San Marcos Mercury | Local News from San Marcos and Hays County, Texas
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November 24th, 2008
Hospice provides comfort and care to those in need

Hospice Care is an available resource to those in need of it in Hays County. Todd Becker is one of several Hays county residents with a loved one in hospice care. Becker’s 87-year-old mother suffers from dementia and Alzheimer’s disease and was admitted to hospice care earlier this month”It’s really not an easy thing to do, you know, to literally watch a parent die,” Becker said. “But getting her into hospice care was probably the best thing we could do for her. It also kind of better prepares you for what’s to come because it’s not something that’s sudden and unexpected.”

In 2007 it was estimated 1.4 million patients received hospice care in the United States. Four out of five hospice patients are 65 years of age or older. The top five chronic illnesses served by hospice are cancer, heart disease, dementia, lung disease and debility unspecified.

Hospice care can be traced back as far as 500 AD where communities would care for the village sick. After the spread of Christianity, monasteries provided care for those who were ill and could not care for themselves. The first modern hospice was founded in London by Dame Cicely Saunders. Hospice care as it is known today was formally introduced to the United States by Saunders in the late1960’s and soon became a common form of care for the terminally ill.

There are six organizations that offer hospice care for the Hays County area. April Coldsmith, Manager of Volunteer Services for Vista Care, said hospice, in a nutshell, is comfort care for the patient as well as the patient’s family members.

“Hospice care is medical, physiological, psychological and spiritual care given to a person at end of life.” she said. “From a social standpoint we help deal with issues the family may face such as saying goodbye, helping with funeral planning and bereavement.”

In order for one to enter hospice care they must first be certified by a physician who, through thorough examination, gives the patient six months to live and thereby declares them to be hospice eligible. However, predicting how long someone has to live is not always accurate.

“We have had patients who live beyond six months and some get better and go off hospice,” Coldsmith said. “Sometimes a patient will be entered into hospice care because they suffer from dementia and may be unwilling to eat. Once in hospice care, they might regain their appetite and become more alert and lively. It all depends on the individual. Sometimes all it takes is a little extra care.”

Coldsmith said their organization also provides care for people undergoing palliative chemotherapy, which is given to a patient solely for comfort if they are beyond the point of cure.

Becker said keeping his mother alive by keeping her in a hospital hooked up to a feeding tube was not something she would have wanted.

“She always told me to just let her go as God intended,” he said. “She wanted to keep her dignity. I know she wouldn’t have wanted us to spend more money by sticking her in a hospital room if there was no chance of her getting any better.”

A study done at Duke University, published by the Hospice Association of America, proves Hospice care to be more cost-effective than inpatient hospital care. Daily hospital in-patient charges for 2007-2008 were averaged at $5,549 per patient while a day of hospice care was averaged at $144 per patient.

According to the Hospice Association of America, $135 is the average cost for routine home day care. Continuous home care can cost $32 an hour. Cost of care may vary with each hospice provider and by state.

There is insurance coverage designed for those in hospice care. Central Texas Medical Center Director of Hospice, Linda Lopez, said hospice care is covered by most insurance companies and is provided by Medicare Part A, which typically pays for inpatient hospital expenses. Most funding comes from patients over the age of 65 who are on Medicare. However, some hospice care providers have been known to provide care for those who cannot afford it through the help of volunteers and donations.

According to a 2008 research survey by the National Hospice and Palliative Care Organization Texas has 286 Medicare-certified hospice providers, the most in the nation.

To honor people living in hospice care, CTMC recently unveiled a small photography exhibit in the San Marcos Activity Center which has photographs of hospice patients enjoying life. She said the exhibit was a way to use art to provide a different perspective of dying.

“Many people have this misconception that people go into hospice to die,” Lopez said. “And really there is a lot a lot of life left in them. Most of the time pictures of hospice patients are depicted as someone shriveled up on their deathbed and that’s just not the way it is.”

In addition to having care given to them by nurses and physicians, volunteers play a large part in hospice care, even though, according to Coldwell, they make up about 5 percent of patient hours. She said volunteers played an integral part during the hospice boom in the 1980’s.

“Hospice care really took off in the U.S. during the AIDS epidemic,” she said. “At that time Hospices were the only places willing to take in AIDS patients. Volunteers played a large part in providing care at that time.”

People can volunteer to do administrative work, direct patient care, offer spiritual guidance or be a bereavement volunteer.

“Some of our volunteers are these sweet little old ladies who make quilts and pillows for our patients,” Coldsmith said. “Other volunteers bake cookies, make Christmas ornaments and one volunteer we have walks a patient’s dog.”

To demonstrate their support for hospice care, Hay’s county Commissioner’s Court declared November Home Care and Hospice Month.

“This is the way we took care of each other before medical care became institutionalized,” Coldsmith said. “It’s just a way of providing a community for people in a world where we don’t always have family near by.”

by Rasmi Hunt

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