Tough as they are to think about, end-of-life decisions are important ones.
Recent statistics show that 92% of West Virginians want to be able to die at home. About 60% actually do.
Planning ahead for end-of-life choices is a smart way to evaluate what is possible and how to make it work.
One of the most important planning steps anyone can take at any age is to complete their Advance Directives, the written instructions and directions for this type of care. All of the choices can be changed at any time.
The West Virginia Center for End-of-Life Care website at www.wvendoflife.org explains various forms which can be completed to carry out a person’s preferences and the decisions that are involved. It is helpful to discuss the Advance Directive’s choices with close family members.
The completed Advance Directive forms can be filed and stored on that website also. Because it is an online resource, medical professionals can access the person’s records at any time.
In recent months, many have wondered how instructions to prevent being kept alive via ventilators and similar means would work in Covid-19 situations. Because the coronavirus is not necessarily a terminal condition, doctors have felt it was appropriate to provide ventilators for patients even with those restrictive Advance Directives in place if it may lead to their recovery.
For hospice care, a physician must certify that a person is terminally ill, based on medical standards.
Medicare, Medicaid and “medigap” insurance will cover that type of care. There is no co-pay charged for hospice services.
A person does not have to be bedridden or incapacitated to receive hospice care. Hospice services can be provided at the patient’s home or in a nursing home or assisted living setting.
Medicare, Medicaid and private insurance cover the costs of hospice services provided by a person’s doctor, a hospice nurse, home health aides, and a social worker.
However, many everyday tasks, such as cooking, cleaning, shopping, transportation, etc., are not covered services for in-home hospice care. Hospice organizations cannot provide 24/7 staffing.
A social worker from the hospice organization will be assigned to coordinate and monitor the care and can provide guidance.
Often, support services may be provided by volunteers. Hospice volunteers receive extensive training on this type of situation and care needs.
Also, be aware that hospice services are different from long-term care provided in a nursing home. They are separate programs serving unique purposes.
Respite care for the patient’s spouse, child, or other caregiver can be arranged to allow them time away from home.
Further, the patient may be able to go to a hospice facility for a short stay to allow the caregivers a respite. The hospice facility, however, is not for long-term stays. A room and board fee will likely be charged while the patient is in the hospice facility. That daily charge is not covered by Medicare, Medicaid, or most insurance plans.
An important advantage of hospice care is the staff’s expertise with medical and emotional concerns that the person and their family may not have faced before. The hospice team’s expertise allows family and friends to be more aware and better prepared for what is involved.
As needed, the hospice team can provide grief counseling during the time they are involved with the patient and family.
If one company does not provide the support needed, the patient can choose a different hospice services provider.
Anyone can request hospice care for themselves or for another person.
Knowing that others can and will help with the unique needs of those with advanced illnesses is a comfort to all those involved.
Additional questions about the legal aspects of end-of-life care and other legal concerns can be answered for those age 60 and over at West Virginia Senior Legal Aid. Call 800-229-5068 to speak with a staff attorney at no charge.
(Deb Miller is a volunteer with West Virginia Senior Legal Aid.)