![\"What](\"https:\/\/s3.us-west-2.amazonaws.com\/img.prod.aplaceformom.com\/main\/uploads\/sa-blog\/2016\/07\/What-Is-a-Terminal-Illness--350x293.jpg\")
and End-of-Life Planning<\/h1>\nand End-of-Life Planning<\/h1>\nReceiving a terminal diagnosis, for yourself or someone you love, can leave you stunned and overwhelmed. There are lots of resources\u00a0to help your family cope with the medical, emotional, caregiving, and planning challenges of a life-ending illness, but it’s not easy to track them down when you’re processing the news. Here\u2019s what you need to know to better understand what a terminal diagnosis means, what your care options are, what your next planning steps are, and how to find support.<\/span><\/span><\/span><\/p>\n Terminal illness is a diagnosis no one wants, and it\u2019s not always an easy diagnosis to understand. Because every patient\u2019s overall health, disease type, and prognosis is different, there\u2019s not a one-size-fits-all medical definition for a terminal illness.<\/span><\/span><\/span><\/p>\n In general, the term \u201cterminal illness\u201d applies to untreatable conditions that will likely result in death within six months, but there are exceptions. The UK-based Marie Curie hospice charity\u00a0<\/span><\/span>explains<\/a>\u00a0<\/b><\/span><\/span><\/span><\/strong>that, \u201cdepending on their condition and treatment, people may live with a terminal illness for days, weeks, months, or even years.\u201d<\/span><\/span><\/p>\n During this time, the focus is on keeping patients comfortable, managing pain and other symptoms, planning for the end of life, and providing emotional support rather than trying to cure the underlying condition. Hospice services can be a tremendous help to patients and their families after a terminal illness diagnosis, and if the diagnosis meets certain criteria, patients may be eligible for Medicare or Medicaid coverage of their hospice care.<\/span><\/span><\/p>\n When a patient has a diagnosed terminal illness,\u00a0hospice care<\/a>\u00a0<\/b><\/span><\/strong>offers<\/span>\u00a0a team-oriented approach to medical care, pain management, and emotional support that is tailored to the patient\u2019s needs. The main focus of hospice care is not to cure a patient\u2019s illness but provide quality care to make sure that they are comfortable. Hospice is usually administered in a person\u2019s home but can be given in an inpatient facility like a nursing home. A hospice care team usually includes the primary doctor, the hospice doctor, nurses, social workers, clergymen, and sometimes volunteers. This team will take care of the patient and administer drugs to manage pain and symptoms, offer support about accepting the end of life, counsel the patient\u2019s family about dying, and make sure the patient\u2019s last wishes are met.<\/span><\/span><\/p>\n There are some questions and misconceptions that may prevent someone from considering entering into hospice care. For example:<\/span><\/p>\n Can a person return to curative treatment if they begin to improve?\u00a0<\/b>The answer is yes, a person can be discharged from hospice and return to curative treatment if their condition begins to improve. They can also return to curative treatment if they simply change their mind, even without significant improvement in condition.<\/span><\/p>\n Does hospice care cause a person to give up or cause death to come sooner?\u00a0<\/b><\/span>In many cases, discontinuing painful or uncomfortable curative treatment (when no improvement is being seen) can actually reduce the stress on a patient. Focusing on treating pain and symptoms of the disease, along with counseling options, can actually help\u00a0<\/span>improve<\/i><\/span><\/em>\u00a0a person\u2019s quality of life overall and may even extend their longevity.<\/span><\/p>\n Can a person only use hospice services for six months?<\/b>\u00a0No. Even though a patient must be given the prognosis of six months or less to live for hospice care to be covered by most insurance companies or Medicare, a person can use hospice services for as long as they are needed.<\/span><\/p>\n The main difference between the two options is the main goal behind them:<\/span><\/p>\n The options aren\u2019t mutually exclusive. It is possible to hire hospice to provide their services to a senior living in a nursing home. But while both are covered by Medicare, they\u2019re rarely covered at the same time. You can usually only make use of both services if you can cover the cost of nursing home care yourself.<\/span><\/p>\n The Medicare program<\/span><\/span>\u00a0defines<\/span><\/span><\/span>\u00a0a terminal illness as one \u201cwith a life expectancy of 6 months or less if the illness runs its normal course.\u201d This definition matters because in order to qualify for\u00a0<\/span><\/span>Medicare coverage of hospice services<\/b><\/span><\/span><\/span><\/a><\/strong>, your doctor and a hospice doctor need to certify this diagnosis in writing. Terminally ill patients seeking Medicare benefits must also sign a statement opting in to hospice care and out of cure-focused treatments.<\/span><\/span><\/p>\n Medicaid coverage of hospice care has life-expectancy rules that vary by state. For example, the Centers for Medicare & Medicaid Services (CMS)\u00a0<\/span><\/span>notes<\/a>\u00a0<\/b><\/span><\/span><\/span><\/strong>that New York State provides Medicaid hospice coverage to eligible patients with a life expectancy of less than a year, while other some states use the 6-month Medicare standard for Medicaid hospice eligibility.<\/span><\/span><\/p>\n If you have\u00a0<\/span><\/span>Medicare Part A<\/b><\/span><\/span><\/span><\/a><\/strong>, then you might be able to have your hospice care paid for partially or in full. You must also meet three other criteria:<\/span><\/span><\/p>\n It is important to note that only your doctor can confirm and certify that you have a terminal illness and sign off on hospice care. Make sure that you talk with your doctor to discuss all options about your illness so that you can make an informed decision about hospice care.<\/span><\/span><\/p>\n Under Medicare, you are allowed to get one hospice consultation with either a hospice director or hospice doctor. You will be able to discuss all your options when it comes to your illness, including pain management and symptoms. Medicare will cover this consultation even if you decide that you do not want hospice care. If you\u00a0<\/span><\/span>do\u00a0<\/i><\/span><\/span><\/em>decide that you would like hospice care, Medicare will cover all the costs of your hospice care as long as they are related to your terminal illness. You need to make sure the care you choose is from a Medicare-approved hospice program. You can\u00a0<\/span><\/span>call Medicare<\/a>\u00a0<\/b><\/span><\/span><\/span><\/strong>to find a hospice program near you that is approved.<\/span><\/span><\/p>\n There are a few things that\u00a0<\/span><\/span>Medicare won\u2019t cover<\/a>\u00a0<\/b><\/span><\/span><\/span><\/strong>under hospice care. These include:<\/span><\/span><\/p>\n All treatments that you had to try and cure or treat your illness before hospice care will also no longer be covered under Medicare.<\/span><\/span><\/p>\n If your doctor diagnoses you with a terminal illness, you have some decisions to make. You may want to seek a second opinion on the terminal diagnosis, or you may decide it\u2019s time to look into hospice care options.<\/span><\/span><\/p>\n Your doctor may refer you to local hospice physician who can assess your care needs, certify you for Medicare or Medicaid coverage as described above, and help you transition to hospice care, which is usually provided at home. To help you find the right hospice for you, the American Hospice Foundation offers a\u00a0<\/span><\/span>checklist<\/a>\u00a0<\/b><\/span><\/span><\/span><\/strong>of questions to ask, including questions about Medicare certification, inpatient care options, and how the hospice team works with family and friends. You can also download and print a 4-page\u00a0<\/span><\/span>checklist<\/a>\u00a0<\/b><\/span><\/span><\/span><\/strong>from the National Hospice and Palliative Care Organization.<\/span><\/span><\/p>\n You’ll also need to start thinking and talking about what you want the end of life to look like and what kind of memorial you wish to have.<\/span><\/span><\/p>\n There aren\u2019t many topics harder to bring up than the prospect of death. Maybe that\u2019s why at the end of life, many families have to make care decisions for loved ones without knowing what they would have wanted. Experts say it\u2019s better to talk early and often about your wishes. Hospice workers and other resources can help your family talk about end-of-life care.<\/span><\/span><\/p>\n Journalist and commentator Ellen Goodman started\u00a0<\/span><\/span>The Conversation Project<\/b><\/span><\/span><\/span><\/a><\/strong>\u00a0to help families with end-of-life care planning after caring for her aging mother. The group offers kits you can use to organize your own thoughts and share your wishes with your family. Another writer,\u00a0<\/span><\/span>93-year old psychotherapist Margie Jenkins, author of \u201c<\/span><\/span><\/span>You Only Die Once: Preparing for the End of Life with Grace and Gusto<\/a>,<\/b><\/span><\/span><\/span><\/strong>\u201d offers detailed recommendations for families preparing for the end of a life.<\/span><\/span><\/span><\/p>\n Decide what you need to do<\/b><\/span><\/span><\/strong>\u00a0before you die, for yourself and for your family after you\u2019re gone. That can be anything from going through old keepsakes to repairing estranged relationships.<\/span><\/span><\/p>\n Get your legal and financial house in order<\/b><\/span><\/span><\/strong>. This is what most of us think of when we think about end-of-life planning, and it\u2019s very important. Estate planning, advance directives for healthcare, and other documents will be your family\u2019s road map during a stressful time.<\/span><\/span><\/p>\n Decide where cherished possessions will go<\/b><\/span><\/span><\/strong>What is a terminal illness?<\/span><\/h2>\n
What is hospice care?<\/span><\/h2>\n
Common questions about hospice care<\/span><\/h2>\n
What’s the difference between hospice and nursing home care?<\/span><\/h2>\n
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The Medicare definition of terminal illness and why it matters<\/h2>\n
Who is eligible for hospice under Medicare?<\/h2>\n
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What hospice services will Medicare cover?<\/h2>\n
What\u00a0<\/span><\/span><\/span>w<\/span><\/span><\/em><\/span>on\u2019t\u00a0<\/span><\/span><\/span><\/em>Medicare cover in hospice?<\/span><\/span><\/span><\/h2>\n
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Next steps after diagnosis of a terminal illness<\/span><\/h2>\n
Talking about end of life care<\/h2>\n