When you have a loved one who is deteriorating in health, you’ll inevitably come across some terms you’re not familiar with. Two terms that you’ll probably hear frequently are home health and hospice (sometimes called home hospice). Unfortunately, these two terms get used interchangeably a lot, which adds to the confusion. Home health and hospice refer to two very different services for two very different scenarios.

Home Health

A patient receives home health services when they need occasional medical services. This can include: physical therapy, speech pathology, occupational therapy, or nursing care. The patient’s doctor will be in charge of overseeing treatment from the various members of the home health team. Regardless of the treatment provided, all progress will be carefully documented to chart any improvement or decline in the health of the patient.

Home health care can be provided for as long as the doctor in charge feels it is working. Once the doctor feels the patient is no longer responding well to home health care, they will recommend the patient be transferred into the care of a hospice provider. This transition isn’t an abrupt or sudden change, often there’s an overlapping period when the home health and hospice agencies are working together to ensure a smooth transition.

Hospice

In order to qualify for hospice care, a patient must have a diagnosis of less than six months from a certified doctor. In most situations, hospice care will be provided at a patient’s home from a Medicare-certified provider. A hospice care team will of some combination of a: social worker, doctor, chaplain, bereavement specialist, volunteer, nurse, and hospice aid.

Although hospice patients are required to have a six-month prognosis, patients can receive care for longer than six months if their physician continues to give a limited life expectancy prognosis. Another big difference between hospice and home health is that Medicare can cover 100% of hospice costs including personal care and equipment, and hospice is available for 24/7 care.

We hope this clears up some confusion, and we hope you’ll consider using Cura-HPC when the time comes for one of your loved ones to enter hospice care. 

Most people have heard the term “power of attorney” before, but a lot of people don’t know that there are actually two different kinds – medical and financial. It’s important to designate both, because only designating a financial power of attorney will not allow your representative to make health care decisions, and vice versa. Laws concerning power of attorney vary from state to state so it’s always a good idea to consult a skilled estate planning lawyer when making these sort of plans.

What Does Power of Attorney Do?

This document allows you to guarantee your medical and financial desires are adhered to in the event you are incapacitated. This is done through a trusted person you elect to carry out your final wishes and make any necessary decisions.

Medical Power of Attorney

A medical power of attorney gives your representative the ability to make decisions about your treatment options and when to remove feeding tubes and ventilators. This person will be charged with making any decision that is not covered in an advance directive.

Financial Power of Attorney

A financial power of attorney will have control of paying bills and selling any assets. They will also have access to any banking and investment accounts, and can make withdraws in order to pay for necessary goods and services.

It is possible to designate the same person as both medical and financial power of attorney, and this is actually quite common. The person you choose could be a friend, family member, or even a lawyer, all that matters is that you pick a competent person you can trust. Once you’ve decided who is right for each role, give a copy of your advance directive if you have one, and go over it to see if they have any questions. 

Dementia is a word most are familiar with, but few fully understand. The majority of people probably think of dementia as a condition that affects memory. While this is part of dementia, it’s not a full and accurate view of the disease. Dementia is actually a fatal disease for which there is no cure.

There are three primary stages of dementia and it’s best for people with older loved ones to be aware of all three stages to spot the early signs of the disease.

Early Stage- The first signs of early stage dementia are small memory lapses like frequently losing or misplacing things. They might also struggle to remember names or words in conversation. Many may try to write this off as a natural consequence of getting older, but if you notice these signs there are early treatment methods that might be beneficial.
Middle Stage- As dementia progresses, individuals will have trouble remembering where they are and what they’re doing. Planning and organizing their days will become increasingly harder as well. Changes in personality or sleep patterns are also very common for this phase.
Late Stage- Once they enter late stage dementia, the individual will require round the clock care. Taking care of themselves, dressing, and eating will all require the assistance of someone else. During this stage, they are also incredibly susceptible to infections and other diseases so keeping up proper hygiene is very important.

How Can Hospice Help?

Once a dementia patient reaches the point that they qualify for hospice care, there are many ways a trained hospice caregiver can help. Typically, in late stage dementia communication is very limited, so it can be hard to understand what the patient needs to be comfortable. Our staff is trained to understand and treat the needs of dementia patients. We can also help family members understand what their loved one is going through and how they can best offer support. 

When a loved one enters into end of life care, it’s natural for family members to experience a reaction known as anticipatory grief. This refers to feeling grief before an impending loss. The emotions associated with anticipatory grief can be hard to understand and manage, but it’s important to remember that this is a natural and common reaction to an approaching loss of a loved one. When going through anticipatory grief here are a few helpful things to keep in mind.

Acknowledge Your Grief- A very common tendency when experiencing anticipatory grief is trying to suppress the grief because you’re loved one is still alive. It’s important to let yourself start the grieving process and not feel like you need to hide your grief. Try to find ways to express your grief in healthy ways like journaling or art.

Reach Out- Odds are you’re not the only one in your family or group of friends who is having anticipatory grief. Don’t be afraid to reach out and talk about what you’re going through with other friends or family. If you’re not ready to talk with people you know yet, find an online forum or a grief counselor to talk with.

It’s Not Giving Up- Just because you accept your grief and are dealing with it doesn’t mean you’re giving up on your loved one. You can still be there to support them, love them, and care for them. Don’t feel like you’re losing all hope of recovery or accepting the inevitable. It’s okay to experience grief and still be hopeful at the same time.

Cherish the Remaining Time- Do your best to enjoy the time you have left with your loved one. When you’re with them, don’t focus on the grief just make the most of the time. Think about how they would want to spend time with you and try to make it happen.

Take Care of Yourself- Greif, even anticipatory grief, can take a huge toll on you. Make sure you’re still sticking to your regular diet and exercise schedule. Avoid the temptation to stay cooped up at home all day. Even in small doses, human interaction and fresh air will go a long way.

The biggest thing to remember is that anticipatory grief is normal, so don’t feel like you need to hide from it. If you feel like the grief is getting to be too much to handle, find an experienced grief counselor to help you work through it. 

Trying to manage end of life care for a loved one when you’re hundreds or even thousands of miles away presents a set of problems few know how to deal with. While this is certainly a difficult time, there are a few things you can do to make it more bearable.

Have an Emergency Plan

Make sure you have a written plan for emergencies your care provider can follow when needed. Having this plan will greatly reduce the stress you feel for not being there when an emergency happens. This plan should include advance directive and power of attorney for medical and financial decisions that might need to be made. A list of contacts for doctors, pharmacies, and lawyers should be included as well. In addition to this plan, ear mark some money for last minute travels and let your employer know you might need to take some time off soon.

Find the Right People

Since you can’t be there, assemble a team of people you trust to take care of your loved one’s needs. Create a list of local friends and family members who can help check in on your loved one from time to time. See if they would also be willing to meet with healthcare providers to ensure your loved one is getting the best possible care.

Maximize Visits

When you’re caring long-distance, the few moments of in person time is incredibly valuable. To make the most of every visit it’s best to talk to the healthcare provider before visiting to get an update on the condition of the loved one. Also ask if there are any appointments that will need to happen while you’re visiting. While you’re there try to take inventory of supplies in the house and double check that all bills are being paid. It’s also important to be intentional about assessing the needs of your loved one to see if their care program needs to be adjusted.

Providing end of life care via long-distance is never easy, but you can make it better. One of the best ways to facilitate long-distance care is to partner with an experienced hospice care facility like Cura-HPC. Our staff will guide you through this process and help make this difficult time easier.