FOR PATIENTS AND FAMILIES
While in the care of Bakersfield Community Hospice, you will be surrounded by a team of compassionate, sensitive, and comforting physicians, nurses, social workers, chaplains, home health aides, and volunteers.
Hospice is a philosophy of care. It is focused around the patient and their loved family and friends. The goal of hospice is to preserve the quality of life for a terminally ill patient so that they may spend their last days with dignity and quality, surrounded by their loved ones. Hospice aims to treat the patient rather than the disease; therefore, it involves the patient and family in making decisions. Hospice neither hastens nor postpones dying but it provides with presence and specialized knowledge during the dying process. Hospice care is typically given in the home but if needed, it may be given in a hospital, nursing home, or a private hospice facility.
Hospice care is meant for the time when all other treatments can no longer help you, and you are expected to live 6 months or less. Hospice provides you with palliative care, which is treatment to help relieve disease-related symptoms, such as pain, but not cure the disease. You, your family, and your doctor decide together when hospice care should begin.
Often, patients and families don’t start hospice care soon enough because they believe that by starting hospice care, they are giving up. This is not the case. If you get progressively better while in the hospice program, you can be taken out and go into treatment once again. The decision is always in your hands. Bakersfield Community Hospice strives to bring back your quality of life and make the best of each day during the last stages of your illness.
Hospice care is a benefit of the Medicare program and is also covered by Medicaid. Most private insurance companies, HMO’s and managed care plans also offer hospice care as a benefit.
YOUR BAKERSFIELD COMMUNITY HOSPICE TEAM
PHYSICIANS
The physicians on the Bakersfield Community Hospice team decide the best plan of care for you with your primary care physician, the other members of the hospice team, and of course you. They are available to make house calls and are highly skilled in relieving your pain and managing your symptoms.
NURSES
The registered nurses that will be involved in your plan of care are specially trained to provide pain relief and day to day care. They are available 24 hours a day, seven days a week for home visits and phone calls pertaining to your care and well being.
SOCIAL WORKERS
Our specialized social workers are there to provide emotional support for you and your family. They help you and your family cope with end-of-life issues and provide you with any other resources that will make your life easier.
CHAPLAINS
Our entire team at Bakersfield Community Hospice believes that emotional and spiritual pain are just as real and in need of attention as physical pain; therefore, our chaplains are always available for spiritual support for both you and your family.
HOME HEALTH AIDES AND HOMEMAKERS
Certified home health aides and homemakers are available to help you with personal care, housekeeping, meal preparation, and small errands.
ROUTINE
When a patient enrolls in a hospice program, there is a wide array of services which are to be provided. If the patient does not have symptoms which are out of control and which require Continuous Nursing care, then the patient is placed on the Routine Home Care Level of Services. This level applies whether the patient resides in a facility or in his or her own home. The patient also has 24 hour access to hospice registered nurses who are "on-call" to answer questions and help you deal with situations that may arise after hours. These services are part of the "hospice benefit" reimbursed by Medicare, Medicaid or private insurance.
RESPITE
Often the caregiver is a family member who provides around the clock care. This can become exhausting. When caregivers need a rest from their responsibilities, patients can stay in a hospital or other inpatient care center for up to five days.
IN-PATIENT HOSPICE CARE
If pain or symptoms cannot be controlled at home, the patient can be cared for in a hospital or other inpatient care center. When the symptoms are under control, the patient can return home.
CRISIS CARE
Skilled nursing services are provided in the patient's place of residence to help during a crisis period as determined by the hospice staff, usually for 8 - 24 hours for a few days at a time to manage uncontrolled symptoms or provide end-of-life care.
BEREAVMENT
Our entire team at Bakersfield Community Hospice believes that emotional and spiritual pain are just as real and in need of attention as physical pain; therefore, our chaplains are always available for spiritual support for both you and your family during hospice care and up to a year after a loved has passed.
PHASES OF GRIEF
The process of bereavement may be described as having four phases:
- Shock and numbness: Family members find it difficult to believe the death; they feel stunned and numb.
- Yearning and searching: Survivors experience separation anxiety and cannot accept the reality of the loss. They try to find and bring back the lost person and feel ongoing frustration and disappointment when this is not possible.
- Disorganization and despair: Family members feel depressed and find it difficult to plan for the future. They are easily distracted and have difficulty concentrating and focusing.
- Reorganization.
TREATMENT
Most of the support that people receive after a loss comes from friends and family. Doctors and nurses may also be a source of support. For people who experience difficulty in coping with their loss, grief counseling or grief therapy may be necessary.
Grief counseling helps mourners with normal grief reactions work through the tasks of grieving. Grief counseling can be provided by professionally trained people, or in self-help groups where bereaved people help other bereaved people. All of these services may be available in individual or group settings.
The goals of grief counseling include:
- Helping the bereaved to accept the loss by helping him or her to talk about the loss.
- Helping the bereaved to live without the person who died and to make decisions alone.
- Providing support and time to focus on grieving at important times such as birthdays and anniversaries.
- Providing continuous support.
- Identifying coping problems the bereaved may have and making recommendations for professional grief therapy.
- Helping the bereaved to identify and express feelings related to the loss (for example, anger, guilt, anxiety, helplessness, and sadness).
- Helping the bereaved to separate emotionally from the person who died and to begin new relationships.
- Describing normal grieving and the differences in grieving among individuals.
- Helping the bereaved to understand his or her methods of coping.
Grief therapy is used with people who have more serious grief reactions. The goal of grief therapy is to identify and solve problems the mourner may have in separating from the person who died. When separation difficulties occur, they may appear as physical or behavior problems, delayed or extreme mourning, conflicted or extended grief, or unexpected mourning (although this is seldom present with cancer deaths).
Bakersfield Community Hospice Chaplains and Social Workers can get you in touch with grief support groups and make referrals for Grief Therapy. We will be with you every step of the way.
Are you caring for someone who may benefit from our services?
YOUR RIGHTS
Bakersfield Community Hospice wants all our patients to know and understand their rights to make medical treatment decisions. We comply with California laws and court decisions on patient’s rights regarding.
- The rights of patients to make their own treatment decisions.
- Treatment options (such as rights of patients to refuse any medical treatment or request any existing treatment to be discontinued.)
- The rights of patient to have a surrogate decision maker speak for them in the event they are unable to speak for themselves.
- Advanced Directives.
WHO DECIDES ABOUT MY TREATMENT?
Your doctors will give you information and advice about treatment. You have the right to choose. You can say “Yes” to treatments you want. You can say “No” to any treatment you don’t want – even if the treatment might keep you alive longer.
WHAT IF I’M TOO SICK TO DECIDE?
If you can’t make treatment decisions, your doctor will ask your closest available relative or friend to help decide what is best for you. Most of the time, that works. But sometimes everyone doesn’t agree about what to do. That’s why it is helpful if you say in advance what you want to happen if you can’t speak for yourself. There are several kinds of “advance directives” that you can use to say what you want and who you want to speak for you.
One kind of advance directive under California law lets you name someone to make health care decisions when you can’t. This form is called a DURABLE POWER OF ATTORNEY FOR HEALTH CARE.
WHO CAN FILL OUT THIS FORM?
You can if you are 18 years old or older and of sound mind. You do not need a lawyer to fill it out.
WHO CAN I NAME TO MAKE MEDICAL TREATMENT DECISIONS WHEN I’M UNABLE TO DO SO?
You can choose and adult relative or friend you trust as you “agent” to speak for you when you’re too sick to make your own decisions.
HOW DOES THIS PERSON KNOW WHAT I WOULD WANT?
After you choose someone, talk to that person about what you want. You can also write down in the DURABLE POWER OF ATTOURNEY FOR HEALTH CARE when you would or wouldn’t want medical treatment. Talk to your doctor about what you want and give your doctor a copy of the form. Give another copy to the person named as your agent. And take a copy with you when you go into a hospital or treatment facility.
Sometimes treatment decisions are hard to make and it truly helps your family and your doctors if they know what you want. The DURABLE POWER OF ATTORNEY FOR HEALTH CARE also gives them legal protection when they follow your wishes.
WHAT IF I DON’T HAVE ANYBODY TO MAKE DECISIONS FOR ME?
You can use another kind of advance directive to write down your wishes about treatment. This is often called a “living will” because it takes effect while you are still alive but have become unable to speak for yourself. The California Natural Death Act lets you sign a living will called a DECLARATION. When you sign a DECLARATION it tells your doctors that you don’t want any treatment that would only prolong your dying. All life-sustaining treatment would be stopped if you were terminally ill and your death was expected soon, or if you were permanently unconscious. You would still receive treatment to keep you comfortable, however.
The doctor must follow your wishes about limiting treatment or turn your care over to another doctor who will. Your doctors are also legally protected when they follow your wishes.
ARE THERE OTHER LIVING WILLS I CAN USE?
Instead of using the DECLARATION in the Natural Death Act, you can use any of the available living will forms. You can use a DURABLE POWER OF ATTORNEY FOR HEALTH CARE form without naming an agent. Or you can just write down your wishes on a piece of paper. Your doctors and family can use what you write in deciding about your treatment. But living wills that don’t meet the requirements of the Natural Death Act don’t give as much legal protection for your doctors if a disagreement arises about following your wishes.
WHAT IF I CHANGE MY MIND?
You can change or revoke any of these documents at any time as long as you can communicate your wishes.
DO I HAVE TO FILL OUT ONE OF THESE FORMS?
No, you don’t have to fill out any of these forms if you don’t want to. You can just talk with your doctors and ask them to write down what you’ve said in your medical chart. And you can talk with your family. But people will be clearer about your treatment wishes if you write them down. And your wishes are more likely to be followed if you write them down.
WILL I STILL BE TREATED IF I DON’T FILL OUT THESE FORMS?
Absolutely. You will still get medical treatment. We just want you to know that, if you become too sick to make decisions, someone else will have to make them for you.
Remember that:
A DURABLE POWER OF ATTORNEY FOR HEALTH CARE lets you name someone to make treatment decisions for you. That person can make most medical decisions- not just those about life-sustaining treatment – when you can’t speak for yourself. Besides naming an agent, you can also use to form to say when you would and wouldn’t want particular kinds of treatment.
If you don’t have someone you want to name to make decisions what you can’t, you can sign a NATURAL DEATH ACT DECLARATION saying that you do not want life-prolonging treatment if you are terminally ill or permanently unconscious.
HOW CAN I GET MORE INFORMATION ABOUT ADVANCE DIRECTIVES?
Absolutely. You will still get medical treatment. We just want you to know that, if you become too sick to make decisions, someone else will have to make them for you.
Remember that:
A DURABLE POWER OF ATTORNEY FOR HEALTH CARE lets you name someone to make treatment decisions for you. That person can make most medical decisions- not just those about life-sustaining treatment – when you can’t speak for yourself. Besides naming an agent, you can also use to form to say when you would and wouldn’t want particular kinds of treatment.
If you don’t have someone you want to name to make decisions what you can’t, you can sign a NATURAL DEATH ACT DECLARATION saying that you do not want life-prolonging treatment if you are terminally ill or permanently unconscious.
HOW CAN I GET MORE INFORMATION ABOUT ADVANCE DIRECTIVES?
Bakersfield Community Hospice physicians, nurses, and social workers are ready to answer any questions you may have about advanced directives
INSURANCE COVERAGE FOR HOSPICE CARE
Hospice care is a benefit of the Medicare program and is also covered by Medicaid.
Most private insurance companies, HMO’s and managed care plans also offer hospice care as a benefit.
Please do not hesitate to contact us if you have questions regarding coverage. Our staff is happy to assist in determining eligibility for the hospice benefit.
For Medicare hospice coverage, patients must:
- Be eligible for Medicare Part A
- Consent to hospice care and agree that he or she wishes to receive “palliative, not curative care”
- Be certified by his or her physician and the hospice medical director as having a “medical prognosis that his or her life expectancy is six months or less, if the illness runs its normal course”
- Continue to have a six-months-or-less prognosis, although some individual patients may receive hospice services for longer than six months as long as they continue to have a limited life expectancy throughout that time
Medicare covers the following hospice services for your terminal illness and related conditions:
- Doctor services
- Medical equipment (such as wheelchairs or walkers)
- Drugs for symptom control or pain relief (may need to pay a small copayment)
- Physical and occupational therapy
- Social worker services
- Grief and loss counseling for you and your family
- Short-term respite care
- Nursing care
- Medical supplies (such as bandages and catheters)
- Hospice aide and homemaker services
- Speech-language pathology services
- Dietary counseling
- Short-term inpatient care (for pain and symptom management)
- Any other Medicare-covered services needed to manage your pain and other symptoms, as recommended by your hospice team
TERMINAL ILLNESS
Terminal illnesses that are covered by Hospice care include, but are not limited to:
- Alzheimer's
- Cancer
- End Stage diabetes
- Heart Diseases
- Huntington’s Disease
- Multiple sclerosis
- Myasthenia Gravis
- Non-Specific Terminal Illness
- Pulmonary Disease
- Stroke
- Amyotrophic Lateral Sclerosis
- Dementia
- End Stage cardiac disease
- HIV/AIDS
- Liver Disease
- Muscular Dystrophy
- Neuromuscular disease
- Parkinson’s Disease
- Renal Failure (acute and chronic)
- Coma
NATIONAL HOSPICE AND PALLIATIVE CARE ORGANIZATION
NHPCO is the largest nonprofit membership organization representing hospice and palliative care programs and professionals in the United States. The organization is committed to improving end of life care and expanding access to hospice care with the goal of profoundly enhancing quality of life for people dying in America and their loved ones.
www.nhpco.org
AMERICAN ACADEMY OF HOSPICE AND PALLIATIVE MEDICINE
AAHPM is dedicated to expanding access of patients and families to high quality palliative care, and advancing the discipline of Hospice and Palliative Medicine, through professional education and training, development of a specialist workforce, support for clinical practice standards, research and public policy.
www.aahpm.org
CENTERS FOR MEDICAID AND MEDICARE HOSPICE CENTER
CMS ensures effective, up-to-date health care coverage and promotes quality care for beneficiaries.
www.cms.hhs.gov
Volunteering
Hospice volunteers provide companionship to people living with a life- limiting illness and help families and caregivers in a variety of ways. In addition to providing patient care, hospice volunteers help with office work, fund raising and community outreach.
Hospice Needs Volunteers
Volunteers provide important services to the people they serve in our community. Whether it’s providing companionship to a person in the final months and weeks of life, offering support to family members and caregivers, or helping with community outreach and fundraising, the contributions of volunteers are essential to the important work provided by Bakersfield Community Hospice.
Compassionate volunteers are at the heart of Bakersfield Community Hospice's mission to providing excellent end-of-life care to each patient and family, serving all people at the end of life’s journey. Hospice Volunteers make a difference in our community every day.
Hospice Helps People Live
Considered to be the model for quality compassionate care for people facing a life-limiting illness or injury, hospice care involves a team-oriented approach incorporating expert medical care, pain management, and emotional and spiritual support tailored to the patient’s needs and wishes.
“BEING A HOSPICE VOLUNTEER GIVES A CHANCE TO PARTICIPATE IN THE BEST PART OF BEING A HUMAN; OUR COMPASSION TO LOVE ONE ANOTHER.”
The focus of hospice is rooted in the belief that each of us has the right to die pain-free and with dignity, and that our loved ones will receive the necessary support to allow us to do so. The hospice team, including hospice volunteers, provides the support needed to ensure the highest quality of life possible for the person living with a life-limiting illness.
Who Can Volunteer?
Being a volunteer can be an intense experience. Being a hospice volunteer can also be an intensely rewarding experience. Bakersfield Community Hospice, volunteers are required to complete a pre-training interview and a twenty-hour orientation class. To learn more about the rewards of being a hospice volunteer, contact our Volunteer Coordinator, Yanis, our Volunteer Coordinator at 661.327.9800.
Volunteer Education
Hospice Volunteers receive training and on-going education opportunities to ensure they feel comfortable with their tasks. Hospice education covers:
- Philosophy of hospice care.
- Services offered by hospice.
- Physical, emotional, social, spiritual issues that people can encounter at the end of life.
- Effective communication when speaking with patients and family members.
- Comfort care.
- The dying process.
- Basic information about grief and loss.
What Hospice Volunteers Do?
As a hospice volunteer, you will be given the choice as to how much and what types of things you want to do. Typical volunteer duties can include:
- Listening to patient’s concerns.
- Being a comforting and supportive presence.
- Engaging in the patient’s hobbies, playing a board game or discussing current events.
- Sharing a special talent or skill.
- Providing time for the caregiver to take care of her/him self.
- Office and clerical support.
- Community education.
- Special events.
- Fundraising activities.
It is the mission of Bakersfield Community Hospice to provide support, comfort and interdisciplinary care to the terminally ill and their loved ones, and to provide education and grief support to the community at large.
For The Media
he publics increasing awareness and need for information on health care generates many media stories. Bakersfield Community Hospice serves as a leading source of reliable and interesting medical information for your readers, listeners, and viewers.
If your story calls for a response from or interview regarding end-of-life issues or bereavement, please contact Bakersfield Community Hospice at 661.327.9800 for immediate assistance.