End of life choices are among the most challenging decisions the individual and/or family will make. Nursing is in an ideal position to assist the patient/family to navigate the challenges of end of life care. Most Medicare/Medicaid Providers of Services like hospitals, nursing homes, and hospices are required to provide the patient with information regarding the right to accept or refuse medical care. An informed nurse can encourage the patient to consider the benefits of exercising the right of self-determination in health care matters. Personal health care preferences can be formalized in an advanced directive or other legally enforceable life/end of life planning document.
Some terminal patients may opt to pursue all available curative options, including extreme life-sustaining measures. Others may choose to avoid drastic measures if a significantly diminished quality of life outweighs the benefits of treatment. Hospice may be an appropriate option for those patients who choose the latter.
Hospice is a medically supervised end of life option that promotes quality of life in a patient's last months. Hospice provides patient-centered care that includes medical, nursing, psychosocial, and familial support for the terminal patient.
Hospice is still a relatively new health care option in America. It continues to evolve to meet the standards set by the Centers for Medicare & Medicaid Services within the limits of funding authorized by the U.S. Congress. It is essential to be familiar with the rules that determine eligibility and the extent of benefits available to the patient as well as the cost and value of the hospice industry.
Much of what is described in this course is about hospice care provided by Medicare and Medicaid Services. To be eligible for Medicare and Medicaid hospice care, the patient must meet the following criteria:
The Veteran's Health administration and some private insurers offer hospice care, particularly for those under 65. Generally, all other hospice care providers follow the approaches outlined by Medicare and Medicaid.
The hospice approaches described here are mostly standard care. Individual providers are now modifying that care because of the COVID-19 epidemic. Providers attempt to provide as much care as possible, limited by the degree of COVID-19 spread in the area. There is a discussion about these modifications throughout the course.
We hope you find this educational offering informative.
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A person must be 62 or older to be eligible for Medicare.
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