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. Understandably, most people are uncomfortable with the idea of stopping an all-out effort to beat the disease. Hospice staff members are highly sensitive to these concerns and always available to discuss them with the patient and family.
Patients and families are eligible for hospice care as soon as a physician’s prognosis indicates the patient has a life-limiting illness. VNA Hospice programs and services are available to Indian River County residents of all ages with a limited life expectancy resulting from any illness.
The patient and family should feel free to discuss hospice care at any time with their physician, other health care professionals, clergy or friends.
Our admissions coordinator will call to set up an appointment with the patient, the patient's caregiver (usually a designated family member) and other family members. A VNA Hospice admissions nurse will then visit the patient where they are residing, or in the hospital, and complete a detailed physical assessment of the patient's condition. Our interdisciplinary services are described, questions are addressed and the patient can choose to come under VNA Hospice care at that time. One of the patient's caregivers must attend the initial assessment, which can be scheduled after business hours and on weekends. Family members are encouraged to be present.
If the patient’s condition improves and the disease seems to be in remission, patients can be discharged from VNA Hospice and return to aggressive therapy or go on about their daily life. If a discharged patient should later need to return to hospice care, Medicare and most private insurance will allow additional coverage for this purpose.
In the early weeks of care, it’s usually not necessary for someone to be with the patient all the time. Later, however, since one of the most common fears of patients is the fear of dying alone, VNA Hospice generally recommends someone be there continuously.
VNA Hospice patients are cared for by a team of doctors, nurses, social workers, counselors, home health aides, clergy, therapists and volunteers. In addition, VNA Hospice helps provide medications, supplies, equipment, hospital services and additional helpers in the home, if and when needed.
No. Although 90 percent of hospice patient time is spent in a personal residence, some patients live in nursing homes, assisted living facilities or the VNA Hospice House.
VNA Hospice believes that emotional and spiritual pain is just as real and in need of attention as physical pain, and it addresses each. Hospice nurses and doctors are up to date on 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 trained in music therapy, art therapy, massage and diet counseling.
Very high. Using some combination of medications, counseling and therapies, most patients can be kept pain free and comfortable.
Usually not. It is the goal of hospice to allow the patient to be pain-free, but alert. By constantly consulting with the patient, VNA Hospice has been very successful in reaching this goal.
Hospice care is reimbursed by Medicare and Medicaid, most private insurance policies, preferred provider organizations (PPOs) and other types of funding. Coverage is available as a benefit under Part A to individuals who elect to receive non-curative care and services for their life-limiting illness by waiving the standard Medicare and Medicaid benefits for traditional treatment of the illness. However, patients may continue to access standard Medicare and Medicaid benefits for treatment of conditions unrelated to the hospice diagnosis.
The Hospice-specific benefit under Medicare and Medicaid provides comprehensive coverage for services that relate to the patient’s life-limiting illness and are outlined in the patient’s plan of care when they enter the VNA Hospice program. This includes medication, nutritional supplements, medical supplies and equipment, and counseling services for patients and families, as well as the services of physicians, nurses, social workers, home health aides, therapists, bereavement specialists and chaplains. At the Hospice House, there is a room and board fee that is assessed to the patient that is not covered by Medicare and Medicaid. The fee is determined when a patient enters the Hospice House.
No, more than one-fifth of hospice patients nationwide have diagnoses other than cancer. Increasingly, hospices are also serving families coping with the end stages of chronic diseases, like emphysema, Alzheimer’s, heart and neuromuscular diseases.
Yes. Patients and families are eligible for hospice care as soon as a physician’s prognosis indicates the patient has a life-limiting illness, regardless if a patient has a feeding tube. VNA Hospice staff provides support and guidance to patients and their families regarding treatment options and end-of-life decisions.
Hospice provides continuing contact and support for family and friends for at least a year following the death of a loved one. VNA Hospice also offers bereavement groups and support for anyone in the community who experienced a death of a family member, friend or co-worker.
VNA Hospice offers 24 hour a day, seven days a week on-call availability for emergencies. To reach VNA Hospice any time, you may call (772) 978-5600.
If hospitalization is needed, the VNA Hospice interdisciplinary treatment team will coordinate the transition and maintain contact with the patient and their family during the patient's stay in the hospital. VNA Hospice has contracts with all hospitals in our service area.
VNA Hospice provides care in skilled nursing homes, assisted living residences and retirement communities. VNA Hospice also provides consultation on pain and symptom management as well as ongoing training/education on patient care, family needs and grief and loss information and support to facility staff.
VNA Hospice serves all of Indian River County, Florida.
The primary/referring physician is a part of the VNA Hospice interdisciplinary treatment team. Team members update and consult with the physician on a regular basis.
If the patient's disease follows its normal course, without curative treatment, the life expectancy is usually six months or less. However, patients will not be discharged from VNA Hospice care if they exceed that time frame, as long as they meet the criteria for receiving hospice care.
Palliative care is the active total care of patients whose disease is not responsive to curative treatment. Palliative care is interdisciplinary, team-based care that helps alleviate pain and symptoms to improve quality of life. Palliative care enhances an individual's overall well being by addressing physical, emotional, social and spiritual needs during a life-limiting or life-challenging illness. Palliative care can be used to help people from the point of diagnosis of serious or chronic disease, even as effort to cure continue.
Hospice is a holistic approach to end-of-life care, in the home or home-like setting, addressing the physical, emotional, psychosocial and spiritual needs of the patient and family. It is important to have adequate time for the interdisciplinary care team to establish a rapport with the patient/family so that goals can be accomplished and care giving relationships and trust life care with your physician.
No. VNA Hospice does nothing to either speed up or slow down the dying process, but recognizes that death is a natural part of life. Just as doctors and midwives lend support and expertise during the time of childbirth, VNA Hospice provides its presence and specialized knowledge during the dying process.
In order to be admitted to the Hospice House, each patient will need to meet the following criteria:
- confirmed diagnosis of a terminal illness
- lack of available caregiver
- care needs exceeding the caregiver's abilities