Page 6 - SFHN MARCH 2022

Sooner Is Better: Hospice Care for

Patients With Advanced Illness

While hospice is consid- has stabilized, the hospice
ered a medical interven- may discharge them. More
tion, it is, more precisely, a likely, the patient will re-certi-
fully funded federal benefit fy as they continue to decline.
intended for patients with Ultimately, a patient decides
advanced illness. As part of if they want to use the hospice
an entitlement program benefit. Their physician can
that patients pay into, it is help them determine eligibili-
a benefit they can use— ty. As a physician myself, I
and tap into sooner. want to understand ways to
If patients do, they support a patient. If I have a
receive the holistic care struggling patient and med-
that a physician alone can- BY ANDY ARWARI, MD ical treatments are no longer
not provide. With hospice, working, I want to provide my
an interdisciplinary team patient with the quality of life
works together to deliver coordinated they desire.
care. A social worker helps patients with For example, a cardiologist referred an
their social needs while a chaplain assists advanced heart disease patient to hospice
with spiritual care. Nurses and physicians care. She spent several months receiving
address the patient’s ongoing pain relief, coordinated care. During this time, her
yet the entire approach is team-based and family learned more about the disease
comprehensive. process while a team of experts supported
The origins of hospice as a community- this patient. Her family thanked the team
based service began in the 1960s, when for their level of care. Many later ask: How
Dr. Cicely Saunders founded St. come I didn’t know about this before?
Christopher’s Hospice in London. The It is our duty to inform patients and
facility paired expert symptom relief with families so that hospice becomes an inte-
physical, social, spiritual, and psychologi- grated part of healthcare. When patients
cal care to meet the needs of patients and near the end of life, the physician becomes
their families. less significant than a chaplain or social
This model evolved in the U.S., and the worker. I have never had a family member
federal benefit under Medicare Part A express any regrets about choosing hos-
1
became permanent in 1985. Payroll taxes pice.
dually paid by employees and employers When selecting a hospice provider, look
help fund this, and individuals eligible at for the level of engagement between team
65 for Medicare Part A are entitled to members and the patient and family. The
access this benefit. Hospice is also covered attention a patient receives in hospice
by most insurance and Medicaid. should increase. It takes an expert team to
Yet so many are not aware of it. Over help navigate the emotions arising during
48% of Medicare decedents do not access this stage of life. In hospice, families
2
their hospice benefit. As a physician, it is become part of the care plan.
my civic duty to inform patients of the The pathway of serious illness is not
enhanced care they can receive. Patients unique. Diseases progress the same any-
and their families are often surprised— where in the world. Yet, the US is the only
they tell me that hospice services seem too country to have a fully funded hospice
good to be true. benefit through Medicare Part A. We must
Currently, more than one-third of share this with our patients. It breaks my
patients live less than seven days in hos- heart to see patients suffer. If we have a
pice. Because of this shortened time frame, holistic approach for providing compas-
these patients miss months of care and sionate care, it is our responsibility to offer
support which would have enhanced their this solution sooner.
quality of life.
Hospice is for the living not just for the Dr. Andy Arwari is a medical director for
dying. It enables advanced illness patients VITAS Healthcare in Miami-Dade, as well as
to be comfortable wherever they are—at an assistant professor at Florida International
home, in assisted living, a nursing home, University and affiliate assistant professor in
or a hospital setting. Hospice also supplies Medical Education at the University of
durable medical equipment, such as Miami. For more information about end-of-
wheelchairs and commodes, which other life care, visit VITAS.com.
medical plans may not cover, making it a
financial benefit as well.
Physicians use a six-month projected 1 History of Hospice. (2021). The National
life span to determine hospice eligibility. Hospice and Palliative Care Organization.
Yet, if a patient is still in the end-stage of
disease at six months, they can renew hos- 2 2021 Edition: Hospice Facts and Figures.
pice care at two-month intervals. The team Alexandria, VA: National Hospice and Palliative Care
will monitor the patient daily. If the patient Organization. www.nhpco.org/factsfigures.

6 March 2022 southfloridahospitalnews.com South Florida Hospital News