Questions, answers on end-of-life care

January 5, 2011

A recent "Aging in Iowa" Opinion package on end-of-life care solicited questions for Norma Hirsch, chief medical director for Hospice of Central Iowa.

Q. What percentage of people you take care of actually get better and get "discharged" from hospice? How do you decide if someone should not be in hospice anymore?

A. Hospice provides pain and symptom management for patients and holistic support for both the patient and the family. While we do not provide curative care, roughly 10 percent of our patients benefit enough from our pain and symptom management and psychosocial support that they exceed the six months or less estimated survival required by Medicare. A patient no longer qualifies for the Medicare Hospice Benefit when the patient's doctor and the hospice medical director use their best clinical judgment to estimate the patient's life expectancy and believe it to be greater than six months. When the patient's prognosis is estimated to be greater than six months, the patient is discharged from hospice services. At the time of discharge Hospice of Central Iowa will assist patients and families to find alternative health care services. In many instances patients can continue to obtain symptom relief through our palliative care services.

Q. What kinds of jobs do volunteers do and how many volunteers do you have?
A. Volunteers are crucial to providing our services. Although we have about 500 active volunteers, we are always seeking additional volunteers. Some volunteer opportunities include patient related and non-patient related services, such as offering companionship, assisting patients with meals or running errands, and light house work or assisting with clerical duties and representing Hospice of Central Iowa at community events. We also are in need of volunteers to assist with our new thrift store, HCI Giving Tree, located in Urbandale.

Q. Are some of the people you serve not Christians and do you have employees or volunteers who work with them regarding religion?
A. Hospice of Central Iowa honors all spiritual and belief systems. Our spiritual care counselors are available to meet with our patients and to support their spiritual needs. Additionally, our patients are encouraged to continue to seek the support of their personal spiritual leaders as desired.

Q. I know Medicare covers some hospice services, but do most private insurers?
A. Medicare provides a hospice benefit, as do most private insurers. Hospice care is also covered by Medicaid. Additionally, donor support through our Foundation ensures our services are available to anyone who needs our care. No one is turned away due to an inability to pay for Hospice of Central Iowa's services, thanks to our patient financial assistance program. Because Hospice of Central Iowa is a not-for-profit organization, any generated revenue is invested back into programs that support our mission in the communities we serve and assists patients in need.