Seven years ago, Jared and his two children, Monica and Stephanie, were faced with a family crisis. Anne, Jared’s wife and mother to Monica and Stephanie, had lung cancer that was diagnosed too late for any type of therapeutic intervention. No one at the hospital took the time to have a constructive and meaningful conversation with the family about end-of-life decisions. Anne simply wanted to go back home to die. Monica agreed with her, but Jared and Stephanie wanted her to stay in the hospital so she could get the care she needed. Unfortunately, Anne passed away in the hospital before the family could agree to follow her wishes.

Could anything have been done to help facilitate the honoring of Anne’s wishes? Perhaps the answer would be yes if some type of end-of-life/advance care counseling occurred prior to Anne’s last hospitalization. One reason why the situation might turn out differently today is because the Centers for Medicare and Medicaid Services (CMS) recently created a new policy whereby physicians will be reimbursed for providing advance care discussions with their patients.

In July 2015, CMS first announced a proposal that would provide patients with the assistance they deserve when it comes to advance care planning. The CMS proposal was approved in October and on January 1, 2016, the new policy went into effect.

The CMS policy empowers anyone faced with the challenges of advancing age and life-limiting illness with the knowledge to make important end-of-life decisions. Physicians can counsel their patients and give them control over the type of care they receive and when they receive it. These discussions can include the following: advance directives, life-sustaining procedures, living wills, durable power of attorney for healthcare decisions, designation of a healthcare surrogate and/or physician orders for life-sustaining treatment.

One area to approach in any advance care discussion is dispelling myths associated with hospice and choosing this type of care. Here are some common misconceptions about hospice:

Myth: Hospice care is only for people with cancer, or those who are bedridden or very ill.
Although many hospice patients do have cancer, hospice serves terminally ill patients of all ages and with all types of progressive and chronic diseases. Many hospice patients are able to enjoy life as much as they did before their diagnoses. This fact is especially true if care is accessed early in their illness. Hospice patients are seen by trained healthcare professionals who can address their medical conditions and provide support to family members.

Myth: Hospice patients cannot live longer than six months.
Once an individual becomes a hospice patient, he or she continues to receive services for as long as the services are required and appropriate. Hospice services are NOT discontinued unless they are no longer required and appropriate or the patient chooses to have them stopped and revokes care.

Myth: Hospice care is expensive.
Hospice care is actually less expensive than care provided in a traditional medical setting. Additionally, Medicare, Medicaid and most other types of insurance cover the cost of hospice care.

Myth: Hospice is a place.
Hospice is not a place but a philosophy of care. Wherever the patient calls home is where hospice care can take place: their residence, an assisted living facility, a nursing home, an inpatient facility or the hospital.
These are just a few of the many misconceptions regarding hospice care. If you would like to openly discuss your end-of-life wishes, please reach out to your physician who can assist in developing plans of care to meet your needs and desires.

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