Hospice St. Elizabeth[/caption]Carol Forsloff--"I don't think she will live past the next month or so, so you need to prepare her for hospice." But who pays for this help from hospice and how?
Molly Gideon's family worries about their mother, whose condition at a hospital had deteriorated significantly. Hospice care was the recommendation by medical staff.
For the senior, the answer for who pays is Medicare. There is a hospice benefit that provides for hospice intervention for an individual with a disease, illness or disabling condition that is determined to likely cause death in the next six months.
Medicare pays for a variety of services related to hospice care including doctor's visits, nursing care, medications and a host of special services, including counseling related to end of life.
80% of those requiring hospice are over the age of 65. What happens to those who don't qualify for Medicare and are too young to receive the benefits?
People without Medicare coverage must rely on private insurance plans. Many private insurers pay for an individual's care during the end-of-life phase. Even in those instances where the patient survives, the costs for care are provided so long as the doctor states that the condition is terminal.
Hospice care does not include payment for room and board, but does pay for respite care for the caregivers. So if a family member is involved in providing care at home, the program provides an aid to give the caregiver a respite in the process.
The dying process is complex, according to those involved in caring for terminally ill patients. For that reason, hospice workers help the family understand the process, as too often family members over-estimate a patient's likelihood of survival. The denial of death is not just confined to the patient in the stages of death and dying but also family members. Hospice is designed to assist with the experience of dying that involves a number of issues, including shock, grief and denial. While some folks will arrange their affairs to make the best use of their time, talents and resources, others may just remain in despair, unless they have help.
While experts maintain the counseling helps the dying deal with the process in the stages of end of life, politicians intervened to prevent its inclusion in the Obama health care bill, with folks like Sarah Palin calling it "death panels," a statement proved false following fact checks. Instead it would allow doctors to provide end-of-life counseling, not recommending suicide or providing the mechanisms for it or pushing people towards unnecessary end-of-life procedures, as was the accusation. While the false claims made against the end-of-life counseling created such a firestorm that the provision was removed from the bill, nevertheless its implementation through a regulation-writing process in 2010, to allow doctors to be paid for helping patients make decisions regarding death and dying. This would help individuals without insurance, or those who do not qualify for Medicare or Medicaid, to have information already available through insurance for those able to pay for it now.
And while questions continue to be raised about the nature and need for hospice, it is a common part of the healthcare provisions in Europe.
