Am just now starting to look into a future hospice scenario for my 92 year old mother. Way back when it seemed there were just a few publicized ones out there. Here in Arizona I was familiar with the names and had a pretty good idea which way to go. Now it seems like every home health agency has one and they have just popped out all over like weeds - many of the names I don't even recognize. Anyway, I am familiar with the hospice concept generally and what it does and does not offer. So, knowing this...is it worthwhile to research them? Does it really matter in the end which one to choose when the services are so similar?
For Profit
Not for Profit.
The Hospice I chose happened to be a Not for Profit. I could not be more pleased with my decision.
If your doctors office, or your Mom's doctors office has a suggestion you could ask them for their recommendations.
If there are any nearby go in and talk to someone. Just like you would interview anyone for a position, or evaluate a new Doctor or Dentist. If you are talking to one that is Not for Profit ask how well they are funded.
Big thing to keep in mind...once you select a Hospice provider you are not bound to them. If there are problems you can call and ask to talk to a supervisor. Although most Hospice have "teams" and you would be assigned to a specific team there is more than 1 nurse on the team, there is more than 1 CNA on the team so if you do not like who has been assigned you could request someone else. It might take time to reschedule people though. And as a last resort you can always either drop Hospice completely if you do not like the approach they are taking or you can contact another Hospice.
When I knew it was time for hospice, I spoke with the treating medical team at that time (my father was hospitalized). The highly recommended treating physician recommended that also. I spoke with the Discharge Planner, who recommended only one hospice company: the one the treating physician used to work with, as an executive.
I contacted them; the individual with who I spoke wanted to sign Dad up that very day. She was aggressive, not particularly cooperative, and I knew within 10 - 15 minutes I would never take him there.
I had a checklist which I used for others which I called, some of which were really peculiar. When I settled on a Catholic nonprofit as the leading contender, I arranged for an interview, met with an Intake person, toured all aspects of the facilities, and documented all my questions.
Someone from another division came out to interview me; when I raised issues asked by other hospice companies, she stated that she could not discuss, or ask, about that specific type of information. Yet all the other companies wanted that kind of information. I realized then how improperly they approached admission and addressing personal issues.
I can't recall specifically right now what information it was that was privileged; I certainly had enough experience with privileged information not to blurt out anything. But I was impressed that this woman had high standards, imposed by the hospital affiliated with the care facility providing hospice.
My decision worked out well; this was the best facility at which I ever took my father. The Sister on site offered me food and comfort, visited my father, as did the priest. But it was informal; no one was garbed in religious attire.
The DON was outstanding, as was the Social Worker. One of the rough days (I think it was the day we made the decision to switch to hospice), the head nurse on duty then brought me a plate of food, thermos of coffee and water.
I'm not religious, but I was never in a position to find religion to be an issue. And it might have been the best decision I made for my father. Looking back, I'm SOOOOOOO glad I didn't even investigate the other contenders more than I did.
On the the other hand, my cousins chose a hospice agency that provided a weekly doctor’s personal visit. I’m sure that took a chunk of $$$ from that agency’s overall budget. The agency they did not provide the daily home certified-nursing assistant that we enjoyed, nor was it associated with a hospice skilled nursing care facility.
My sister, living in another state, found a hospice agency for her husband that provided as needed face-time calls with the hospice doctor, a skilled nursing facility if needed, daily caregiver visits, social worker, chaplain, nurse, hospital bed, supplies, wheelchair, etc.
Each hospice agency gets a daily lump sum per patient from Medicare. The agency pools the funds and decides what services it’ll provide within their budget. Ask questions, seek input from others who’ve used hospice agencies in your area. Also look for online reviews (instrumental in my sister’s decision for choosing an agency to go with).
I never heard of hospice until my Mom was in the hospital, and the case worker told me about this wonderful group. Thus, I used the Hospice group she recommended. A meeting was set up so the group could explain their work, and for me to ask any questions. I also used the same group for my Dad.
Twenty years ago, when my dad died (in the hospital) of congestive heart failure a hospice person showed up to give support as they were actually trying to get my dad into a hospice facility (he died that same day so it never happened). However, the woman was very kind and supportive and actually ended up being with my mom when he died. (Of course, he died in the literally 5 minutes when I left the room to go home and walk my dog.) Anyway...I very much appreciated that she was there especially for my mom at that moment, and obviously I have never forgotten her. I don't know if that would have been the scenario today. I hate being cynical, but these comments confirm that hospice has become in large measure another money maker for the health care industry.
Dad was on hospice for over 3 years. He had prostate cancer that had spread to the kidney, lungs, and bones. I was told he would have a “speedy demise.” He didn’t, but his cancer diagnosis and his continued decline did enable him to stay on hospice for all that time. He had marvelous male CNA's who became his genuine friends.
Last week, I had my 92 year-old aunt admitted to a local hospice house owned and managed by one of our hospitals. My aunt had fallen a week before and fractured her femur, no surgery could be done due to her age and the fact that she had previously had hip replacement surgery. She also had advanced Alzheimer's. The hospital where she was admitted after her fall, wanted me to send her to a Rehab facility and even provided “their” list of possibilities. The Nurse practitioner said she was not a match for rehab, yet the case manager wanted us to place her in rehab. I called the hospice facility and asked them if there was any possibility of having her admitted. In less than 24 hours she was in this lovely facility.
Because I had visited a friend at this particular hospice house, I knew about it’s high recommendation and the caring staff. This was a great fit for her. The entire staff from the intake nurse to the Social Workers were fabulous. The nurse saw that my sister-in-law was playing hymns on her phone to calm and comfort my aunt and immediately went to retrieve a CD player and lovely CD's of hymns. They played that for her most of the time.
Having the necessary pain medications for end of life (including pain patches for break-through pain) are in my opinion a modern medicine blessing. I am grateful for the way it calmed and relaxed my parents and my aunt when they each needed it most. The medications do not speed up death, but they do allow it to take it’s natural course and keep the patient from the discomfort that the dying process brings.
Research the groups you know about. Ask your family, friends, neighbors if they’ve ever used a particular group and what they learned. “Word of mouth” may be the best advertisement for a hospice group, believe me if they did not meet the needs of the patient, your friends will voice that.
I'm happy with Good Shepard Hospice. Point is this--if you are not happy with the hospice you sign up with, you can easily revoke it by signing a paper, and get on a new hospice. You do not need a doctor's order because Medicare will see them as being hospice even when you revoke them.
Whatever you do, if you hear or see VITAS--RUN FOR THE HILLS!
***VITAS IS HORRIBLE***
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