Hospice Hope

What is hospice?Hospice Hope is a program for individuals and their families who are facing a life-limiting illness. An interdisciplinary team works with patients and their families, dealing with their physical, emotional, social and spiritual needs, at a time when a curative approach to care is no longer available.

Through skillful pain and symptom management and the supportive services of a professional and volunteer team, every effort is made to provide comfort and to enhance the quality of life for patients and families, enabling them to live as fully as possible.

What is hope? Hope is the belief that life and death have meaning. Hope is not the certainty of a good outcome.

Who is eligible?Agnesian HealthCare Hospice Hope serves those with a limited life expectancy, such as:

• End-stage heart, lung, liver, kidney or pancreatic diseases

• Cancer patients referred by a healthcare provider

• Some neuromuscular diseases, such as Lou Gehrig’s, multiple sclerosis or others considered appropriate by a healthcare provider

• AIDS patients

• Any condition considered

Who can make a referral?A referral may be made by the patient, family members, friends, healthcare provider, clergy or other agencies. After referral, a Hospice Hope registered nurse will contact the patient’s healthcare provider to see if hospice care is appropriate. A Hospice Hope associate will then contact

the patient and family to explain the program, and to see if they are interested in Hospice Hope. Hospice admission can then occur.

Who is on the Hospice Hope team?• ATTENDING PHYSICIAN - directs the medical care.

• MEDICAL DIRECTOR - represents the attending physician at weekly team meetings and provides program policy direction.

• HOSPICE NURSES - coordinates care as primary nurses, and are trained in pain and symptom control and comfort measures; the majority of registered nurses are certified by a national exam as hospice nurses.

• HOSPICE SOCIAL WORKER - assesses psychosocial needs, provides personal and financial counseling, and works with needed community resources.

• VOLUNTEERS - fill the gap between loved ones and professional caregivers. Volunteers are able to provide additional support and presence to patients and their families.

• HOME HEALTH AIDES - assists with personal care and related services.

• SPIRITUAL CARE - exists in the hope and belief that through appropriate care, patients and families will be free to attain a degree of mental and spiritual preparation for death that is satisfactory to them. Individual beliefs of the patient and family are always respected. If families desire, their own clergy are contacted to provide spiritual support. Agnesian HealthCare chaplains are available for patient and family support.

• BEREAVEMENT CARE - grief support follow-up for family/significant others, including children, for as long as needed.

Where Does Hospice Provide Care?ROUTINE HOME CAREThis provides a mix of professional and volunteer services on a regularly scheduled basis. It enables patients to live as fully as possible in their home environment and provides support for family members.

HOSPICE/NURSING HOME PROGRAMHospice Hope provides hospice care to terminally-ill nursing home residents and their families at contracted facilities. Hospice Hope works collaboratively with the patient’s provider and nursing home staff.

HOSPICE/ASSISTED LIVING FACILITIESHospice Hope provides hospice care to terminally-ill residents and their families at community-based residential facilities (CBRF) or residential care apartment complexes (RCAC).

HOSPICE HOME OF HOPEThis residential facility, located at 400 County Road K, Fond du Lac, offers hospice care to individuals who no longer wish to remain at home.• Sunroom/porch area• Meditation room • Patio, gazebo and outdoor pond • Licensed, Medicare-certified, Joint Commission on Accreditation of Healthcare Organizations (JCAHO) accredited

INPATIENT CAREHospice Hope serves patients in acute care settings for brief periods if needed to help stabilize uncontrolled symptoms.

CONTINUOUS HOME CAREHospice Hope provides “round-the-clock” staffing at home for brief periods if needed to help stabilize uncontrolled symptoms.

INPATIENT RESPITE CARERespite care relieves family members and significant others from the ongoing pressure and stress of care by removing a patient from the home for a period of up to five days at a time and placing them in a contracted site. Contact Hospice Hope for a list of contracted facilities.

When to referThe best time to refer an individual is when the prognosis is approximately six months and the person will be receiving palliative (comfort rather than cure) care. Many patients are admitted to hospice care with only weeks of life remaining and are unable to receive the full benefits of hospice care. Hospice is most effective when there is sufficient time to fully assess needs and strengths, to develop a suitable individualized care plan, and most importantly, to establish a relationship of trust to help patients and their loved ones through the terminal stage of illness.

TYPICAL EVENTS WHICH IDENTIFY A REFERRAL

• When continuation of curative treatments will increase patient’s suffering and not affect a positive change in the patient’s condition

• When there is a transition from curative to comfort care

• When a family shows stress, fatigue and concern with the responsibilities of caring for the patient

• When there are frequent emergency room visits

• When there is a hospital discharge with need for hospice home care services

• When a patient has the need for more aggressive management of symptoms, such as:

- pain, chronic or acute - complicated wounds - bowel obstruction - draining fistulas - nausea, vomiting - decubitus ulcers - profound weakness - pathological fractures - respiratory distress - difficulty swallowing - anorexia

• When patient/family would benefit from the full range of supportive services offered by hospice care

• When there is a concern for minimizing further costs to patient and family

• Medicare/Medical Assistance requires certification of a six-month prognosis

Admission Guidelines• Patient has a limited life expectancy of approximately six months if the disease follows its usual course

• A physician’s order is required

• Curative measures are no longer effective or appropriate

• Patient does not want aggressive life support measures implemented

• Patient resides within the service area of a Hospice Hope office

• A relative or caregiver must be available in the home or an alternate plan for care must be established

• Patients residing in contracted skilled nursing facilities may be eligible if Medicare is not paying for room and board

Procedure for referralAnyone can refer to Hospice Hope by calling (920) 923-7950 or (800) 236-4156.

• Physician determines appropriateness for hospice care

• Social worker or admission nurse will verify insurance information and set up appointment with the family for the assessment

Financial information• Admission to Agnesian HealthCare’s Hospice Hope is not based on ability to pay

• Most private insurance companies include hospice services among their benefits

• Hospice Medicare/Medical Assistance/insurance benefit covers many services not covered in traditional Medicare, including medications, medical supplies and equipment, and does not work with an 80/20 deductible for inpatient care (see Hospice Medicare/Medical Assistance benefit insert for more information)

• Attending physicians continue to bill Medicare Part B. Consulting physicians who render care related to the terminal illness bill hospice for 100 percent of the Medicare allowable rate.

Hospice Medicare/Medical Assistance benefitThe Hospice Medicare Benefit is a comprehensive benefit for hospice patients who are eligible for Medicare Part A. A similar benefit is also available for Medical Assistance patients. It includes a continuum of hospice home care and inpatient care.

The Hospice Medicare/Medical Assistance benefit is of value to patients and families in the following ways:

• Makes hospice financially responsible for payment of all approved services except attending physician’s services

• Covers medications, medical supplies and equipment (relative to the terminal illness) needed to manage the terminal illness at home and in other settings

• Provides up to five days respite care at a contracted site to relieve family from stresses of providing care at home

• Provides inpatient care when symptoms are out of control and cannot be managed at home

• Medicare hospice patients do not have to pay a 20 percent deductible; approved services are covered at 100 percent

• Allows therapies for comfort that may not be covered by traditional Medicare guidelines (such as music therapy)

• Patients continue to be eligible for care regarding conditions unrelated to the terminal illness through traditional medical coverage

• The Hospice Medicare Benefit is divided into periods, each of which requires a certification of the terminal nature of the illness by the attending physician: two 90-day periods and unlimited 60-day periods as long as the patient remains eligible for the hospice benefit; patients can opt out of the Hospice Medicare Benefit at any point and change to traditional Medicare/Medical Assistance coverage immediately

Volunteer programVolunteers are the heart of the Hospice Hope program. Volunteers can choose from a number of opportunities. The opportunities mentioned below are important in providing needed hospice care to terminally-ill individuals and their families in the community.

VOLUNTEER OPPORTUNITIES MAY INCLUDE:

• Companionship

• Respite for the primary family caregiver

• Additional presence and support during the final hours

• Certified pet therapy

• Certified Reiki therapy

• Veteran program/recognition

• Bereavement follow-up

• Office assistance and other non-patient contact areas of service

Training programAll Hospice Hope volunteers are required to complete a comprehensive training program and receive ongoing staff support, annual education and in-services. Volunteers are treated as members of the Hospice Hope care team. If you think you’d like to be involved in Hospice Hope on a volunteer basis, contact the volunteer coordinator at (920) 924-4662 or (800) 236-4156 in Fond du Lac; (920) 294-6220 or (800) 361-9499 in Green Lake.

How is care provided?Hospice Hope facilitates care in the home if it is appropriate and if the patient and family so desire. If home care is no longer possible or appropriate, hospice care is provided in a hospital setting, in a contracted nursing home, other facility or at the Hospice Home of Hope.

Coordinated staff services include medical direction, nursing care, social work services and other professional services. Registered nurses are available for visits 24 hours a day, seven days a week.

Pain and symptom management by trained hospice associates enhances the quality of life for patients. The family, in terms of emotional and spiritual needs, are both seen as recipients of care, as well as the patient. Meaningful relationships and family ties are encouraged and supported. Trained volunteer help is used extensively to support the patient, family and staff. Bereavement support for the family/significant others extends for up to 13 months after the patient dies. Family members are invited to a “Celebration of Remembrance” and are contacted by trained volunteers.

Not only does Hospice Hope care about me, they care about what my family is going through too.

Hospice care services• 24-hour, on-call nursing availability

• Nursing visits (scheduled and emergency)

• Social workers

• Home health aides

• Volunteers

• Counselors

• Spiritual care

• Bereavement care (13 months supportive care for family/significant others); also available (to eligible patients with prior approval) are Medicare/Medical Assistance/special insurance benefits• Medication costs relative to palliative (comfort rather than cure) care

• Medical equipment and supplies

• Oxygen, radiation, chemotherapeutics

• Physical, occupational and speech therapies

• Inpatient days outside DRG

• Continuous home care nursing during crises

• Respite care (up to five days)

Patients need not be homebound to qualify and will not be billed - Hospice Hope will be billed.

Agnesian HealthCare’s Hospice Hope is a licensed, Medicare-certified, JCAHO - accredited hospice agency.

Hospice service costsAll families who need and desire Hospice Hope can receive services regardless of financial resources and available insurance. Hospice Hope relies on grants and donations to provide funds necessary to provide this unreimbursable care.

Donations and grantsDonations, gifts, contributions, grants and bequests allow us to provide comprehensive care for terminally-ill patients or patients with life-threatening illnesses. This may include unreimbursable care, bereavement care and family support, oncology treatments, equipment for treatment, and other care. This tax-deductible philanthropic support can be directed to the Agnesian HealthCare Foundation, 430 E. Division Street, Fond du Lac, Wisconsin 54935 or by calling (920) 926-4959.

For more informationHospice Hope is a non-profit, Medicare-certified, licensed hospice agency. For more information or service, call:

Home-Delivered Services Home Care Hospice Hope Hospice Home of Hope

Fond du Lac: (920) 923-7950, (800) 236-4156 Green Lake: (920) 294-6220, (800) 361-9499

A registered nurse is available 24 hours a day.

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