When someone you love is approaching their final days, it is devastating and hard to fully comprehend. Often families are left reeling from this heartbreaking reality only to be faced with the difficult choice of having to decide between nursing home care for their loved one, hospice at home, or a hospice care facility. Choosing where your loved will receive their end-of-life care requires thoughtful consideration of the critical differences between these choices.
Hospice Care
The general rule is that hospice care may be provided to someone when they have six months or less left to live and can no longer be helped by medical treatment. Hospice provides supportive or palliative care which is focused on providing compassion while keeping the patient comfortable. It is up to the patient, the patient’s family, and their doctor as to what hospice care is needed and when it should begin. Hospice care can be provided in the patient’s home or a facility. This approach emphasizes management of the patient’s pain and other symptoms rather than treatment of the disease. Its focus is on allowing the patient to move towards their final transition with the highest quality of life possible surrounded by their family.
Nursing Home Care (without hospice)
When a resident is not on hospice, nursing homes provide round the clock skilled licensed nursing care for patients in a facility. The primary focus of this care is to treat the illness and work towards helping the patient recover. Unlike hospice, the care patients receive in this setting is not centered on meeting the emotional needs of the patient, but instead, their daily, physical, immediate, and emergency medical needs as they try to heal and ideally leave the facility.
For those who rely on Medicare, they will find that Medicare covers hospice care, whether at home or in a nursing home. It is important to note that, while Medicare covers limited rehabilitation in a nursing home, and hospice suervices may be covered in a nursing home, Medicare does not cover long-term care “room and board” of a resident at a nursing home. This leaves the patient and their family having to assess what is most needed as well as is most practical for their care. Many people will find that nursing home care affords them daily and medical care which they are unable to obtain at home, but it is lacking in terms of being focused on their comfort and emotional support.
The Choice
Ultimately, if possible, talking to your loved one about what they want regarding their care is the best way to help them make the choice that makes the most sense for their situation. From there you can help them make informed decisions by consulting with their doctor and getting a realistic idea of what to expect going forward. If it is not possible to effectively communicate with them, it is important to consider what you believe they would want and what the doctor is recommending.
Whatever end-of-life decision is made affects the patient and the family in significant ways. Therefore, it is essential to consider all of the implications of your decision. Our office has attorneys and other sources who understand and can help you contemplate all aspects of these choices to help make informed decisions. Please contact us if we may be of assistance.