughout Marion County. The only requirement is that the patient is residing in Marion County for at-home care. Our Hospice Houses have no residency requirement and come from all over the country.
6. Who pays for hospice care?
Hospice of Marion County services are covered by Medicare, Medicaid, most private insurances and HMOs (Health Maintenance Organizations). However, no eligible patient is ever denied hospice care because of inability to pay. Unfunded care is made possible by ongoing financial support through local fundraisers, our five thrift stores, memorial gifts and the generosity of donors.
7. I’ve never cared for a terminally ill person before. How will I know what to do?
One of the first things the Hospice of Marion County team will do is prepare a care plan that will address the individualized needs of the patient. The team works with each family to teach them how to care for their loved one. The hospice staff will visit regularly and is always available to answer questions. At the end of a long, progressive illness, nights especially can feel long, lonely and scary. Hospice of Marion County is staffed around the clock so we are available by phone at any hour. Nurses, family support counselors and chaplains make night visits as needed by the family. Hospice of Marion County is always just a phone call away.
8. What do hospice patients do when unexpected medical crisis occur?
Call nurses are available 24 hours a day by calling either our main number 352-873-7400 or a specific team number, which will be posted next to the phone. Family members will be instructed in advance on how to respond to a crisis.
9. What about hospice care for children?
Hospice of Marion County cares for patients of all ages. We have cared for those from three days old to 104 years of age.
10. Does hospice provide any help to the family after the death of a patient?
Hospice of Marion County is available to the family for up to 13 months after the death of a loved one to provide bereavement support. Individual counseling and support groups are also available to anyone in the community who is grieving regardless of whether they have used hospice services.
A specialized grief support for young people is offered through our Camp Mariposa program, which helps them learn coping skills and begin to heal. Like all bereavement support, these groups are offered as a free community service, which are supported by our fundraising events and the generosity of special donors.
Ask the Doctor: Mery Lossada, MD
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Your Questions Answered…
Q: Dr. Lossada, I am worried about giving my father morphine. He seems so drowsy and I can’t rouse him. Is this drug dangerous?
A: Your father may sleep for many hours after the first few doses of any opioid. This does not mean the dose was too high or that the medication is hastening the end-of-life process. In fact, long sleep could be the first comfortable rest your dad has had in a very long time. Our specially trained pharmacist carefully prepares dosages specific to the individual to provide just the right amount to ensure the patient’s comfort and safety. It is a fact that these pain-reducing drugs are safe for terminal patients; they cannot become addicts because opioids are not used as recreational drugs, but rather as adding quality of life, when pain and symptoms are properly managed.
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