This is a review of one of the four care levels that is covered by the Hospice benefit: RESPITE CARE. Respite is a service that provides care for a patient when the family needs a short period of a few days having someone else provide all care for the patient. Circumstances for this are typically unique that the family/caregivers need to leave the patient. A few examples of possible reasons for seeking respite care include: traveling to attend a wedding or graduation, to have home repairs performed, or to attend to their own health needs. The patient must be at their baseline and unable to be by themselves for those few days in order for Respite care to be offered. Respite care is often under utilized.

The Hospice benefit covers a renewable 6 month period. There are numerous provisions under this benefit and patients that are willing to accept the service sooner have a better opportunity to utilize the many different aspects of the Hospice service. A patient that qualifies and accepts the service does not eliminate every type of treatment by allowing the hospice team to help. Hospice does not require a patient to forego all treatment but the service does focus on quality of life and comfort. Studies reveal that patients that accept Hospice service earlier feel they have higher quality of life, and live better and longer than patients that wait till the last few days of life.

This episode provides a short discussion of the mechanics of CPR. We also briefly discuss why it may not be successful for sicker patients.

We review information basics of other Life Sustaining Treatments, such as: Ventilators, Artificial Nutrition, Blood product administration (transfusions), and Dialysis. LST's are life sustaining treatments - not life promoting treatments, not life restoring treatments or quality of life recovery treatments. Consider informing your physician and your family of your choices before a time of crisis. Electing a DNR, or Do Not Resuscitate order, does not eliminate all interventions and treatments. It can mean that a person wants every reasonable treatment but if the heart ceases to function, that a natural death (rather than one on machines) is preferred. Many elect for natural death with medical support to manage their symptoms, preferring to receive compassionate care at the end of life from a trained team through the entire process of death.

A Health Care Surrogate is the person that knows you and what quality of life means to you. A person you trust to be your voice should you never not be able to interpret detailed health information and make choices for yourself with regards to Complex Medical Decisions (not finances). This should be a person you have communicated with over time about how you like to live, what suffering means to you and your personal preferences for where you want to be at the end of life (at home with family and friends or at a hospital on machines).

Your physicians and nurses will want to know what you would and would not accept. This may change over time as disease states typically advance over time or as new treatments become available. Health Care has enjoyed tremendous advances in care and there are times when Ethical and Moral questions arise. The patient, family, physician and nurses may all ask for guidance to answer the question: would the patient find their health condition and this type of care as Life Promoting or Death Prolonging.

Today we wanted to talk about the burden of serious illness. In addition to the symptoms the patient experiences, there is additional burden on the patient and their loved ones. In this episode, we talk briefly about some of the different types of burden as well as some coping techniques that we have seen and encourage in our patients.

Hospice is not a death sentence. It is help by specially trained disciplines and offers many caring people to provide assistance to a patient and support the family as end of life approaches. We want people to not fear Hospice but to see how much help can be provided by the dedicated people that choose this employment as a way to demonstrate compassion for critically ill patients and families that are frightened beyond belief.

Hospice is a medical service that visits you in your home, providing assistance and care to patients and their family through a life-limiting illness. To receive hospice, you must qualify for and elect to receive this benefit which is covered by most insurance. The team of providers is comprised of many disciplines, including:

Palliative Medicine is a newer medical specialty to provide care and symptom management for patients with serious illness. Palliative medicine is not the same as Hospice. There are physicians that are specifically trained for Palliative Medicine and they have had their own exams and certification board since 1997, the American Board Hospice and Palliative Medicine.