Page 2 - 2016Progress.March20

2 – El Dorado NEWS-TIMES – Sunday, March 20 Progress 2016 – Education/Health
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SOUTH • ARKANSAS • COMMUNITY • COLLEGE
HEALTH
2337
The Hospice Medicare Benefit
By: Marsha Cowling Outreach Coordinator Life Touch Hospice
A sad statistic for this country is the under use of the hospice Medicare benefit. The initial eligibility is 180 days with unlimited extensions. The sad statistic is that the average length of stay in hospice care is seven days. These patients and families lose a minimum of 173 days of free medical care and service because they called so late in the disease process. Medicare and Medicaid
and most private insurance pay 100% of the cost of medications, equipment, and supplies that are related to the hospice diagnosis which sometimes includes treatment such as dialysis or BiPAP if that is necessary for comfort. To combat the idea that a hospice patient must be in the dying process, I offer that we have had patients who drive and go on vacations. They are not all bedridden and
helpless and some stay active for quite a while under hospice care. Occasionally, on hospice care the patient improved to the point that they must be discharged because they now appeared to a physician to be capable of living longer than six months. So what are the early indications that a person qualifies for hospice care? Let’s have a look, by diagnosis:
Dementias
• Having trouble walking without assistance
• Has very little meaningful verbal communication
• Unable to bathe or dress without assistance
• Cannot control bowel or bladder
• Has had weight loss, infections, falls, multiple emergency room trips in the last 12 months.
POSSIBLE DIAGNOSES, BUT NOT LIMITED TO:
Alzheimer’s Disease, Parkinson’s Disease
Heart Disease / CHF
• Swelling of legs and/or feet and/or arms
• Unable to carry on any physical activity without experiencing symptoms
• Tires easily (may not be able to carry on conversation for very long)
• Symptoms are present even when resting
• Physician reports that the heart is very weak
• Recent cardiac hospitalization, not on transplant list, unable to tolerate heart surgery/not candidate for heart surgery
Kidney Disease
• Patient not seeking dialysis
• Patient is swollen most of the time
• Very weak and sometimes confused
• Patient not a candidate for kidney transplant
Lung Disease
• Short of breath at rest
• Unintentional weight loss
• Must sit straight up to breathe • Pursed lips and rapid breathing • Chronic Co2 retention
• Hospitalizations or ER visits for lung infections and/or respiratory failure or distress.
POSSIBLE DIAGNOSES, BUT NOT LIMITED TO:
COPD, Emphysema, Lung Disease
Liver Disease
• Swollen abdomen
• Malnutrition, weight loss
• Abnormal clotting
• Draining of fluid from the abdomen by physician
Neurological Diseases
• Noticeable overall decline
• Weight loss
• Tires very easily
• Choking when attempting to eat or drink within last 6 months Can still be eligible with a feeding tube)
POSSIBLE DIAGNOSES, BUT NOT LIMITED TO:
CVA, Parkinson’s Disease, ALS, MS
HIV/AIDS
• Weight loss
• Not responding to treatment
• Presence of other medical problems
• Infections
• No HIV drug therapy or refuses the therapy
• CD4 count <25 or present viral load >100,000
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