The twilight of life
On a cold and dreary winter day in Coeur d’Alene, warmth and love emanated from inside the Hospice of North Idaho’s Hospice House. A man with his family nearby was tended to by a nurse — they watched as he breathed slowly and said nothing, but it was clear they loved him very much. This man’s final days and hours, maybe minutes, were made easier by hospice care.
“We go to great lengths to make this experience the best it can be,” said Cindy Reed, the director of Hospice House. “We will all go through this at some point.”
Hospice of North Idaho has served nearly 20,000 patients since opening in 1981 and is the largest hospice care operation in the state of Idaho, owning one of two in-care facilities in the state. Hospice of North Idaho is much more than just a facility. It comprehensive end of life care for individuals and their families.
“We're owned by the community,” said Reed. “We don't refuse anyone care because of their ability to pay or their reimbursement status. The only criteria are very simple: You have to have a physician's order, you meet the prognosis guideline that is set up by Medicare, and you want hospice care. Other than that, we have to follow Medicare's guidelines, but it's never based on financial reasons.”
Hospice of North Idaho is holding a wine tasting fundraiser Saturday, Feb. 6, at Hayden Lake Country Club. The event starts at 5:30 p.m. and includes a raffle for a trip to Spain.
“Taking care of a Medicare patient can overrun what Medicare pays us, and we also provide care regardless of whether we receive reimbursement, so all of our fundraising goes towards that,” said Reed.
Hospice of North Idaho, which is Medicare certified, typically cares for more than 50 percent of all those who die in Kootenai County every year. They also assist patients in Benewah, Shoshone and sometimes Bonner counties.
“We’re incredibly busy,” said Cindy Reed, a registered nurse and Hospice House director. “Our staff is working on 24 hours a day, seven days a week. “
Reed provided a breakdown of key hospice terms and answered questions commonly asked about hospice care.
When should I start looking into hospice care for myself or a loved one?
Anyone who has a life-threatening or life-limiting illness can explore having palliative care, which is essentially making a person as comfortable as possible.
That's maybe a little less intimidating than hospice care, but it's a good way to start looking to start looking at end-of-life care planning. Hospice actually offers a palliative care program that would provide nurse case management and palliative care physician oversight and support.
They can help you with some of the decision making. For example, resuscitation, antibiotics and feeding tubes.
Why is having a plan important?
Having a plan is important so that your loved ones know your wishes when you are no longer able to articulate them.
It’s ok to ask for help. There are no wrong questions. You may not be appropriate to be admitted to a hospice program, but at least you have the information, so you know when it might be appropriate when the time comes. For those who do need hospice care, who might think 'I don't want Hospice to come out, because it's the last thing I do,' I always recommend that it's sort of like a shoe: you can try it on and see if it fits, and if it doesn't fit, you can take it off. There's nothing written in stone, you can always see if hospice is a good fit for you. If it doesn't fit, make a change. This is a really precious time, and nobody wants to waste that.
When it is it time for me to go on hospice care?
Medicare's guideline is that the Hospice Medical Director and Primary Care Physician agree that the prognosis is six months or less if the illness runs its normal course. Medicare requires this status to be continually checked under specific guidelines (first
for two 90-day periods, then for every 60 days afterward).
If every time they are evaluated they meet these criteria, then on they go with hospice care. If the patient stabilizes or goes into remission, hospice assist with discharge planning. If the patient continues meet that criteria, they stay on hospice. We could potentially have someone longer than a year, but it has to meet the Medicare criteria. When we’ve been reviewed by Medicare, we pass with flying colors. Typically having someone too long isn't as big of a problem for us as when we have them for too short. Our referrals often come too late, and it's better to have somebody for three to four months as opposed to a day or two.
How do you get into get into Hospice of North Idaho?
To utilize the Hospice House, you have to be a patient of Hospice of North Idaho. The referral process to Hospice of North Idaho begins with your active or current health care provider. If you are a current Hospice of North Idaho patient receiving hospice care at home, and symptoms become unmanageable in your current setting, you may be transferred to the Hospice House for more aggressive palliative care.
-- Written by Marc Stewart.
Marc Stewart is Director of Sponsored Content for the Coeur d’Alene Press. He can be reached at mstewart@cdapress.com or 208-664-8176, ext. 2011.