More than anything, you want your aging or ill loved one to be pain-free and comfortable. For many people, this means avoiding hospitals and nursing homes when suffering from a chronic or terminal illness. However, caring for someone who is in pain or who is nearing the end of their life is extremely difficult to do without help. Fortunately, there are options for getting support while caring for a loved one with medical, physical, and emotional needs. The kind of support you need depends on your loved one’s prognosis and end-of-life wishes. As elder law attorneys, we have had many clients experience these kinds of care, and we think it’s important to share this information. Before you get to the point of deciding which kind of care is right for your elderly loved one, you should make sure they have the necessary legal documents in place.
Planning for Long-term and End-of-Life Care
While not an easy conversation to have, it will be much easier to make decisions for your parent or spouse when they need help if you have discussed their wishes ahead of time. This means sitting down to talk about a variety of potential situations and what they would ideally like to have happen if they come to pass. For example, if your mother becomes physically disabled, would she want to be in a rehabilitation facility or have in-home care? If your father has been diagnosed with early dementia, who does he want to make decisions on his behalf when he is no longer able to? Getting these questions answered and sharing their wishes with the rest of the family is the first step. The next step is making sure their wishes are legally enforceable with a comprehensive estate plan that includes:
- Advance Medical Directive. This document is an official statement of the person’s wishes in the event of their incapacitation. It might express their desire not to be put on life support in certain situations, or it might make it clear that every effort should be made to prolong their life. While this is a useful tool for informing loved ones of a person’s wishes, it is not necessarily legally binding in every situation.
- Power of Attorney. A Healthcare Power of Attorney appoints a representative to make healthcare decisions on someone else’s behalf if they are unable to do so for themselves. This is a legal document that should be acknowledged by doctors and hospitals.
- HIPAA Authorization. Medical records cannot be released to a third party without a signed release from the patient. It can be difficult to begin communicating with your loved one’s doctors about their condition without one.
- Wills & Trusts. Making sure your loved one’s estate is in order before they become incapacitated is essential for making financial decisions and maintaining peace in a family. An up-to-date Will and Revocable Living Trust are important tools for protecting your loved one’s valuables and ensuring that their wishes for leaving a legacy are honored.
As you are helping your loved one get their affairs in order, take the opportunity to explain what kinds of care will be available if they need support one day and get a feeling for their preferences. This can ease the burden of making decisions for another person when they are unable to share their desires coherently.
What Is the Difference Between Hospice and Palliative Care?
The day has come when your loved one needs more help than you can provide. You have had the necessary conversations, and their estate plan is in good shape. Now you need to find the appropriate kind of care. Does your loved one need hospice or palliative care? What is the difference? It’s actually inaccurate to say that your options are one versus the other because hospice is a type of palliative care. However, the term hospice is generally used to refer to end-of-life care, while palliative care refers to care given at any point in a serious illness. The goal of both types of care is to make the patient more comfortable. Specific services that might be offered are described below.
Hospice Is Provided in the Final Stages of Life
The goal of hospice care is to provide support to a dying patient and their family and friends. Hospice is usually recommended when a patient has a life expectancy of six months or less. All curative treatments are stopped, but that doesn’t mean that medical care is stopped. Patients in hospice are offered:
- Pain and symptom relief
- Emotional and spiritual support
- Nutrition and hydration
- Guidance in making funeral plans
- Assistance navigating the healthcare system
Hospice services continue for family members after their loved one has died in the form of grief support, follow-up wellness checks, and more.
Patients Receiving Palliative Care Are Expected to Survive
Patients with cancer, heart failure, Parkinson’s disease, dementia, and other diseases can benefit from palliative care when they are particularly weak from treatment. Palliative care provides many of the same services as hospice but attempts to cure the disease continue. A palliative care provider will administer pain relief, help with feeding and bathing, offer emotional support, and help family members who are providing care. A patient receiving this kind of care is expected to live more than six months and may even improve or recover.
How and Where to Get Hospice or Palliative Care Services
Often, an organization or service will provide either hospice or palliative care, depending on the needs of the patient, but this is not always the case. Many organizations strictly provide only hospice care. Patients can receive both kinds of care in a hospital, nursing home, or dedicated center, or they can have caregivers come into their home. It is important that conversations about getting these vital support services start early with your loved one’s doctors. It is not easy to accept that it’s time for hospice, but the sooner you do, the sooner the help will come.