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GENTIVA HOSPICE facts and myths · One on One With a Professional

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Good morning, good morning, good morning, and welcome, welcome, welcome,
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And it is time now for one on one with the pro and today
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we are going to be speaking with Michelle and she's with Gentiva Hospice. How
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you doing, Michelle, I'm doing great. Good morning. Well you always
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you always bright, vibrant and ready to go. You have more energy.
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I don't know what you're on, but I'll take a case of it.
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High on life, baby. You go. Well. Today we're going to
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talk a little bit more about Gentiva Hospice and myths and facts. Yes,
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sir and boy, I got to tell you what. First of all,
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tell people what hospice is in a like a thumbnail sketch. Okay, So
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I'll just give you the definition. By definition, hospice care is an advanced
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plan of care in which we focus on the patient, their specific needs,
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the needs of their family, and do not focus on curing a disease.
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So it is an advanced care plan. It's a team approach to patient and
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family care. It's all encompassing and we take care of their patie since physical,
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mental, psychosocial, spiritual, and emotional needs, all of it.
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Wow, Okay, here are some myths becoming a hospice patient means that you're
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giving up hope. Absolutely not. Hospice care is offering a different kind of
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hope. A lot of people feel like hospice is going to be facilitating or
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encouraging the death process, and that is absolutely false. It does not encourage
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death and dying at all. We simply keep the patient comfortable, educate the
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family. So, in my opinion, when we talk about offering a different
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kind of hope, it's a hope for a better quality of life for whatever
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time remains, rather than trying to extend that time frame with interventional measures that
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might make the patient more uncomfortable. So it's offering a different kind of hope
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in that we give them a better quality of life with their family. Kay
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Michelle, My next question is hospice Is it a place? Is it a
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physical place? The answer to that is yes and no. So there are
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hospice houses in the area. And there's one here right here in Barbersville called
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the Journey Home, and then there's two in Tulsa. One's called Port of
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Chailey, one is called Clarehouse. Those are kind of like a hotel for
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hospice patients, and those are only for patients who are in their last within
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about thirty days of passing. For those patients who don't want to pass at
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home but also do not want to be in a hospital, nursing home place
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like that, it gives them more of a home setting for passing, but
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yet it does not leave the family with that memory of, you know,
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of the patient passing in their home. But hospice as itself is not a
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place in particular. It's a plan of care. So we take care of
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the patient wherever they call home, whether it's in a nursing home, an
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assistant living, independent living at home. We even at one point when I
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was with a different provider, we actually had a homeless patient that we would
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see at the John three to sixteen mission in Tulsa. And I even heard
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at one time they had a patient that they actually saw under his bridge where
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he considered home. That was his home. Yes, And so we absolutely
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went and did his visits where his home was and kept him comfortable where he
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wanted to be. Wow, that's amazing. We are talking with Michelle from
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Gentiba Hospice and we're going over faction myths of hospice. Hospice is for those
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who are closed to death or actively dying. Okay, that's another one of
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those yes and no questions. So yes, it can be for those who
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are actively passing or are very very close to the process of dying, but
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it doesn't necessarily mean that. So hospice care is for anyone who has a
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terminal illness and they're not seeking aggressive treatment for that illness. So that doesn't
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mean that you should have to wait until they're in their last forty eight to
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seventy two hours of life to put them on hospice care. We want to
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be able to take care of them and their family as long as possible.
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So we have patients who've actually been on service for over a year. Long
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as they're continuing to show decline and still meet criteria for hospice care, they
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can stay on our service. So this is one that I want to make
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sure people really really get because the longer they're on service, the better their
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benefit, the better the experience. Sixty percent of patients and families that were
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surveyed said they wish they had been referred to the hospice plan sooner. So
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when they get referred late in the process and they only have a short time
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to be on our service, they don't get the time to meet the staff,
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you get to know them well, get that relationship established, and they
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really miss out on a lot of the benefits that we can help them with
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as far as end of life planning, navigating through legal processes, if there's
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any family dynamics that need to be worked through, spiritual needs that the chaplain
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can help them navigate through unresolved anger or unresolved guilts that maybe they're dealing with.
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There's so much that hospice can do for that patient and the family,
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as far as additional resources in the community that our social worker can help with.
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So if you only come on service for those last few days, all
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we really have time to do is manage the immediate pain management pain needs,
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and the family really misses out on the whole, the all encompassing aspect of
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hospice care. So it isn't just for someone in the last few days.
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Great, we are talking about hospice myths and facts, and Michelle is with
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the Gentiva Hospice. Our next question myth or fact hospice patients must sign a
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do not resuscitate a DNR. Is it's called in the hospital right. The
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answer to that one is no, you absolutely do not have to have a
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DNAR in place to come onto hospice services. That is something that we discuss
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with the family and the patient. Oftentimes a patient they don't understand the ramifications
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of what CPR might do to someone who is in a compromise stay already,
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So we talk about the benefits versus the risks of all of those things.
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And it's not a requirement to have a DNR in place. We do encourage
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it because if someone is you know, in a terminal state, oftentimes to
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see CPR process can do more damage than actually would be I mean, I'm
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not going to say, you know, saving their life is going to cause
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them more problems, but there's just a lot of things that can go wrong
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with CPR. So we do talk about that and we you know, just
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talk with the family, see what's the best for them and their decision.
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They don't have to do it immediately. It's something that they can change their
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mind as they go, but it's not required. Very good. Another one
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of the facts or myths ready for this one, hospice care is only for
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cancer patients. Well, you know, when hospice first originated way back in
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the eighties. That's how it was designed. It was implemented to care for
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cancer patients in their very end stages to keep them pain free. And so
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that's where that myth came from, that it's only for cancer patients. That's
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kind of how it originated. But it has evolved so much. I tell
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everyone, think about your the very first cell phone you ever had. So
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my first cell phone was about the size of a suitcase. You plugged it
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into your cigarette lighter and your and you could barely make a phone call out
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if you were able to do that at all, because of the signal.
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But now how we now have a whole little computer in our hand, if
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it's right in our pocket. So much has changed with technology. Same goes
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with healthcare and with the hospice process. So things have changed so much over
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the last thirty years that hospice now encompasses any terminal illness at all. Wow,
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that's cool. Only a doctor can refer you patient for hospice care.
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Myth or fact, that is also a myth. So the process is that,
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yes, we do have to have a doctor's order to put a patient
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on our hospice care, but anyone can make the referral And what I mean
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by that is anyone could call me and say, I have someone in mind
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that I think could qualify for the benefit of hospice. Can you visit with
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them to me, that's the referral you're making the referral. You're making that
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connection to put me in contact with the family. And then, because I'm
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not a nurse, I don't have to have an order to go visit with
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them, do an informational just explain the benefits, find out what their goals
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are, what they want, and if I feel like they are eligible or
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in that, you know, within that hospice window, then I can reach
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out to their physician and get the order from the physician. But anyone can
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make a quote unquote referral. We just have to get a doctor's order to
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put them on service. Now here's one of those factsor myths that I've seen
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families to flip a coin over this because they weren't sure until they finally asked
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the question, if you choose hospice care, you could never see your family
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physician. Again, that is absolutely false. That's what I'm here to score
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that one. Yes, So we generally tell people that the need to see
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your family physician is almost eliminated because our hospice nurses are coming in there and
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our team we're doing such a good job managing their care that generally they don't
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need to go see their physician anymore because we're handling everything that they need right
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there in their home. But that doesn't mean that they can't go see their
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family physician. There are some billing issues that come along if they if we
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have them on hospice care for a COPD exacerbation and they go see their pomonologists,
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So those things are related. So where the billing issue comes is that
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Medicare won't pay for that family physician visit or the pomonologists visit and the hospice
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care. So we just need to talk with them about what they're going to
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the doctor for if it's something that we can handle at home, and then
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if it's not anything that we can handle in and they do need to see
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their physition. We just need to work through that from a billing standpoint,
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and there you go, and you don't have to be worried about anything else.
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Just let the let the folks who take care of the books take care
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of that. That's right. Speaking of the books, hospice care expensive,
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yes or no, absolutely not. Hospice care doesn't cost the patient family anything.
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Medicare covers the cost of hospice one hundred percent. Medicaid also has a
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hospice benefit coverage, and most commercial insurances have a hospice benefit included as well.
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It just depends on your policy. So Gentiva is contracted with most commercial
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insurances. So what we do is when a referral comes in, we run
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the patient's information. Most of them have Medicare and if it's a Medicare plan,
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we don't have to worry about it. What's good to note is that
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a lot of people think, well, I don't have Medicare anymore. I
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got a Medicare replacement plan now, so I don't have Medicare. What does
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that mean? If the patient has ever had a Medicare number at all,
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whether you have a replacement now, if you have a supplement, it doesn't
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matter any kind of Medicare replacement plan that's in place. When the patient goes
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on hospice, it flips to traditional Medicare for payment. So even if you
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have a Medicare advantage plan and you have a humanity replacement or community care Medicare
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replacement plan. Traditional Medicare covers the cost of hospice one hundred percent. Okay,
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here's our last one here. Medicare hospice benefit cover is only six months
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of care. Now we've kind of touched on that before. That is the
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general rule for CMS guidelines for hospice is that a patient would is, you
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know, kind of in that six month window of their life. But no
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one really knows that, you know, I don't have a crystal ball,
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and no one really knows what someone's time is. So if after six months
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of care, the patient is still with us and they still qualify, we
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absolutely can continue their care. There's no limit to how long they can be
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on hospice as long as they continue to show eligibility, meaning they're still still
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showing some decline, they still have that terminal illness, they still need that
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extra help in the home, so there's no limit. However, some patients,
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after a couple of months on hospice, they seem to level off.
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I'm not going to say that they ever get better necessarily, but they're no
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longer showing decline. So if they plateau, they're no longer showing decline.
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By hospice guidelines, we can't keep them on service, so we would graduate
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them from hospice care and then if in a few weeks something else happens and
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they show the decline, we can pick them back up again. So there's
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no limit to how long they can be on hospice or how many times they
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go off and come back on. A lot of people think hospice is a
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one and done. You know, you get on, you stay on,
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and you pass, or you get off of hospice and now you've used up
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your benefit and you can't go back. But that's not the case. Living
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fact, President Carter absolutely hospice for a long time and it's working out pretty
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good for him. How can we get a hold of you, Michelle to
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learn more or perhaps set up an appointment. The best way would be just
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to either send me an email and we can put that up on your yeah
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well on the post, or they can call me. Do I give my
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number over the air? My direct line is nine one eight for zero four
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six eight nine nine nine one eight for zero four six eight nine nine.
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That's my direct cell number for work, and they can leave a voicemail if
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I don't pick up one thing I do like to note is that hospice is
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one of the most underutilized benefits in healthcare. People don't understand this, but
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less than fifty percent of people who are eligible for the hospice benefit actually take
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advantage of it. And I think that's because they just are lack of education
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out that people don't know about it. They don't know all the ins and
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outs and how beneficial it can be. So we're trying to educate people and
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let them know that it's out there, it doesn't cost you anything, and
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take advantage of it. One of my five daughters is a hospice nurse in
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Saint Louis, and she just says, you know, the families, they
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very glad that they've taken a part of it. Absolutely, Yes, scary
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step, but after all, they're just so thankful someone was there in their
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corner. Yeah, they usually say, I wish we had done this sooner.
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Yeah, that's exactly what these Michelle with Gentiba Hospice has been our guest
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here today on one on one with the pro