House or Home
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Hospice care is a delicate and precious form of healthcare for anyone who, when a disease runs its normal course, has been given a life expectancy of six months or less. The unknown elements of a life limiting illness can be daunting, overwhelming and scary. When hospice is involved, they help shift this chapter of life from death to living; living fully and focusing on things that matter most for the patient and their family. Campbell County Health's Hospice team's purpose and goal is to provide the patient, family and friends with a chapter in life full of dignity, respect, comfort, and quality.
How is Hospice Care Given?
Hospice care is given by a multitude of healthcare professionals and volunteers within three care models categorized as
- general inpatient hospice (GIP)
- respite care
- routine home care, home hospice or outpatient hospice (used interchangeably)
General inpatient hospice and respite care are both provided in a 24-hour facility such as a hospital or hospice house; while home or outpatient hospice is provided where the patient calls home.
General inpatient care (GIP) is intended to help manage a crisis situation and control unmanaged symptoms; typically lasting one to two days of inpatient care. One indicator for needing general inpatient care is when registered nurse (RN) care is needed an average of every 30 minutes.
Respite care is intended to provide a break, for up to five days, for caregivers who normally provide care in the home and includes the intent for the patient to return home within those five days. Respite care also provides for the last few days of life when a patient and family don't want to die where they call home.
Who Pays for Hospice Care?
Patients who prefer an inpatient care facility such as Close to Home Hospice House are often eligible to use their private insurance or Medicare benefit that covers outpatient hospice for the inpatient setting but not for room and board. Medicare and most private insurance do not cover 24-hour care charges, also called room and board (R&B). Therefore, the patient and family are considered self-pay and are responsible to pay for the $265.50 per day of room and board charges. Patients who qualify for Medicaid, which is usually income based, can use this benefit to cover the room and board costs in a 24-hour facility. Medicaid covers at $90.88 per day for room and board.
What Happens When Hospice is in the Home?
Routine home care, home hospice or outpatient hospice is provided where the patient calls home. Home can be the patient's residence, assisted living, a group home, nursing home and even the home of a family member. Nurses, CNAs, social workers and volunteers visit the patient's home as often as necessary to provide care needs.
Whether in the home or just a phone call away, nurses work closely with the doctor to manage symptoms and provide appropriate medications, medical equipment and other supplies needed for care. Additionally, nurses talk with the patient and family about the stages of death, how to help the patient with discomforts and other care needs. During regular in-home visits, CNAs assist with and teach the caregiver about bathing, dressing, meals and meal alternatives along with other daily living needs. Along with caring for the patient's physical needs it is essential to tend to the emotional and spiritual needs of both patient and family. A hospice social worker guides the patient and family in their emotional journey, supports any spiritual needs by making arrangements with the chaplain or church and helps facilitate bucket list items or final wishes. Humans are social creatures and the hospice philosophy uses trained volunteers to help with social needs. Volunteers participate in 16-hours of hospice specific training and then become available to provide breaks for caregivers, add conversation or help with interests of the patient such as scrap booking, memoir writing and more.
End-of-life is different for every single patient and family and knowing an expert is available when you need them, day or night is invaluable. In the moment of change or need, families don't need to get their loved one to the Emergency Department, wait until morning or try to figure it out themselves. A hospice nurse is available by phone 24-hours-a-day, seven-days-a-week and 365-days a year to answer questions, provide support, make a home visit or deploy emergency care when needed.
Comfort and quality of life at home, 24-hour support from the hospice team and the most insurance coverage are often what lead patients and families to choose hospice at home. The majority of hospice care in Campbell County, Wyoming is provided in this manner. Ultimately, now and in the future, as citizens and our neighbors close and open chapters in their lives, Campbell County Health's Hospice team is ready to provide excellent care every day.
Download the Typical Week of Hospice Care at Home infographic (PDF).
To learn more about Home Health and Hospice, please visit www.cchwyo.org/hhh.